ACA Rate Increases For 2019

[kimcdougc]

I am keeping a close watch on this thread. 2019 is coming up fast. I already pay $1,656 for two a month. Hope and pray it will go down for 2019.

 

[teejayevans]

I found these rate submissions by BC/BS for Florida for 2019. They range from -2.37% to 7.37%. That is very encouraging!

Final rates not listed yet - that I am aware of.

Maybe now Mr SG will get his boat!

 

[simple girl]

Maybe now Mr SG will get his boat!

We'll see about that...

 

[deserat]

Being retired military I pay nothing except shipping on some of my drugs. My insurance includes my wife. I have Parkinson's, she just had surgery and radiation treatment for breast cancer.

I irritated several friends over the last 30 years by trying to convince them to not quit military service totally, but transfer to the Reserves until they have their 20 years.
Even if the monthly check is small, the benefits are worth it.

That monthly check for me will be actually much larger than I anticipated and the benefits I have now as a gray area retiree, the GI bill, TSP and then when I turn 60 for TRICARE (which I hope is still around for retirees) are icing. I just never quit and after 30 years, looked at what I had earned and fell over in amazement. Not as good as an active duty retiree starting all of the bennies at 20, but better than most others without it.

 

[REWahoo]

...after 30 years, looked at what I had earned and fell over in amazement.

Typical reaction from someone who learns they are loaded and living in fat city.

 

[Splash]

I haven't seen anything yet. Waiting on pins and needles.

Our only ACA choice available to us for 2018 was a regional co-operative. They offered a few in-network only plans, no bronze or HSA plans. Their rates increased 63% from 2017. That was bad enough but some pretty reliable sources say they will be pulling out of the exchange after 2018.

Looks like it will be a bumpy ride until Medicare eligible in 9 years.

No letter yet, but saw today on https://ratereview.healthcare.gov/ that our current insurer will be participating on the exchange in 2019 and has filed for a 19% rate REDUCTION.
Also, last week it was announced that a different insurer will be returning to WI after not participating on the exchange in 2018. I'm thinking these developments are tied to the Federal Government's recent approval of the Wisconsin Reinsurance Program.

 

[Texas Proud]

No letter yet, but saw today on https://ratereview.healthcare.gov/ that our current insurer will be participating on the exchange in 2019 and has filed for a 19% rate REDUCTION.
Also, last week it was announced that a different insurer will be returning to WI after not participating on the exchange in 2018. I'm thinking these developments are tied to the Federal Government's recent approval of the Wisconsin Reinsurance Program.

Interesting link.... the headline says my insurance is looking for just under 4%, but the text behind says something completely different... I removed the insurers name...

Removed... is requesting a 9.4% premium increase for its individual policies sold in the Removed... Standard Individual HMO product effective January 1, 2019. Removed... Standard Individual HMO members would receive premium increases ranging from 6.8% to 28.4% depending on their geographic location and metal tier
​

 

[Mulligan]

I am keeping a close watch on this thread. 2019 is coming up fast. I already pay $1,656 for two a month. Hope and pray it will go down for 2019.

Another option if healthy is one I am considering. I just checked and short term health insurance plans for up to 12 months are now being sold in my state. I presently pay $450 for a $7500 deductible. I could get a $10k deductible for $140 a month. I know I can get it because I passed with flying colors an underwritten term life policy I just took out this month. One could just align the expiration date to ACA enrollment period and then duck back into it if one developed an ongoing illness. Because you would get dropped like a hot potato from insurance carrier upon renewal time with the short term carrier.

 

[Cut-Throat]

I am keeping a close watch on this thread. 2019 is coming up fast. I already pay $1,656 for two a month. Hope and pray it will go down for 2019.

Nope!

 

[TheKrell]

My wife and I pay about $2800 per month for an EPO with a Very high deductible. We ONLY have insurance within about 40 miles of our city. When we travel, we would be completely uninsured were not for the fact that we buy travel insurance.


Prior to ObamaCare, we paid about half that rate and had PPO coverage nationwide.

 

[MBSC]

My wife and I pay about $2800 per month for an EPO with a Very high deductible. We ONLY have insurance within about 40 miles of our city. When we travel, we would be completely uninsured were not for the fact that we buy travel insurance.

ACA compliant plans are required to make a "usual and customary" payment for out-of-network life threatening emergencies within the U.S. You may be balanced billed the difference in most states but to say you are "completely" uninsured is incorrect.

Balance Billing protections by state: https://www.commonwealthfund.org/pu...n/balance-billing-consumer-protections-states

ACA Emergency Services Rules

Under the 2015 final regulations a plan or policy satisfies the copayment and coinsurance limitations when it provides benefits for out-of-network emergency services in an amount equal to the greatest of:

(1) The amount negotiated with in-network providers for the emergency service furnished;

(2) The amount calculated using the same method the plan generally uses to determine payments for out-of-network services (such as the usual, customary, and reasonable charges) but substituting the in-network cost-sharing provisions for the out-of-network cost sharing provisions; or

(3) The amount paid under Medicare for the emergency service.

Each of these three amounts is calculated excluding any in-network copayment or coinsurance imposed on the patient. This is sometimes referred to as the “Greatest of Three” or the “GOT” regulation because it sets a floor on the amount health insurance issuers offering nongrandfathered group or individual health insurance coverage are required to pay for out-of-network emergency services under this provision at the greatest of the three listed amounts.

Reference: ACA Emergency Services Rules Clarified (T.D. 9744) - Tax & Accounting Blog

 

[Mulligan]

Healthy people who are tired of over paying ACA premiums stuck with rack rates really need to study these short term health insurance plans that are good for 12 months. After looking at info on ehealthinsurance, I find these plans better for me than my piece of crap ACA plan I dont use anyways. These short term plans allow you to go to use any hospital or Doctor, unlike my ACA which is very limited.

 

[explanade]

Healthy people who are tired of over paying ACA premiums stuck with rack rates really need to study these short term health insurance plans that are good for 12 months. After looking at info on ehealthinsurance, I find these plans better for me than my piece of crap ACA plan I dont use anyways. These short term plans allow you to go to use any hospital or Doctor, unlike my ACA which is very limited.

The plans HHS is planning to introduce in October requires underwriting so they can give you premium info online?

I think they said pre existing conditions will raise premiums.

Hope someone produces good comparison engines to show what is and isn’t covered between these short term and ACA plans.

 

[Mulligan]

The plans HHS is planning to introduce in October requires underwriting so they can give you premium info online?



I think they said pre existing conditions will raise premiums.



Hope someone produces good comparison engines to show what is and isn’t covered between these short term and ACA plans.

Or prexisting conditions may deny you coverage or exclude that illness from payment. I have no pre existing conditions and just passed a thorough blood and urine exam for a life insurance policy so I know I am good to go, and cut my premium by 65%.
You can go to ehealthinsurance and check out policies now and the companies have all info brochures of the actual polices to read also.
Several states though are blocking this under the guise of “protection” though. They want to make sure males pay higher premiums just in case they get pregnant or suddenly become addicted to drugs and need drug rehab treatment. Other states are allowing the expansion to 12 months already. There are several 12month plans I like already. The pricing is there.

 

[MichaelB]

Healthy people who are tired of over paying ACA premiums stuck with rack rates really need to study these short term health insurance plans that are good for 12 months. After looking at info on ehealthinsurance, I find these plans better for me than my piece of crap ACA plan I dont use anyways. These short term plans allow you to go to use any hospital or Doctor, unlike my ACA which is very limited.

Health care is not any less expensive as a result of this plan. If the policy has a lower premiums, there is less coverage. Health insurance is very complex, and most people don’t understand the details, so a new, limited option will probably leave some people exposed and underinsured.

Medicare seems to work, and large group employer plans seem to work. It’s still not clear why we want to make individual insurance less like them and not more like them.

 

[Mulligan]

Health care is not any less expensive as a result of this plan. If the policy has a lower premiums, there is less coverage. Health insurance is very complex, and most people don’t understand the details, so a new, limited option will probably leave some people exposed and underinsured.



Medicare seems to work, and large group employer plans seem to work. It’s still not clear why we want to make individual insurance less like them and not more like them.

Micheal you are conflating total healthcare costs of country versus costs of individuals who do not consume healthcare, but dutifully are responsible and pay for their healthcare premiums. This IS less expensive for certain populations. An individual who is healthy does not have to subsidize other populations by going this route as they are “grouped” back into a healthier population. Its a viable option for many. One can dream about Medicare for all, but I deal in reality of today and this is where we are at. ACA screwed me over, and this is an option for me to get out of it.

 

[ShokWaveRider]

Micheal you are conflating total healthcare costs of country versus costs of individuals who do not consume healthcare, but dutifully are responsible and pay for their healthcare premiums. This IS less expensive for certain populations. An individual who is healthy does not have to subsidize other populations by going this route as they are “grouped” back into a healthier population. Its a viable option for many. One can dream about Medicare for all, but I deal in reality of today and this is where we are at. ACA screwed me over, and this is an option for me to get out of it.

OK till you actually get sick, have an accident and need "Proper" health insurance.

 

[BeachOrCity]

Micheal you are conflating total healthcare costs of country versus costs of individuals who do not consume healthcare, but dutifully are responsible and pay for their healthcare premiums. This IS less expensive for certain populations. An individual who is healthy does not have to subsidize other populations by going this route as they are “grouped” back into a healthier population. Its a viable option for many. One can dream about Medicare for all, but I deal in reality of today and this is where we are at. ACA screwed me over, and this is an option for me to get out of it.

I completely get how anyone who is healthy and consumes few medical services finds aca premiums outrageous. The challenge is most health care costs are incurred by covering a very small percentage of the population who have an major illness etc. So at any given time 90 some percent of people will feel like they are subsidizing this small percent of people.

All of the new temp plans dont cover anything pre existing and won’t renew year to year on anything pre existing. You should check carefully whether they will cover that heart attack if you are currently on a cholesterol drug etc.

The effect of these temp plans will be to siphon off healthy people from the aca plans and make the aca premium situation even worse. Not an issue for folks with subsidies but a big issue for anyone not subsidy eligible and with any kind of even moderate health care need.

Be careful what you wish for.

 

[scrabbler1]

Micheal you are conflating total healthcare costs of country versus costs of individuals who do not consume healthcare, but dutifully are responsible and pay for their healthcare premiums. This IS less expensive for certain populations. An individual who is healthy does not have to subsidize other populations by going this route as they are “grouped” back into a healthier population. Its a viable option for many. One can dream about Medicare for all, but I deal in reality of today and this is where we are at. ACA screwed me over, and this is an option for me to get out of it.

Mulligan, when you buy health insurance, or any type of insurance, you are paying for the possibility that something bad happens and you will need to use it. I was not a consumer of HI for many, many years until 3 years ago when I became sick and ended up in the hospital for 12 days. I was very thankful for the ACA and the coverage it afforded me even though I had never made a claim before.

Similarly, I have been buying my own car insurance for 32 years and have never made a claim. But while my premiums have paid claims to other policy holders within the risk pool, some of whom may have never made a claim before, I am also paying for the possibility that I join that pool of people who have never made a claim.

 

[MichaelB]

Micheal you are conflating total healthcare costs of country versus costs of individuals who do not consume healthcare, but dutifully are responsible and pay for their healthcare premiums. This IS less expensive for certain populations. An individual who is healthy does not have to subsidize other populations by going this route as they are “grouped” back into a healthier population. Its a viable option for many. One can dream about Medicare for all, but I deal in reality of today and this is where we are at. ACA screwed me over, and this is an option for me to get out of it.

Mulligan, you and I have had similar discussions going back years, and it looks like they will continue forever. It’s not insurance if it only works for some people.

My point was not Medicare for all. It was simply - if large employer group insurance and Medicare are working, we might consider making individual insurance more like them, instead of less like them.

 

[Mulligan]

OK till you actually get sick, have an accident and need "Proper" health insurance.

Do you even know what these plans cover? Do you know how to align expiration date of coverage into alignment with ACA coverage? These plans certainly arent suitable for you if you are unwilling or unable to assess what they provide versus what one needs. I cant even go to a hospital within 30 miles of my home thanks to ACA. With this plan I could go to the one a few miles away from me. Sometimes blanket comments arent relevant.

 

[Skoach]

Healthy people who are tired of over paying ACA premiums stuck with rack rates really need to study these short term health insurance plans that are good for 12 months. After looking at info on ehealthinsurance, I find these plans better for me than my piece of crap ACA plan I dont use anyways. These short term plans allow you to go to use any hospital or Doctor, unlike my ACA which is very limited.

What happens on these plans if you develop a 'expensive' illness during the plan period? I assume they pay until the end of the period, but is there guaranteed renewability? If not aren't you in trouble now that you have a preexisting condition when you go to renew?

 

[MBSC]

I have no pre existing conditions and just passed a thorough blood and urine exam for a life insurance policy so I know I am good to go, and cut my premium by 65%.

If the policy has a lower premiums, there is less coverage. Health insurance is very complex, and most people don’t understand the details, so a new, limited option will probably leave some people exposed and underinsured.

Most people use the narrow definition of pre-existing condition, meaning the condition did not exist until it was detected. Most STMs use the broad definition of pre-existing condition, meaning the condition probably existed prior to detection.

She bought a short-term plan from Golden Rule Insurance, a unit of UnitedHealth Group Inc., so she’d be covered between jobs, according to court documents.

Then, she was diagnosed with breast cancer.

Despite showing evidence she was unaware of the cancer when she bought the policy, the insurer didn’t pay for Jones’s treatment, leaving her with a $400,000 medical bill, according to a complaint she filed against the company in September 2016.

The judge sided with Golden Rule and dismissed the case in August, finding the policy agreement clearly stated that preexisting conditions wouldn’t be covered, even if the customer was unaware of the condition. Jones wasn’t diagnosed until after she bought her policy.

In another case, William Masterson of Arkansas sued Starr Indemnity & Liability Co. in 2013 after the company denied a claim for more than $300,000 in expenses incurred after he was diagnosed with throat cancer during his policy period.

Reference: https://www.bloomberg.com/news/arti...directive-renews-preexisting-conditions-fight

 

[Mulligan]

Mulligan, you and I have had similar discussions going back years, and it looks like they will continue forever. It’s not insurance if it only works for some people.



My point was not Medicare for all. It was simply - if large employer group insurance and Medicare are working, we might consider making individual insurance more like them, instead of less like them.

Micheal, I dont disagree with you. But that isnt reality. That is why we have had these discussions for years, that dream is no where near fruition. Your suggestions though noble, are not the reality we live in. Where we are is where we are, and one has to deal with it in the situation that best serves them. Be it, “managed income”, subsidies, continue working, etc, etc.

 

[Mulligan]

Most people use the narrow definition of pre-existing condition, meaning the condition did not exist until it was detected. Most STMs use the broad definition of pre-existing condition, meaning the condition probably existed prior to detection.

I never said it was the best situation or even desirable. But there are stories all over from insurers that deny payment all the time too.