Obamacare premiums

[2B]

I guess one great thing is that people who were not insurable before are now insurable at a resonable cost. Any of us could have been in their situation, so compared to that, it's all good.

In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states. I've not known anyone in Texas over 50 that could get any other policy without substantial exceptions. Who wants HI that doesn't cover heart attacks and strokes?

The cost for a single individual age 62 was $7,500/yr with a $7,500 deductible. There were no family plans. A couple had to get two individual plans. The comparable costs for the new exchange plans are not drastically lower from the limited information I've seen. I'm waiting for the rush to settle down before looking at plans.

 

[sheehs1]

Our premiums alone for our COBRA conversion policy this year are close to $30K, regardless of income. Just sayin.

ouch daylatedollarshort! Why is your COBRA so high? Is it for 2 people or entire family?

 

[sheehs1]

sheehs1,
Sorry to hear about your situation. If it's any consolation, you've got plenty of company.

Thanks samclem. I'm sure we will have plenty of company.

 

[KiraC]

I think cost of health care is going to be a huge factor in where people decide to live in the coming years, just like state income taxes are currently a big factor.

It will be a factor for me.

Too bad insurance is limited by state. If the insurance companies were able to be national and we weren't restricted by the state where we live, the insurance landscape might be very different.

 

[sheehs1]

or you aren't smart enough to figure out a way to limbo under the 400% bar, you do take it is the pie hole. .

brewer12345, your post seems to indicate a person has some control over it indicating they are "less than smart" if they can't figure it out. That is not necessarily true.
Some, like us, have no way to reduce our MAGI further, unless we take on MASSIVE debt and risks. We would have to many things including dismantle our lives and our purposes to get under the 400%.
I predict some will do those things but only if they are barely making if over the threshold to begin with.

 

[MichaelB]

I think Brewer was just referring to folks that can control their income. Clearly people receiving salaries or pensions cannot easily do that.

 

[sheehs1]

Just curious since I don't know but where can someone get the same health insurance coverage on their own for less than this cost?

And why would you also need to factor in the copays, deductible and out of pocket since most health insurance have these anyway. Seems to me they should not be part of the formula when comparing.

Doesn't "Obamacare" stop once you turn 65 and start Medicare unless you opt for supplimental insurance which would be your own choice. Then the only cost is Medicare at about 1/10 your projected premium.

Cheers!

I don't know Badger. But we will be looking I am sure. From where I sit, one needs to factor in their max pain for health care in any given year or at least consider it. Hence the add ons of the co-pays, deductibles and out of pocket expenses. Meaning that projected $15,000 is JUST for premiums before setting foot in a doctor's office. Why would you NOT factor in your other costs when performing a comparison?

It is part of the analysis as far as I am concerned. There is a big difference between 60% coinsurance and 90% coinsurance. We currently have 0% coinsurance, so we KNOW what our max pain is going to be every year.

None of the ACA plans have 0% coinsurance.

 

[sheehs1]

OK, but your increase is basically $2880 a year. It isn't like your premiums went up $12k a year. You were already paying close to $10k a year.

I'm not saying it is fun to get a big increase in premiums. Last year, on DH's retiree policy, our premium increased over 200% and that was with him going off the policy as he was going onto Medicare! And, this increase wasn't ACA related. It was based upon the claim experience of the group (Megacorp only absorbs a 5% or so increase a year - anything above that is on us). So, yes, I do know it is no fun to get a premium increase and one can get that with ACA or not with ACA...

No katsmeow, our premiums are going up over $5,000 a year. I think you did the calculation for one person or just based on my husband's increase. I'm expecting costs to increase as this rolls out.

All I am saying is to pay the $15K plus in premiums BEFORE setting foot in a Doctor's office is really rather ridiculous.

I would rather have lower premiums and more costs "for use". Charge me more if I go to the doctor or have an illness but allow me lower premium costs when I don't use it. Of course, pontificating that thought is useless at the moment.

 

[FIRE'd@51]

ouch daylatedollarshort! Why is your COBRA so high? Is it for 2 people or entire family?

Note she said COBRA conversion, not COBRA.

 

[sheehs1]

I think Brewer was just referring to folks that can control their income. Clearly people receiving salaries or pensions cannot easily do that.

I'm sure he was. Just wanted to say "a lot of people can't do this".

 

[2B]

It is part of the analysis as far as I am concerned. There is a big difference between 60% coinsurance and 90% coinsurance. We currently have 0% coinsurance, so we KNOW what our max pain is going to be every year.

None of the ACA plans have 0% coinsurance.

My employer has two insurance options. One is a 0% copay with a $3,000 deductible then it goes to 80% coverage until the ~$10,000 OOP max is reached. For me and DW, this costs $438/yr. Cobra (full cost + 2%) is $9960/yr. There is a second plan with a very low deductible but the premium effectively are the $3000 divided by the number of pay periods. There are copays for the doctor and prescriptions and the OOP max is the same. The copays are not included in OOP and go on after you meet the OOP max. I've tried to convince people that this plan is more expensive than the "high deductible" (not that I think $3000 is all that high) but they like to know they won't get hit with a "big medical expense."

DW and I usually don't hit the deductible. We did this year with our his-and-hers colonoscopies. I am also more interested in a high deductible/lower cost HI plan because we like most people are not heavy health care consumers. We also have the assets to absorb the rare but eventual big bill. Just knowing that the OOP max is manageable is all I need to know.

Unfortunately, the ACA seems to be modeled after the older style "full coverage" plans that seem to have been disappearing in the employer health insurance model. For those of us that are solvent, it will cost us money without providing any value.

 

[Fermion]

ACA is the great equalizer for those who feel they got a bit of a shaft being forced into the 401K program instead of a guaranteed pension. While bearing all of the risks of the market in their retirement, at least they can control income to qualify for ACA.

I would still rather have a $70,000 a year pension, but I will take this ACA gift with open arms.

 

[M Paquette]

In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states.

The trick is that some state high risk pools have a limited number of openings. Back in 2010 that route would have had me wait listed for a year before I would get coverage. There were other pools available if I had a coverage gap of six months or more, with other catches. Prior to retirement I wound up drawing out a huge decision tree to chart a path that would keep our family covered. There were lots of dead end and coverage break paths that I had to avoid. In fact, the safest path involved changing coverage to an in-state HMO prior to retiring, which would allow doubling the length of COBRA coverage and permit a type of continuation coverage for all family members in case we didn't qualify for underwritten coverage, as well as time to meet a 'no medical problems '. Time window for underwriting.

 

[FANOFJESUS]

My income is below the federal poverty limit here in MO. Since MO did not expand medicaid my insurance will be going up even though I make under 11k a year. That is wild. I am learning that under 11.5k in many states you are in danger.

 

[FinanceDude]

An interesting article this morning about this from KFF Where You Live Determines How Much You Pay For Health Insurance - Kaiser Health News

So much for "affordable"............

 

[Sue J]

My income is below the federal poverty limit here in MO. Since MO did not expand medicaid my insurance will be going up even though I make under 11k a year. That is wild. I am learning that under 11.5k in many states you are in danger.

What happens if you estimate your income at just enough to stay out of medicaid and just make it into a subsidy? Then you can have insurance all year and when it gets reconciled it turns out you just didn't make enough.

Not implying fraud here, just thinking that when you estimate income you can try to be optimistic.

 

[daylatedollarshort]

Note she said COBRA conversion, not COBRA.

When we first went on COBRA, the premiums were ~1K a month for a bare bones plan. We are in our fifties with kids.

Last year megacorp dropped the bare bones policy so our only choice was to pay ~2.3K a month, but at least that included dental, vision, hearing and whatever else comprehensive plans cover.

When COBRA ended this summer, we looked at HIPAA, conversion, and small business policies. The HIPAA and conversion policies were all well over $2K+ a month for just medical. This does not include spa treatments. This is what people our age with kids have to pay to get guaranteed issue, not employer subsidized health insurance policies in our zip code.

The small business policies were somewhat cheaper premium-wise but they had very high deductibles and OOP maxes so this year we would not have come out ahead by taking them.

We called all the insurance companies and agents, looked at all our options, made spreadsheets, compared policies and this is the best we could do.

Middle aged and above households without employer insurance and pre-existing conditions in the U.S. prior to the ACA were simply screwed. We can afford it but prior to the ACA most middle or lower income families in our spot would simply have had to go without health insurance. I am not looking for sympathy for us, but before you complain about the ACA think about how maybe you or people you care about could easily end up in a spot like we did.

 

[daylatedollarshort]

The $30K has been commented on before. I have Cobra available at $830/mo for a $3,000 ded w/HSA. That's just under $10K. If I threw in kids, it would still be under $15K/yr. I can only assume that for $30K it includes spa treatments and on-call doctors that come to the house with no deductible. If not a super plan, they are really getting it stuck to them.

So because your COBRA payments are less you can't understand that an older couple with kids in a high COL might pay more for a COBRA conversion (not COBRA) policy?

Even COBRA rates are based on the insurance plans your former employer had in place, so the rates for someone who worked at Walmart might be totally different than someone who left Morgan Stanley. Then add in premium differences for age, kids, COL factors, etc.

My point is that pre-ACA, most households like us are in quite a pickle. For many, a bankruptcy or no health insurance or maybe both kind of pickle.

 

[fh2000]

When we first went on COBRA, the premiums were ~1K a month for a bare bones plan. We are in our fifties with kids.

Last year megacorp dropped the bare bones policy so our only choice was to pay ~2.3K a month, but at least that included dental, vision, hearing and whatever else comprehensive plans cover.

When COBRA ended this summer, we looked at HIPAA, conversion, and small business policies. The HIPAA and conversion policies were all well over $2K+ a month for just medical. This does not include spa treatments. This is what people our age with kids have to pay to get guaranteed issue, not employer subsidized health insurance policies in our zip code.

The small business policies were somewhat cheaper premium-wise but they had very high deductibles and OOP maxes so this year we would not have come out ahead by taking them.

We called all the insurance companies and agents, looked at all our options, made spreadsheets, compared policies and this is the best we could do.

Middle aged and above households without employer insurance and pre-existing conditions in the U.S. prior to the ACA were simply screwed. We can afford it but prior to the ACA most middle or lower income families in our spot would simply have had to go without health insurance. I am not looking for sympathy for us, but before you complain about the ACA think about how maybe you or people you care about could easily end up in a spot like we did.

+1

 

[FANOFJESUS]

What happens if you estimate your income at just enough to stay out of medicaid and just make it into a subsidy? Then you can have insurance all year and when it gets reconciled it turns out you just didn't make enough.

Not implying fraud here, just thinking that when you estimate income you can try to be optimistic.

A person could do that but would have to pay it all back at tax time. I know I will not make that much so it would be wrong also. I estimate a little but I know it down to a few hundred dollars which in my case will not help me. I am about 3k short of the level.

 

[Martha]

In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states. I've not known anyone in Texas over 50 that could get any other policy without substantial exceptions. Who wants HI that doesn't cover heart attacks and strokes?

The cost for a single individual age 62 was $7,500/yr with a $7,500 deductible. There were no family plans. A couple had to get two individual plans. The comparable costs for the new exchange plans are not drastically lower from the limited information I've seen. I'm waiting for the rush to settle down before looking at plans.

Risk pools are not available in every state. And for the states that have pools the variation in coverage, cost and limitations are huge.

 

[M Paquette]

So much for "affordable"............

This reminds me of the friendly advice I got here several years ago when I was looking for coverage I could afford. Something about how I should just move... Gosh. Not the most practical advice for most folks.

 

[REWahoo]

Risk pools are not available in every state. And for the states that have pools the variation in coverage, cost and limitations are huge.

Shouldn't that be "had" instead of "have"? Aren't all pools going away on Jan 1?

 

[Martha]

Shouldn't that be "had" instead of "have"? Aren't all pools going away on Jan 1?

I thought about the verb use. It will be "had" as of the first of the year. Actually, in Minnesota they are keeping their pool going for another year to give people time to shop.

 

[Rosie]

Well, this obamacare cliff thing is going to crucify 60 year olds with a little over 62000 in income and no way to reduce.

So ~ $500 per month for 2 people aged 60 with an income of $62,000, with no limitations for prexisting conditions, is being "crucified" ?

Take the income up to 63k the premium is over twice $5,890 per year.

Of course not, at least for the people in your example. But if you are either "stuck" with a pension that pays over 400% FPL (people who I am sure I will be busy shedding tears for) or you aren't smart enough to figure out a way to limbo under the 400% bar, you do take it is the pie hole.

Hey folks, sorry to take up more bandwidth, but I just want to apologize to ripper et al. -- I didn't realize the (steepness? is that a word?) of the Obamacare Cliff, and how making a small jump from $62,000 to $63,000 income makes such a large difference in the cost of premiums for a couple.

I'm learning a lot about the ins & outs of HI exchanges & such from this forum, so thank you all.

- Rosie