If you have ACA health insurance, what is your experience?

Julieta · Post by **Julieta** » Sun Apr 20, 2014 3:31 pm

I'm checking the MN Sure website and discovered a plan call MN Care for incomes less than $23k for a single person or
$31k for a family of 2 persons.

The monthly premium payment is $50. There are additional payments for using the insurance but they are also at a low cost.

Does your ACA state website have a similar program for this income level?

southerndoc · Post by **southerndoc** » Sun Apr 20, 2014 5:44 pm

If it is an HIE plan, I would strongly reconsider it. It's a huge hassle as many hospitals aren't participants. The few patients I've had who were under HIE plans that needed admission required 3-5 hours before setting up a transfer to a participating hospital.

Julieta · Post by **Julieta** » Sun Apr 20, 2014 7:54 pm

Don't know ...I'll find out.

llessac15 · Post by **llessac15** » Sun Apr 20, 2014 8:21 pm

I don't have ACA insurance, but I am a practicing Oncologist in MS. The few ACA plans we have seen over the past few months have been awful. Worse than Medicaid. We are not seeing anyone with ACA plans. We would lose thousands of dolllars if we did see them. They are being referred to the local academic center. Just my 2 cents.

bluemarlin08 · Post by **bluemarlin08** » Sun Apr 20, 2014 8:59 pm

Talk to folks most daily that bought plans and don't realize their network is so small. Poorly explained to the insured.

dm200 · Post by **dm200** » Sun Apr 20, 2014 9:23 pm

While I am on Medicare, my wife has several years before qualifying for Medicare. She was on an (actually VERY) expensive individual plan with an HMO (Kaiser). She wanted to stay with Kaiser, but we very much wanted lower premiums and a reasonable plan. While the enrollment process was difficult, frustrating, etc. - she was enrolled successfully well before the cutoff for January 1, 2014 coverage and, obtained an approximately equivalent plan with Kaiser (perhaps better, in some respects). The monthly premiums, even before the credit/subsidy, were only 2/3 of what she paid before and, with the credit/subsidy are less than half what she was prevously paying.

Our experience, therefore, on balance is outstanding for what coverage and benefits she has now vs. what she had in 2013. Because she is in a plan from the same provider (Kaiser in her case) there is zero change in the physicians and providers available to her.

llessac15 · Post by **llessac15** » Sun Apr 20, 2014 9:34 pm

dm200, Your post pointed out something that I should have said with my post above. The patients we have seen with ACA plans were patients that would otherwise have no insurance. People in your situation are just shopping for your best deal.

freddie · Post by **freddie** » Sun Apr 20, 2014 9:40 pm

As far as I can tell my ACA plan is about the same as my old BCBS plan (same network, 250 lower deductible, cost is with is 15 dollars more) except for some added coverage (i.e. kids dental and vision). As always before signing up for a plan you should make sure the network matches your needs.

Gary Guss · Post by **Gary Guss** » Sun Apr 20, 2014 9:45 pm

My wife and I have a gold plan, its saving us about $800/month vs. what we were paying also same network and doctors, in her case she had a pre-exisitng condition knee, in my case had a heart attack and then cancer serveral years back. So far so good. You can hate it if you want to, but its been a great thing for us.

GG.

Flobes · Post by **Flobes** » Sun Apr 20, 2014 9:49 pm

I have ACA insurance, in a state with its own Exchange.

I carefully studied the plans availabile for me, including networks and out-of-network coverage. And I sought advise from my primary care physician.

The new network is much larger than my previous private insurance. And much more is covered (wellness, services, procedures, tests). It's the best health insurance I've ever had. Better than when I was on a corporate luxe plan. Better than when I was on a deluxe civil servant plan.

In early retirement, I have low income (I can control my MAGI), so I qualified for both generous subsidy and extensive cost-sharing benefits.

My ACA insurance is $44.89/month after subsidy (Exchange listed at $1087.60/month). Because of Cost-Sharing Benefits, my deductible is $0 (zero!), with a maximum annual out-of-pocket of $500 in-network, $1,000 out-of-network.

As it happens, tomorrow I am seeing a specialist and getting specialty testing. Free!

I quickly perused the MN Sure website, and scanned info about MN Care. It seems to be a MN Program, run by state health dept, for those with income too high for Medicaid, but income deemed to low for buying affordable insurance. And MN CAre seems to not be ACA insurance. (My state offers Medicaid Expansion, but not this other layer of public-run in-between.) So I think you'll need MN-specific feedback, not just general comments about the ACA.

If you want to know how ACA works, including subsidies and cost-sharing benefits, PM me.

Ged · Post by **Ged** » Sun Apr 20, 2014 9:54 pm

My son went from a pretty minimal plan that had a lot of coverage limitations to a pretty broad coverage plan with higher deductibles for an additional $100. When you think about what insurance is supposed to be I think what he has now is far superior.

sambb · Post by **sambb** » Sun Apr 20, 2014 10:01 pm

i know of a few top doctors that stopped taking the plans. will be interesting to watch what happens. then again, i know of some top docs that have opted out of medicare also

JMacDonald · Post by **JMacDonald** » Sun Apr 20, 2014 10:08 pm

My brother has medical insurance for the first time. He is self employed and has never purchased insurance until now. One reason is that he has a preexisting condition that would have prevented him from getting insurance even if he tried before now. So the ACA is a good thing for him and his family.

englishgirl · Post by **englishgirl** » Sun Apr 20, 2014 10:47 pm

The cheapest plans available to me were HMO plans with limited networks. So I paid more for a PPO plan with a bigger network. There are plenty of different "ACA" plans, but I suspect plenty of people just picked the cheapest option without really realizing that it was an HMO.

For me, it's a better plan than I had before, but it costs me a bit more per month than I was previously paying. It has higher deductibles, but then my old plan didn't cover medications at all - if I'd got into a situation where I needed expensive meds, that could easily have severely tested my financial resources.

To the OP: Plans are priced based on age, and county. Then, you may qualify for subsidies based on income. There's really no way for us to figure out if there's an equivalent plan for your income level without knowing the age too. What you should look into is whether the plan will work for YOU, including the network of doctors available.

dm200 · Post by **dm200** » Sun Apr 20, 2014 11:08 pm

llessac15 wrote:dm200, Your post pointed out something that I should have said with my post above. The patients we have seen with ACA plans were patients that would otherwise have no insurance. People in your situation are just shopping for your best deal.

Grouping this post with the previous one:

I don't have ACA insurance, but I am a practicing Oncologist in MS. The few ACA plans we have seen over the past few months have been awful. Worse than Medicaid. We are not seeing anyone with ACA plans. We would lose thousands of dollars if we did see them. They are being referred to the local academic center. Just my 2 cents.

Let me see if I understand what you are seeing and doing (or not doing)- from the point of view of a medical provider. In your area, you are saying that you have chosen to not participate in the ACA plans available to you because the reimbursement for the medical services you provide are too low for your practice to be able to live with. So, when a patient with one of these ACA plans inquires with your practice, you do not see them because you do not accept their insurance. Is my understanding correct?

Assuming my understanding is correct, I thought (perhaps incorrectly) that to be "acceptable" as an ACA insurance plan, the plan was required to have an "adequate" number of providers to meet the medical needs of those who enroll in that plan. Are you saying that these plans that you are seeing do not have any providers of the medical services that those enrolled need? If that is what you are saying, do you have any idea or understanding of how these ACA plans have been certified?

[PLEASE note that I am just trying to better understand the ACA and am making absolutely no judgment or expressing any opinion about your choice to not participate in a plan that you judge to inadequately compensate you for the services you provide]

Ron Ronnerson · Post by **Ron Ronnerson** » Sun Apr 20, 2014 11:36 pm

I recently switched from buying insurance off the exchange to purchasing the gold coverage through the exchange in CA. I'm a fairly healthy 39 year old. For virtually the same price, my coverage is far better now. For example, my deductible has gone from $5900 to $0. I pay something like $10 more a month for the premium compared to the old insurance I had (I don't receive a subsidy). I have the same doctor, all nearby hospitals accept the new insurance, and prescriptions costs are slightly lower now. Overall, I'm definitely satisfied with the insurance.

However, the process of getting the insurance has not been fun. I keep receiving letters to prove that I'm an American citizen or the insurance will be cancelled. My wife got coverage on the exchange too and hers was processed without any such issues. I sent a copy of my passport in by both fax and mail but the letters kept coming. Each time I called customer service, the hold time was about an hour. The customer service reps have said that documentation is received in a different city and their system doesn't allow them access to see what has come in and whether or not it's been accepted. All they say is not to worry about it if I've sent what they've requested. They've said these letters have gone out to a lot of people automatically and it's unclear why they're being sent out. Since I've already cancelled my previous insurance, these reassurances don't go very far. I've been frustrated by the process but the insurance itself has been great.

BrandonBogle · Post by **BrandonBogle** » Mon Apr 21, 2014 12:28 am

My gf got BCBS of NC BlueAdvantage plan has been great. Network had been large that all my preferreds take it and looking around, there was ample choices in every quality. Cost is around $150/mo + $30 for dental. This is a cost sharing plan with a $250 deductible and $750 annual max out of pocket, $5/copays for general and generic Rx, $15 copays for specialist. Considering previous insurance quote (didn't buy) was $575/mo and switching my plan from me-only to me + 1 would be $325/mo with a larger deductible and higher copays.

Mom got an HMO plan, but picked such a plan since the total monthly cost was $0. Network participation is decent, but not amazing. We expected as such and this struck a balance. Just starting on her early retirement income placed a premium on knowing fixed costs. The next higher plan would be $40/mo and be a PPO plan with $10 or so deductibles. I wanted her on this plan, but she saw the dollar signs and decided the limitations of HMO would be acceptable.

Uncle went on an ACA plan, but do not know his details. I know he pays less than $100/mo and did not have to switch doctors.

My employer provided plan saw only two changes. Increased $1.60/mo and primary copays are 50% instead of $25. My primary charges $55 copays and thus, barely a difference for me. Speciality are still fixed dollar amounts.

lululu · Post by **lululu** » Mon Apr 21, 2014 5:18 am

Julieta wrote:I'm checking the MN Sure website and discovered a plan call MN Care for incomes less than $23k for a single person or
$31k for a family of 2 persons.

The monthly premium payment is $50. There are additional payments for using the insurance but they are also at a low cost.

Does your ACA state website have a similar program for this income level?

I will just note to check if your doctor(s) are in the plan you are considering.

As to doctors in general being reluctant to participate, that's something I hear about Medicare, which I'm on, but have hardly seen in reality. I think in the years I have been on Medicare maybe one or two doctors' offices have said no Medicare patients. I have several medical things going on, and see doctors at two of the best medical groups in the country via Medicare. Medicare + Medigap is the best insurance coverage I have ever had, including decades of having employee coverage from various companies.

goaties · Post by **goaties** » Mon Apr 21, 2014 5:46 am

To answer the OPs question: yes, our ACA-participating for-profit insurers in our state are offering a plan which costs $50 a month for folks in that income range...however, I found that the network of doctors and hospitals were too restrictive. I ended up opting for a $150/month plan which has an extensive network, almost no deductible, and very low copays. I haven't been able to afford coverage this good in 15 years! Plus, if the ACA holds, I believe the biggest win will be the ability to get sick and not have your rates skyrocket ("re-underwriting", as it was euphemistically called).

SnapShots · Post by **SnapShots** » Mon Apr 21, 2014 7:40 am

What a great thread about the ACA. [OT comments removed by admin LadyGeek]

Levett · Post by **Levett** » Mon Apr 21, 2014 7:46 am

SnapShots wrote:

"What a great thread about the ACA."

I agree.

It shows the maturity of any number of Boglehead posters.

Exemplary, in my view.

Lev

Jfet · Post by **Jfet** » Mon Apr 21, 2014 8:14 am

Does anyone have the Blue Cross/Blue Options PPO plan in Florida? We will have to choose a home state for taxes and ACA while traveling around the USA and I was considering Florida and this ACA plan because of the nationwide network.

scrabbler1 · Post by **scrabbler1** » Mon Apr 21, 2014 8:42 am

I have been on a variey of plans since I Early Retired back in late 2008. Having been on COBRA for the last 17 months of working (I had become ineligible for group health becasue I had cut my hours too much, intentionally), I had one more month of COBRA (under $400 per month) before I switched to an individual plan starting in 2009. Here in New York where the individual market is hostile and expensive, my premiums were still a reasonable $470 per month. But by 2011 those premiums had risen nearly 50% to around $700 per month.

However, by 2011 the ACA had already passed, a godsend for me. I switched to a low-cost BCBS hospital-only plan for the rest of 2011, planning to stay with it through the end of 2013 when I could enroll in a less expensive and broader exchange-based plan through the New York Marketplace exchange. It was a minor nuisance going through the process (most of my problems were with BCBS) but I got a Silver plan, also through BCBS, which cost about the same as the old COBRA plan (under $400) but without dental coverage (which was fine, had a lot of costly dental work just before I lost the coverage in 2009). I expect to receive a federal subsidy, albeit not a big one because I am near the top of the income limit to qualify. That's icing on the cake as fas as I am concerned.

So, I am once again paying under $400 per month as I was under COBRA which fits well into my ER budget. And I have a comprehensive plan, unlike the hospital-only, non-ACA-compliant plan I had in 2011-2013, a plan I knew would be canceled (so I not only did not mind getting a cancelation notice, I expected it). I am quite happy with the ACA.

gerrym51 · Post by **gerrym51** » Mon Apr 21, 2014 8:50 am

i retired last year at 62 and bought Romneycare in MA. I am now on Obamacare in MA. I get no subsidy-pay 550.00 a month

hicabob · Post by **hicabob** » Mon Apr 21, 2014 8:58 am

In CA where I live it seems fine, in fact all the same docs as the company insurance I had last year. $498/mo w/ no subsidy. ACA has been really nice for many people who want to retire pre-medicare.

Julieta · Post by **Julieta** » Mon Apr 21, 2014 9:09 am

I am pleased about all the high quality responses here and appreciate the fact that we have a reasonable and factual group of responders. It is helpful to avoid political commentary...and to get the facts on how the program is working for us. I am hopeful that we will all gain useful information and this forum will meet the needs of its members.

Julieta · Post by **Julieta** » Mon Apr 21, 2014 9:24 am

dm200 wrote:
llessac15 wrote:dm200, Your post pointed out something that I should have said with my post above. The patients we have seen with ACA plans were patients that would otherwise have no insurance. People in your situation are just shopping for your best deal.
Grouping this post with the previous one:

I don't have ACA insurance, but I am a practicing Oncologist in MS. The few ACA plans we have seen over the past few months have been awful. Worse than Medicaid. We are not seeing anyone with ACA plans. We would lose thousands of dollars if we did see them. They are being referred to the local academic center. Just my 2 cents.
Let me see if I understand what you are seeing and doing (or not doing)- from the point of view of a medical provider. In your area, you are saying that you have chosen to not participate in the ACA plans available to you because the reimbursement for the medical services you provide are too low for your practice to be able to live with. So, when a patient with one of these ACA plans inquires with your practice, you do not see them because you do not accept their insurance. Is my understanding correct?

Assuming my understanding is correct, I thought (perhaps incorrectly) that to be "acceptable" as an ACA insurance plan, the plan was required to have an "adequate" number of providers to meet the medical needs of those who enroll in that plan. Are you saying that these plans that you are seeing do not have any providers of the medical services that those enrolled need? If that is what you are saying, do you have any idea or understanding of how these ACA plans have been certified?

[PLEASE note that I am just trying to better understand the ACA and am making absolutely no judgment or expressing any opinion about your choice to not participate in a plan that you judge to inadequately compensate you for the services you provide]

I am expecting to hear your explanation about these posts and look forward to clarifying my understanding of the program and the reasons you do not participate in the plan.

+1

snowman · Post by **snowman** » Mon Apr 21, 2014 9:30 am

Our experience has been great. We are a family of 4, both parents in 50s, self-employed. In 2013, we were paying slightly over $1K/month in premium for a HDHP ($6K deductible). We signed up through our state exchange without a hiccup for a silver plan with generous benefits for pretty much the same monthly premium. While we don’t qualify for subsidy (our income is generally slightly over MAGI limit), it’s good to know it’s there in case our income drops unexpectedly. Our deductible went down to $1.5K. After many, many years, we can now see the provider and actually KNOW the cost of the visit ahead of time!

While we still pay an enormous amount of money for health insurance compared to W-2 employees, it’s infinitely better under ACA. Our deductible went down, benefits went up, we cannot be denied coverage (this is huge!), which means we can actually switch plans during annual enrollment period if we wish to.

Confused · Post by **Confused** » Mon Apr 21, 2014 9:39 am

Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."

Julieta · Post by **Julieta** » Mon Apr 21, 2014 9:48 am

Confused, your premium is quite reasonable before the ACA, and correctly so you would choose to remain under your plan. How is it your rate was so reasonable? Were you under a specific program through your state? Please share more facts to help us understand your situation before.

cubedbee · Post by **cubedbee** » Mon Apr 21, 2014 9:49 am

Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."

Because you are in the 0.1% that is wealthy enough to actually self-insure their own healthcare claims? Or because you like to gamble that you will stay healthy while you are uninsured and not incur a healthcare claim that could drain a significant amount of your assets and/or bankrupt you?

Julieta · Post by **Julieta** » Mon Apr 21, 2014 9:52 am

SnapShots wrote:What a great thread about the ACA. [OT comments removed by admin LadyGeek]

Would you mind sharing your state?

Pam01 · Post by **Pam01** » Mon Apr 21, 2014 9:54 am

I have an ACA Plan with the same insurance company that I had my previous health coverage with. Not an HMO, but a PPO. The ACA plan covers all the providers as in-network providers that I normally saw before ACA. Changing to ACA hasn't made a difference in my case from the perspective of quality of medical care. The only difference is lower premium, even though I do not qualify for a subsidy and pay full premium as a result. My premium is roughly 50% lower with ACA plan than with COBRA.

For me ACA works great and I, for one, appreciate to be in a position to use it.

Oh, and I was also able to sign up for ACA plan with my state run exchange without any hiccups. It was also fairly easy to get answers to all my questions by speaking to the Exchange's and insurance company's customer service representatives before I signed up for the plan.

[Edited to add details about exchange signup]

dm200 · Post by **dm200** » Mon Apr 21, 2014 9:58 am

Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."

What kind of Humana insurance could you have possibly been covered by (two of you) for only $89/month? I find it very, very difficult to believe that you would have been charged double the price for half the service. What are the details? Ages? Tpe of coverage? your state? etc.

bluemarlin08 · Post by **bluemarlin08** » Mon Apr 21, 2014 10:09 am

My plan went from a monthly premium for wife and I of $740 to $1165. In addition, had a family deductible of 3000, now individual deductible of 3000. Same network as before, no subsidies. Would have been happy if I had a large subsidy, but not so much with higher premiums and deductible. Most people I talk with are happy with the plans if their premiums are subsidized.

dm200 · Post by **dm200** » Mon Apr 21, 2014 10:15 am

bluemarlin08 wrote:My plan went from a monthly premium for wife and I of $740 to $1165. In addition, had a family deductible of 3000, now individual deductible of 3000. Same network as before, no subsidies. Would have been happy if I had a large subsidy, but not so much with higher premiums and deductible. Most people I talk with are happy with the plans if their premiums are subsidized.

Other than the deductible going from family to individual, were there any other changes (good or bad for you) in the coverage? For example, were some appointments, tests, procedures now no charge when in the past they were charged for? How about things like copays for services?

My guess is that you are younger and a considerable part of this increase may be due to the required changes in how age is considered in setting the premiums.

TheGreyingDuke · Post by **TheGreyingDuke** » Mon Apr 21, 2014 10:19 am

I am a Vermont resident, the changes that ACA imposed had been already enacted in Vermont (no denial for pre-existing conditions, no lifetime limitations) as well as other reforms, including community rating. All providers are in the two insurers doing business (Blue Cross and MVP) and our experience with ACA was that the premium went down a bit, less than 5% but I was able to buy dental at a reasonable price. I do purchase high deductible plans.

Julieta · Post by **Julieta** » Mon Apr 21, 2014 10:29 am

dm200 wrote:
Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."
What kind of Humana insurance could you have possibly been covered by (two of you) for only $89/month? I find it very, very difficult to believe that you would have been charged double the price for half the service. What are the details? Ages? Tpe of coverage? your state? etc.

+1

Julieta · Post by **Julieta** » Mon Apr 21, 2014 10:33 am

So far, I am led to believe that the ACA has been positive for most. From the posters who were negative, there have been no responses yet. We'd sure like to hear from you...

cheapskate · Post by **cheapskate** » Mon Apr 21, 2014 10:41 am

Great thread ! Hope it does not get political and locked !!

I don't have ACA (yet), but I am actively researching it, hoping to take early retirement (or at least several months off). Based on past negative experience, I did not want to go on COBRA.

As others mention, it is critical to research what ACA plans your preferred medical groups/hospitals/doctors accept (larger hospitals and medical groups should have this on their website). Here in Northern CA, I find that there are large differences county-county on what the different plans cover. For example, Blue Shield PPO coverage is amazing in the county I live in, but very very limited in a neighboring county. I found it extremely useful to talk to a insurance broker (connected to a large national bank). She spent a few hours researching plans best suited for us, and answering questions. Amazingly, premiums for the same identical plan, when purchased through her office was slightly lower than the CA website. I assume this is because they kick back some of the commissions to clients. She assured me that there was no difference whatever purchasing a plan through her office or through the CA website.

Julieta · Post by **Julieta** » Mon Apr 21, 2014 10:41 am

sambb wrote:i know of a few top doctors that stopped taking the plans. will be interesting to watch what happens. then again, i know of some top docs that have opted out of medicare also

Would you explain by what you mean by "top docs"?
Specialist? Well known or renowned in their field?
The term is not clear to me.

dm200 · Post by **dm200** » Mon Apr 21, 2014 10:46 am

Julieta wrote:So far, I am led to believe that the ACA has been positive for most. From the posters who were negative, there have been no responses yet. We'd sure like to hear from you...

Yes - so would I. "Details" are, IMO, important as well. While it is true that, for many, deductbles may be higher and may be individual rather than "family" - often, though, certain services (such as office visits) are covered with only a copay - even if the deductible is not met for that year. Some services may have zero copay. One (of many, many..) misunderstandings of the plans offered was/is the bekief that to get any benefits of a plan, you always had to meet the deductible first. Often, that was/is just not true.

bungalow10 · Post by **bungalow10** » Mon Apr 21, 2014 10:54 am

My brother is on an ACA plan. He left a crappy job for one that is better, but didn't provide insurance, at the end of last year. The ACA enabled his job change and for that I'm grateful because his quality of life was horrible with his former employer. He is in his early 30s and does have a minor medical issue (which is getting better with the new employer!!) and so far has been satisfied with his insurance. He's low-ish income but not low enough to get a subsidy, but still thinks his insurance is affordable. He hasn't had to change his doctor or pharmacy.

^^This is the national exchange. My state did not opt to do their own exchange.

Confused · Post by **Confused** » Mon Apr 21, 2014 10:56 am

dm200 wrote:
Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."
What kind of Humana insurance could you have possibly been covered by (two of you) for only $89/month? I find it very, very difficult to believe that you would have been charged double the price for half the service. What are the details? Ages? Tpe of coverage? your state? etc.

Super high-deductible. $11,100 each. If we had been in a horrific accident together, for example, we'd have to fork out $22,200 to reach each of our deductibles, but everything was covered after that, 100% with no co-pay. Pretty much covered anything you could ever need, including prescriptions (barring elective cosmetic surgery, for example), but covered absolutely nothing, literally nothing, until you reached the deductible. Healthy, 20-somethings in Utah with no conditions of any kind. When we originally signed up it was only $69/month, but when they raised it to $89, we dropped it for being too expensive. We never used it for any reason. One of the two of us did see a doctor during the couple of years that we had coverage (just to make sure everything was on the up-and-up before dropping insurance), including getting an ultrasound, but we just paid cash for the doctor visit - $120.

Since we have no prescriptions or any of that jazz, we only wanted to be insured in case of a catastrophe. But now? To get the same service (to be covered in the event of a catastrophe), would cost $180 each, instead of $89 combined. Quadruple the cost to insure us in the event of catastrophe? I don't roll like that.

bungalow10 · Post by **bungalow10** » Mon Apr 21, 2014 11:10 am

Confused wrote:
dm200 wrote:
Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."
What kind of Humana insurance could you have possibly been covered by (two of you) for only $89/month? I find it very, very difficult to believe that you would have been charged double the price for half the service. What are the details? Ages? Tpe of coverage? your state? etc.
Super high-deductible. $11,100 each. If we had been in a horrific accident together, for example, we'd have to fork out $22,200 to reach each of our deductibles, but everything was covered after that, 100% with no co-pay. Pretty much covered anything you could ever need, including prescriptions (barring elective cosmetic surgery, for example), but covered absolutely nothing, literally nothing, until you reached the deductible. Healthy, 20-somethings in Utah with no conditions of any kind. When we originally signed up it was only $69/month, but when they raised it to $89, we dropped it for being too expensive. We never used it for any reason. One of the two of us did see a doctor during the couple of years that we had coverage (just to make sure everything was on the up-and-up before dropping insurance), including getting an ultrasound, but we just paid cash for the doctor visit - $120.

Since we have no prescriptions or any of that jazz, we only wanted to be insured in case of a catastrophe. But now? To get the same service (to be covered in the event of a catastrophe), would cost $180 each, instead of $89 combined. Quadruple the cost to insure us in the event of catastrophe? I don't roll like that.

Just curious... what year did you drop the $89 insurance?

bluemarlin08 · Post by **bluemarlin08** » Mon Apr 21, 2014 11:22 am

Other than the deductible going from family to individual, were there any other changes (good or bad for you) in the coverage? For example, were some appointments, tests, procedures now no charge when in the past they were charged for? How about things like copays for services?

My guess is that you are younger and a considerable part of this increase may be due to the required changes in how age is considered in setting the premiums.

Currrent plan does offer maternity but at age 64 no need, I hope. Plan is a HDHP, no changes from past plan and no additional benefits I can tell. Most of my clients that are unsubsidized had substantial rate increases, this is in Tennessee. No copays. Perhaps our state is unique, but talking to agents in other states they have experienced the same as I have, much higher rates for the same plan.

snowman · Post by **snowman** » Mon Apr 21, 2014 11:27 am

cubedbee wrote:
Confused wrote:Looked at the website shortly before the March 31 deadline. They wanted $180/month to ensure just me. Before the ACA, my spouse and I both had health insurance through Humana for $89/month. With ACA, double the price for half the service? No thanks, I'll pay the "no health insurance tax."
Because you are in the 0.1% that is wealthy enough to actually self-insure their own healthcare claims? Or because you like to gamble that you will stay healthy while you are uninsured and not incur a healthcare claim that could drain a significant amount of your assets and/or bankrupt you?

Apparently, neither. Read her response in this thread http://www.bogleheads.org/forum/viewtop ... 6#p1527230, and draw your own conclusion:

"See, the problem is that you assume that I would do something about the major illness, condition, etc. Just because you suddenly get pneumonia doesn't mean you are suddenly required to visit a doctor. Just because a doctor prescribes some expensive medication to take for the rest of your life, it doesn't mean you are required to do so. You claim I am assuming potentially unlimited financial risk in the form of medical costs. I claim I will never have those medical costs because I will refuse those medical services."

Naikansha · Post by **Naikansha** » Mon Apr 21, 2014 11:37 am

My son, a graduate student in California with a preexisting condition now has a silver plan with a very low premium. This is the best insurance he has ever had while living away from family. He is quite pleased.

Confused · Post by **Confused** » Mon Apr 21, 2014 11:46 am

bungalow10 wrote:Just curious... what year did you drop the $89 insurance?

October 31, 2012, I believe, is when it expired and we didn't renew for the new $89/month that it would've been until October 31, 2013. I had previously been uninsured for 17 months since finishing university. At 18 months uninsured is when Humana required a medical examination before re-signing up, so we signed up when I had gone 17 months. Insured for a couple of years, and now uninsured since November 2012. And now that I get no discount for being young, healthy, and less of a risk for the insurance company? The 1% uninsured tax is where it's at.

gerrym51 · Post by **gerrym51** » Mon Apr 21, 2014 11:53 am

have an Obamacare policy. I opted for higher prices silver plan(not 2nd lowest obamacare subsidizes) because the cheaper plans did not cover hospitals/doctors i wanted.

even then the plans are only a great deal if your are subsidized for premium AND out of pockets and co-pays(obamacare has TWO different kinds of subsidies)

i pay 550.00 a month for single coverage with a 2000.00 deductible and 6350.00 out of pocket based on silver plan 70/30 split.