2017 ACA plan previews
2017 ACA plan previews
My apologies if someone already posted this but 2017 ACA plans can now be previewed on healthcare.gov.
https://www.healthcare.gov/see-plans/
https://www.healthcare.gov/see-plans/
Re: 2017 ACA plan previews
If you want a good laugh, check out zip code 85382 (Phoenix). The only option is Ambetter which is a Medicaid-like company with small provider network. Rates...
40-year-old parents with two kids:
Bronze - $1333/mo
Silver - $1422/mo
Gold - $1978/mo
50-year-old parents with two kids:
Bronze - $1688/mo
Silver - $1799/mo
Gold - $2503/mo
60-year-old parents with two kids:
Bronze - $2335/mo
Silver - $2489/mo
Gold - $3463/mo
40-year-old parents with two kids:
Bronze - $1333/mo
Silver - $1422/mo
Gold - $1978/mo
50-year-old parents with two kids:
Bronze - $1688/mo
Silver - $1799/mo
Gold - $2503/mo
60-year-old parents with two kids:
Bronze - $2335/mo
Silver - $2489/mo
Gold - $3463/mo
Last edited by BruDude on Mon Oct 24, 2016 11:00 am, edited 1 time in total.
Re: 2017 ACA plan previews
Thanks for the update.
The number of providers in my area has shrunk from 5 to 2. No PPOs/POSs. Just the big two left - BCBS and Kaiser. Prices seem okay though mainly because the tax credit has increased to offset the large increases in premium prices (assuming the tax credit amounts are correct). Seems like the ACA is not going to be around for very long if it continues at this rate. The plans are also ACA specific with specific networks for these plans and no out of network benefits - seems like they are cutting coverage as well as increasing prices.
The number of providers in my area has shrunk from 5 to 2. No PPOs/POSs. Just the big two left - BCBS and Kaiser. Prices seem okay though mainly because the tax credit has increased to offset the large increases in premium prices (assuming the tax credit amounts are correct). Seems like the ACA is not going to be around for very long if it continues at this rate. The plans are also ACA specific with specific networks for these plans and no out of network benefits - seems like they are cutting coverage as well as increasing prices.
Re: 2017 ACA plan previews
Thanks for the update. Anyone know if there are options outside of the ACA plans that meet the requirement for having insurance? Just one provider in my area and I don't like the options I'm being given and my income is too high for any subsidies. Maybe the wife needs to go back to work to get employer provided insurance
Last edited by doug4523 on Mon Oct 24, 2016 3:28 pm, edited 1 time in total.
Re: 2017 ACA plan previews
You can search around for health insurance brokers or check directly with the "big name" insurers like BC/BS, Aetna, United, etc.doug4523 wrote:Thanks for the update. Anyone know if there are options outside of the ACA plans that meet the requirement for having insurance? I don't like the options I'm being given and my income is too high for any subsidies.
Re: 2017 ACA plan previews
I'm not sure how many non-exchange plans they include but try gohealth.com - I use them to search instead of hc.gov as they have a bunch of information like HSA-eligibility that I found useful last year, that was either missing or incorrect (!) on my state exchange site.doug4523 wrote:Thanks for the update. Anyone know if there are options outside of the ACA plans that meet the requirement for having insurance? Just one provider in my area and I don't like the options I'm being given and my income is too high for any subsidies. Maybe the wife needs to go back to work to get employer provided insurance
Don't forget the 2016 bronze deductible is around $7k per person (max $14k per family plan). That's between $23k and $30k in out of pocket costs before insurance kicks in at all. Yikes. Talk about reducing incentives for self-employment (at a time when many folks have no other choice) or early retirement.BruDude wrote:40-year-old parents with two kids:
Bronze - $1333/mo
Silver - $1422/mo
Gold - $1978/mo
Last edited by mac808 on Mon Oct 24, 2016 3:40 pm, edited 2 times in total.
Re: 2017 ACA plan previews
Thanks for the info. Looks like I need to keep my job.
Re: 2017 ACA plan previews
Thanks for the link.
I just looked up my area. I am comparing to my own current employer-provided coverage: $1725 / month , parents + 3 kids, $10,000 deductible, no dental / vision , but this is a PPO ( the $1725 is total cost, employer + employee portion).
I am told it is going up next year by about $500 per month due to 2 employees having incurred very high costs last year . ( the company has about 120 employees or so , so not large enough to self insure, but not small enough to get community rating) , and we only had one company ( BC/BS ) willing to offer insurance .
The BCBS ACA HMO is cheaper for the same deductible ( about $1200/ month ) . I am basically insuring against catastrophic loss ( I already pay medications and doctor visits out of pocket to the tune of $4,000 or so per year , and invest my HSA contributions )
Does anyone know the rules on whether one can just opt out of employer plan and chose an ACA plan? How does it affect the employer if too many people go on the exchange?
I just looked up my area. I am comparing to my own current employer-provided coverage: $1725 / month , parents + 3 kids, $10,000 deductible, no dental / vision , but this is a PPO ( the $1725 is total cost, employer + employee portion).
I am told it is going up next year by about $500 per month due to 2 employees having incurred very high costs last year . ( the company has about 120 employees or so , so not large enough to self insure, but not small enough to get community rating) , and we only had one company ( BC/BS ) willing to offer insurance .
The BCBS ACA HMO is cheaper for the same deductible ( about $1200/ month ) . I am basically insuring against catastrophic loss ( I already pay medications and doctor visits out of pocket to the tune of $4,000 or so per year , and invest my HSA contributions )
Does anyone know the rules on whether one can just opt out of employer plan and chose an ACA plan? How does it affect the employer if too many people go on the exchange?
Re: 2017 ACA plan previews
Thanks for alerting me to this. I've been waiting to see if the rates are better than the off market plans. They aren't.
And this will be the last month my family has health care insurance. It's a sense of relief, in a way.
JT
And this will be the last month my family has health care insurance. It's a sense of relief, in a way.
JT
- dodecahedron
- Posts: 6563
- Joined: Tue Nov 12, 2013 11:28 am
Re: 2017 ACA plan previews
For comparison, NY (Capital District, Albany and suburbs) has dozens of plans. The age of the adults is irrelevant to pricing in our state as NY does not allow insurance companies to base premiums for adults on their age. Our state has its own exchange and our NYS preview page is here.BruDude wrote:If you want a good laugh, check out zip code 85382 (Phoenix). The only option is Ambetter which is a Medicaid-like company with small provider network. Rates...
40-year-old parents with two kids:
Bronze - $1333/mo
Silver - $1422/mo
Gold - $1978/mo
50-year-old parents with two kids:
Bronze - $1688/mo
Silver - $1799/mo
Gold - $2503/mo
60-year-old parents with two kids:
Bronze - $2335/mo
Silver - $2489/mo
Gold - $3463/mo
Family plan (unsubsidized) covering husband and wife of any age (and any number of kids)
Bronze: $850/mo to $1364/mo
Silver: $1068/mo to $1593/mo
Gold: $1309/mo to $1903/mo
My favorite network (CDPHP, which is top ranked nationally for quality) is in the middle of the pack, price-wise (they have several bronze plans in the $1,100 range, several silvers in the $1200 range, and several golds in the $1500 range.)
Of course, although these are less than the costs in Phoenix, they are still a substantial chunk of change. That said, a family of four with MAGI under $96,000 will receive tax credits to help pay for them. With or without subsidies, they may be large enough to help increase itemized deductions on Schedule A get over the 10% of AGI threshold.
Last edited by dodecahedron on Mon Oct 24, 2016 4:46 pm, edited 1 time in total.
Re: 2017 ACA plan previews
You can waive employer coverage but you won't be eligible for a subsidized ACA policy unless your employer coverage is unaffordable.villars wrote: Does anyone know the rules on whether one can just opt out of employer plan and chose an ACA plan? How does it affect the employer if too many people go on the exchange?
What is Affordable Employer Coverage Under ObamaCare?
- WolfpackFan
- Posts: 399
- Joined: Mon Mar 08, 2010 1:18 pm
Re: 2017 ACA plan previews
+1Thanks for the info. Looks like I need to keep my job.
Our family would only be eligible for two crappy plans.
Re: 2017 ACA plan previews
My bronze plan is going from 1414 to 2009 a month for the bronze plan for me and the wife. 4 years to go till Medicare.
Re: 2017 ACA plan previews
The administrators of the plan say that participants should be insulated from sticker shock because of increased subsidies. So whose paycheck are those subsidies coming from?jjface wrote:Prices seem okay though mainly because the tax credit has increased to offset the large increases in premium prices (assuming the tax credit amounts are correct). Seems like the ACA is not going to be around for very long if it continues at this rate.
Re: 2017 ACA plan previews
Our company's HSA premiums have gone up 26% for 2017. But getting a Bronze plan will increase our deductibles to $12,000 for a family, which makes the HSA not so desirable. This is also hitting small businesses hard. Illinois is down to 1 insurance company from 5 last year.
I'll gladly pay you Tuesday for a hamburger today.
Re: 2017 ACA plan previews
We have a over 100 plans to choose from.
Our new Silver Plan appears to have a price reduction, about 29/month for the two of us (MFJ, both over 60).
Not bad at all.
Our new Silver Plan appears to have a price reduction, about 29/month for the two of us (MFJ, both over 60).
Not bad at all.
-
- Posts: 29
- Joined: Tue May 31, 2011 9:45 pm
Re: 2017 ACA plan previews
No complaints from me. I have 29 silver plans to choose from. Will change to a new insurer that has started in my state . My premium with the subsidy will be about 10 per cent lower for a near identical plan with the same doctors etc.
Re: 2017 ACA plan previews
Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
Mak 3 fund portfolio: 50% US small cap value & US Small cap (IJS, IJR), 40% Emerging Markets (IEMG, VWO, FPADX), 10% US REIT (VNQ)
Re: 2017 ACA plan previews
My cost is going up significantly. But, that concerns me less than the narrowing of networks. My current plan is eliminating the three major hospitals in the state from its network.
I am trying to find a high deductible plan that has an excellent network. Easier said than done.
I am trying to find a high deductible plan that has an excellent network. Easier said than done.
Re: 2017 ACA plan previews
My 2016 BC plan went up 30% for 2017 but thankfully Kaiser is moving into the area and charge less than my current BC plan. Having had them years ago I prefer Kaiser too.
-
- Posts: 3314
- Joined: Wed Feb 03, 2010 9:17 am
Re: 2017 ACA plan previews
It strikes me as being a catastrophic health insurance plan, but I rather doubt that many of those using the ACA exchanges can really afford that type of plan.MikeMak27 wrote:Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
- simplesimon
- Posts: 4566
- Joined: Mon Feb 25, 2008 7:53 pm
Re: 2017 ACA plan previews
You're paying $3k/year when you're healthy and $10k when disaster strikes, which in your case is anything above $10k but could be in the hundreds of thousands of dollars. As a young healthy 30 year old, the disaster scenario is unlikely but not impossible. I think there are many areas of improvements needed in the U.S. healthcare system, but fraud and paycheck theft? No.MikeMak27 wrote:Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
Re: 2017 ACA plan previews
After reading your post, I became curious and found this:basspond wrote:So whose paycheck are those subsidies coming from?
"MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.
"The other source of revenue is a tax increase on the wealthiest Americans," he says. "Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes."
source: http://www.npr.org/sections/health-shot ... -subsidies
An individual is liable for Additional Medicare Tax if the individual’s wages, compensation, or self-employment income (together with that of his or her spouse if filing a joint return) exceed the threshold amount for the individual’s filing status:
Filing Status - Threshold Amount
Married filing jointly - $250,000
Married filing separate - $125,000
Single - $200,000
Head of household (with qualifying person) - $200,000
Qualifying widow(er) with dependent child - $200,000
Source: https://www.irs.gov/businesses/small-bu ... dicare-tax
Full List of All Taxes in ObamaCare / All Taxes in the Affordable Care Act
The following list of new ObamaCare taxes collectively raises over $800 billion by 2022. Here is a complete list of new fees and taxes contained within ObamaCare:
ObamaCare Taxes That Probably Will Not Directly Affect the Average American
• 2.3% Tax on Medical Device Manufacturers began in 2014
• 10% Tax on Indoor Tanning Services began in 2014
• Blue Cross/Blue Shield Tax Hike
• Excise Tax on Charitable Hospitals that fail to comply with the requirements of ObamaCare
• Tax on Brand Name Drugs
• Tax on Health Insurers
• $500,000 Annual Executive Compensation Limit for Health Insurance Executives
• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
• Employer Mandate on business with over 50 full-time equivalent employees to provide health insurance to full-time employees. $2,000 per employee – $3,000 if employee uses tax credits to buy insurance on the exchange (AKA the marketplace). (starting 2015 for employers with 100 or more FTE and 2016 for those with 50 or more.)
• Medicare Tax on Investment Income. 3.8% over $200k/$250k
• Medicare Part A Tax increase of .9% over $200k/$250k
• Employer Reporting of Insurance on W-2 (not a tax)
• Corporate 1099-MISC Information Reporting (repealed)
• Codification of the “economic substance doctrine” (not a tax)
ObamaCare Taxes That May Directly Affect the Average American
• 40% Excise Tax “Cadillac” on high-end Premium Health Insurance Plans 2018
• An annual $63 fee levied by ObamaCare on all plans (decreased each year until 2017 when pre-existing conditions are eliminated) to help pay for insurance companies covering the costs of high-risk pools.
• Medicine Cabinet Tax
Over the counter medicines no longer qualified as medical expenses for flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs), and Archer Medical Saving accounts (MSAs).
• Additional Tax on HSA/MSA Distributions
Health savings account or an Archer medical savings account, penalties for spending money on non-qualified medical expenses. 10% to 20% in the case of a HSA and from 15% to 20% in the case of a MSA.
• Flexible Spending Account Cap began in 2013
Contributions to FSAs are reduced to $2,500 from $5,000.
• Medical Deduction Threshold tax increase began in 2013
Threshold to deduct medical expenses as an itemized deduction increases to 10% from 7.5%.
• Individual Mandate (the tax for not purchasing insurance if you can afford it). Starting in 2014, anyone not buying “qualifying” health insurance must pay an income tax surtax at a rate of 1% or $95 in 2014, to 2.5% in 2016 on profitable income above the tax threshold. The total penalty amount cannot exceed the national average of the annual premiums of a “bronze level” health insurance plan on ObamaCare exchanges.
• Premium Tax Credits for Small Businesses began in 2014 (not a tax)
• Advanced Premium Tax Credits for Individuals and Families began in 2014 (not a tax)
• Medical Loss Ratio (MLR): Premium rebates (not a tax)
NOTE: Tax amounts above are subject to increase over time.
Source: http://obamacarefacts.com/obamacare-taxes/
- Don Christy
- Posts: 391
- Joined: Sun Oct 11, 2009 10:33 pm
Re: 2017 ACA plan previews
A slew of preventive services must be covered without a copay, coinsurance, or subject to deductible.MikeMak27 wrote:Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
“Speak only if it improves upon the silence." Mahatma Gandhi
Re: 2017 ACA plan previews
Random Poster wrote:
It strikes me as being a catastrophic health insurance plan, but I rather doubt that many of those using the ACA exchanges can really afford that type of plan.
?? Non government worker early retirees are a fairly large ACA group and they have enough $$ not to work.
Re: 2017 ACA plan previews
I've been happy with Washington state health exchange. My particular plan is going away but I will choose a high deductible plan next year and be able to contribute to an HSA. If I lived in a state without a health exchange, I would be talking to my legislators about that.
Re: 2017 ACA plan previews
That's what I'm looking for also. No PPOs at all and I have 4 choices this year - a Medicaid clinic, the company I used for 2015 which had a poor, narrow network (before I realized this), the company I used for 2016 (which was good, but just cut literally half their network while raising prices, now no nearby hospitals, etc), and one that looks passable but literally has no coverage for their network on the far side of town.Hayden wrote:My cost is going up significantly. But, that concerns me less than the narrowing of networks. My current plan is eliminating the three major hospitals in the state from its network.
I am trying to find a high deductible plan that has an excellent network. Easier said than done.
I guess I now need to add trip insurance to my health insurance costs since I'll need that for all my vacations, including road trips to the next state over, since otherwise I will get hit with out of network, completely uncovered expenses if I need anything short of an ER visit.
Last edited by Tanelorn on Tue Oct 25, 2016 12:12 pm, edited 1 time in total.
-
- Posts: 3314
- Joined: Wed Feb 03, 2010 9:17 am
Re: 2017 ACA plan previews
I haven't seen any data on the subject, but do you think that early retirees* (1) constitute the majority of those using the ACA exchanges; and (2) were the intended beneficiaries of the ACA exchange and associated subsidies?hicabob wrote:Random Poster wrote:
It strikes me as being a catastrophic health insurance plan, but I rather doubt that many of those using the ACA exchanges can really afford that type of plan.
?? Non government worker early retirees are a fairly large ACA group and they have enough $$ not to work.
* Of the high-net-worth/low-income-by-choice-or-design type.
Re: 2017 ACA plan previews
Unfortunately for men under 50 there isn't much of anything included. I think we get 1 free PCP visit annually. But it doesn't include any lab tests or imaging. And if the visit becomes more complicated than an ''annual checkup'' and they add an extra billing code then we're on the hook for that as well. So really the ''free services'' are worth about $100 (what it would cost to see a PCP for 30 mins). Older folks and women get a bit more (free mammogram, etc). The point others are making about the networks is very valid as well. Last year when I had to select a PCP it was mostly nurses with a handful of foreign trained MDs thrown in. Out of several dozen providers I could only find a single US trained MD who was participating (and I didn't call to verify he was actually participating and that his panel was open to new patients).Don Christy wrote:A slew of preventive services must be covered without a copay, coinsurance, or subject to deductible.MikeMak27 wrote:Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
Re: 2017 ACA plan previews
No and no, but many early retirees, such as myself, pay the full non-subsidized rate. I expect most boglehead type early retirees paying non-subsidized rates get bronze with an HSA if available since that seems most economically sensible. I've found that the difference in non-subsidized cost between bronze and the "better metal" plans tends to be very close to the difference in the deductible.Random Poster wrote:I haven't seen any data on the subject, but do you think that early retirees* (1) constitute the majority of those using the ACA exchanges; and (2) were the intended beneficiaries of the ACA exchange and associated subsidies?hicabob wrote:Random Poster wrote:
It strikes me as being a catastrophic health insurance plan, but I rather doubt that many of those using the ACA exchanges can really afford that type of plan.
?? Non government worker early retirees are a fairly large ACA group and they have enough $$ not to work.
* Of the high-net-worth/low-income-by-choice-or-design type.
- Don Christy
- Posts: 391
- Joined: Sun Oct 11, 2009 10:33 pm
Re: 2017 ACA plan previews
Here's a list of covered preventive services.mac808 wrote:Unfortunately for men under 50 there isn't much of anything included. I think we get 1 free PCP visit annually. But it doesn't include any lab tests or imaging. And if the visit becomes more complicated than an ''annual checkup'' and they add an extra billing code then we're on the hook for that as well. So really the ''free services'' are worth about $100 (what it would cost to see a PCP for 30 mins). Older folks and women get a bit more (free mammogram, etc). The point others are making about the networks is very valid as well. Last year when I had to select a PCP it was mostly nurses with a handful of foreign trained MDs thrown in. Out of several dozen providers I could only find a single US trained MD who was participating (and I didn't call to verify he was actually participating and that his panel was open to new patients).Don Christy wrote:A slew of preventive services must be covered without a copay, coinsurance, or subject to deductible.MikeMak27 wrote:Data point: 30 year old male, single, no tobacco use or children. The cheapest bronze plan available with an HSA eligible account has a monthly deductible of $246.64, a deductible of $5500, and an out of pocket max of $6550. So nothing is really covered for the first $9510. That doesn't seem like health insurance. It seems more like fraud or paycheck theft.
http://www.hhs.gov/healthcare/facts-and ... index.html
I'm in employer group plan, so haven't explored network issues.
“Speak only if it improves upon the silence." Mahatma Gandhi
Re: 2017 ACA plan previews
RE: Provider networks - I have a number of clients in Houston. None of the plans available on the individual market allow access to Texas Children's Hospital, MD Anderson, or Houston Methodist, which are the three major hospitals in the city. I am seeing this more and more every year. The networks are changing so much that I have just started telling clients they need to verify providers on their own, I simply don't have the time to do it anymore for every client.
Re: 2017 ACA plan previews
I can attest that men under 50 do get a "free" $20 flu shot. Woo hoo.Don Christy wrote: Here's a list of covered preventive services.
http://www.hhs.gov/healthcare/facts-and ... index.html
Not much else on that list that is of help unless you are already pretty unhealthy or at high risk for sexually transmitted diseases. Woo hoo.
JT
Re: 2017 ACA plan previews
Being too healthy to need much in the way of medical services is a good thing. Be grateful for your health while you have it.
Re: 2017 ACA plan previews
I did start to laugh before I started crying for humanity! Perhaps the ACA plan preview page should come with a warning now that reading the 2017 rates could trigger a cardiac event.BruDude wrote:If you want a good laugh, check out zip code 85382 (Phoenix). The only option is Ambetter which is a Medicaid-like company with small provider network. Rates...
Re: 2017 ACA plan previews
This is something I never considered when thinking about where to early retire. For early retirees who need to purchase individual insurance, where are the good locations, i.e., places where it is possible to purchase a plan with a large network?
Re: 2017 ACA plan previews
Wherever it is, it's going to change next year.Hayden wrote:This is something I never considered when thinking about where to early retire. For early retirees who need to purchase individual insurance, where are the good locations, i.e., places where it is possible to purchase a plan with a large network?
-
- Posts: 1479
- Joined: Wed Mar 23, 2016 9:28 am
- Location: SE Michigan
Re: 2017 ACA plan previews
Hayden, it's a great question. But any answers you get today, based on recent trends, will become meaningless in a year anyway. Many locales are experiencing shrinking policy options and shrinking provider networks. And then there is the potentially unpredictable impact of tax credits.Hayden wrote:This is something I never considered when thinking about where to early retire. For early retirees who need to purchase individual insurance, where are the good locations, i.e., places where it is possible to purchase a plan with a large network?
For example, as an early retiree in Southeast Michigan, we appear to have lots of plans (in our age brackets, 55-60, healthcare.gov shows 41 Silver plans). Sounds stellar, but most of this are minor derivations of identical plans. 8 different HMO policies from the same insurer in that 41 number are identical, except for size of provider network and small out of pocket limitations. There are only 3 PPO policies available for 2017 here, and those are virtually identical. Personally, 2017 changes have pushed us to switch from PPO to HMO (otherwise our net of credit costs would be up 40% for 2017). Even calling doctors offices to confirm accuracy of provider listings is rough - lots of errors and changes in getting these simple lists. We'll work through it, but I'm just saying that trying to pick an area that is likely to have a large network 3 years in the future is going to be worse than predicting market returns for the same period. Much worse. And believe me, I would love to be proven wrong. I would start packing the moving van next year.
The other thing that makes comparisons difficult, occurs when the tax credit is used (our case). That credit is determined on expected total medical expenses using the benchmark plan (2nd lowest Silver Plan). In theory, ACA will help defray large increases by higher credits. That is what our local newspapers are incorrectly saying this week. But in actual practice, our market has continually seen a single bottom-feeder type insurer offering a single low-priced "benchmark" policy for a given year. Then they leave the marketplace after 1 year, and somebody else comes in to do the exact same thing. The result - there is no accurate way to predict tax credit impact from year-to-year, at least until the insurer market gets past its learning curve and these benchmark rates stabilize.
I'm really interested in how others answer your question, but I think this whole process is too transitional to bank on any particular answers. At least for a while.
-
- Posts: 3909
- Joined: Sun Apr 03, 2016 5:41 pm
Re: 2017 ACA plan previews
Survey type question:
Several posters have commented that their options for 2017 are limited and much more expensive. Others have commented that they will have multiple options, some of which may end up cheaper. Do these experiences split evenly between states that are running their own exchanges vs states that left it up to the national exchange?
For example, here in Washington state (which runs its own exchange), there are 9 carriers with Silver plans, with 47 options. Before subsidies, monthly rates are in the $225-350 range with deductibles between $2,000 and $4,000. In Texas, by comparison where I used to live (no state exchange), there are 3 carriers with 18 plans. Before subsidies, $250 - 400 per month with similar deductibles.
Several posters have commented that their options for 2017 are limited and much more expensive. Others have commented that they will have multiple options, some of which may end up cheaper. Do these experiences split evenly between states that are running their own exchanges vs states that left it up to the national exchange?
For example, here in Washington state (which runs its own exchange), there are 9 carriers with Silver plans, with 47 options. Before subsidies, monthly rates are in the $225-350 range with deductibles between $2,000 and $4,000. In Texas, by comparison where I used to live (no state exchange), there are 3 carriers with 18 plans. Before subsidies, $250 - 400 per month with similar deductibles.
Re: 2017 ACA plan previews
I had sticker shock too. Prices up over 20% since last year and only 1 PPO option. And I live in Los Angeles. In one of the most populous places in the States and just one PPO option available. Like others talked about I took a look at other cities to see costs and they are lower than LA but since I have no idea what could happen in the future moving to get it seemed silly.
I buy direct from the company as rates on exchange and off (direct) are identical and I can't get any discount due to MAGI being too high.
I could go HMO to get lower rates - but I really don't like the idea of not being able to choose my own doctor should something bad happen. Ah well, being an early retiree does have some costs associated with it that were unplanned for at retirement.
I buy direct from the company as rates on exchange and off (direct) are identical and I can't get any discount due to MAGI being too high.
I could go HMO to get lower rates - but I really don't like the idea of not being able to choose my own doctor should something bad happen. Ah well, being an early retiree does have some costs associated with it that were unplanned for at retirement.
BH Contests: 23 #89 of 607 | 22 #512 of 674 | 21 #66 of 636 |20 #253/664 |19 #233/645 |18 #150/493 |17 #516/647 |16 #121/610 |15 #18/552 |14 #225/503 |13 #383/433 |12 #366/410 |11 #113/369 |10 #53/282
Re: 2017 ACA plan previews
TropikThunder wrote:Survey type question:
Several posters have commented that their options for 2017 are limited and much more expensive. Others have commented that they will have multiple options, some of which may end up cheaper. Do these experiences split evenly between states that are running their own exchanges vs states that left it up to the national exchange?
For example, here in Washington state (which runs its own exchange), there are 9 carriers with Silver plans, with 47 options. Before subsidies, monthly rates are in the $225-350 range with deductibles between $2,000 and $4,000. In Texas, by comparison where I used to live (no state exchange), there are 3 carriers with 18 plans. Before subsidies, $250 - 400 per month with similar deductibles.
I don't think you understand the problem. While some plans are becoming more expensive and some cheaper, all of the plans are seeing benefits deteriorate. ACA plans reimburse physicians and hospitals poorly. The better hospitals and physicians are or already have dropped these plans. I am located in a major city, and the Top 3 cancer hospitals do not take ACA listed plans. Regardless of me purchasing the best plan of 15+ available to me, I have 0 options that get me to better hospitals and physicians. I can't blame the physicians and hospitals as I have also dropped such plans from my practice.
ACA has severely damaged the quality of care available to self-employed individuals/families.
I am seriously considering starting a business with someone in the same boat as me, so that we could qualify for the better corporate policies. The purpose of the business would not be to make money, but to obtain quality insurance. Either that or my wife may need to get a job merely to get us decent insurance.
Enjoy life but save vigorously!
Re: 2017 ACA plan previews
You are lucky. I live in a Top 6 American city by population, and there are 0 PPO options.sperry8 wrote:I had sticker shock too. Prices up over 20% since last year and only 1 PPO option. And I live in Los Angeles. In one of the most populous places in the States and just one PPO option available.
Enjoy life but save vigorously!
Re: 2017 ACA plan previews
Number of plans in my area that include ANY of the three major hospitals AND are HSA eligible = 0Hayden wrote:My cost is going up significantly. But, that concerns me less than the narrowing of networks. My current plan is eliminating the three major hospitals in the state from its network.
I am trying to find a high deductible plan that has an excellent network. Easier said than done.
Number of plans in my area that include ANY of the three major hospitals AND are NOT HMO's = 0
Edit: Number of plans in my area that are NOT HMO's (regardless of providers) = 0
While an HMO offers most coverage for everyday ailments, I believe the real purpose of health insurance is for a catastrophic event, some as a rare cancer, etc. An HMO may cover some of the costs with such a catastrophic diagnosis, as was discussed in another thread, it will not cover special treatments, such as MD Anderson, etc.
So, are the policies available on the exchange the ONLY type available to individuals, or are there more individual policies, and possibly some PPO's, available through brokers if you don't care about subsidies?
Re: 2017 ACA plan previews
There are off exchange policies which don't offer subsidies. I have investigated these with a good broker before my state made being a good insurance broker non-economic(!). Basically, they are just slight variations of the exchange plans. Maybe you can tilt your coverage to be a little better for drugs/labs and a little worse for doctors visits, stuff like that, but nothing substantive. There are no PPO plans available to me at all and I checked all the individual carriers and small group ones too for my area. They had these before a couple years back and they all folded under the regulations and adverse selection / cost risks of the ACA. Many others are being shut down across the country. My bet is we're seeing the "Medicaid for the middle class" scenario play out as the insurers and healthcare providers have a race to the bottom in terms of trying to provide something that's at least breakeven. Good doctors and hospitals don't have to take low reimbursements, and won't. Insurers don't have to provide plans / coverage that lose them money, so they won't. This will take a few years to figure out, but we're getting there quickly.Saving$ wrote:So, are the policies available on the exchange the ONLY type available to individuals, or are there more individual policies, and possibly some PPO's, available through brokers if you don't care about subsidies?
Re: 2017 ACA plan previews
I would happily pay your business overhead costs to join your company if you figure this out (seriously! I'm healthy too ). I am also looking into this. Feel free to PM me if you want to share experiences.mcfroggin wrote:i am seriously considering starting a business with someone in the same boat as me, so that we could qualify for the better corporate policies. The purpose of the business would not be to make money, but to obtain quality insurance. Either that or my wife may need to get a job merely to get us decent insurance.
Re: 2017 ACA plan previews
So the off exchange plans (without subsidy) might have a slightly different premium, co-pay, etc, but if they don't offer PPO plans on the exchange the chances are an individual does not have the option to buy one? This is almost (not quite) as bad as before the ACA - at least back then if you did not meet the underwriting guidelines you could buy what seemed like a ridiculously high cost PPO in a state high risk pool. I'm guessing those premium costs are similar to the current cost of a PPO, if they offered it. At least now there is no underwriting, and there are "lower" cost options available, but the trade off is no full coverage PPO's available...Tanelorn wrote:There are off exchange policies which don't offer subsidies. I have investigated these with a good broker before my state made being a good insurance broker non-economic(!). Basically, they are just slight variations of the exchange plans. Maybe you can tilt your coverage to be a little better for drugs/labs and a little worse for doctors visits, stuff like that, but nothing substantive. There are no PPO plans available to me at all and I checked all the individual carriers and small group ones too for my area. They had these before a couple years back and they all folded under the regulations and adverse selection / cost risks of the ACA. Many others are being shut down across the country. My bet is we're seeing the "Medicaid for the middle class" scenario play out as the insurers and healthcare providers have a race to the bottom in terms of trying to provide something that's at least breakeven. Good doctors and hospitals don't have to take low reimbursements, and won't. Insurers don't have to provide plans / coverage that lose them money, so they won't. This will take a few years to figure out, but we're getting there quickly.Saving$ wrote:So, are the policies available on the exchange the ONLY type available to individuals, or are there more individual policies, and possibly some PPO's, available through brokers if you don't care about subsidies?
I don't get the logic of not offering any PPO plans. They offer a wide range of premiums. Surely they could offer a PPO on the upper end of the cost that would at least provide those willing to pay with the PPO option?? What is the logic of just not offering the option, even if only in the private market?
Re: 2017 ACA plan previews
Well it can't hurt to check as insurance now is all very state and local region dependent. However, PPOs are increasingly hard to find and if there aren't any on the exchange, it doesn't bode well for finding one off the exchange. Good luck!Saving$ wrote:So the off exchange plans (without subsidy) might have a slightly different premium, co-pay, etc, but if they don't offer PPO plans on the exchange the chances are an individual does not have the option to buy one?
That's the economics of guaranteed coverage. While you might think they could just charge a bit more, the problem is that if you offer very good doctors and very good care networks via a PPO that aren't offered elsewhere, then almost 100% of the very sick people will buy that plan and the people like you or me who are pretty healthy but want a good choice just in case are a very small fraction of the pool. If say half the people were very sick and half weren't, you'd have to price the PPO premium to be half the cost of care for a very sick person. At that point, it wouldn't be worth it for you or I to pay ~$50k/year in premiums so we'd stop buying it. Now they'd lose money and have to reprice it to 100% of the cost of a really sick person. Since the regulators won't approve those giant premiums, these plans lose money while they exist until the insurance company decides to close them.I don't get the logic of not offering any PPO plans. They offer a wide range of premiums. Surely they could offer a PPO on the upper end of the cost that would at least provide those willing to pay with the PPO option?? What is the logic of just not offering the option, even if only in the private market?
That's why I say the incentives of the ACA have created this race to the bottom in terms of quality of care. There's a floor in that the sufficiently poor people who get big subsidies and will buy the basic plans regardless of their health, sick or not, since the plans are basically free (to them, not to the taxpayer). At that point, you've got a mixed enough group that you can have risk pooling and insurance be economic again. But that level of care is whatever the regulators are willing to budget for and if the increases don't keep pace with healthcare cost inflation, as they haven't, some combination of the insurance shareholders and the quality of care have to lose out for the difference.
Re: 2017 ACA plan previews
Can a one-person business purchase a small business policy? Are there small business policies that are better than those available on the individual market?Tanelorn wrote:I would happily pay your business overhead costs to join your company if you figure this out (seriously! I'm healthy too ). I am also looking into this. Feel free to PM me if you want to share experiences.mcfroggin wrote:i am seriously considering starting a business with someone in the same boat as me, so that we could qualify for the better corporate policies. The purpose of the business would not be to make money, but to obtain quality insurance. Either that or my wife may need to get a job merely to get us decent insurance.
-
- Posts: 284
- Joined: Sun Jan 04, 2015 8:42 pm
Re: 2017 ACA plan previews
There is sticker shock in some areas, but people forget that employer based single coverage can easily cost $5-7k per year when you count employer contribution.
And you really can't compare them, at all, to individual plans that were pre-ACA; the plan can't drop you when you get sick because of technicalities or failure to disclose all pre-existing "conditions" no matter how minor. I used to call those old individual plans "ghost insurance" - they'd disappear when people tried to use them!
And you really can't compare them, at all, to individual plans that were pre-ACA; the plan can't drop you when you get sick because of technicalities or failure to disclose all pre-existing "conditions" no matter how minor. I used to call those old individual plans "ghost insurance" - they'd disappear when people tried to use them!
Re: 2017 ACA plan previews
We are in Tennessee which is one of the states where the premiums went up over 50% but you cannot really compare apples to apples because for 2016 we had an option of 30+ health plans to choose from. In 2017 we have 4 plans offered and our plan was discontinued. Only plans available BCBS are 1 Bronze, 2 Silver and 1 Gold with premiums ranging from 1757/month to 3765/month for 2 people. Not too bad huh? 15,000 deductible and all plans NOW pay at 50% after the deductible is met except the Gold plan which is 3258/month. Not only are the premiums not affordable but the benefits have been cut to the bone.DetroitRick wrote:Hayden, it's a great question. But any answers you get today, based on recent trends, will become meaningless in a year anyway. Many locales are experiencing shrinking policy options and shrinking provider networks. And then there is the potentially unpredictable impact of tax credits.Hayden wrote:This is something I never considered when thinking about where to early retire. For early retirees who need to purchase individual insurance, where are the good locations, i.e., places where it is possible to purchase a plan with a large network?
For example, as an early retiree in Southeast Michigan, we appear to have lots of plans (in our age brackets, 55-60, healthcare.gov shows 41 Silver plans). Sounds stellar, but most of this are minor derivations of identical plans. 8 different HMO policies from the same insurer in that 41 number are identical, except for size of provider network and small out of pocket limitations. There are only 3 PPO policies available for 2017 here, and those are virtually identical. Personally, 2017 changes have pushed us to switch from PPO to HMO (otherwise our net of credit costs would be up 40% for 2017). Even calling doctors offices to confirm accuracy of provider listings is rough - lots of errors and changes in getting these simple lists. We'll work through it, but I'm just saying that trying to pick an area that is likely to have a large network 3 years in the future is going to be worse than predicting market returns for the same period. Much worse. And believe me, I would love to be proven wrong. I would start packing the moving van next year.
The other thing that makes comparisons difficult, occurs when the tax credit is used (our case). That credit is determined on expected total medical expenses using the benchmark plan (2nd lowest Silver Plan). In theory, ACA will help defray large increases by higher credits. That is what our local newspapers are incorrectly saying this week. But in actual practice, our market has continually seen a single bottom-feeder type insurer offering a single low-priced "benchmark" policy for a given year. Then they leave the marketplace after 1 year, and somebody else comes in to do the exact same thing. The result - there is no accurate way to predict tax credit impact from year-to-year, at least until the insurer market gets past its learning curve and these benchmark rates stabilize.
I'm really interested in how others answer your question, but I think this whole process is too transitional to bank on any particular answers. At least for a while.
It gets better. BCBS has managed to cut benefits where this is more like an HMO instead of a PPO plan. The main hospital in our area is not covered and only 2 out of 6 of our doctors are in the ACA for 2017. The mammogram facility is not covered. The only drug prescribed is not covered.
Until I read DetroitRick's post I assumed we would have access to the same hospitals and doctors that are currently under the ACA for 2016. His post made me research the ACA health plans fine details. Many of the Dr's and hospitals are running from Obamacare just like the insurance companies.
We don't know what we are going to do since paying an annual premium of 21,000 is outrageous for very limited care. We were planning to retire this year but now are looking at other options.
Last edited by cricket49 on Wed Oct 26, 2016 8:02 am, edited 1 time in total.
Expect the best. Prepare for the worst.