What A Deal! [Affordable Care Act policy costs]

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athan
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What A Deal! [Affordable Care Act policy costs]

Post by athan » Sat Oct 27, 2018 1:20 pm

Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?

Jazzysoon
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Re: What A Deal!

Post by Jazzysoon » Sat Oct 27, 2018 1:28 pm

I think it depends on how much healthcare you use in a year. A friend has RA and her weekly shot to manage that condition is $7,000, just shot, not any clinic staff related time. So that is $364,000 of services she is getting for less than her group plan of $6,000 year premium. She has also has severe migranes which also causes her to incur additional treatments on a recurring basis.

FrogPerson
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Re: What A Deal!

Post by FrogPerson » Sat Oct 27, 2018 2:09 pm

Well, $17,000 is one minor hospital admission, one slightly complicated ER visit. One MVA, one illness, one surgery. My spouse was medivaced and hospitalized 50 days, 17 in ICU on a ventilator due to a very very reaction to a flu vaccine. Medical bills topped $750,000. Our child has an orthopedic birth defect. 22 surgeries and a leg he climbs mountains on that cost over $1 million - insurance covered all but about $200,000 in deductibles, co-pays and expenses not covered. Our family policy is about $21,000 a year. It is a deal and we'd have been bankrupt many times without it.

BanquetBeer
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Re: What A Deal!

Post by BanquetBeer » Sat Oct 27, 2018 5:06 pm

Lol, I know y’all are trying to show that medical is worth it but you’re also advertising where their money is going.

We pay in, don’t mind helping those who are unfortunate medically. Who knows if we will be in the future? That’s why it is insurance - nobody wants to pay for others and nobody wants to pay it alone when they get ill.

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bottlecap
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Re: What A Deal!

Post by bottlecap » Sat Oct 27, 2018 6:51 pm

Well then, I guess we all ought to pay $15,000 a year for car insurance, because a minor car accident could result in those expenses easily.

JT

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Watty
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Re: What A Deal!

Post by Watty » Sat Oct 27, 2018 7:46 pm

athan wrote:
Sat Oct 27, 2018 1:20 pm
and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option)
For perspective that is $4,250 a year($354 a month) per person for the coverage.

After I retired I used COBRA for a while and that was around $500 a month per person.

I am not getting medicare yet but that $354 a month is less than we pay for my wife's medicare supplement, part B premium, and the part D drug supplement combined. The Medicare coverage is better than the high deductible plan but we had both paid payroll deductions into the Medicare system for 35+ years while we were working.

TravelGeek
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Re: What A Deal!

Post by TravelGeek » Sat Oct 27, 2018 9:57 pm

athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
I am continuing my employer-provided insurance via COBRA at the moment. I am paying $1450 per month for two people. Wanna trade? :) :shock: :)

As you probably know, COBRA is 102% of the cost to the employer (2% for admin costs). In other words, my former employer was charged this amount while I was employed.

Bottom line: the cost of healthcare and the cost of insurance for healthcare is high in the US. Ranting isn't going to change that, and discussions about possible remedies is likely off topic for this forum.

Jb526
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Re: What A Deal!

Post by Jb526 » Sat Oct 27, 2018 10:22 pm

Congratulations on the savings!

My situation turns out to be the opposite, at least from what I can tell. I was able to view renewal paperwork which has already posted to the health plan marketplace website, and my premium is increasing next year if I allow it to renew into the same exact plan. However, when I browse this plan on the marketplace site without signing in to my account, the premium shown is cheaper, about what I pay currently. I'm wondering if the renewal premiums are automatically increased, essentially penalizing a policy holder for being an existing customer. :confused

I was also hoping for better selection when it comes to HSA-eligible plans. Using my own personal criteria, the site presents me with a generous list of over 20 plans, but when I narrow it down to plans that are eligible for an HSA, I'm offered only a single plan from which to choose. That certainly narrows things down.

Hopefully a call to customer service can clear this up. I really don't want to switch insurers, as I've been very pleased with the one I have currently.

sawhorse
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Re: What A Deal!

Post by sawhorse » Sun Oct 28, 2018 1:25 am

athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
That's about $350 per person per month. You'd be hard pressed to find a PPO, either employer or individual, that costs less. In fact you'd be hard pressed to find an HMO that affordable.
Last edited by sawhorse on Sun Oct 28, 2018 1:38 am, edited 1 time in total.

sawhorse
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Re: What A Deal!

Post by sawhorse » Sun Oct 28, 2018 1:30 am

Jazzysoon wrote:
Sat Oct 27, 2018 1:28 pm
I think it depends on how much healthcare you use in a year. A friend has RA and her weekly shot to manage that condition is $7,000, just shot, not any clinic staff related time. So that is $364,000 of services she is getting for less than her group plan of $6,000 year premium. She has also has severe migranes which also causes her to incur additional treatments on a recurring basis.
Prescription drugs are a major reason healthcare costs so much in the United States. $364k per year is insane. The same injection probably costs 1/5 of that in another country.

It's great that she was approved for such an expensive injectable biologic. I was denied a daily injectable that costs about $1000 per week. I would seriously consider traveling to another country if it wasn't so suspicious to carry a ton of vials and needles through customs.

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midareff
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Re: What A Deal!

Post by midareff » Sun Oct 28, 2018 7:26 am

Wife's and my coverage for insurance will be $13,952 this coming year, + however much my Medicare goes up, and there's no Dental in that. I expect after drugs and co-pays will be about $21K for the year, assuming no dental surprises. FWIW, I have wet macular and the drug they use is about $4K a shot, roughly ten times yearly. Been treated for prostate cancer to the tune of $170K, my cost was $80.
Insurance only costs a lot if you are still alive.

staythecourse
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Re: What A Deal!

Post by staythecourse » Sun Oct 28, 2018 8:28 am

FrogPerson wrote:
Sat Oct 27, 2018 2:09 pm
Well, $17,000 is one minor hospital admission, one slightly complicated ER visit. One MVA, one illness, one surgery. My spouse was medivaced and hospitalized 50 days, 17 in ICU on a ventilator due to a very very reaction to a flu vaccine. Medical bills topped $750,000. Our child has an orthopedic birth defect. 22 surgeries and a leg he climbs mountains on that cost over $1 million - insurance covered all but about $200,000 in deductibles, co-pays and expenses not covered. Our family policy is about $21,000 a year. It is a deal and we'd have been bankrupt many times without it.
Correct. These plans are meant as catastrophic plans. The deductible is high as you cover normal stuff, but one big issue and it is piece of mind knowing the max you will pay is you deductible limit.

I have a normal family plan as an inidividual plan through BCBS which I grandfathered in and is no longer even offered since ACA. I have already twice hit the max deductible (10k) for the family. Kid had RSV pneumonia at 18 months and this year as we are doing some GI workup for some GI issues. It is piece of mind that health care will never cost me more then 10k in any year (of course that is on top of my premiums).

Good luck.
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munemaker
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Re: What A Deal! [Affordable Care Act policy costs]

Post by munemaker » Sun Oct 28, 2018 8:58 am

athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
OP, since you are no longer legally required to have ObamaCare, you truly DO have the option. I am curious as to whether you have been actually buying such policies or just stirring the pot.

By keeping out taxable income down, we paid $1,600/year total. This includes my wife and I combined. This was for a silver plan with zero deductible; there are copays, of course. It is a very good plan and I feel like we are getting a deal.

Stormbringer
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Re: What A Deal!

Post by Stormbringer » Sun Oct 28, 2018 9:10 am

sawhorse wrote:
Sun Oct 28, 2018 1:30 am
Prescription drugs are a major reason healthcare costs so much in the United States.
It's definitely worth shopping around. I was prescribed blood pressure pills last year. The brand name was $10 a pill. Walgreens sells 30 generic tablets for $90. Costco is $13.67 for 90 tablets -- so cheap that it isn't even worth putting it on my insurance.
"Compound interest is the most powerful force in the universe." - Albert Einstein

Cpadave
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Re: What A Deal! [Affordable Care Act policy costs]

Post by Cpadave » Sun Oct 28, 2018 10:07 am

Our cheapest option for 2019 is now 19K for family of 4. It was 17K in 2018. They really need to fix this problem.

michaeljc70
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Re: What A Deal! [Affordable Care Act policy costs]

Post by michaeljc70 » Sun Oct 28, 2018 10:53 am

For us (both in our 40s in IL) the cheapest plan went up about 7% and the plan we are on (it appears, I haven't compared every detail) is going up 10%. There are only 25 plans available from 3 insurers, down from 27 plans this year. The most expensive plan is $1340 with a $750 individual deductible and a $7900 individual out of pocket max. So, if we went with that plan and both had anything beyond a minor issue we'd be looking at around $32k in costs ($1340x12+$7900+$7900).

boglesmind
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Re: What A Deal!

Post by boglesmind » Sun Oct 28, 2018 10:59 am

Watty wrote:
Sat Oct 27, 2018 7:46 pm
athan wrote:
Sat Oct 27, 2018 1:20 pm
and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option)
For perspective that is $4,250 a year($354 a month) per person for the coverage.

After I retired I used COBRA for a while and that was around $500 a month per person.

I am not getting medicare yet but that $354 a month is less than we pay for my wife's medicare supplement, part B premium, and the part D drug supplement combined. The Medicare coverage is better than the high deductible plan but we had both paid payroll deductions into the Medicare system for 35+ years while we were working.
+1. Great perspective.

Boglesmind

boglesmind
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Re: What A Deal!

Post by boglesmind » Sun Oct 28, 2018 11:13 am

TravelGeek wrote:
Sat Oct 27, 2018 9:57 pm
athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
I am continuing my employer-provided insurance via COBRA at the moment. I am paying $1450 per month for two people. Wanna trade? :) :shock: :)

As you probably know, COBRA is 102% of the cost to the employer (2% for admin costs). In other words, my former employer was charged this amount while I was employed.

Bottom line: the cost of healthcare and the cost of insurance for healthcare is high in the US. Ranting isn't going to change that, and discussions about possible remedies is likely off topic for this forum.
+1. Too many people want free lunch (i.e. at the cost of the rest)

We are paying $1300/month for 2 for COBRA coverage. $650/month per person vs. $354 that OP claims to pay. OP indeed has a great deal.

Boglesmind

michaeljc70
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Re: What A Deal!

Post by michaeljc70 » Sun Oct 28, 2018 11:16 am

boglesmind wrote:
Sun Oct 28, 2018 11:13 am
TravelGeek wrote:
Sat Oct 27, 2018 9:57 pm
athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
I am continuing my employer-provided insurance via COBRA at the moment. I am paying $1450 per month for two people. Wanna trade? :) :shock: :)

As you probably know, COBRA is 102% of the cost to the employer (2% for admin costs). In other words, my former employer was charged this amount while I was employed.

Bottom line: the cost of healthcare and the cost of insurance for healthcare is high in the US. Ranting isn't going to change that, and discussions about possible remedies is likely off topic for this forum.
+1. Too many people want free lunch (i.e. at the cost of the rest)

We are paying $1300/month for 2 for COBRA coverage. $650/month per person vs. $354 that OP claims to pay. OP indeed has a great deal.

Boglesmind
I think everyone knows that overall kids consume a lot less healthcare than older people. I don't think it is a fair comparison.

Big Dog
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Re: What A Deal! [Affordable Care Act policy costs]

Post by Big Dog » Sun Oct 28, 2018 11:28 am

since you are no longer legally required to have ObamaCare,
Small nit: technically, enrolling in an approved medical plan is still required (depending on employer size). However, the tax penalty for non-compliance has been eliminated. (That's the gist of the current law suit against the ACA.)

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aspirit
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Re: What A Deal! [Affordable Care Act policy costs]

Post by aspirit » Sun Oct 28, 2018 11:32 am

Cpadave wrote:
Sun Oct 28, 2018 10:07 am
Our cheapest option for 2019 is now 19K for family of 4. It was 17K in 2018. They really need to fix this problem.
Isn't it wonderful though that some families of 4 get health insurance for free.
I too see this as unreasonable & unsustainable, particularly if the population grasps the inequity.
Time & tides wait for no one. A man has to know his limitations.

aqan
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Re: What A Deal! [Affordable Care Act policy costs]

Post by aqan » Sun Oct 28, 2018 11:34 am

IMO You definitely need the catastrophic coverage for the worst case scenario. If you really don’t need any regular checkups etc, I’d go with the cheapest high deductible plan. If that happens to be 17K, so be it. At least its tax deductible :mrgreen:

Another option I’ve heard on this forum is to get the non working spouse a part time job at Starbucks, that will get you a cheaper health insurance:) not sure if that’s applicable in your situation but just wanted to put it out there.

michaeljc70
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Re: What A Deal! [Affordable Care Act policy costs]

Post by michaeljc70 » Sun Oct 28, 2018 11:44 am

aqan wrote:
Sun Oct 28, 2018 11:34 am
IMO You definitely need the catastrophic coverage for the worst case scenario. If you really don’t need any regular checkups etc, I’d go with the cheapest high deductible plan. If that happens to be 17K, so be it. At least its tax deductible :mrgreen:

Another option I’ve heard on this forum is to get the non working spouse a part time job at Starbucks, that will get you a cheaper health insurance:) not sure if that’s applicable in your situation but just wanted to put it out there.
If you are self employed or they are more than 7.5% of AGI. That is going to 10% in 2019.

sawhorse
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Re: What A Deal!

Post by sawhorse » Sun Oct 28, 2018 1:46 pm

michaeljc70 wrote:
Sun Oct 28, 2018 11:16 am
boglesmind wrote:
Sun Oct 28, 2018 11:13 am
TravelGeek wrote:
Sat Oct 27, 2018 9:57 pm
athan wrote:
Sat Oct 27, 2018 1:20 pm
Just checked the Affordable Care Act website, and my family of 4 will have the option of paying $17,000/year for a high deductible PPO (2018 cheapest option), compared to $21,000/year last year for an HMO (2017 cheapest option).

I feel like I'm getting a deal!

Anyone else ever feel like they are getting a deal, even though they know deep down they are getting ripped off?
I am continuing my employer-provided insurance via COBRA at the moment. I am paying $1450 per month for two people. Wanna trade? :) :shock: :)

As you probably know, COBRA is 102% of the cost to the employer (2% for admin costs). In other words, my former employer was charged this amount while I was employed.

Bottom line: the cost of healthcare and the cost of insurance for healthcare is high in the US. Ranting isn't going to change that, and discussions about possible remedies is likely off topic for this forum.
+1. Too many people want free lunch (i.e. at the cost of the rest)

We are paying $1300/month for 2 for COBRA coverage. $650/month per person vs. $354 that OP claims to pay. OP indeed has a great deal.

Boglesmind
I think everyone knows that overall kids consume a lot less healthcare than older people. I don't think it is a fair comparison.
It's fair to compare it to COBRA/employer family plans. When employers, at least the ones I'm familiar with, offer plans, they don't charge you based on age. You'd be hard pressed to find an employer family PPO plan that costs less than athan's plan.

For what it's worth, $354 a month is less than I paid in the mid-2000s in my early 20s for an employer plan COBRA with 50% coinsurance.

randomguy
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Re: What A Deal!

Post by randomguy » Sun Oct 28, 2018 2:03 pm

sawhorse wrote:
Sun Oct 28, 2018 1:46 pm


It's fair to compare it to COBRA/employer family plans. When employers, at least the ones I'm familiar with, offer plans, they don't charge you based on age. You'd be hard pressed to find an employer family PPO plan that costs less than athan's plan.

For what it's worth, $354 a month is less than I paid in the mid-2000s in my early 20s for an employer plan COBRA with 50% coinsurance.
The comparison by dividing the plan cost by 4 isn't really fair but the high level point of insurance cost ~20k/year for a family of 4 is correct. It doesn't matter if you are getting your plan from an employer or ACA that is in the ball park (cheap plans might be 15k and expensive ones 25k with some regional adjustments) but health is expensive and has been for a couple decades now. It just isn't anywhere as near in your face when your employer is paying half of it.

As far as making this actionable, is there anything you can do other than move somewhere else in the US that has lower rates or live without health insurance? Not that I am aware. You could go with something like health sharing but that isn't health insurance and I have a feeling that they will dump you when you get a 300k/year condition. I will let you decide if it is moral or not to buy health insurance later if you go that route.

bling
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Re: What A Deal! [Affordable Care Act policy costs]

Post by bling » Sun Oct 28, 2018 2:22 pm

wow....is 17k normal for an ACA plan? my employer is doing annual enrollment right now, and our HDHP plan is almost 3x cheaper.

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dm200
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Re: What A Deal! [Affordable Care Act policy costs]

Post by dm200 » Sun Oct 28, 2018 2:24 pm

There continue to be a lot of differences from one state to another.

sawhorse
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Re: What A Deal! [Affordable Care Act policy costs]

Post by sawhorse » Sun Oct 28, 2018 2:56 pm

bling wrote:
Sun Oct 28, 2018 2:22 pm
wow....is 17k normal for an ACA plan? my employer is doing annual enrollment right now, and our HDHP plan is almost 3x cheaper.
How much is your employer paying? I can't imagine a health plan for 4 people costing $6k per year.

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Re: What A Deal! [Affordable Care Act policy costs]

Post by LadyGeek » Sun Oct 28, 2018 3:57 pm

This thread has run its course and is locked (not actionable). General comment threads are off topic in the forums with "Personal" in the title. See: A reminder that non-investing general comment threads are OT
- It must be personal. In other words, you must be asking about your own situation. You can also ask on behalf of someone specific, such as a family member.

- It must be actionable. You must be able to do something specific with the replies that will make a difference in your situation.
If you have a specific question, please ask directly and provide sufficient information for members to supply appropriate advice.
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