Yes, we are also charged overhead costs when we visit medical centers that assess such costs, even if we only see the providers in their office and don’t use any of the facilities. Insurer pays these fees and says they are fine. I pay my copay which generally doesn’t include those fees.
Today, 5 days into the enrollment period, I got a letter from our insurance company letting me know what the plan will cost next year. The amount is DOUBLE what I was charged this year. Double. This is an ACA plan. Except that the word Affordable hardly applies. We are looking at over $2000 a month to cover my husband and myself.
@bookreader Are you in a rural area or urban area?
The sacrificial lambs of this plan are starting to feel the heat and pain. I has always been the plan to carry the costs on the backs of unsubsidized individuals - those with a sense of responsibility who will carry coverage come hook or crook and small family businesses.
Now, the ACA reinsurance fund is underfunded. There are lawsuits by insurance companies who have not been paid the guaranteed funds to help them cover their costs incurred by the ACA mandate.
It’s going to get worse. There are still a small number of grandfathered/grandmothered plans in place. We still have ours. Now, our current plan is completely ACA compliant and it is obviously profitable for BS or they would have taken the opportunity to cancel. Next year, the law says the grandmothered plans must go. So, more small family businesses kicked into the individual market…of course the are needed to carry the costs.
http://www.modernhealthcare.com/article/20151001/NEWS/151009996
Someone has to makeup the $2.5 shortfall…Looks like a “big thank you” is due to all those force into an unsubsidized individual market plan.
Oh…and who wants to bet the cadillac tax never ever gets implemented. All the unions are fighting it’s implementation, (you can draw your own political conclusions). So, again a supposed funding source has simply not materialized.
Really, what did ya all expect? There’s no free lunch…it might appear free if you are being hosted…but someone…somewhere pays. This is what happens when you act before thinking…because the appearance of action has short term benefits and you hope the short attention span of our general populace will work in your favor by the time the poo hits the fan.
I’m the OP of this thread…and inwould like to see it stay open…so I’m going to politely ask that you keep,your politics OUT of this discussion. Please.
I specifically did not go into politics…hence the ‘draw your own conclusions’ comment. Where in the comment did I discuss politics? Mathematics maybe, but not politics.
Don’t forget to shop again on the ACA marketplace to see what other options you have. I can move into a new plan for 2017 with the same provider for similar terms at less money than the “renewal” I got in the mail.
DD just went in to review her options since her provider informed her that her previous plan is no longer covered and would cost a lot more outside the marketplace. Using her last year’s income she would make too much for Medicaid and too little for a subsidy. Her insurance would actually cost more than the plans available for people who made more. Since VA did not sign on to the extended Mediciad there is definitely a doughnut hole. She recalculated her income to include a new data for her current jobs and she just squeaked over the lower limit for a subsidy. So now she has a sliver plan much better than her previous catastrophic plan for a lot less. Crazy thing though, when her income was too low for the subsidy she could not sign up for that plan at all. The ones she could get in the ACA marketplace cost more than the unsubsidized silver. The numbers are nuts.
@Midwest67 - I live in the suburbs. Neither urban or rural.
It is really distressing to read about the amounts people are paying for their health care.
One of the things we did with our D when she was getting insurance off the exchange and not making much was to monitor the amount she put in an IRA. We could swing her income and increase her subsidy. Or when our state had a minimum income for health care make sure she met this by not putting money in an IRA.
If you have a 401k and no employer health care you could try and reduce your income by even more.
As usual, its a numbers game.
An overview of increases
As noted before (#193), most people are not aware of how much medical care actually costs, because it is typically hidden behind insurance coverage, which is usually mostly paid for behind the scenes by their employer (or the government in the case of Medicare).
For people who receive medical insurance through their employers, it may be interesting to find out how much you employer pays for the medical insurance it gives you as part of the benefit package (in addition to what you pay from payroll deductions). At the very least, it will be less of a surprise if you end employment there and pay for a COBRA plan or other plan that you have to pay for yourself.
We have not had employer-based insurance since our kids were wee babies, and they are both in college now.
H & I have been buying health insurance out on the open market for years. We were lucky in that we were not burdened by pre-existing conditions, have not had a serious illness to contend with, and we were able to buy health insurance for ourselves and the kids year after year.
We would opt for high deductible plans in exchange for lower premiums. Some of the plans would allow x amount of doctor visits at a co-pay. We never had a serious illness, so we did not have to test that $10K deductible. But, we felt like we had money leftover to pay for the dentist and to pay for vision, which were not covered under the health insurance plan.
Now, the health insurance plans are so expensive, and the out of pocket costs (co-pays and deductibles) are so high, that it’s like having a mortgage on a second home. And, it’s still extra to get ourselves dental and vision care.
Not. happy.
I paid cobra for my d when she aged out of our insurance and ACA had not been passed. Thank goodness for both the cobra and then ACA otherwise she was uninsurable in her early 20’s. And yes it was expensive.
I don’t know what the answer is but I know what it isn’t.
Affordable health care should not be just for those who are lucky enough to have employee group health insurance.
Just bcos an employer pays 60, 70, or 80% of the costs, does not make the medical costs any lower, i.e., “affordable”, as those costs are just part of employee compensation. For example, our 80% PPO plan costs a total of $1780/mo ($22,000/yr) for family coverage, of which a portion is paid by the employees.
A different way to look at that number is as a % of wage/salary. For someone making say, $60k, that is over a one-third increase in labor costs. Of course, this is no different that that paid by small business, which we are.
Same as Midwest. No employee health coverage for the past 20 years. But before we could still afford the premiums with reasonable but somewhat higher deductibles. As self-employed we can go months with no or low income. 1900 a month is not going to be possible - and it feels like there is no incentive to remain self employed/keep a small family business going.
pschmomma, if you have low income it is very possible that it is profitable to stop working and go on welfare, including medicaid. if it does not bother you do the math and maybe go for the OPM option. (other people’s money)
Yes, this is a significant competitive disadvantage for American labor compared to, for example, Canadian labor. Both the US and Canada have similar government spending on health care as a percentage of GDP, but private spending (mostly by employers) on health care is substantially higher in the US than Canada. (And this has been the case for years, both pre-ACA and post-ACA – ACA did not cause this problem, but did not solve it either.)
Looking at my employer’s plans for 2017, the employee contributions, and the claimed percentage that the employer pays, the total cost (employer + employee) seems to range from $7,000 to $11,000 for just the employee, and $17,000 to $23,000 for the employee and family. The high end is a PPO plan, while the low end is a high deductible PPO plan with HSA.
Our current policy was canceled, and the replacement policy will cost $400 per more per month, and have a deductible twice the size of the old one. Since the Affordable Care Act passed, our premiums have gone up by more than $10,000, and the deductible has gone through the roof, and this is for a healthy family with minimal medical claims.
Here is an article in Forbes about some impacts of the law.