@TatinG FYI We currently pay over $1,100 a month for a bronze plan with a $6,500 per person/$13,000 family deductible. The health share quote I got was for one less person (my son will be moving to an employer sponsored plan) and was $710/month for 2018.
“Health sharing ministries are ACA compliant in the sense that they count as insurance. However, they don’t cover the essential benefits.”
@“Cardinal Fang” Educate me. How can it be considered compliant without covering the essential benefits? Maybe it is semantics but I feel like I’m missing something here.
By law, people who get their insurance through health sharing ministries are exempt from the individual mandate. That is, they comply with the ACA.
Next year I will be paying over $800 per month for a single individual. I am thinking of rolling the dice and opting out.
We’re too concerned about getting wiped out financially should one of us get cancer, have a stroke/heart attack, etc. to not have insurance, but with ridiculous premiums it sure is tempting.
“By law, people who get their insurance through health sharing ministries are exempt from the individual mandate. That is, they comply with the ACA.”
So, is it basically a loophole built into ACA to based on lobbying from certain corners. I really wasn’t aware of this before so interesting.
https://www.nytimes.com/2016/12/10/opinion/sunday/should-i-lie-about-my-beliefs-to-get-health-insurance.html
https://www.buzzfeed.com/lauraturner/christian-health-care?utm_term=.sog9llQDb#.fmL0wwWPx
Oh brother…yes…he got a subsidy for his premiums last year…income will be the same…$42,000 for the year…or so.
So…guessing he should keep his Silver plan…right? Unless for some oddball reason the Gold is less costly.
Yes…DD is not in an expansion state. She can’t get a subsidy because her income is too low. So…she buys Direct,y from the company. The question this year will be…which company…Kaiser or Ambetter. This is GA…and Ambetter is new to the market in her area. I’d love some opinions on Ambetter.
@thumper1, I doubt that Silver would be right for your son. The situation in Arizona is complicated for people who get subsidies. He needs to look at different metal levels from different vendors. There will be bad deals and good deals for him. Probably Silver would be a bad deal.
I know more and more people, mostly small self-employed people, moving to the health sharing ministries. So far, they have been pretty happy with them.
One of them gave me the brochure and I didn’t recall the attending religious services regularly part, but maybe I missed it. Most of the people I know using it wouldn’t be adverse to signing a statement of faith, etc.
For the most part, this pool of people were the ones previously buying on the individual market and paying for childbirth out of pocket. They had lower premiums for large deductibles and were used to absorbing the smaller costs or negotiating cash payments with doctors.
I also have more people just plain opting out and taking the penalty and the gamble. The networks and choices here are far too narrow and premium increases were high–sigh, I know, probably the same everywhere.
Do you know anyone who has moved to the health sharing ministries and then had a big claim?
No, not yet on big claims. That is why I said “so far…”. Then again, I’ve known people on group insurance who have had long, protracted battles for things that were covered, or even things that were pre-authorized…in writing…on multiple occasions. That would be my data point of one–ME!
@“Cardinal Fang” then what did you mean by this?
So the health insurance company I’ve been contracting with pulled the trigger on a bunch of layoffs on Friday, and let a lot of their contractors go as well. I heard from someone in management that they’d had 2 plans – 1 if the subsidies stayed, and 1 if they didn’t (no layoffs with the first plan). With healthcare at 1/6 of the economy, the subsidy cut could increase unemployment.
@thumper1, If his income stays the same, but the unsubsidized premium for the reference Silver goes up, then his subsidy goes up by the same amount. He can use that subsidy on any plan.
It’s confusing, I know, but for a subsidized person with a specific income, there is a specific price (a specific maximum percentage of their income) that they pay for the reference Silver, and whatever the reference Silver costs above that price is what the person gets for their subsidy.
Let’s say for someone who makes $42K, the max is $280 (it’s not, but it’s something like that). But let’s say in 2017 the reference Silver plan, the second-cheapest plan, actually has a premium of $380. Then the person’s subsidy would be $100. They could have bought the reference Silver for the $280, or applied the $100 subsidy to buy a cheaper plan or a more expensive plan.
Now they’re shopping for 2018. Their income is still $42K, so their max for the reference Silver is still $280. But now, prices have gone up. Now the reference Silver costs $480. Now instead of a $100 subsidy, they have a $200 subsidy. They could buy the reference Silver for $280 as before, or they could use that $200 subsidy for a different plan.
So…I need to have him cost it all out…with gold and silver…and see.
Luckily…there is only one vendor to deal,with…and I think they only have one of each metal olan…or maybe two. Not a,lot of comparison shopping to do!
Thumper, CF is saying that if your kid’s income is the same, then his net cost for premiums for the reference silver plan will be essentially the the same no matter what the full cost premium is.
So lets simplify the math and assume that your son’s subsidy level leaves him paying 10% of his income on insurance. (It’s actually always slightly lower, but 10% is easier math). We’ll assume a $42K annual income, so $4200 out of pocket on insurance, or $350 a month.
The “reference” silver is second lowest cost, but as I recall, there’s not many options in your kid’s market – and to keep things simple, I’ll assume one plan only in each metal band.
So lets assume that in 2017 the premiums for each metal were Bronze $300, Silver $400, Gold $500
Since Silver was $400 but hypothetical buyer maxed out at $350, there would be a $50 subsidy (Silver cost minus what is essentially an EFC for health care) And that would have left the insured having the option to buy Bronze at $250, Silver at $350, or Gold at $450.
Now its 2018 and let’s assume smaller increases for Bronze and Gold, but a bigger one for Silver to compensate for the eliminated CSR payments. So, hypothetically: Bronze $350, Silver $550, Gold $550.
Buyer’s income is stable, so buyer still needs to pay $350 to buy a Silver. (That’s what CF means by if “he has the same income this year, his price for the reference Silver plan is the same this year as it was last year.”) His $350 cost share doesn’t change.
But now since the Silver is $550, the subsidy amount is $200 - and that $200 subsidy can be applied to any plan on-exchange: so for 2018, Bronze would be $150, Silver $350, Gold $350…
If the CSR charge is spread more evenly among premiums, it’s still cheaper to buy Bronze because of the increase to Silver – for example, if the full premiums are Bronze $400, Silver $500, Gold $600 – - the premium increases are spread more evenly - but the subsidized buyer still only pays $350 for Silver and has a $150 subsidy that could optionally be applied to Bronze or Gold instead, so Bronze $250, Silver $350, Gold $450.
Whether to buy Silver vs. Bronze may come down to other factors --such as differences in copays or prescription drug benefits. The basic math is simply whether or not the amount paid in premiums is likely to exceed the amount paid in out-of-pocket health care costs. (And I don’t agree with CF that Silver would be a bad choice – in California, it would be because the surcharage is applied only to Silver plans, so Californians who don’t qualify for CSR plans should either save a bundle on their premiums with a Bronze plan, or else move up to a more generous Gold plan with lower deductible and copays, for essentially the same cost as a Silver. But I don’t have a clue about Arizona -if premium increases are spread evenly across-the-board, then there may not be any meaningful difference between the 2018 and 2017 in terms of relative value among subsidized plans).
Bronze won’t work. RX copays and deductibles are way too high. We did that number crunching last year.
If Gold is the same cost…with better RX coverage…that might be the way to go.
@calmom there is only one provider. It used to be Healthnet…but my son thinks they were bought out last year by Ambetter…anyone know?
It’s covered the basics…and the RX is reasonable…for genetics…not so much so for name brand.
It’s still Health Net, but they appear to be offering in Arizona under the name of Ambetter. https://www.ambetterhealthnet.com/
Sorry, duplicate post.
Wonder if it’s the same company as Ambetter which is being offered in the northern Georgia counties?
If so…my e my kid 2 should get that?