@thumper1, for Kid 2, as for Kid 1, there’s not any substitute for running the numbers. Look at the what they expect to need for medical care, and see which plans are the best for them.
And that’s my advice for everyone buying individual insurance this year. You should not re-enroll in the same policy without looking at what’s available. Very likely there is a better bargain out there for you.
On a Facebook group I’m in, some people have been posting their eye-popping premium increases. But then, when we look further, we discover they don’t have to pay those eye-popping increases, either because they can buy a different plan, or because their premium subsidy will cover the entire increase and they’ll pay the same as last year.
I’m not saying your insurance premium will be the same as last year. I’m saying, shop around. Make comparisons. Talk to a broker or a navigator. Don’t get taken by a bad deal when a better one is available for you.
I just discovered my D’s ACA insurance is nearly doubling in cost for 2018, and there aren’t really any good alternatives.She is 20, but her college doesn’t offer insurance and my office doesn’t cover dependents, so I’m paying the full price. I make enough that I don’t get a subsidy, but not enough that this doesn’t hurt since I’m a single parent.
One colleague said I should stop having her be a dependent for taxes and then she could go on Medicaid since she doesn’t make a lot at her part-time job. That seems a bit extreme, though, and I haven’t looked at the numbers, but since my taxes would jump I think it might be a wash.
@Barbalot, Have you checked different metal levels for your daughter? In the states where premiums are nearly doubling, they are typically nearly doubling for Silver, and going up much less for other metal levels. Even if you are sure which insurance company to buy from, you should check which metal level and which policy to buy from that insurer.
Catastrophic plans mostly cost about the same as Bronze. It’s difficult to make a plan that satisfies the out-of-pocket limit and also has cheaper premiums than Bronze.
@“Cardinal Fang” - the problem with shopping around is that different companies also tend to have different networks. It is one thing if it’s just a matter of switching plans within the same company – but another entirely when the lower cost plans are HMO’s with an entirely different network than the one the person has been using. I’ve been aware all along that I am paying a premium for the plan that lets me use what I think is the best hospital in my region. With the California surcharge on the Silver, If I switched to the Kaiser Bronze HSA right now, I’d have virtually -0- cost for premiums – the fact is that I would lose some of my credits because they would have no where to go. (Covered Cal will still charge me $1/month, but the tax credit is higher than the premium amount).
But there’s that whole wanna-keep-my-doctor thing… money is important, but it’s not the only thing.
I do think the healthcare.gov website, which is what is used in my state, makes it relatively easy to compare because you can search on certain doctors/providers/hospitals to see if they are in a particular plan.
Like @calmom, we’ve made the choice to not take the cheapest offer for us in a certain metal level because of the network differences.
It does require setting aside some time to look at all the plans for both coverage levels and network coverage. But, given both the money involved and the importance of decent healthcare, it’s worthwhile investing that time. I do live in a state with a handful of insurers, which is good, but results in several dozen options to parse through.
One thing to make note of each year is that many plans’ in-network lists can change from year to year. So automatically choosing the same plan next year without checking whether your desired provider(s) will still be in-network for the plan next year could result in an unexpected surprise.
The bronze and silver plans have very hefty deductibles. My D was badly injured in a car accident this summer, and while things are going fairly well now, we probably will have more doctor visits than most 20-year-olds next year. There are only two companies offering plans, BCBS and Kaiser. I don’t want to switch to Kaiser (whose rates are only modestly lower) since she would have to change all her doctors.
Different companies have different networks, and not only that but different plans from the same company have different networks. That’s definitely a consideration.
On the other hand the savings from switching can be substantial.
If I had an income of $42K, just under the subsidy limit, my monthly payment would be
$340 for a Silver plan from Kaiser with a $2500 deductible
$353 for a Gold Kaiser plan with lower copays and lower drug prices and a $0 deductible
$300 for a Gold Kaiser “coinsurance” plan again with a $0 deductible
$1 for a Bronze plan with a $6500 deductible.
They all have the same network; it’s Kaiser. I can’t conceive of a reason why I’d want to buy the Kaiser Silver plan. It’s better for nobody of my age with my (hypothetical) income. Either Gold or Bronze would be better.
This is an example of why it’s right to shop around. Maybe the Silver from Kaiser was good for me last year or the year before, but I can’t see how it would be right for me this year.
Suppose I was the same person with the same $42K income, but I liked a PPO. Blue Shield has PPOs in Gold, Silver and Bronze.
$307 for Bronze, $75 copay, $6500 deductible
$692 for Silver, $35 copay, $2500 deductible
$902 for Gold, $25 copay, $0 deductible
Again, Silver doesn’t look like a good choice for anyone who is looking at those prices. I’m pretty sure (not positive) that they all have the same networks.
I just got an email from Costco saying that they are selling plans. I am going to look into this and compare it with what I currently have. https://www.cbcins.com/quote
Looks like Costco isn’t selling their own insurance. They appear to be brokers for insurance companies. Nothing wrong with that, but you can also go to other local brokers.
Well, you could go to a broker, select a plan and then just buy it from the company directly if you thought the broker was crooked. But while I’m sure there are crooks among brokers as among all industries, I haven’t heard tons of stories or really any stories about people being swindled when they gave money to a broker and didn’t get an insurance policy.
I have heard a story recently about a woman buying a short term insurance policy, being diagnosed with breast cancer, then not being covered because the cancer was a pre-existing condition even though the woman didn’t know about it. The courts upheld the insurer. Apparently insurers are allowed to write policies that don’t cover pre-existing conditions that the person doesn’t know they have. This is not on the broker, but the insurance company.
For 2018 enrollment, subsidy limit is $48K. ($48,240 to be exact). So not “just under” — but rather at about the 350% mark.
(Posting because this sort of detail could lead someone to mistakenly believe they are ineligible for a subsidy. So in this case of a bright line demarcation, accuracy is important)
The difference beween paying $902 vs. $692 for a premium is $210/month, or $2520 over the course of a year - almost exactly the same as the deductible. For someone who is likely to meet their deductible, then Gold is clearly the better option. Buf for someone who historically is a low-end user – lets say someone who typically might see a doctor two or three times a year and get one or two prescriptions for generic stuff, like antibiotics — then buying Gold is essentially pre-paying a deductible that won’t be used through extra premium dollars.
So I disagree with your opinion that Silver is a bad deal.
Now, if you are not likely to hit a $2500 deductible, then the difference between $6500 and $2500 is meaningless – and with my hypothetical of 3 doctor visits, the $40 difference between bronze & silver copay is $120, whereas bronze premium cost is saving $4,620 over the course of the year for premium dollars … so bronze really is the best bet for the low-end user. Sure, in the event of an unanticipated illness or emergency, that Gold plan will suddenly look great – but Gold is running $7,140 more than Bronze for direct, out-of-pocket costs of paying the premium each month – so the Gold user has paid more than the $6500 deductible in premium costs. (Plus there is a somewhat higher risk of insurance lapsing becaue the person can’t afford to pay their premiums at the higher end).
Now, the math becomes entirely different for people with higher end costs and more frequent doctor visits.
But bottom line, you either have a high deductible or you pay roughly the same as your deductible in up-front premium dollars. And the affordability of premiums in terms of monthly budget has an impact as well … from a practical standpoint, I have to pay my insurance premiums up front, every month, on time – but if I run up medical bills toward my deductible, I generally won’t be billed for several weeks until after the service has been rendered, and I’ll be able to buy time and stretch out payments if needed. Back in the days when my monthly expenses exceeded my income, I learned pretty quickly that unpaid medical bills were the easist to defer and drag out. Now that I am “rich” in the sense that I earn more than I spend, I don’t think much about those things – but if money were tight, that pay-in-advance vs. pay-later part of the equation would have been a huge factor.
Some of this is hypothetical, as calmom and Fang show, as an example of the kind of analysis you need to do. And as Fang keeps saying, check for your state, your particulars, and your options.
The point is good that, for younger folks, changing doctors may be an acceptable move, for some, for the better costs overall.
The problem with bronze, we know, is where your choices are a monstrously high deductible. This may or will vary by state.
For our independent kids, it’s also possible some families will find bronze is a premium your child can manage, a step toward full independence. The kids can pay for routine/sick visits, labs, etc. Then, in the event of a catastrophe, some families may be in a position to help meet the deductible, until fuller coverage kicks in. For some, worth considering.
But that’s only a number on paper, which only comes into play if you are going to use your deductible. And $6500 isn’t “monstrously high” compared to +$7000 in premium dollars, which is the difference between the Bronze & Gold plans that CF indicated.
One thing I liked very much about ACA is the ability to change plans during open enrollment. Before, I was kind of stuck – I worried that if I got sick I’d be stuck with a high deductible plan and wouldn’t be able to shift to anyting else because I’d be precluded from signing onto a different plan due to medical underwriting.
With ACA I know that if my health situation changes, I have that high deductible in year #1 to worry about, but the following year I could switch to a more favorable plan. It’s not really about the deductibles in any case, because maximum out-of-pocket is pretty much the same across plans- it is about the interplay of the deductibles with copays for medical visits and prescription benefits.
And yes, I can see how the cost/benefit analysis changes somewhat if you are advising your kids on what they should buy. (My kids are way past “independent” at this point – with good jobs and employer provided insurance available both from their own and their respective spouse’s employers. My daughter actually is in charge of benefit planning for her workplace - whatever insurance function would be filled by a HR department if her employer actually had an HR department … so she probably knows way more about insurance and insurance options than I do at this point.)