Of course, those who are not strongly attached to their physicians (or dislike them) may want to change anyway.
Those who need to see more different physicians on a regular basis (primary care plus specialists for their conditions) may have a harder time managing yearly insurance changes, whether they are considering changing insurance, or even staying on the same insurance but seeing physicians move in and out of networks.
Those using Kaiser can at least tell easily what is covered, although individual physicians may leave Kaiser or move to Kaiser, possibly requiring changing to a different one within Kaiser.
My kid two will be changing doctors regardless of whether she chooses Ambetter or Kaiser. She has an Anthem POS plan which is ending. That allowed her to continue to see her PCP here in CT…in network. Oh well!!
Both of my kids are big uses of the Minute Clinic for medical general,things…like pink eye…or possible strep.
My kid one will only take a olan that his eye doctor is ON.
Re: high deductible…one if our kids had a major medical emergency in 2015. She used up her $5000 deductible between her ambulance ride, and the trauma docs in the ER. All other costs were then covered.
When I was researching our options last year, I did only consider plans where husband and I could keep our PCPs. Especially husband’s as he really liked him and that meant going with an option that wasn’t our cheapest option. With that PCP leaving the state as well as the PCP who took over the practice also leaving the state in 2017, seems like we shouldn’t have placed so much emphasis on that. PCP turnover is pretty high in our area - not just networks but leaving practice or moving out of the area.
If you buy a plan directly from the exchange or an insurance company, they generally have to meet the ACA requirements, and they are supposed to say, I think, if they aren’t via some loophole or grandfathered exception. So read the fine print.
This was a huge problem before the ACA, and it was very hard for the average consumer to understand the quality of the health care plan they had until it was too late. The basic coverages of the ACA give you consumer protections that your healthcare will be decent (it will actually be “healthcare insurance” with “pooled risk”).
@Romani, below is the article about the short term plan and the woman whose breast cancer wasn’t covered. This is a problem with short term plans, probably not all but certainly some. All ACA-compliant plans have to cover pre-existing conditions, whether the enrollee knew about the condition or not.
Short term plans are lucrative for brokers. I’ve heard the commission is 15% to 20%.
Well, I was able to get a look at some premiums for 2018. There are 2 insurers in CT who do individual plans both on and off exchange. We currently have a bronze HSA plan on the exchange that we pay $1130/month for (Just DH & I)
Our current insurer doesn’t list their exchange plans on their website, so I have to wait until 11/1 to see what that will be, altho they should be sending us info on next year’s premium for our current plan.
Their off-exchange bronze HSA plan is $2000/month - 77% more than we’re paying this year!
The other insurer posts both on and off exchange plans on their website.
Their on exchange bronze HSA plan is $1672/month - 48% more than we’re paying this year!
Their off exchange bronze HSA plan is over $2000/month.
This is even more ridiculous than I was expecting.
Wow, shellfell, those are big increases. That sounds terrible for you.
Are there also other insurers that will be participating in your area?
I’m surprised that the one insurer has an off-exchange policy that is so much more expensive than the corresponding on-exchange. Usually it’s the opposite.
What are the Silver and Gold premiums for these insurers? I’m curious if Silver is close to Gold. Supposedly Connecticut was putting the CSR surcharge on Silver only.
Another thought on your insurance, shellfell. You say that your insurer’s Bronze HSA is going up a whopping 77%. Do you know how much the other insurer’s Bronze HSA has gone up? That is, you say it would cost 48% more than what you are paying, but how much more does it cost in 2018 than it cost in 2017?
The state of Connecticut says that Anthem’s prices are going up an average of 31.7%. ConnectiCare’s three subsidiaries’ plans are going up an average of 27.8%, 27.7% and 24.0%. [These are averages weighted by the number of people in each plan.]
ConnectiCare is doing the Silver Switch, supposedly, which means that Silver plans are going up much more than Bronze and Gold plans.
Knowing all this, I’m surprised that your Bronze HSA plans are going up so much. I’m not doubting you, because I can’t fathom why you wouldn’t be telling the truth. But I’m mystified. Maybe HSA plans were drastically underpriced in Connecticut last year? How much did the Silver HSA go up?
I didn’t bother looking at what Silver and Gold premiums were after I saw what the Bronze plans will be. I do know that the premiums for those plans are more than for Bronze since the plans were listed in order of premium cost.
It;s not my insurer that’s going up 77%. That’s the other insurer. I can’t see yet what my insurer will charge for my plan for 2018 until 11/1, altho they’re supposed to inform us of the new premium by mail before then. I’m not hopeful given what I’ve seen for their off-exchange plans.
I really don’t think HSA plans were drastically underpriced this year. We got the lowest premium bronze HSA plan we could find and it was still $1130/month for 2 adults.
I can’t fathom how a couple making barely more than $65000 could afford to spend almost 1/3 of their income on health insurance and not qualify for subsidies. Fortunately, that’s not us, but I never expected to spend $20,000 for health insurance.
If your income is low enough, the silver plans with cost sharing may be the way to go. I broke my foot this year and had surgery, and after paying $450 deductible and $2000 out of pocket, everything began to be covered 100% including prescriptions. It has been a tremendous help. Surely some of your children qualify for cost sharing at between 100 – 150% of poverty level income. Cost sharing lowers deductibles, copays and out of pocket expenses.
I see, shellfell. So we don’t have any information about how much any individual CT plan has gone up. We have one premium from 2017, $1130 for HSA Bronze, and several premiums for different HSA Bronzes for 2018: $2000, $1672, over $2000.
I hope you get good news about the rate increase for the plan you’re on! It was the cheapest in 2017, so hopefully it will also be the cheapest in 2018.
If your income is low enough for good cost-sharing, under 200% of the federal poverty line, Silver is probably the way to go, and most people in that situation buy Silver. Cost sharing makes the plan equivalent to a Gold or Platinum plan, and premium subsidies make it affordable.
Hang on a sec. Help me out, tax mavens. Aren’t subsidies for 2017 based on income in 2017? And if someone wants to reduce their 2017 taxable income so it is below 400% of federal poverty level, if it is not very much above 400% of FPL, doesn’t that person have simple strategies they can execute right now to do so?