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<p>Maybe that’s the intended consequence.</p>
<p>I am not so sure since it sounds like exchanges were not part of the budget based on item 4.</p>
<p>[The</a> Four Things You Need to Know About Obamacare’s First Day - Businessweek](<a href=“Bloomberg - Are you a robot?”>Bloomberg - Are you a robot?)</p>
<p>California update:</p>
<p>I just got off the phone with a sales agent at Anthem Blue Cross. She says that their computers are all crashing and they are unable to sign people up for the new plans today, and that they also cannot provide network information. The provider network database has not been fully uploaded and they were told in a staff meeting today to expect that information to be online on October 8. (So if you click the link on their web site to see whether your doctor is in their network, the info you get isn’t accurate or complete). </p>
<p>She also says that they they will have the ability to sign up people for the exchange policies as well as their own policies, and Anthem seems to be doing a great job of screening calls to ask about income so they know what to recommend. However, the sales agent did not know whether their provider networks for the exchange-sold policies will be identical or co-extensive with the networks for the identical policies they will be selling directly. </p>
<p>The reason I was talking to Anthem is that I want an HSA and had been under the mistaken impression that Blue Shield was offering the only HSA compatible plan – but now I see that both Kaiser & Anthem also offer HSA plans. (I had misread information that there would be “one” Bronze HSA plan on the individual exchange to mean “one” company – but apparently they mean “one” plan that each of the companies on the exchange could sell if desired). Kaiser offers the lowest cost plan but, of course, that is the Kaiser HMO. Anthem’s plan is $50 less per month than BS, and as far as I can tell the plans are identical except for provider network – that is, they are going to cover exactly the same services and pay out exactly the same benefits. I have a feeling they are also going to to have pretty much co-extensive networks, but I do have to confirm that before I sign the dotted line. </p>
<p>Anyway… I think I’ll wait until things settle down a little to sign up. The Covered California site seems to be a little more responsive now, I’m testing to see if I can set up an account.</p>
<p>Texaspg – the exchanges aren’t directly impacted by the budget impasse, but I don’t know what happens when the federal exchange calls for incidental tech support. Are there full time employees on the exchange staff with that responsibility? or is that something that is provided on an as-needed basis from a different federal agency? or is there a private tech company under contract to provide such support? I have no clue. </p>
<p>I am pretty confident that the federal budget would not impact the states that are running their own web sites. For example, the technical end of the Covered California web site is being managed by Accenture – see <a href=“http://www.healthexchange.ca.gov/Solicitations/Pages/HBEX4.aspx[/url]”>http://www.healthexchange.ca.gov/Solicitations/Pages/HBEX4.aspx</a></p>
<p>Are there any exchanges up and running in states like Texas which are not supporting their own exchanges that have been created by Federal Government?</p>
<p>Well, after ignoring my own advice about entering data into a noticeably sluggish and unresponsive web site, I have succeeded in setting up an account for myself on the Covered California web site. CC’ers note: I was given a set of 5 security questions to choose from, including the option of my combined SAT score. And no, I don’t have any clue what that might have been. (Plus they didn’t ask whether that meant in one sitting anyway).</p>
<p>^ I thought all CCers knew their SAT score…lol…</p>
<p>Well, I could tell you my kids’ scores… </p>
<p>But I don’t think that’s a useful security question for CC’ers anyway, given that most people on CC have repeatedly broadcast their SAT scores to the whole world. ;)</p>
<p>SAT scores? Haha! Do they check with the college board for accuracy?</p>
<p>We have decided to wait a while. Our guess is things will settle down at some point. Since coverage doesn’t start until January 1, we aren’t in a huge rush!</p>
<p>" CC’ers note: I was given a set of 5 security questions to choose from, including the option of my combined SAT score. ."</p>
<p>That is hilarious! I’m not sure if you’re joking or actually serious that it was a question, but either way, very funny.</p>
<p>I am still getting no security questions on the North Carolina (federal) website, and after entering name, email, username, pw info to set up an account I keep getting the unavailable message - so I can’t start yet on the healthcare.gov website. but…</p>
<p>The Blue Cross/Blue Shield website now has 2014 plan information, and when I enter estimates for 2014 income (low end and high end) the premiums I am getting are very reasonable - in the $300 - $600 range, so I can breathe a sigh of relief and come back to it in a month when I can look very closely at the plans and make sure my doctors all participate and all that. No hurry right now. The big variable in my income has been Roth IRA conversions. I don’t have to do a Roth IRA conversion. Without that we are barely above the poverty level. I better not buy lottery tickets. I can’t afford to win. :D</p>
<p>I’m a little bemused by the shock and outrage that the sites are not working perfectly on Day One. It’s a big, new, complicated, high-profile launch; it would have been shocking if it HAD been glitch-free. Personally, I’m going to wait at least a week. Besides, there is no need and no point in signing up on the first day. It’s not like they’re going to run out of insurance.</p>
<p>Does seem like an overreaction. Of course a project this huge will have glitches. I understand why people are anxious and curious, but really, give it a bit.</p>
<p>I checked the website for Covered California. It’s not bizarre to check - even if I do not currently need it. Things change. People lose jobs. You can have great insurance and then lose it when your COBRA runs out. I couldn’t get a complete picture there because you have to APPLY to find out your prices - and I am not thrilled about applying for something just to get a price quote. I checked at the Kaiser site - where I currently have coverage. I also checked out EHealth. </p>
<p>I am even more stunned at the prices than what was anticipated. More costs for less services. Many more out of pocket costs that we took for granted at Kaiser. One of the appeals of Kaiser HMO is that it will pay for the lab costs and MRI’s and doctors visits after your copay. You jump through hoops to get care, but when you do - if you need something big, ie, surgery, it is usually going to pay.</p>
<p>So, hypothetical - put in some numbers for our family and the prices range from $1091 to $1900 a month. Before a deductible. After the deductibles, which range from $1000 to $12,000, you could be spending $13,000 a year and not even seeing a doctor. </p>
<p>If you see a doctor, it could be $20 or $40 or $65 copay for that. Out of pocket costs could be in the neighborhood of another nearly $13,000 if we run up medical services that year. </p>
<p>We chose Kaiser a few years ago when we were getting back on our feet financially after a job loss. Even our COBRA cost, in comparison, was less than the mid-range plans on the Kaiser website. </p>
<p>I hope others are seeing more affordable price options. This quote really depressed me - after the other thread started months ago, I was hoping that what I saw on a few of the websites was just the preliminary workings of the plan. Now I realize that without a doubt - if we lose this coverage, we will not be able to paraphrase keep the insurance we already had. It will be different, and much, much more costly.</p>
<p>Are you sure that insurance bought directly from Kaiser is the same price as Kaiser insurance bought on the exchange?</p>
<p>Someone working for VA hospital called a talk show today and mentioned that they have received letters saying they are no longer supporting the private insurance subsidies and she needs to give up BCBS.</p>
<p>Many of the people trying are radio and TV hosts. MSNBC had a clip of one of the hosts trying to get through to talk to someone after having issues getting beyond the initial registration and being on recorded message to hold on for over 25 minutes (not sure if she ever got through since the clip was being played on the radio).</p>
<p>
That is NOT true. All you have to do to get prices is to scroll down the page and click the link to the “Shop and Compare Tool” – at <a href=“https://www.coveredca.com/shopandcompare/[/url]”>https://www.coveredca.com/shopandcompare/</a> – this information has been online and available for at least a month- I think it actually went up some time in August.</p>
<p>Before today that link was more prominent as it was near the top of the page – it has been pushed down now that there is a direct entry to apply – as I think it should be – but it identified with a large graphic icon in the center of the page (near the bottom) so I don’t think its that hard to figure out. </p>
<p>I personally think that part of the site is very well designed, and unlike the application section (which essentially takes you to a different, secure site) – that section of the site has been running smoothly all day long. (As I think I explained above, it’s an easy matter to scale up the non-secure stuff to be prepared for a lot of traffic – its when you are trying to sustain a secure connection for database entry that things get trickier)</p>
<p>LasMa, the Kaiser site has both the exchange plan and its own variations. That includes an alternative HSA with a $3500 lower deductible, which might be appealing to someone who has moderate to high use of medical services – the full premium is still less than Blue Shield is charging for its Bronze HSA. </p>
<p>Samarai- you wrote – “. You jump through hoops to get care, but when you do - if you need something big, ie, surgery, it is usually going to pay.” – ALL of the ACA plans have a maximum annual out of pocket of $6350 per person, maximum of twice that per family. So if you “need something big”, you’ll hit a point where the insurance is paying 100% no matter what plan you choose. In fact, mathematically, you’ll hit that point sooner with the low end Bronze plans, because you’ll run most of it up while meeting your deductible. With a higher priced plan you’ll have the sense of the insurance paying more, because you’ll have a lower copay and you’ll only be expected to be paying a fraction of the costs earlier on, but you will have paid the difference in premiums.</p>
<p>This is NOT new. I did the same math in the 90’s when choosing insurance, and I helped my son go through the same math 8 years ago when he quit his job and needed to buy an individual policy. There is always a differential in premium cost vs deductible and copay. Insurance companies arrive at their premiums through risk analysis – and they are a whole lot better at figuring that out than we customers are. </p>
<p>I’ve now created a spreadsheet where I have the rates I would pay as an individual for 8 different plans, from Bronze through Platinum laid out. </p>
<p>On an individual level – based on the rates I would pay -the Bronze plans are the best for low end annual medical expenses of up to around $4000, and they are the best for high end expenses of $10,000 or more. There is a band between about $4000-$12,000 when the benefit of the lower deductible and co-payment with the Silver plan can be recouped. </p>
<p>Obviously the math would be somewhat different when you are trying to project out the cost of medical care for a family – but its still the same basic process. Mathematically the insurance company has factored in the difference in benefits into premium costs.</p>
<p>calmom - that is very helpful! I’ve been looking at the plans and wondering how to figure out which would be best in terms of co-pays, deductibles, premium costs. I never would have considered that the bronze plan might possibly be the cheapest if we actually needed lots of care! But I suspect we’ll fall in that middle band…</p>
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That’s because of the $6350 out-of-pocket max ($12,700 for a family). Once you have hit that max, the insurance picks up everything. So if you know that you will be running up that level of charge, you come out way ahead once you get used to the idea that you’ll just pay full cost during the first few months of each year. </p>
<p>The math is somewhat different if you know that you will qualify for a subsidy – basically, under those circumstances, the Silver and Gold plans start to look pretty attractive. </p>
<p>I’d suggest that most people should take a look at what their medical expenses have been over the past 3 years, taking an average, and then using that for planning purposes. Of course if someone has recently been diagnosed with a serious illness or knows that they need surgery in the coming year, then they should plan around the known expenses.</p>