<p>I agree with you, Calmom, about the group market. Big companies want to keep insurance costs down for their employees. If they see that the individual market is cutting costs by shutting out expensive hospitals, they’ll say, “I want some of that action.”</p>
<p>Or the insurance companies will push them to that, simply by the way the premiums in the plans are priced.</p>
<p>The only real difference is that the employer pool is separate, and if some employers/industries tend to be very low risk, their rates might not be subject to the same degree of pressure as the individual market or risk pools for different employers. With employer insurance, occupational risk becomes something of a factor: some jobs or industries might just be more dangerous than others.</p>
<p>I have a question for y’all. We have individual insurance and it was cancelled. Trying to find something that will work for us now but it hasn’t been easy. Here’s my issue. My daughter is considering colleges out of state and I’m having a hard time finding insurance where she’ll not be out of network if she goes out of state. Should I then just buy her insurance if that happens and buy it through that state’s exchange/insurers? My daughter has a recurring skull base tumor issue so having medical insurance for her is a must! Has anyone had this issue yet - the out of state thing?</p>
<p>Since you don’t know where your daughter will be attending college at this point, I think you should just buy whatever works for now. With the ACA, if the in-state coverage you buy now isn’t going to work for college, you’ll have the option of either signing her up for insurance offered by the university (if you feel that’s a good policy), or enrolling her in insurance in the state where she attends college, if that is a better option. Her relocation to a different state will enable her to enroll in a plan outside the open enrollment period. Emergency care is always covered, in or out of network, so the main decision you will face is where you want her home base for care to be.</p>
<p>“In other words, neither one of us comes under the umbrella of Obama’s “promise” that we could “keep” our pre-ACA plans because both of us opted to give up our plans after ACA passage.”</p>
<p>This is NOT what Obama said. He said if you like your plan and doctor you can keep them, period. No and(s), if(s) or but(s) anywhere in that sentence. He never said you can keep your plan as long as you were enrolled prior to March 23, 2010.</p>
<p>The plan I want to keep is the plan I have now, not the one I had prior to 2012. My current plan is a grandfathered plan, even though I lost my grandfather status. </p>
<p>Calmom, you are doing a lot of speculating about the premiums for these grandfather plans but as of now it is just guesswork. I have contacted BS and have been told that any premium increase (if any) for the grandfathered plans has not yet been determined.</p>
<p>I have a hunch very few people are going to give up the grandfathered plans. Most people like these plans much more than the ACA-compliant plans. Yeah, there are some people who will leave because of the subsidies, but I bet even some of them will be reluctant to leave the grandfathered plans. </p>
<p>You also have to remember everyone in the grandfathered pool has already been underwritten, and, as such, I would expect much healthier people in this pool than what you will see on the exchanges. As of right now the only people going to the exchanges are those with preexisting conditions or who qualify for subsidies, Of course, even this remains to be seen because according to the numbers collected so far no one is signing up. Most states have seen numbers in the single digits. It better turnaround pretty quickly, or the exchanges will experience the infamous death spiral due to the lack of healthy people willing to pay the outrageous premiums for these high deductible, limited network plans.</p>
<p>" Should I then just buy her insurance if that happens and buy it through that state’s exchange/insurers?"</p>
<p>That is what Anthem Blue Cross told me. I was told to Buy my kid’s insurance in the state where my kid resides. </p>
<p>“My daughter has a recurring skull base tumor issue so having medical insurance for her is a must! Has anyone had this issue yet - the out of state thing?”</p>
<p>Sorry to read about your daughter. I wish her the best. I guess if you want your daughter treated where you live you might want to buy her insurance in your state too. I have no idea how that works.</p>
<p>Goldenpooch, before ACA, companies change insurance companies, costs, provisions all of the time. This is not an ACA thing, so yes, if a company decides to do this, former plans will not be available to employees. To, me the stipulations were clear, as no rules were put in place prohibiting companies from making changes, and rules are in place forcing changes for those who have plans that are not ACA compliant. Taking some of these comments verbatim is so unreasonable, IMO. You have to use some common sense here.</p>
<p>As for those taking the more expensive plans, well, we are a family who is taking more insurance than the past few years have indicated we should take. Our premium will cover another family or two. We are buying the insurance for insurance sake, not because we know we need the payouts. We did not meet our deductible this year, nor in most years, much less the amount paid in premium by employer and by us. Oh, yes, insurance cos have made out on us most year.</p>
<p>But once upon a time, many years ago, we had to tap into the the insurance cache and had terribly high insurance costs when my little boy was diagnosed with leukemia. That is why we paid for upper level insurance, and always have taken the better coverage, particularly what will cover the most in the event of a catastrophe. The maximus are what concern me, because that is where we could go under if some high cost medical event occurs. Yes, it hurts when we owe $10K out of pockt, but in time we can pay that off. $1M, nope. Big problem, life changer, and there are doctors, procedures unavailble when not a life threatening if you don’t have good medical coverage.</p>
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<p>You speak as if that’s the case for everyone. My grandfathered plan is $592 a month. That’s over $7000 just in premiums. I may not spend less on the exchange but I won’t spend more and my network is the same.</p>
<p>On the out of state thing…</p>
<p>Don’t rely on me as an expert, but I did read about that on the healthcare.gov website last night while looking for something else. If two members of the family live in different states, they can buy insurance on either state’s exchange. However, there seemed to be another stipulation that, if both parents buy in one state, dependent children must also be covered on that state’s exchange. I don’t know how this works in the real world…</p>
<p>What about the multi-state plans that are available on the exchange? Are they not useful for many with kids in college?</p>
<p>Where would you find a multi-state plan on the exchange?</p>
<p>Oddly, this whole OOS issue seems to nullify the 26 year olds can be kept on your policy promise. </p>
<p>I see this college age kid issue as a huge problem, as I said at the start of this thread.</p>
<p>The 26-year-olds can stay on your policy was a way to get kids insured before 2014. And it did. </p>
<p>Even in 2014, it will be useful for a lot of people. Like me. My son lives with us, and is under 26. Like the majority of people under 65, we have employer-supplied insurance. We can put him on our insurance, and we have done so.</p>
<p>Also, don’t most kids go to college in-state? I’m pretty sure they do, because the majority of college students are in community college.</p>
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<p>Maryland offers two multi-state plans on the exchange - both through BCBS. One has $1500 deductible and one has $500 deductible. Both offer in and out of network coverage - better in network of course. </p>
<p>It seems they are available in 30 states. </p>
<p>[OPM</a> Multi-State Plan Program Fact Sheet](<a href=“http://www.opm.gov/healthcare-insurance/multi-state-plan-program/opm-multi-state-plan-program-fact-sheet/]OPM”>http://www.opm.gov/healthcare-insurance/multi-state-plan-program/opm-multi-state-plan-program-fact-sheet/)</p>
<p>Edited to add: Maybe multi-state doesn’t have anything to do with getting coverage in different states. Maybe it just means the same policies are offered in these states. It would seem to be a way of addressing it if the networks were required to honor the insurance across state lines.</p>
<p>I just watched a so-called expert on TV saying that these grandfathered plans are garbage. He said they all have annual and lifetime caps, and you can be thrown off the plan if you get sick. None of these things are true for my plan and I bet for millions of other people. The amount of misinformation and propaganda getting spread around by the media is ridiculous.</p>
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<p>I guess it depends which numbers you run. Students in New Jersey leave to go out of state for college at much higher rates than students who leave their state to go to New Jersey.</p>
<p>[More</a> NJ Students Head Out of State for College Than Come In | NJTV News with Mike Schneider | Public Media New Jersey](<a href=“http://www.njtvonline.org/news/video/brain-drain-taylor/]More”>More NJ Students Head Out of State for College Than Come In | Video | NJ Spotlight News)</p>
<p>If only calculating community college students, then yes, most college students attend a nearby community college campus. But some kids do o out of state to community college for various reasons - cost, opportunity, parents move before graduation, seeking to establish residency in a state or to transfer easier to a specific school. Lots of variables. </p>
<p>But more specifically, kids do go out of school for college - as one of my own kids has done - and what do we do for those kids?</p>
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<p>Just read the link I posted more carefully and the multi-state plans do offer coverage to families with members in more than one state. Does everyone else on this thread live in the 15 states that don’t have multi-state plans yet?</p>
<p>cartera45, I looked up Ca. on the OPM site and there are 4 silver and gold multi-state plans by Anthem. This is the first I heard about it. What exactly do they cover out of state. How extensive is the in network coverage out of state and how do you identify the providers?</p>
<p>Many of those community college kids do not have mom and dad paying for their lives. Many of them are not scrambling to find health insurance since they are healthy and if they must they will choose to pay 95-bucks and opt out of this whole thing.</p>
<p>Sure, they could get hit by a bus…but fortunately, most of them don’t.</p>
<p>But New Jersey is anomalous, because it’s so small. Nationwide, most kids go to college in-state.</p>
<p>I’m not saying that there is no issue for kids who go to college out of state. I’m saying that those kids are in the minority. </p>
<p>I was wrong about the number of community college students, though. There are fewer community college students than four-year college students.
[College</a> Enrollment Statistics | Statistic Brain](<a href=“http://www.statisticbrain.com/college-enrollment-statistics/]College”>College Enrollment Statistics - Statistic Brain)</p>
<p>But if you count up the community college students, and half the public four-years (a conservative estimate of the percentage of in-state students at publics) you see that the majority of students go to college in-state.</p>