Open Enrollment is November 1st to January 31s, you must be enrolled by the 15th of the month prior to your 1st of the month start date, so Dec 15 for a Jan 1 start.
This is definitely an issue in some states, and will likely vary year to year. Silver subsidies based on the price of the second cheapest plan offered in the state really screw the people who live in areas where those cheap plans are not offered. There seem to be some cheap HMO based, limited coverage plans for people who live in the biggest city in the state, but not for people in other areas, but the subsidies are calculated based on that 2nd cheapest plan
The subsidy is based on the second cheapest plan available to the person. I live in the SF Bay Area. If I were eligible for subsidies, my subsidy would be based on the second cheapest Silver plan I could buy. It wouldn’t make any difference if there were other, cheaper plans in southern California or the Central Valley; my subsidy would be based on local plans that I could buy.
It is a little strange, because it seems (this is based on very limited experience, 2 years of ACA) they change the plans every year so you have to do some research every year and can’t just automatically renew your plan and expect to get basically the same plan. A little ironic given the history of that phrase, “If you like your plan… blah blah” LOL, turns out to be untrue every year! Under the old system, pre-ACA, we were able to increase our deductible/ increase our coinsurance % with a mouse click - something we did once to reduce premiums. But, you couldn’t switch to a plan with a lower deductible without a full medical review. Made sense at the time, but under the ACA you can just sign up for whatever plan you want. I am going to take a look at paying more for a lower deductible plan for 2016 and going for a battery of diagnostic tests that would go against my deductible and up to this point I have opted not to undertake. I still have more procrastinating to do and won’t get motivated until November.
This is funny! I would call it "ironic" except I already used that word. My wife, just now, got a phone call from BCBS advising her that our current plan is being discontinued and will not be offered in 2016. Even funnier, they do not yet have the complete list of plans (and costs) that will be available for 2016. That information should be available November 1. So we will have to go through the entire search process from scratch, looking at policies and checking to see if our doctors take that plan. We will also be looking at other providers.
We just got our letter from Anthem; same plan, but with a 13% premium increase. So we will go shopping too. But we don’t mind, because before ACA, we just had to swallow the increase. We did that for 20+ years. Now we have options.
I hate having to shop for insurance every year. To me, it is just plain frustrating. I have also read ( I think here in CC) that sometimes the list of doctors that accompany a particular plan, can be inaccurate. It is very time consuming to have to do this research every year.
I helped my daughter find an ACA plan in California. She called and asked if a particular doctor was covered by the plan and was told yes. She went to the appointment and was told no. Fortunately, it was only about $150, but still…
The number of enrolled is not close to what the CBO projected. So of course the risk is not as spread as it needs to be. A $675 penalty is not enough to get the intentionally uninsured to insure themselves.
If you are subsidized, it might be a good deal…it usually is when someone else is paying your bill. If on the other hand you are a full pay player in the individual market…it’s ugly.
if you can avoid the exchange policies do so. if you can not get insurance from your employer or your parents…try to get a direct non exchange plan. many doctors do not want to touch the exchange plans.
And plenty of doctors are fine with them. We haven’t had any trouble at all finding providers, in almost two years of use.
ETA – It might depend on where you live. If your state’s government is hostile to ACA, doctors might be as well. But in our state (CA) and in D’s state (WA), none of us have run across a doctor, lab or hospital which doesn’t take exchange plans.
H’s insurance is about the same premium as prior years (maybe up a bit). His is provided by his former employer as a retirement benefit. Looks like copays on medications will be significantly higher, especially if you’re using non-formulary medications. H & I both take maintenance medications, but so far the copays have not been too painful.
@LasMa … That could possibly be because you have purchased a PPO? Here in Texas it is the HMO plans that give the most barriers for both patients and providers.
LaMas: In my region of CA there are NO PPO plans offered on-exchange. The Dr’s which my family has used for years now always ask about specific insurance policy info when you call to make an appointment. They do not take EPO or HMO plans. It is region dependent.
We were offered small group coverage for another year. As per the ACA H and W businesses are no longer groups but must go to the individual market. Insurance companies have discretion as to when a group needs to rectify - we were not asked to do so this year. So, our old plan which we liked and had for many years was cancelled because it’s not ACA compliant. Instead, we’ve been offered a new plan, with a considerably higher deductible and higher OOP costs. The offer letter indicated what the old cancelled plan WOULD have cost and the cost of the new plan. That increase is 30%. The actual increase in premium from what we were paying this year to what we will be paying next year is 65%!!! That’s not a typo. Our new plan with higher OOP costs is running us 65% more than our old plan. Oh, and it’s a BRONZE level plan.
Our regions’ off-exchange offerings do include a very very limited PPO selection. However, the off-network private individual plan PPO’s do not have NEAR the provider network offered by our PPO group plan, and are similar in cost. For example, ALL BSCA plans on the individual market now exclude Stanford. So, really…it’s ugly.
