self employed here. Our premiums dropped about 500 dollars a month but they now do NOT cover out of network. So if you go to someone out of network you cover whole cost. If you travel, same rules apply. The only time they don’t apply is out of state and emergency. However, the have a disclaimer that you may still pay a higher cost even with an emergency. There is 4 carriers this year but all have the same out of network law so…were stuck.
S (age 29) is in SC. Premium going up 4%. Only one carrier on the exchange and like for @birdie3, only a very limited EPO network is offered with zero non-emergent OON benefits…at all. Glad he is able to get insurance, but the very limited choice leaves a bit of a bitter taste.
"for a self employed/self insured family is it worth it to check costs for college students using the college insurance? I never thought of that. We will have two children in college for the next two years. "
@TS0104 - yes, it’s always worth examining and running the numbers on the alternatives. We’re also self employed and our son is also at UChicago. When we ran the numbers, it made more sense for us to keep our son on our family insurance plan because there was no difference in cost for one or two children and the provider network in Chicago was good even though we live in Florida. I suspect for families that live in a different state from their children’s college and whose insurance doesn’t have a good provider network in the college state so would have to buy their kid a separate policy in the college state, the college plan may be a better deal.
Here are some of the things to consider:
- How are your current premiums structured? For example, our plan includes all children at one rate, so dropping our college aged son from the plan doesn’t save us any money since we still have another son at home.
- Does your family plan have a good provider network in the state and city where your child is in college? Run some scenarios to understand how coverage will work at college. If your current plan doesn’t contract with any docs, clinics, hospitals or other providers in the area where your kid goes to college that could be a problem. Although most plans will cover emergency services at hospitals outside the provider network, even for emergencies there will often be follow up visits and other services needed.
- Similar questions for the college plan. Does the college plan just cover providers local to the college? When your kid is home for summer, does that mean s/he won’t have access to providers who will be covered under the college plan?
- How comprehensive is the college plan? UChicago’s plan offers good coverage. But each college offers different coverage. Make sure you understand what the plan does and doesn’t cover.
No penalty for not having health insurance starting 2019. Wonder how many will drop out, and how the decrease will affect viability.
Moderator’s Note: Some posts were removed due to a previously banned poster returning.
Finally got a chance to see what catastrophic plans we’re eligible for. We have 2 choices, one of which would cost $2200 less than our current plan will be for 2019, the other is $1500 less. Not as much of a break as I had hoped for. The deductibles are also higher for the catastrophic plan - in essence, once the deductible is met, we would reach our OOP max. The less expensive plan, although an HMO, says we don’t need referrals to see specialists, but I have to call them to be sure my generic meds are covered (I’m thinking that maybe because the plan is meant for those under 30 that they don’t cover drugs for cholesterol and HBP). The other catastrophic plan has some coverage for dental, but there aren’t many dentists in their network, so we’re not sure that’s a deciding factor.
Even with the least expensive catastrophic plan, we’re still looking at paying $20000 to cover 2 adults, which is still more than we paid in 2018. Thankfully, DH is eligible for Medicare late in 2019.
It’s shocking, the price tag for those premiums, and very surprising that a catastrophic plan is not more affordable.
Where’s my pitchfork and torch?
We’d qualify for an affordability exemption based on the catastrophic plan’s premium. Going without insurance is not an option we’d consider though.
I didn’t want to speculate, but privately I figured you wouldn’t have much of a savings with a Catastrophic plan as opposed to a Bronze plan, simply because there is little difference between a Catastrophic plan and a Bronze plan.
^^definitely spot-on for my zip code. Just checked Covered California and compared the Bronze PPO with Bronze PPO+HSA, and the difference was $8.00 per month. (Carrier was Blue Cross.)
$810 (or $818) per month for a woman age 62.
It’s just unbelievable that for people our age that the cheapest insurance we can get is still $20,000.
Those are both Bronze plans. A Catastrophic plan is different. In California it seems to be called a “Minimum Coverage” plan. Covered California won’t show them to you if you’re over 30.
I checked; in my area Minimum Coverage plans are a whole lot cheaper than Bronze plans. (This is not true in some areas, but it turns out, in my area they’re a lot cheaper.) This is because unlike all the rest of the plans they are mostly available to people 30 or under, they are mostly bought by healthy people, and they have a separate risk pool.
$20,000 for two people age early 60s?
Government spending on Medicare seem to be about $11k per person. Total spending per person on Medicare (including private spending on supplemental plans and out of pocket costs) seems to be about $19k per person. Obviously, this does include people beyond their 60s. But medical care in the US is expensive no matter how you look at it, though the amounts may be a shock to someone used to having the majority of the costs subsidized by employers and hidden from view when receiving medical services.
We will pay $341+ and H’s former employer (the Fed govt) will pay $1000+/month for our annual family plan BCBS PPO excellent coverage. We are grateful to have this group insurance and believe the premiums are so low for several reasons—fed govt is such a large “group” and includes many young, healthy workers and can require that coverage be broad with low copays. The network includes most providers in HI as well as many nationally.
We have H covered under Medicare A&B as well, for the B premium. Because the insurance is as good or better than Medicare D and Medicare Advantage or Medigap plan, we don’t need to get any of those. H rarely has any copays. H did work 45+ years with the fed govt.
@HImom, when you post about your “excellent” coverage (which you do often), I always feel like you’re gloating. I’m sure you don’t mean to be unkind but when people are lamenting the high premiums and shoddy coverage on the open market and how they can barely afford health insurance these days, you rub salt in the wound when you repeatedly tell them how good you and your family have it. Just sayin’ …
I am not sure how posting about excellent personal coverage is being helpful on this thread, unless the message is we should all work for the federal government.
I’m sorry and of course don’t mean to be hurtful. Insurance is just one if the many factors to be considered in compensation and just showing what COULD happen IF the Pool in the US included nearly all young healthy people with older people who may have more medical expenses. That is the only reason I chime in about this. If that isn’t a good reason I will refrain from participating in such topics.
We are with friends right now. For both couples one is Medicare eligible (one is on A and B, I am on A only) - both spouses still work - could otherwise retire but work for the health insurance. The individual plan options here are terrible and are HMO only.
“But medical care in the US is expensive no matter how you look at it, though the amounts may be a shock to someone used to having the majority of the costs subsidized by employers and hidden from view when receiving medical services.”
This bears repeating. Nobody has cheap healthcare in this country.
Last week, H needed an MRI for his shoulder and we opted to pay out of pocket at a MRI place we found online (versus running it thru the insurance and having it cost 2x as much and having it apply towards the deductible which isn’t met).