healthcare.gov I looked at my plans without giving personal or contact info. I just needed to input my county.
Question since so many of you are well versed on the ins and out of ACA: And sorry if its too basic. For those of you with dependents attending colleges in other states, what do you do? Several of the plans I looked at seemed to confine PCPs to my state so how would my kids be covered in a different state. Maybe I’m looking at the wrong kind of plans. Dozens come up so it takes some digging. Do you do a family plan or have the kids do their own or through their university?
Yep, @romanigypsyeyes , I well remember your insurance odyssey, and the times you’ve needed to make changes for various reasons.
@doschicos Our patchwork insurance system makes it tricky when the kids go to school out of state.
My D’s college insurance was major medical only, with a rather low cap, so we waived that and kept her on DH’s plan. I called Anthem (Blue Cross at the time IIRC) and they told me that there was a nationwide network of BCBS providers which she could use. I remember that they sent her her own card to carry. Based on everything I know about Anthem, I really doubt that it would have been as easy or cheap as they told me. Luckily, she didn’t have any medical needs while she was at school which couldn’t be handled by the student health center, including her gyn exam and birth control. For her acne issues, as well as dental and vision, we took care of those things here, when she was home on breaks and summer. (Which raises another question which I don’t know the answer to: For kids who take the college insurance, what’s the coverage when the student is home on breaks?)
ETA – But that was back in 2009, and a lot has changed since then. You might want to start by calling your carrier.
I never put in my real details, when just window shopping. I do keep the birth year and approx MAGI, since that’s relevant. We don’t need to state address.
Doschicos, our offerings allow for emergency care in the college area on all plans. D2 could also have used an “in-network” specialist near her college. With college health services, what would come up is a specialist.
At home, we don’t distinguish a PCP, though it’s an option and OV can be cheaper if that doc is a “patient centered medical home.”
Unlike CA or some others, we’re in New England, where it can be common to cross state lines for lots of reasons. Depending on where you are, YMWV. Your mileage will vary.
Agree, you ask the carrier.
In our case, the college health insurance ran August to August and visits to the home doc were covered. What was not included was out of the US. We didn’t use college insurance because on our plan, it was more cost effective to keep her on ours and the coverage was significantly better.
@doschicos, We live in NJ and DS goes to school in DE. He needed his own policy since I started on Medicare. All NJ offers is HMOs, EPOs (with only emergency coverage at college) and POS starting at $ 380 a month. We opted to take his school insurance for less than $ 100 per month and it’s a BCBS PPO with better coverage than our previous gold PPO group plan.
I’ve had Anthem Blue Cross Blue Shield for awhile and my heart stops every month when I have to write the check.
I am looking to find a better out of pocket deal. Currently I have a $500 deductible and pay $566/month that I purchase privately without a subsidy. I am also looking for insurance for my college aged child.
“Anyone who thinks I’m lying about several plans can ask LasMa and others for confirmation. I’ve detailed them on the other ACA threads and privately.”
Not sure if asking how it could be possible to have several plans since January 2014 is implying that you are lying. I consider several to be 5-6-7 ACA plans, and I don’t know how that happens. Seems like a simple question to answer without having to read other threads. It seems a terrible system if one is forced to constantly change plans.
busdiver, for sick people, and for lower-income people, it is a huge blessing compared to what we used to have (how much of a blessing still unfortunately depends on what state you live in). Those who have never had to negotiate the individual market have no idea how awful it was before we had some protections. I’m very happy that my D has been able to get good, affordable insurance in both IN and WA. And I’m very happy that DH has the option of shopping for 2016 insurance if he doesn’t like his 2015 insurance. Neither of those was possible before.
@raclut That’s a tiny deductible which you can almost certainly increase, which would give you a lower premium. Have you run an estimator on the exchange? That will give you a good idea of what’s available, even if you buy direct from the insurer. There are some very low OOP plans, but of course the premiums are going to be a lot higher. But that’s always been true.
“busdriver, for sick people, and for lower-income people, it is a huge blessing compared to what we used to have (how much of a blessing still unfortunately depends on what state you live in). Those who have never had to negotiate the individual market have no idea how awful it was before we had some protections. I’m very happy that my D has been able to get good, affordable insurance in both IN and WA. And I’m very happy that DH has the option of shopping for 2016 insurance if he doesn’t like his 2015 insurance. Neither of those was possible before.”
I am very glad that your daughter has been able to get good insurance. I am not knocking every aspect of the ACA. There have been some important changes that should have happened a long time ago, with or without it. However, I hope they will continue to work to fix the aspects of it that are not working. If one has to constantly change plans, that’s something that’s not working. Keeping track of all that, meeting the deductible each time, could be costly and confusing. So much easier to have a comprehensive plan that one could keep, no matter their situation. Part of why I’ve always been in support of Medicare for anyone who wants it—on a sliding income scale. But that’s an entirely different discussion.
I agree with you that the new system is far from perfect, and I agree with you about the ultimate solution. One of the big problems is the need to change everything if you move. But again, that’s always been the case, and is nothing new with ACA.
I just don’t understand why there is a penalty for having better insurance than the government thinks you need. I pay for more car insurance for my car because I want rental car reimbursement, I pay less for D’s car insurance because the extra coverage isn’t worth it for us. Is it wrong that I choose to pay for an extra benefit? Our current employer paid “cadillac” plan will cover our kids when they at college out of state but that will likely change in 2018 when the cadillac tax goes into effect.
H’s company is international and I’m sure it cost them less in bookkeeping to be able to offer all employees in the US the same coverage than insurance that is regulated state by state.
Currently both Clinton and Sanders are denouncing this part of the ACA and calling for the repeal of the cadillac tax. Because of the the way it’s worded, employees have no say because the tax is pay by the employer.
We are a family of five so anything over $5,500 per person per year (or less than $460 per person a month) will be taxed at 40%. We paid more than that for COBRA almost a decade ago when DH was between jobs!
I believe this includes all insurance vision and dental but I’m not sure. Last year they made us switch our vision plan so it wasn’t part of our health insurance which cost us a significant amount since all five of wear glasses and two are legally blind without glasses.
@busdriver11 “However, I hope they will continue to work to fix the aspects of it that are not working. If one has to constantly change plans, that’s something that’s not working.”
One does not, nor cannot constantly change plans. The ACA works like any insurance, with an open enrollment period once per year. That is the only time you can typically change plans. There are exceptions, of course, just like employer based insurance. These include when one has a major life event, baby/divorce/marriage, if one has a major change in income, or if one moves to a new state. Open enrollment runs from Nov-Jan, in other words, right now, so people are learning about their new premiums, and making choices for new plans. This means, lots of online discussions and rants, just like every Nov.
@lasma My plan is a grandfathered plan so I don’t think anyone can get such a low deductible anymore. I will have to do some research. The large deductables on the ACA are scary.
One doesn’t have to “constantly change plans.” (It’s the kind of statement than can confuse others.) You don’t even have the chance to change exchange plans, at will. There has to be a qualifying circumstance or be within the window.
And if you do change, the insurer can track deductible and mine credits amounts already paid. Etc. I had a 1500 ded, dropped D2, moved to a 3k plan and what I had already paid on my own, against deductible, was credited to the new deductible. In general, I’m not sure why we don’t just look up and confirm how different aspects really affect us.
Wonder how it works when the Obamacare plans hit the Cadillac tax level. With costs rising, seems like it could be soon. So if you are paying for it yourself, will they tax you 40% of the amount over the max allowed to be paid? Or if you get a subsidy, will the taxpayers have to pay the 40% tax? What constitutes a Cadillac plan may eventually be pretty meager.
The Cadillac tax is obscene. They should just limit the amount a company can write off rheir taxes, and let the chips fall where they may. Encouraging employers to offer worse health care plans or they will get overtaxed helps no one, but I guess it makes others feel better for some reason.
There are larger and smaller deductibles offered by most plans. You pay more for a smaller deductible because the insurer is kicking in its money sooner. If you don’t need a low deductible, why pay more for one?
Raclut, figure what your medical usage has been, what it could be. My usage this year has been zip except preventative. Then you run it against the specifics of various plans. How much does it end up costing us if we need nothing special vs if we rack up 3k or 10k+ in med services?
It was fine to switch to that 3k ded, though I did hold my breath, so to say. And I kept the monthly costs manageable.
really who’s business is it if you’d rather pay more for a smaller deductible or pay less for a larger deductible? If you have a job that offers a perk of more affordable health insurance why is this a problem that the government needs to get involved with?
Does anyone forsee ACA disappearing? Different balance of power in DC? My family currently has a very good private policy in terms of coverage but it is costing us a HUGE, HUGE amount. I have been reluctant to get rid of it because if we drop off it, we can’t get back on. It wouldn’t be offered to us again. It would be much cheaper for us to go the ACA route - coverage isn’t as good in terms of out of pocket and deductibles but made up for with much lower premiums. I’ve probably been stupid for not switching yet but, due to preexisting conditions in the family, it would be very tough to get insurance again should things go back to what they were before ACA. Perhaps I shouldn’t be so reluctant to switch but the fear and risk of no insurance down the road has made me very indecisive in this matter, which isn’t my normal approach to most things.
First, it’s a concern to people like raclut, that the cost is $566/mo. Not everyone has a lush employer plan that covers all or nearly all of cost.
From the Kaiser family Foundation, a good resource:
“The so-called Cadillac tax is an excise tax on high cost health plans offered by employers. Beginning in 2018, health plans that cost more than $10,200 for an individual or $27,500 for a family plan will be subject to the tax, which is 40% of the amount that exceeds those thresholds. For example, if a family plan costs $30,000, the employer that offers the plan would owe 40% of $2,500 ($30,000 minus $27,500), or $1,000 for each family it covers under that plan.” (These thresholds will go up.)
Of course, many employers will seek to reduce the total costs of the plans they offer. And yes, that may mean a higher deductible than today or a larger co-share. But look into this before jumping.
One of the big problems is the need to change everything if you move. But again, that’s always been the case, and is nothing new with ACA.