Have anybody used Healthcare.gov to get health care coverage?

[island911]

Yeah, they can only dictate that people have to BUY a certain product. (risk insurance)

[jyl]

I used healthcare.gov to find and switch to a new plan. There were a lot of different insurers and plans to go through, almost too much choice, but I selected one and have been pleased so far. No problems with my doctors taking the insurance, but I did check before buying the insurance. I deliberately chose a high deductible plan. The premium is actually lower than my prior corporate group coverage, which had similarly high deductibles. It will go up next year, but will still be slightly lower.

We are a healthy family, so paying for health insurance is always going to be irritating, until one day when something happens. Being self insured seems crazy to me. A family member gets hospitalized for something, plan on $5000 a day . . .

[jgreen]

Interesting topic. I retired at 62 and had COBRA coverage for 18 months. When that ended I needed another 18 months of coverage to get to Medicare. Bought independent policy for 12 months - $584 month. For 2016 company raised premium to $705. I looked into Obama care and qualified for a subsidized premium totaling $275 month for the same coverage. This works because my income in retirement is so low.
What is of concern is that I saved well for retirement, debt free, own a home free and clear and quite frankly can afford the higher premiums, yet the government is pretty damn quick to get me under their "wing" and the application never considers assets or savings for eligibility.

[Rich76_911s]

Originally Posted by Dave Kost

Tobra-

Thanks for the response.

Both my doctors are approved under the plan- Connect Blue EPO 5500. When I checked the costs, you can fill in a question air that asks what doctor and medication you will be using. Both doctors are approved as well as the medications.


The cost is $389 month verses $740.00. Both BCBS plans.

Thoughts? Am I confused? Sound to good to be true?

Help

OK I didn't read the rest of the thread. But the reason you are getting 2 different prices is that the .gov website is giving you the price post the "subsidy," and the health insurance company is giving you the full price for the plan. So the government is kicking in $351 per month, and you are paying the rest.

So the plan costs $740/month irregardless of which site/contact you use. Just the insurance company didn't adjust it for the refund the government is going to give you.

At least that is my assumption, and if you were asking about identical plans from 2 different sources I'm pretty darn sure that is correct.

The whole thing is quite messy and confusing, and getting clear and correct information is almost impossible. As tobra mentioned you can't count on the website actually being accurate with your doctor accepting or not accepting.

Also be aware of co-insurance that is tied onto many plans. The co-insurance makes deductibles what I'd call "soft deductibles" at best. So you pay your deductible but with co-insurance you still get stuck paying 30% or more of the bill after you've paid the deductible. Silver plans seemed to be the worst offenders when it came to co-insurance after you pay your deductible. I made excel spreadsheets comparing all the different plans and except for a very small window of annual expenses it made more sense to use the bronze plan than silver. The higher premiums for silver plans combined with co-insurance after you've paid the deductible really killed the appeal of a silver plan for me. If I recall correctly anything below $7,000 or above 12,000 in annual medical expenses, it was better to have the bronze plan than silver. Between 7 and 12K in annual medical expenses silver plans were slightly cheaper.

Do yourself a favor and just check out the stridehealth webpage. They have a pretty cool tool that will allow you to compare 2 plans in action and you can see what your estimated medical expenses would be for different things (ie a broken ankle or a hernia). Even if you have already decided and put it into place, it's worth checking out for future years.

[Dave Kost]

JGreen- I am in the same boat as you. Cobra then independent policy until medicare. Obamacare ended up saving us money. I went to BCBS to see my new policy costs for 2016 and it went from 620 to 750/ month- thats what drove me to healthcare.gov.

I think the insurance company's don't want to offer the gov policies unless you ask them. You go in to see them and they offer you a policy that THEY benefit from. Just be an informed buyer. Im saving ~$3k a year on my monthly policy plus lowered my deductible to $750/ year. (I didn't qualify for an earnings discount.)


I just want to pass this information along. Check the rates on the gov site.

[Tobra]

Fairly certain the insurance companies can't offer the .gov policies, but that varies from state to state. You are only eligible for the discount if you go through the online exchange to get the policy subsidy. The way the law is written, you can only get the subsidy if the state has set up an exchange, but I think they executive ordered their way around that. I think the subsidy is considered income too, as far as the IRS is concerned, but could be wrong about that. I don't think anyone understands how it is really.

[red-beard]

Originally Posted by Tobra

Fairly certain the insurance companies can't offer the .gov policies, but that varies from state to state. You are only eligible for the discount if you go through the online exchange to get the policy subsidy. The way the law is written, you can only get the subsidy if the state has set up an exchange, but I think they executive ordered their way around that. I think the subsidy is considered income too, as far as the IRS is concerned, but could be wrong about that. I don't think anyone understands how it is really.

They do. But you can only get the subsidies if you go through an exchange

[Tobra]

I think that depends on which state you are talking about.

[flatbutt]

Good grief this all sounds so confusing.

[jyl]

It took me about four hours to choose a plan.

Of course, I was somewhat anal. I built a spreadsheet with three scenarios: a healthy year, a year with one significant health issue requiring a short hospital stay, and a year where multiple family members had hospitalizations. Then I plugged a few different plans' premiums and terms into that, to compare. When my head started to hurt, I picked one. Then checked doctors and reputation.

In all fairness though, I probably spent less time picking a health plan than my wife spends choosing a couch.

[onewhippedpuppy]

In KS you can't go direct to the insurance companies, they send you directly to the govt website. By dictating that everyone will have insurance and standardizing policy coverage and rates, they have essentially created a government managed monopoly.

[KFC911]

I'd been with BCBS for years, as that was the last plan when I left the corporate world. My individual BCBS was less than former group rate, but would have increased significantly next year. Lots of options/plans with ACA plans, BCBS was still significantly higher....I switched to Aetna....for a much more reasonable rate. Time will tell....

NC BCBS rates are set by law....80% goes towards previous year payouts....So,
costs + 25% = Ins Cos do NOT lose sweetheart deal....

[Nathans_Dad]

One thing to keep in mind is that many of the low cost plans will not pay for certain services once you actually get sick. One prime example I deal with every day is the Medicare replacement plans. They are lower cost as an outpatient but once you get into the hospital you discover they just won't pay for certain things. The most common issue I deal with in the hospital is rehab denials. Patient comes in, has a stroke and physical therapy recommends acute rehab. Their medicare replacement plan denies rehab, instead telling us to send the patient to a SNF (which is a nursing home). Then the patient and their family is furious that they can't go to acute rehab despite the fact that the doctor and the physical therapist recommend it. I have to explain that you get what you pay for.

Buyer beware!

[Tobra]

So what you are saying is that if something sounds too good to be true, it probably is