Health Care Insurance Questions

[freckles527]

I'm looking for two topics of information to further help my husband and I as we prepare to full time next year.

1. Has anyone registered and applied for health insurance through the new healthcare.gov site? I'm interested if you registered and did not apply for insurance or if you did apply for insurance. Were your rates (plans) better or worse?

2. If you are not planning on using the above, what insurance plan are you using for 2014. If you can provide provider, plan and monthly cost for couples around late forties and fifties I would really appreciate it.

We live in Florida and will have our first gig in Florida and plan to stay in this area, but would like to have an opportunity to travel out of Florida (once in a while) so looking for plans that would meet our needs. We have no health issues.

Thank you!

[DianneOK]

Gone political....closed

[monkey44]

And, we all should be able to predict -- eventually, if we leave this medical care issue in the private sector, we'll all go broke and have minimal coverage and maximum deductible.

One day, this country will wake up and put health care under the Medicare umbrella for all citizens, and charge according to income. Otherwise, the profit taking health care companies will continue to raise rates and charge exorbitant fees, and we'll continue needing federal and/or state subsidies.

If we're gonna subsidize it, keep in mind we subsidize the PROFIT of HMOs not the health care. If anyone has ever used health care of any sort lately, count the number of paper-pushers you see, compare that to the number of health care professionals you see on one visit. Then ask yourself where your fees go.

[docj]

JimM68 wrote:
As a small business owner, I've always had no choice but to buy individual health insurance. I've used most of the biggies in the industry over the years, and currently use blue cross blue shield of illinois.

Many years ago, I made the choice to get a high deductible major medical policy. Our card gives us discounts, but until that 5k deductible is met, we pay every dime.

For a family of 4 in Illinois, we've been at $450/month. Over the past 10 years, annual increases have been 10% or more. We've never met a deductible, they have never paid a dime.

With the "new system", our previous policy is flat gone. BCBS will not renew it after 1-1-14 even if we pay the penalty.
I've been unable to get far enough thru healthcare.gov to get a quote, tried several times.
On the BCBSIL site, they give me a bunch of choices for "conforming" plans. In all cases, my deductible is up 20%, a bunch of coverage I don't need is included (maternity? contraception? pediatric dental?)
The cost is DOUBLE what I have been paying.
But even with my near 6 figure income, I qualify for a $321 per month federal subsidy, which brings it down to a mere 25% increase over last year.

But that I have to get from healthcare.gov, and I cannot get that far without an error of some sort.

At the risk of stepping over the politics line, why the heck would our government WANT to put me on welfare?

I don't understand why you consider taking a subsidy to be the same as putting you on welfare. An effort is being made to make healthcare more affordable. Medicare is a subsidy and was called Socialist when it was enacted. Today most people consider it to be a standard part of life in the US. Healthcare coverage could have been expanded by making it like Medicare but the decision was made to manage it through the private sector. As a result the only way to "level" prices is to subsidize the premiums.

[TucsonJim]

Mountain Mama - Yes, that premium price is the total montly cost for both of us.

[JimM68]

As a small business owner, I've always had no choice but to buy individual health insurance. I've used most of the biggies in the industry over the years, and currently use blue cross blue shield of illinois.

Many years ago, I made the choice to get a high deductible major medical policy. Our card gives us discounts, but until that 5k deductible is met, we pay every dime.

For a family of 4 in Illinois, we've been at $450/month. Over the past 10 years, annual increases have been 10% or more. We've never met a deductible, they have never paid a dime.

With the "new system", our previous policy is flat gone. BCBS will not renew it after 1-1-14 even if we pay the penalty.
I've been unable to get far enough thru healthcare.gov to get a quote, tried several times.
On the BCBSIL site, they give me a bunch of choices for "conforming" plans. In all cases, my deductible is up 20%, a bunch of coverage I don't need is included (maternity? contraception? pediatric dental?)
The cost is DOUBLE what I have been paying.
But even with my near 6 figure income, I qualify for a $321 per month federal subsidy, which brings it down to a mere 25% increase over last year.

But that I have to get from healthcare.gov, and I cannot get that far without an error of some sort.

At the risk of stepping over the politics line, why the heck would our government WANT to put me on welfare?

[Mountain_Mama]

TucsonJim wrote:
My wife and I will both hit 60 next year. She is already retired, and I'm retiring in November. We will be on our own for health care. I'm still waiting on the price of Cobra coverage, so I might go that way. However, for comparison purposes, I've been able to set up an account on the federal exchange and price some policies. If Cobra is too expensive, I'll probably go with the policy I show below. This policy is full price because with our income, we do not qualify for a discounted rate:

Platinum Plan
Monthly premium $870.36
Deductible $0.00
Max Out of Pocket ($2,000 per person) - $4,000 per year
Doctor Visit - $20.00
Specialist Visit - $40.00
Generic Drug price - $10.00

Just curious and making clear for myself...The monthly premium above is for the both of you?

[docj]

TucsonJim wrote:

freckles527 wrote:
TucsonJim thank you for this information. I really appreciate it!

You're welcome. But I forgot to mention how you can rack up $4K in out of pocket expenses. Emergency room visits are $150 each, and if you're hospitalized, it's $500/day until you reach the max per person. For example,

If I was in the hospital for six days, my maximum would be $2000. If the DW was also hospitalized, she'd have the same charges. I don't expect that we'd hit the $4K limit, but it's nice to know we won't go bankrupt if we have a serious health issue.

But these examples of costs are for the specific plan you chose. The maximum out of pocket stays the same for all plans, I believe, but some have higher premiums and lower co-pays than others. It's all a question of how you take the risk. Some people would rather pay more per month but have less to pay if and when they do get sick. On the other hand if they are healthy in a particular year they would have paid all those extra premiums without getting much back. It's like any other insurance you purchase; you balance cost and risk.

[TucsonJim]

freckles527 wrote:
TucsonJim thank you for this information. I really appreciate it!

You're welcome. But I forgot to mention how you can rack up $4K in out of pocket expenses. Emergency room visits are $150 each, and if you're hospitalized, it's $500/day until you reach the max per person. For example,

If I was in the hospital for six days, my maximum would be $2000. If the DW was also hospitalized, she'd have the same charges. I don't expect that we'd hit the $4K limit, but it's nice to know we won't go bankrupt if we have a serious health issue.

[freckles527]

TucsonJim thank you for this information. I really appreciate it!

[TucsonJim]

My wife and I will both hit 60 next year. She is already retired, and I'm retiring in November. We will be on our own for health care. I'm still waiting on the price of Cobra coverage, so I might go that way. However, for comparison purposes, I've been able to set up an account on the federal exchange and price some policies. If Cobra is too expensive, I'll probably go with the policy I show below. This policy is full price because with our income, we do not qualify for a discounted rate:

Platinum Plan
Monthly premium $870.36
Deductible $0.00
Max Out of Pocket ($2,000 per person) - $4,000 per year
Doctor Visit - $20.00
Specialist Visit - $40.00
Generic Drug price - $10.00

[cnehodgdon]

Living in NY, we applied through the exchanges here. There are tax credits available based upon income. The rates were MUCH less than the COBRA available to us. While the coverage is a bit less with a couple of higher deductibles, the savings more than made up for the cost of the deductibles.

It did take several tries to get my account set up due to the huge numbers accessing the site. I found it very easy to navigate. I had a couple of questions and each time I called the state number, I spoke with knowledgeable people who took their time to answer my questions.

One other suggestion is to look into discount prescription cards that are available online. Most offer a decent discount on 90-day supply of medications. I looked at several to compare.

Hope this helps to answer your questions.