Healthcare Exchange/Marketplace Discussion

[monarch64]

Spinning off the premiums thread, a new one to talk about your experiences, whether they are personal, friends/family, whatever.

I've been trying to use the new marketplace website to no avail. Curious what others' experiences have been.

It's a much-needed date night for my husband and me, so I won't be able to participate for the next few hours, but I'll be interested in what others have to say about the new health care marketplace.

ETA: I probably didn't word this very well--I'm trying to post between rushing around getting myself ready to go out and taking care of my kiddo so my husband can do the same. If someone wants to give a more concise description or start another thread that is more clear, feel free and I'll ask the admins to delete mine later.

 

[monarch64]

I'll leave this thread up through the weekend,

So far, with zero responses, seems like a waste of time. Here's hoping that's not the case.

 

[amc80]

I want to reply but am waiting until I'm in front of a computer.

 

[TooPatient]

Went to look at what ours would be just out of curiosity. After looking, I'm REALLY hoping that FI's company keeps their insurance and that he continues working for them. (They are mega company and already made changes last year in preparation so I'm hoping changes won't be too bad...)

Three of us in the house. FI, me, and 14 year old. All reasonably healthy.

Coverage comparable to what we have now (80% coverage after deductible) would be $1500/month! (plus double the deductible to $8,000 and no out of pocket limit listed)

Cutting coverage to 50% after $15,000+ deductible would still run us about $1,000/month.

 

[monarch64]

Thanks, TP. That seems pretty high. Some would argue that hey, preexisting is covered now, and a ton of female-related stuff, so I guess that's a trade-off you have to think about when looking at the prices. Actually I don't even know if that makes sense. I should be sleeping!

I just tried to log in and got a "system is down, blah blah blah" error. Awesome.

 

[TooPatient]

Thanks, TP. That seems pretty high. Some would argue that hey, preexisting is covered now, and a ton of female-related stuff, so I guess that's a trade-off you have to think about when looking at the prices. Actually I don't even know if that makes sense. I should be sleeping!

I just tried to log in and got a "system is down, blah blah blah" error. Awesome.

I had the "system down" message too. It finally worked when I was up at an awful hour (2:30am).

Our coverage already includes all of the mental care (inpatient and outpatient, drug rehab, etc -- I think coverage is 100% up to a certain point and then 90% on other stuff), female stuff (including massive infertility coverage, all preventative care, all birth control, etc), preexisting, and more. We even have coverage at 80% for up to 10 massages per year per person.
Maximum we can pay out of pocket (I'm sure there is an asterisk...) is $2500/year after the deductible (family limit so it isn't per person).

The $1500/month would actually be a big step down in coverage and have double our current deductible. There were no plans that had the level of coverage we do now.

 

[ericad]

I'm on my state's health exchange site. I have 33 plans available to purchase, ranging in price from $213/month to $419/month, depending on deductible and out of pocket max levels. A Premera "gold" level plan runs about $350/month, with a low deductible and out of pocket max. I'm pretty happy with these options and they're far more affordable than I had hoped!

Obviously, for those of us who receive employer sponsored health insurance, it's much more than what we pay out of pocket because our employer pays 80%-50% of our premiums. But that's not who the exchange is for. It's for the uninsured, and if I were uninsured I'd be happy with a $200/month high deductible plan (if I'm young and healthy), or a $350/month lower deductible plan for extra coverage.

 

[minousbijoux]

I have worked for years and would normally not be so focused on this, but for the first time in a long time, I find myself out of work and paying via COBRA for my sons and myself, just shy of $2K/month. But COBRA is for a finite period of time, and then ends, at which point we are subject to being "qualified" with application of preexisting condition nonsense...So this could not come at a better time.

 

[ericad]

I have worked for years and would normally not be so focused on this, but for the first time in a long time, I find myself out of work and paying via COBRA for my sons and myself, just shy of $2K/month. But COBRA is for a finite period of time, and then ends, at which point we are subject to being "qualified" with application of preexisting condition nonsense...So this could not come at a better time.

Hope you find something great on the exchange!

 

[JewelFreak]

COBRA is the most expensive insurance there is! When both DH & I were unemployed, we took out individual insurance, which was much less than COBRA. Big rip-off.

I just read -- there's so much wrong info around, haven't checked to see if it's true -- that anyone on Medicare can't go to the Emergency Room without being sent by their primary care doc. It would be treated as outpatient services, which Medicare won't pay for anymore. So you're having a heart attack in the middle of the night & you have to wait to track down your regular doctor for permission?

Other thing in the article said Medicare patients who get cancer are triaged by age. If you're, say, 75, you get in line behind younger people waiting for treatment. This part I can believe -- they took $716 billion out of Medicare to "pay" for Obamacare.

Our parents & grandparents aren't gonna have it easy. But who cares, they're old anyhow, right?

--- Laurie

 

[ksinger]

COBRA is the most expensive insurance there is! When both DH & I were unemployed, we took out individual insurance, which was much less than COBRA. Big rip-off.

I just read -- there's so much wrong info around, haven't checked to see if it's true -- that anyone on Medicare can't go to the Emergency Room without being sent by their primary care doc. It would be treated as outpatient services, which Medicare won't pay for anymore. So you're having a heart attack in the middle of the night & you have to wait to track down your regular doctor for permission?

Other thing in the article said Medicare patients who get cancer are triaged by age. If you're, say, 75, you get in line behind younger people waiting for treatment. This part I can believe -- they took $716 billion out of Medicare to "pay" for Obamacare.

Our parents & grandparents aren't gonna have it easy. But who cares, they're old anyhow, right?

--- Laurie

COBRA costs depend on how much your company was paying for your insurance, nothing more. I was on COBRA too, back in 2005-6, and I didn't find it all that expensive, maybe I was just braced for worse - as I seem to recall right at $300/mo, and the plan my former company had was really good with no deductible. (I'll concede you'd pretty much never find one like that now...ah the good old days! snort.)

And here is more info as a starting point for researching a debunking the above claims you've read. They're pretty much all pants-on-fire type stuff.

http://www.politifact.com/oregon/statements/2013/jun/08/chain-email/will-seniors-be-denied-cancer-treatment-under-obam/

http://www.snopes.com/politics/medical/kithil.asp

 

[Smith1942]

As you might know from the other thread, my husband and I are self-employed and we pay $1,100 per month for medical, dental and vision coverage, for an excellent plan which is right for us as we have quite a few healthcare needs.

I went on to the MA exchange to see if there's anything better out there for us, to start Feb 1 2014. There were 90 plans to choose from, with a choice of $480 - $1500, for the two of us. However, when I clicked on a given plan to see the details, I got an error message. It remains to be seen whether you can see all the small print before you buy, not just the obvious info of deductible, OOP maximum etc.

I'm not buying any policy I can't see in full before purchase. I haven't forgotten the plan which had no diabetes care in the small print last time I was buying health insurance.

 

[Efe]

Our options are a silver plan for $16,353 premiums with $12,700 maximum out-of-pocket. The Bronze plan would be $10,575 premiums and didn't give a figure for maximum out-of-pocket. This is for 70% coverage and for 2 people. There are no words.

 

[ksinger]

Our options are a silver plan for $16,353 premiums with $12,700 maximum out-of-pocket. The Bronze plan would be $10,575 premiums and didn't give a figure for maximum out-of-pocket. This is for 70% coverage and for 2 people. There are no words.

I'm curious. I just went out to Healthcare.gov, and took the link to the Kaiser Family Foundation's "calculator", which DOES come with a caveat that it is a rough estimate of costs, so I keep that firmly in mind. But still, I could not find any combination of age or income for 2 people on a silver plan, that got over about 7500 for 2 people (I put in two 64-year olds with a 300,000.00 household income). May I ask what state you're in, because what you're saying sounds pretty grim indeed.

I have not checked what is actually available in my state yet, I'm in Oklahoma, so I expect it will be pretty awful, since well, it's Oklahoma.
:-\ If the 'ol gov doesn't start up again soon, my checking may not be mere curiosity, and may be because I HAVE to. :-\

 

[Efe]

We live in Virginia and my husband is 64 and I am 54. I took a screen shot to email to my husband, but am not comfortable sharing it as it has too much personal info. Obviously, income has a lot to do with the number, but I believe zip code is also a factor. I have not yet been able to get onto healthcare.gov so I am hoping for MUCH better news.

 

[ksinger]

We live in Virginia and my husband is 64 and I am 54. I took a screen shot to email to my husband, but am not comfortable sharing it as it has too much personal info. Obviously, income has a lot to do with the number, but I believe zip code is also a factor. I have not yet been able to get onto healthcare.gov so I am hoping for MUCH better news.

Ah! OK...did a bit of digging, and while this is an article about Kansas, it explains some of the wild differences we are seeing.

http://www.kansas.com/2013/09/22/3013422/zip-code-can-affect-insurance.html

 

[minousbijoux]

I have worked for years and would normally not be so focused on this, but for the first time in a long time, I find myself out of work and paying via COBRA for my sons and myself, just shy of $2K/month. But COBRA is for a finite period of time, and then ends, at which point we are subject to being "qualified" with application of preexisting condition nonsense...So this could not come at a better time.

Hope you find something great on the exchange!

Thank you - and likewise!

 

[minousbijoux]

I can't wait until we are out a few years from this point, and all the sturm and drang has calmed down and we've adjusted - one way or another, we've adjusted. I am really curious to see what things will look like and what people will think then. Stay tuned!

 

[ruby59]

As you might know from the other thread, my husband and I are self-employed and we pay $1,100 per month for medical, dental and vision coverage, for an excellent plan which is right for us as we have quite a few healthcare needs.

I went on to the MA exchange to see if there's anything better out there for us, to start Feb 1 2014. There were 90 plans to choose from, with a choice of $480 - $1500, for the two of us. However, when I clicked on a given plan to see the details, I got an error message. It remains to be seen whether you can see all the small print before you buy, not just the obvious info of deductible, OOP maximum etc.

I'm not buying any policy I can't see in full before purchase. I haven't forgotten the plan which had no diabetes care in the small print last time I was buying health insurance.

As a fellow diabetic, I hear you. Rhode Island's exchange is not much better. I can only go so far before I get error messages. My husband is self employed. He gets his through a group rate for him, his partners, and employees. Mine is through where I work. For me, we pay a portion and the deductible is high. I am happy with it, but am curious to see what they can offer.

And to the Pricescoper above and the quote she got, all I can say is "Yikes."

 

[ericad]

Our options are a silver plan for $16,353 premiums with $12,700 maximum out-of-pocket. The Bronze plan would be $10,575 premiums and didn't give a figure for maximum out-of-pocket. This is for 70% coverage and for 2 people. There are no words.

$16k per year? Per month? And you got this from your state's exchange site, correct?

 

[Beacon]

Most likely that is per year. I have seen other sites where posters indicate they are looking at $14K per year health insurance premiums off the exchanges.

Honestly, people cannot pay these kinds of bills. It's like having a kid in college.....forever.

We're in trouble here.

 

[Beacon]

Just ran what the exchange costs for us:

Plans somewhat close to what we have now are 12k - 14K per year. The cheapest I see is 9K/year with very skimpy coverage.

We do not qualify for "assistance".

Good luck to people paying this.

How much is that penalty again? It's looking attractive.

edited to add: this is for northern California, two people no dependents. Max $12700 out of pocket.

 

[Efe]

Our options are a silver plan for $16,353 premiums with $12,700 maximum out-of-pocket. The Bronze plan would be $10,575 premiums and didn't give a figure for maximum out-of-pocket. This is for 70% coverage and for 2 people. There are no words.

$16k per year? Per month? And you got this from your state's exchange site, correct?

$16K plus $12,700 max out of pocket per YEAR. As I said, I got this off of the Kaiser Family Foundation website's calculator. I have since run the numbers with the contiguous zip codes and one of them brings down the premiums to $13,111, with the same max out of pocket.

I have no idea what we are going to do. We are going to wait until we get the new rates from our current policy, which should come within the next couple of weeks to see our options. I am assuming that they will be even higher, since my current policy does not cover the 10 required coverage items (which includes maternity care) under the ACA.

 

[Beacon]

I suspect there will emerge some very interesting custom made insurance policies, at least I hope so.

It's a very bad deal to pay out 14K per year for coverage with high out of pocket expenses and an out of pocket 12.7K. People may fear a terrible illness might bankrupt them, but these kinds of fees will almost certainly bankrupt some.

In the meanwhile, people are going to cut back expenditures in other areas, if only out of fear of paying these kinds of bills, never mind when they actually do have to start paying them. Having this news bomb on us as we enter the holidays is going to make for a VERY promotional Christmas. So vendors - prepare to drop your prices!!

 

[brightlight]

The premium and deductible for comparable coverage would be slightly more, but the maximum out of pocket costs would more than double. I had been trying for years to switch insurance companies and kept getting rejected by multiple companies at different times, and I was so grateful that I could no longer be denied coverage for a pre-existing condition that I would have been ok with a bump in costs. However, some of the prices I'm seeing posted are REALLY high.

 

[amc80]

Here are some of my options for myself, DH, and DS (13 months):

Least expensive: $596/month- $10k family deductible, 40% coinsurance, out of pocket max = $12,700

Most expensive: $1172/month - $1300 family deductible (in network) or $13,000 (out of network), 20% coinsurance, out of pocket max of $12,700 (in network) or $40,000 (out of network)

$40k out of pocket max? Are you freaking kidding me? Oh, and ER visits are $100 for the first one and $600 for any others. Ouch.

We don't meet the requirements for assistance. I looked to see what would happen if DH stayed home (since it's a possibility) and we had another kid...and we still don't qualify.

I guess my employer provided $589/month policy ($500 deductible, $2k out of pocket, 0% coinsurance) is looking better and better :-/

 

[ericad]

Well, I know that my husband's employer option would cost over $1k/month for him + spouse, with $5k/person in annual out of pocket max. This has always been the range. So that's $12k-$14k annually (we're both young) with $10k in annual out of pocket max, for 80% coverage (but we have no deductible). Because his employer contributes towards the premiums, our portion of the monthly premiums is much less, but this is what our insurance costs, and always has cost.

So I guess I don't expect anything I find on the exchange to be far off from this. These premiums predate ACA, they've been this high for years and years. $16k/year with $6k/person in OOP max is, for sure, very high. But have people been paying that much less before ACA? Maybe our plan has always just been extremely expensive?

ETA - don't misunderstand, I think paying over $1k/month is outrageous!

 

[amc80]

But have people been paying that much less before ACA? Maybe our plan has always just been extremely expensive?

My current plan is $422 a month...so $166 a month less than my new plan. The big difference is I currently have no deductible and my copays are less than what they will be on the new plan.

 

[Beacon]

Here are some of my options for myself, DH, and DS (13 months):

Least expensive: $596/month- $10k family deductible, 40% coinsurance, out of pocket max = $12,700

Most expensive: $1172/month - $1300 family deductible (in network) or $13,000 (out of network), 20% coinsurance, out of pocket max of $12,700 (in network) or $40,000 (out of network)

$40k out of pocket max? Are you freaking kidding me? Oh, and ER visits are $100 for the first one and $600 for any others. Ouch.

We don't meet the requirements for assistance. I looked to see what would happen if DH stayed home (since it's a possibility) and we had another kid...and we still don't qualify.

I guess my employer provided $589/month policy ($500 deductible, $2k out of pocket, 0% coinsurance) is looking better and better :-/

Amc, what state are you in?

 

[amc80]

Here are some of my options for myself, DH, and DS (13 months):

Least expensive: $596/month- $10k family deductible, 40% coinsurance, out of pocket max = $12,700

Most expensive: $1172/month - $1300 family deductible (in network) or $13,000 (out of network), 20% coinsurance, out of pocket max of $12,700 (in network) or $40,000 (out of network)

$40k out of pocket max? Are you freaking kidding me? Oh, and ER visits are $100 for the first one and $600 for any others. Ouch.

We don't meet the requirements for assistance. I looked to see what would happen if DH stayed home (since it's a possibility) and we had another kid...and we still don't qualify.

I guess my employer provided $589/month policy ($500 deductible, $2k out of pocket, 0% coinsurance) is looking better and better :-/

Amc, what state are you in?

The land of legal gambling and prostitution...aka Nevada.