Abrupt jump in health insurance costs? (patient, deductible, specialist, monthly)
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So you are getting less for your money. That happened to us too. "Good news, your premiums aren't going up! Oh, OK, but your deductibles are."
We've faced one huge increase in premiums and/or decrease in services year after year since the ACA was enacted. We had small increases (which we expected) each year prior to the ACA but the minute it was enacted our premiums went out the roof, and have stayed there since then. Just when I thought a $5000 EACH deductible was crazy, we got the deductibles for 2019 raised - to $6650 each. Basically all we have is preventive care and catastrophic care.
I have to laugh at the ACA deductibles. My current plan deductible is higher than the average medical bankruptcy in the country (14K versus 10K average medical bankruptcy), yet the plan is not HSA compliant.
For 2019 it looks like I am qualifying for a subsidy thankfully, although I would prefer my income would have as high in the past so I wouldn't qualify. So far the sign up with this new insurer has not inspired confidence. Took 3 phone calls to get someone to take my payment to initiate coverage for next year.. Guess they aren't used to people paying for the insurance? My previous privately purchased plans went much smoother in setting up plan and payment.
My housemate and I are both on UHC Plan F and her premium went down $10 a month and mine went up by $2. She has been on it almost 2 years longer than I and was paying about $14 a month more than I. $2 a month I am not going to complain about. UHC is doing away with Plan F either '19 or '20 but people who are already covered by it are grandfathered in on it. Thank goodness, the premiums are steep, $214 a month but I have no deductibles, no co -pays, nada! I think this plan is the best bang for the buck hands down after reading the posts! $214 sounds like a pittance compared to you guys!
Our insurance costs have gone up greatly every year since the ACA was enacted. Just got the BCBS PPO 2019 plan and here are our costs for a husband and wife:
Monthly premium: $1000
Individual deductible: $6650 each
Yes, terrible. We are self employed.
About the only good news is that preventive care is still covered at 100 percent and that after we meet our huge deductibles, everything in network (and it is a good network) is covered at 100 percent. So there's that.
Ugh.
Like you I was self employed but turned 65 at the beginning of 2018 and was able to get on Medicare. What a relief! I was paying $880 a month in 2017 for the same sort of terrible policy. You paid each month and then continued to pay the full cost of every doctor visit because the deductible was so high. You will be very relieved to get Medicare -- now with Part B, a good supplement AND a Part D drug plan I pay about $400 a month -- may go up slightly for 2019 but it is a GREAT deal. And it pays for just about everything.
Like you I was self employed but turned 65 at the beginning of 2018 and was able to get on Medicare. What a relief! I was paying $880 a month in 2017 for the same sort of terrible policy. You paid each month and then continued to pay the full cost of every doctor visit because the deductible was so high. You will be very relieved to get Medicare -- now with Part B, a good supplement AND a Part D drug plan I pay about $400 a month -- may go up slightly for 2019 but it is a GREAT deal. And it pays for just about everything.
I agree. I retired in 2014 and my ACA premiums were about $450/month with a $6K deductible. Every year it got worse- they'd try to dump me into a PPO plan with a crappy network and (in some cases) ZERO coverage out-of-network and I'd have to find another insurer. I ended up with a $900/month premium last year, a $6,000 deductible and a crappy network. I'm very thankful that my medical issues during those years were never any more serious than a case of raging poison ivy.
Self-employed, semi-retired 58.5 year old in Massachussets, have the cheapest/high deductible policy (healthy, active, practically never using medical services). Premium for 2019 went up by $50 per month (ie, $600 per year), but is still below $5,000 per year (ie, about $405 per month). It just feels a bit unpleasant because the premium barely went up at all for the past 10 years (basically, just a few $ per month, never more than about $150 per year). MA has had a good health insurance situation which somewhat enabled my early semi-retirement (at 49); hope this is a one-time event related to federal policy change, and will not become the annual 12% increase trend...
Self-employed, semi-retired 58.5 year old in Massachussets, have the cheapest/high deductible policy (healthy, active, practically never using medical services). Premium for 2019 went up by $50 per month (ie, $600 per year), but is still below $5,000 per year (ie, about $405 per month). It just feels a bit unpleasant because the premium barely went up at all for the past 10 years (basically, just a few $ per month, never more than about $150 per year). MA has had a good health insurance situation which somewhat enabled my early semi-retirement (at 49); hope this is a one-time event related to federal policy change, and will not become the annual 12% increase trend...
Sadly 12% is really, really low for ACA. I'm up over 300% since 2013, which doesn't happen with 12% increases. Most states told insurers to set prices assuming that the penalty and cost sharing subsidy would be done away with last year. That's why it was such a low 12% increase.
Sadly 12% is really, really low for ACA. I'm up over 300% since 2013, which doesn't happen with 12% increases. Most states told insurers to set prices assuming that the penalty and cost sharing subsidy would be done away with last year. That's why it was such a low 12% increase.
But a 12% year to year increase is really HIGH for a high-deductibke Bronze plan in Massachusetts. MA was the first state that introduced mandatory health insurance (I think it was in 2005 or 2004), which has been far better than regular ACA (ie, better quality and cheaper, at least for the residents of middle-class zip codes, where nearly everyone pays taxes and contributes premiums to the insurance pool, with very few residents being subsidized. I understand MA healthcare premiums are determined by zip code, and if everybody in the zip code pays their full premium, then each individual or family premium goes down - because you are not subsidizing anyone else, just paying for your own risk % in the common insurance pool. What drives the cost of insurance up are the people who do not pay into the insurance system, but receive full benefits, subsidized by those who do pay. That is precisely why health insurance in Western Europe is so good and affordable: because almost everyone pays into it, and very few are subsidized. The situation in my MA zip code is very similar to that of Western Europe, which is why it surprises me that the premium went up 12% this year, as it usually goes up less than half of that from year to year).
Until this year (2018) I had clung to my individual grandfathered Anthem Blue Cross plan. The plus was an unrestricted network - see any doctor in the country who accepted Anthem Blue Cross. The minus was huge rate increases every year, anywhere from 12% to 24%. Not ACA compliant, so it didn't include the perks such as free annual mammogram. I was afraid to change because once you leave a grandfathered plan, there's no going back. But the 2018 rate increase to over $1000/month tipped me over the edge. I'm still a few years away from Medicare. After much angst, I changed to an off-exchange Blue Shield Silver plan for $874/month during last year's open enrollment.
I have been greatly pleased with this new plan. Off-exchange (no subsidy) but ACA compliant, so the annual mammogram is free as is the annual women's Gyn visit and annual visit with my internist. Some of these were costly under my old grandfathered plan. This was a win. My annual bloodwork was also a lot cheaper, so Blue Shield must negotiate a better deal with the lab.
Alas, this Silver plan is raising its rate from $874/month to $969/month in 2019. I am changing to the Bronze plan which is $849/month. It includes 3 doctor visits (including Urgent Care) per year Before Deductible, with a copay. The annual preventive visit with internist is still free, as is the annual women's/gyn visit, and the mammogram. I saw 3 doctors this year, so next year should be about the same (knock on wood). I'll be saving $1,440/year in premiums by changing to Bronze which would cover a lot of medical bills to break even. The deductible is $6300. I only spent about $400 counted toward deductible this year, so unless I have a grave illness or accident, the deductible is moot. The Out of Pocket maximum is $7,550 which is the only figure to pay attention to. I think of it as somewhat self-insuring up to $7,550, above which the insurer covers all allowed charges at their in-network negotiated rate.
Since I'll now be at the lowest rung (Bronze), if rates increase a lot in 2020 I will have no lower option to switch to. But health insurance keeps changing and evolving and we must make the best decisions with what's available. The ACA changes gave me options to leave my grandfathered plan and not face nosebleed premium increases. Not eligible for a subsidy, but my Bronze rate in 2019 will probably be close to 40% less than my grandfathered plan would have been, had I kept it.
Last edited by wildflowers27; 11-28-2018 at 01:01 PM..
I'm having to again initiate health insurance coverage out-of-pocket (not through an employer). Previously, as in last year, it was in the $300 range. Looking again in the past few days, the lowest I've seen is in the $600 range. That's a significant change; doubling in costs.
What's up with this? I have a theory, but would like feedback. Anyone else seeing this kind of thing?
What happened is the Federal Government eliminated the mandatory insurance requirement earlier this year, which keeps young people from signing up for insurance since they don't have to now. The lack of young healthy people drives up costs for everyone. Some states, like NJ, instituted their own state-wide mandatory insurance requirement in order to prevent NJ residents plans from rising after the Federal law was struck down. My policy actually went down about $25 a month vs last year.
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