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Old 11-05-2016, 01:32 PM
 
16 posts, read 11,848 times
Reputation: 28

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without getting into a debate about politics or insurance in general, I'd like to hear what other people in similar situations have found. My wife and I are both self-employed, make too much for subsidies and have 2 kids with another on the way. We live in central Austin and are happy with our current doctors, but it seems we will have to switch insurance plans again. We had a BCBS PPO in 2015, then that disappeared, and we now have a Aetna EPO. Aetna sent us a letter saying that plan was being phased out, but my research seems to have found: Aetna EPO ("Leap Everyday Austin Redbud"), a CIGNA EPO ("Local PLus"), and a few varieties of BCBS HMO's. Has anyone had any experience with any of these?
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Old 11-05-2016, 02:00 PM
 
Location: Austin, TX via San Antonio, TX
9,851 posts, read 13,698,680 times
Reputation: 5702
I'm going to foundation communities to get a better understanding of my options as I have to purchase my own insurance as well. Since you are central udcreccomend going to their location in airport. Unlike many of their services there are no income guidelines for this service.
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Old 11-05-2016, 02:22 PM
 
Location: Austin, TX
1,825 posts, read 2,828,191 times
Reputation: 1627
I buy my own insurance off the exchange and had a selection of quite a few plans last year. My premiums are going up 32% this year and I have only one other option in the "category" I prefer (lower deductibles). I'm sticking with my current plan just because the other choices are nearly 2x as much.
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Old 11-05-2016, 03:57 PM
 
743 posts, read 1,372,240 times
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Quote:
Originally Posted by alanesmith View Post
without getting into a debate about politics or insurance in general, I'd like to hear what other people in similar situations have found. My wife and I are both self-employed, make too much for subsidies and have 2 kids with another on the way. We live in central Austin and are happy with our current doctors, but it seems we will have to switch insurance plans again. We had a BCBS PPO in 2015, then that disappeared, and we now have a Aetna EPO. Aetna sent us a letter saying that plan was being phased out, but my research seems to have found: Aetna EPO ("Leap Everyday Austin Redbud"), a CIGNA EPO ("Local PLus"), and a few varieties of BCBS HMO's. Has anyone had any experience with any of these?
I've had the same experience as you. Had BCBS in 2015 (was really happy with that) but they pulled out for individual policies. So switched to Aetna EPO this year...ok if your doctor is in their network. But cost us even more than last year's policy. Now they've pulled out too.

Choices are really slim for us next year. I'm seeing a catastrophic option that might be what we have to go with, but with kids with health issues, it honestly stinks to be in this position. Our startup does not have a plan, so we are also looking at trying to get employed elsewhere to get coverage.

If you are an individual in Texas trying to buy a plan, it really stinks. Just the opposite of what we were told...that good coverage won't be tied to your employer anymore, but that's the way it's turned out. We are willing the spend the money on good coverage but finding no good options to purchase.
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Old 11-05-2016, 05:13 PM
 
Location: central Austin
7,228 posts, read 16,103,544 times
Reputation: 3915
Yes, my brother is self-employed in CA, the lack of self-insurance options in Texas is one big reason while he decided to stay there. He has many more options there.
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Old 11-06-2016, 08:16 AM
 
316 posts, read 849,565 times
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We are self-employed and do not qualify for subsidies. The following rates are for a couple nearing retirement:

2016
Aetna Bronze ~$850 (discontinued)

2017
BCBS Bronze ~$1300
Cigna Local Plus ~$1450
Aetna Leap ~$1700
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Old 11-06-2016, 02:03 PM
 
16 posts, read 11,848 times
Reputation: 28
the prices are not as much a problem as the selection of doctors, or the difficulty of dealing with the insurance company. Aetna, for example, had listed our pediatrician as in-network, which I confirmed with a phone call before signing up. From January through March, however, they kept rejecting claims as out-of-network - accumulating $2000 as unpaid. It was only when the other parents (in same situation) got together that they relented, and agreed that the practice was in-network
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Old 11-06-2016, 02:10 PM
 
7,736 posts, read 4,988,604 times
Reputation: 7963
I own my own company here in Austin . I am married with 1 son. We had a 0 deductible plan with Humana and were paying 800 a month. I just got my obama letter saying that Humana is dropping my plan and now I won't have insurance at the end of the year. I tried shopping Humana again and it looks like they pulled out of Texas because I seen 0 plans available for my zip code.....


Please let me know if you find 0 deductible plans for less than 1000. Thank you
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Old 11-06-2016, 03:40 PM
 
Location: Avery Ranch, Austin, TX
8,977 posts, read 17,552,407 times
Reputation: 4001
I am SO glad DW came out of retirement and is working for a company with great med benefits. Our 'individual' policy(for which we paid THOUSANDS over the years) simply got dropped by our former insurer. Essentially, the letter stated: Oh, yeah...we aren't covering individuals after November(last). Good luck! Pretty sure they made some good $$$$ off us.
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Old 11-07-2016, 03:10 PM
 
Location: Dallas
31,290 posts, read 20,740,494 times
Reputation: 9325
Quote:
Originally Posted by Jimmyp25 View Post
I own my own company here in Austin . I am married with 1 son. We had a 0 deductible plan with Humana and were paying 800 a month. I just got my obama letter saying that Humana is dropping my plan and now I won't have insurance at the end of the year. I tried shopping Humana again and it looks like they pulled out of Texas because I seen 0 plans available for my zip code.....


Please let me know if you find 0 deductible plans for less than 1000. Thank you
Good luck with that unless you qualify for taxpayer subsidies.
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