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To whoever used to have individual Healthy NY plan Oxford Liberty, what did you switch to? The only option I found was the Marketplace (unfortunately), I had NO DEDUCTIBLE, as my plan was 7 years old ... Was not cheap, was paying the same as on the Marketplace WITH TAX CREDIT AND had NO deductible, my plan was awesome. I hate these Obamadoesntcare plans.
I picked the Gold plan which was the closest to what I had, anybody know what's the deductible for a silver plan? The Marketplace website of NY says 250 which sounds awfully wrong, considering the Gold s 600/person.
Thanks
There is no "Obamacare Plan". The marketplace is just a place to shop for coverage. It's hard to follow what you are asking. Silver plans have deductible from $1000-12,000, just depends on what you want. Chances are you are going to end up paying about the same overall if your new plan is only costing you $250/month vs $600/month with your old plan--at least that is what I think you are saying. Find a plan with a $4000 deductible and you will come out ahead vs your old plan.
My current plan costs abt 950 for 2 people with $1200 deductible. Co pay after deduct. $25
My old plan used to cost the same and had no deductible. Co pay (no deduct) $20!
There is no way I can come ahead vs my old plan.
P.s. I know there is no obamadoesntcare plan, trust me I know, I spent so much time on that website and fighting with their reps you have no idea.
The plans offered on the marketplace are a joke, most of them have a network of about 10 doctors per specialty. United is the one who has the largest network and is also the most expensive on the marketplace.
The Silver United plan on the Marketplace indicates $250 as deductible.
The Gold United plan on the Marketplace indicates $600 per person as deduct, which is correct. The NY state of health website is a joke, it gives wrong info.
My current plan costs abt 950 for 2 people with $1200 deductible. Co pay after deduct. $25
My old plan used to cost the same and had no deductible. Co pay (no deduct) $20!
There is no way I can come ahead vs my old plan.
P.s. I know there is no obamadoesntcare plan, trust me I know, I spent so much time on that website and fighting with their reps you have no idea.
The plans offered on the marketplace are a joke, most of them have a network of about 10 doctors per specialty. United is the one who has the largest network and is also the most expensive on the marketplace.
The Silver United plan on the Marketplace indicates $250 as deductible.
The Gold United plan on the Marketplace indicates $600 per person as deduct, which is correct. The NY state of health website is a joke, it gives wrong info.
You are missing the point...for a plan that costs less than $950/month you could pay a higher deductible but still less than you are paying in premiums. I'm sorry but a $600 deductible is NOTHING and likely when you met your out of pocket max your care is covered at 100%. If your old plan was like my friend in NY's old plan, you didn't have a cap on your out of pocket expenses, which means you could have paid way more than $600/year in co-pays.
I found the NY site to be very easy to use actually. It sounds like what you need is to find a broker that can help you through this process and explain what all this means to you since it seems to be difficult for you. Maybe check at your bank or with your financial planner to see if they have an insurance brokerage. You don't pay any extra for them to help you.
Healthy NY plans were a good deal for those who qualified. They were ended due to the ACA.
NY plans still are much more expensive than other states. Unless you are getting a subsidy, don't expect a good deal.
Note that Health Republic and Empire plns sold in the marketplace have severe issues in not getting information right and id cards out in a reasonable time. In fact, Empire is giving those affected 3 weeks of premiums back to them.
Check with a broker, particularly if you don't qualify for a subsidy as some carriers have plans that aren't on the exchange.
@Golfgal: You may be correct about the out of pocket limit.
@NSHL10: i looked into Health Republic as their rates were reasonable through the marketplace but no doctor I know accepts it.
I spoke to many brokers, they are more confused than I am.
We do qualify for a subsidy but it's still expensive.
I called Health Rep out of the Marketplace few months ago and told me they were waiting to be approved for some new plans.
United also gave us a hard time with cards, But let us print temporary ones through their website.
@Golfgal: You may be correct about the out of pocket limit.
@NSHL10: i looked into Health Republic as their rates were reasonable through the marketplace but no doctor I know accepts it.
I spoke to many brokers, they are more confused than I am.
We do qualify for a subsidy but it's still expensive.
I called Health Rep out of the Marketplace few months ago and told me they were waiting to be approved for some new plans.
United also gave us a hard time with cards, But let us print temporary ones through their website.
Then you need to find a better broker.
If you qualify for subsidies, depending on how much you qualify for, you may get subsidies on your out of pocket costs as well. You can compare the out of pocket costs on the marketplace information to that of the information on the company website and you will see if you are getting a reduction in out of pocket costs as well. My friend in NY has a plan with a $6000 OOP max, but her max OOP is only $1500. Her co-pays are $15 vs $30. NY is heavily HMO networks so yes, it's hard to find a big network there. Why not call your current doctors and ask their insurance people which plans they take and go from there?
I did call my doctors, they mostly take big insurances (specifically off the marketplace) because I guess most of their patients have good insurances from work .... Individual plans in NY are no good, doctors dont want to deal with them b/c they dont get paid or if they do, they get pennies.
It is a fact that most states have narrower networks on the "subsidy exchange plans". If you want full access to all doctors and all hospitals, you may need to have to pay for it in a non exchange policy and forgo your subsidy. Though, I know there are some states that offer PPO's as well. Like New York, my current state is all HMO's on the exchange with one POS Co-Op.
Way before the ACA our insurance companies have never been set up to be fair for all. It is set up for, those who can afford it, or work for the best companies, as they get the best plans with the biggest networks, lowest or no deductibles for the least cost. So if you want to forgo your subsidy, you can buy a different plan that will cost more. Insurance companies have been pricing policies this way for years. Nothing new here.
The cost sharing part of the subsidy plans is only available to Silver Plans and those who are under the 250%% of the poverty level (adjusted according to the size of your family)
Having to purchase an individual plan has always been much more expensive for less coverage than most company policies. We have always been the ones who have been shafted in every abuse known by insurance companies. The ACA has not eliminated this, but it has improved it. As an example, a company policy (except HSA policies) can not have a deductible of no more than $2,000, while an individual's policy is typically in the $4,000 range.
We also must pay more for a comparable policy than a company will, though the ACA has narrowed the gap somewhat. We also pay for our policy with our "after tax" dollars, where people receiving insurance through their company are not paying any taxes on it. (though the new Republican policy would change this) An individual is never been able to change their policy from year to year when they have any kind of health problem without serious consequences.
An individual policy was very much at risk of rescission if you contact a serious costly illness. So many of these things have either been eliminated or lessened with the ACA laws, but it is still not a level playing field by any stretch.
"No deductible" plans (even HMO's ) are expensive. I know, I carried one for my son for many, many years. In looking back now, I see, it was not the route to go in his case, and the insurance made out very well by him. Though when I got "the letter from BCBS when we were in Florida, that offered a comparable "no deductible" ACA plan to replace his existing plan, it was actually a little cheaper.
However, with New York having such high cost in insurance policy costs due to stringent state policies, it would be hard to pass up the subsidy if it is substantial, and you might need to change a couple of doctors for a year or two and see how it goes. A lot of insurance companies are adapting the "wait and see" approach, and are hesitant to put too much out there until they test the waters.
Last edited by modhatter; 02-13-2014 at 01:35 PM..
Not sure my other post went through. I wrote that new insurances popped out of nowhere with the Marketplace, like Oscar, but again, they have a very limited selection of drs.
In NY the subsidy is available also for gold plans, not sure abt platinum but I think so.
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