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I've had HSA plans since 2006. I know the ins and out.
I am talking max $2000-3000 out of pocket in network for pre ACA. Zero co pay after $2000-3000 is met.
None of this co insurance crap. Once $2000-3000 is met. Even drugs are covered at 100%. In the early HSA days circa 2006,2007 drugs weren't covered 100% after meeting deductible. But since 2008 drugs have been covered 100%
Most of my friends have these plans.
What the ACA does is "move the goal posts".
They set one deducible as $2000. But than add co insurance where your "max" out of pocket is $6350 for singles and over $12000 as family.
If you read my post. My wife and 2 kids have their own $6000 max out of pocket expense for 2013 for around $600/month. That's max $6000. Even drugs are covered after $6000. In 2014 if she wants a $6700 max out of pocket expenses the premiums will jump dramatically 40%. If she wants to keep her similiar $600/month for 2014 than she will incur a potential max out of pocket $12000.
For every you, there is a me. I have a wife and two kids on mine and their share is 500 a month. They each have ZERO deductible. The insurance pays 80% from the first dollar. When our out of pocket on everything except premiums hits 2K for any one of them or 4k in the aggregate, we are done for the year (at the 4k, of course). If one of them had a 10K expense for example, we would pay 2K and that would be it for that person for the rest of the year. No more medical expenses at all. If I want to be on this plan the cost doubles to 1000 per month. The company had exactly the same policy in their 2013 offerings but I can't get a quote on it because when I do it starts asking me underwriting questions about my health. So I don't know if it went up or not or how much for 2014.
For every you, there is a me. I have a wife and two kids on mine and their share is 500 a month. They each have ZERO deductible. The insurance pays 80% from the first dollar. When our out of pocket on everything except premiums hits 2K for any one of them or 4k in the aggregate, we are done for the year (at the 4k, of course). No more medical expenses at all. If I want to be on this plan the cost doubles to 1000 per month. The company had exactly the same policy in their 2013 offerings but I can't get a quote on it because when I do it starts asking me underwriting questions about my health. So I don't know if it went up or not or how much for 2014.
I am individual plan.
What are you on? You are mentioning company policy? If it's a company policy. Unless you failed to enroll within a certain time. By law they cannot discriminate against pre existing conditions.
Ponderosa is on a group plan thru his company or was. He doesnt know nothing about the individual market and me and him went around on the same thing you are doing with him a day or so ago... 4-5 pages ago. He is either clueless or is a paid obama bot..
Ponderosa,
Once again group company plans are/were different than private individual plans.
Group plans are cover all
Individual plans are pooled with like covered policies.
That is why cost went up when all must be covered items.
What are you on? You are mentioning company policy? If it's a company policy. Unless you failed to enroll within a certain time. By law they cannot discriminate against pre existing conditions.
It's an individual plan. By company I mean the company selling it. I'm not on it though. I am still thinking about it. Contrary to what I said a few days ago, the network appears to be a lot smaller than I thought. I spoke to three different people at the "company" and got three different answers about who is in the network and who is not. I am taking the position that if it is 15% less than anything like it on the exchange it is probably because the network is, in fact, the narrow one. I could probably live with that as none of us go to the doc much and really don't care who it is anyway. We live in a big city and there are still hundreds of docs who definitely are in the plan. The other thing I continue to weigh is a plan that costs 250 a month less but is an HSA. It is sort of what your is like. You pay the first 2K out of pocket (4k family) and then it pays 80% of everything until the standard ACA out of pockets are reached. I like it for its simplicity and the savings of course. And interesting, it motivates me to take care of myself physically. If I sign up, you won't see me on the forum as much. I will be hitting the pavement.
It's an individual plan. By company I mean the company selling it. I'm not on it though. I am still thinking about it. Contrary to what I said a few days ago, the network appears to be a lot smaller than I thought. I spoke to three different people at the "company" and got three different answers about who is in the network and who is not. I am taking the position that if it is 15% less than anything like it on the exchange it is probably because the network is, in fact, the narrow one. I could probably live with that as none of us go to the doc much and really don't care who it is anyway. We live in a big city and there are still hundreds of docs who definitely are in the plan. The other thing I continue to weigh is a plan that costs 250 a month less but is an HSA. It is sort of what your is like. You pay the first 2K out of pocket (4k family) and then it pays 80% of everything until the standard ACA out of pockets are reached. I like it for its simplicity and the savings of course. And interesting, it motivates me to take care of myself physically. If I sign up, you won't see me on the forum as much. I will be hitting the pavement.
My advise...
If you and your family are healthy and dont go to drs much and dont take many meds the. The lowest monthly premium is the best option.
I am sorry you are paying much more than if you were in thos situation 2 yrs ago. My families (of 4) doubled from before aca to after.
I hope you are seeing what the truth is and are starting to understamd why we are complaining. A health care system law would be fine if it was care not insurance...it doesnt have anything to do with hating obama for being black, liberal or etc....
If obamacare was written right... That is bare basic minumims with low caps and goverment covers overages then this conservative would have voted in favor of it. ACA is a money grab and i guess if you and the like wake up and notice... And so something about it.... At least we cam fix this!
If you and your family are healthy and dont go to drs much and dont take many meds the. The lowest monthly premium is the best option.
I am sorry you are paying much more than if you were in thos situation 2 yrs ago. My families (of 4) doubled from before aca to after.
I hope you are seeing what the truth is and are starting to understamd why we are complaining. A health care system law would be fine if it was care not insurance...it doesnt have anything to do with hating obama for being black, liberal or etc....
If obamacare was written right... That is bare basic minumims with low caps and goverment covers overages then this conservative would have voted in favor of it. ACA is a money grab and i guess if you and the like wake up and notice... And so something about it.... At least we cam fix this!
I have to agree in many ways. The reason I can save big is that I have the option to have less coverage. My existing early retiree policy is a great policy, rich network, reasonable out of pocket, every hospital and treatment you can imagine is covered. But it is expensive and, knock on wood, I have never had bills anywhere near what the premiums cost. For others like you that have had less expensive options to start, having to go into plans that can offer more of things you really have no use for is OK, but not if you have to pay more too. And you are spot on about we should be paying for care and not for insurance company Leer jets and profits. I almost puked at those shots of Obama sitting around the table with the insurance company CEOs and accountants the other day. It is all about them coming out favorably and not about the people who are struggling to make ends meet.
It's an individual plan. By company I mean the company selling it. I'm not on it though. I am still thinking about it. Contrary to what I said a few days ago, the network appears to be a lot smaller than I thought. I spoke to three different people at the "company" and got three different answers about who is in the network and who is not. I am taking the position that if it is 15% less than anything like it on the exchange it is probably because the network is, in fact, the narrow one. I could probably live with that as none of us go to the doc much and really don't care who it is anyway. We live in a big city and there are still hundreds of docs who definitely are in the plan. The other thing I continue to weigh is a plan that costs 250 a month less but is an HSA. It is sort of what your is like. You pay the first 2K out of pocket (4k family) and then it pays 80% of everything until the standard ACA out of pockets are reached. I like it for its simplicity and the savings of course. And interesting, it motivates me to take care of myself physically. If I sign up, you won't see me on the forum as much. I will be hitting the pavement.
Well congrats if you are able to find an affordable plan. The ACA works for people like you as it should (for someone with pre existing conditions).
But you gotta see the bigger picture here
Obama and the Dems made a big deal about people like yourself on individual market (or cause employers don't offer affordable coverage).
Those people like yourself who try to shop individual insurance often face high hurdles cause of pre exiting doing conditions. But do the math. You like Obama try to minimize the fact that 3% of those on individual markets are facing sky high premiums by saying its a small percentage of the population.
Yet by my own calculation. Since most people have Medicare medicaid or employer sponsor care. Those people are not barred from insurance cause of pre existing f conditions.
So people like yourself really make up maybe 1-3 million of Americans with pre existing conditions who cannot afford insurance on the individual market pre ACA? Right? 1-3 million is a very small percentage. But you are one of those. So it hurts. It really hurts when you are personally affected.
So think about the 5-7 million (of the 15 million American on individual market). 5% get insurance through the individual market. 50% are expected to pay "full price" with no subsides. And those making between 250-400% of poverty may be a wash in terms of any savings even with subsidies.
So how would you feel if you were on of the 5-7 million facing sky high premiums and double the deductible. That hurts too. It really hurts. Most of these people are "rich". They are in the 20-25% tile of income.
Sorry but for you there are about 100 me's who had the cost of their policy see a tremendous increase this year.
I do think my situation is not that common. I was in a Cadillac plan my employer offered but I paid for. Now I can still get that Cadillac plan or I can buy a Chevy or a Fiat 500. You all are kind of in the opposite predicament. You are forced to look only at policies that offer things you would rather pass on in because you do not need them or in the name of economy. On the other hand, most of what I have read suggests that about as many will come out ahead in the new plans as behind mainly due to subsidies at the low end. That is no consolation to those who will pay more, of course.
One other thing that I have learned in this discussion is that there is a huge variation in pain or pleasure depending on where you live. In some states, in some counties of states, you have a large choice of plans and you have insurers who are actually competing for business trying out a business model that attracts young people with low rates, and even new none profit co-ops that are in there with niche products. In other places, you get the Blues only, no competition and rates that reflect that reality. The BC policies on my exchange are the most expensive. They have staggering deductibles and high copays. If that is all I had to choose from I would be beside myself.
I am self employed and self insured for a family of three. I have had a very good, high end insurance plan for the past 4 years.
It has gone up every year.. except this year.
This year I received notice that the premium will be reduced by $12 due to having to meet the 80/20 expenditure rule under the ACA.
I'm so mad!!!!!
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My health insurance went DOWN. Please explain.
