Affordable Health Care Act: anyone started pricing yet?

peggy_j
peggy_j Member Posts: 1,700
edited June 2014 in Employment, Insurance, and Other Financial Issues
Affordable Health Care Act: anyone started pricing yet?
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  • peggy_j
    peggy_j Member Posts: 1,700
    edited September 2013

    Has anyone started pricing the plans that are available under the Affordable Health Care Act?(effective Jan 2014. We should be able to sign up before that, maybe in Oct)

    The State of California has a rate calculator on this website

    http://www.coveredca.com/fieldcalc/

    The plan that's closest to our current plan (from my DH's employer) is the highest grade, Platnium, which would run me $600/mo (I'm 48). Maybe that's a good price, I don't know. But it does mean I can buy insurance in the open market, if needed. (despite being a health insurance pariah ;)

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  • ibcmets
    ibcmets Member Posts: 4,286
    edited September 2013

    Unbelievable--Never been so lucky to be on Medicare with my 2ndry ins.

    Terri

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2013

    My coverage is still with my same carrier (through my husband), increased only by about $10 annually for fiscal year 2014.  Because my husband receives some VA benefits he did have to fill out some paperwork with them so that if he was uninsured he could obtain coverage through their marketplace if he desired, as could I.

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  • truebff
    truebff Member Posts: 642
    edited September 2013

    I lost my health insurance Aug. 31st with more surgeries and treatemnt still needed.  Becaseu I was holding off on taking AI's and because -with my doctor- I eleected an ultrasound rather than a toxic for me radiation and breast tissue damaging mammogram last round.

    Had they carried me over, they would have kept me even as our family income was starting (finally! after the recession and cancer) to go back up again, they would have at least kept my coverage until a certain earning point.

    However, we are now making a few thousand dollars too much to be eligible for enrollment for other subsidised care and too little for good care, which is still astronomical due to my "preexisting" condition of having had cancer.

    Our best hope is Obamacare if it ever works out.

    So THIS thread will be extremely important for me to stay aware of. Thanks for posting it.

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited September 2013

    I've been looking at the California site some more. These plans seem to include a longer list of preventive care services that are provided a no cost to the patient (no copay), including the BRCA test for those who are at high risk (hopefully this means a standardized and comprehensive list of criteria. As I posted in an earlier thread, the health insurance companies have different criteria for who is at risk for carrying the BRCA gene). A list is here (second question, "What do I get for my premium?") So if this list is longer than existing plans, it may be hard to do an apples-to-apples comparison on the price.

    http://www.coveredca.com/fieldcalc/#faq

    And yes, the fact that we all, unfortunately, now have a pre-existing condition, it means we can buy health insurance on the open market, if needed. That's priceless.

    truebff: can you go on COBRA?

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  • MNSusan
    MNSusan Member Posts: 305
    edited September 2013

    UnitedHealthCare dropped me on 6/30 for a pre existing condition (recurrent breast cancer).  I'm currently covered by the Minnesota High Risk Pool but they've sent me a letter that they're dropping me 12/31.  Minnesota has released some price info but hasn't put up definitions of the "metals" categories yet.  I'm hearing that even with Platinum coverage, 10% is still out of pocket.  The choices are by county and in my county it looks like there will be four plans to choose from.  I'm getting emails nearly every day with a little more info.

    My premium with the High Risk Pool is $412/mo with $5,000 deductible.  I don't expect it to go down with the new system.

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  • lisa-e
    lisa-e Member Posts: 819
    edited September 2013

    I have insurance through my employer, so do not need to go through the exchanges to get insurance next year.  But I am overjoyed with the fact that I will be able to purchase insurance on the open market if I need to in the future.  Right now, if I lost my job I would be an insurance pariah.

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  • lisa-e
    lisa-e Member Posts: 819
    edited September 2013

    So just for fun, I went to the CA website and used the calculator.  I am older than peggi, so would pay slightly more.  The rates I would pay for coverage under the two higher tier plans are similiar to the total cost of my insurnace now (my employers contribution and my contribution).   I am not elegible for subsidies, but that doesn't surprise me.

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  • truebff
    truebff Member Posts: 642
    edited September 2013

    Peggy,

    No cobra doesn't come into play with my circumstances.

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  • NancyD
    NancyD Member Posts: 3,562
    edited September 2013

    My COBRA is ending as of the end of February 2014. I looked briefly at the NY State plan:



    http://www.nystateofhealth.ny.gov/



    It goes by county and my current insurer is not available in my county. I will have to do a bit of research before I make a choice.



    My income transitioned from the end of my severance in March to Social Security as of June, so it's kind of a mixed bag and will likely go down further in 2014. Would I pay based on my 2013 income? There will be a significant drop between years and I'm worried that I won't be able to meet my household expenses in 2014 if I have to pay based on 2013 income.



    Does anyone know if I include my adult daughter (no longer a dependent and will have her own insurance from employer) in the count to determine income status? That has always confused me. What if I rent out a room? Would that person count?

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  • Chickadee
    Chickadee Member Posts: 4,467
    edited September 2013

    This is so new to all of us and These are really specific questions. If it was me I'd ask the state agency on the website. Best to get it from the horses mouth.

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited September 2013

    SusanMN, based on what I'm reading, it looks like all states will have 4 tiers, Platinum 90, for example, is intended to cover 90% of a patient's out of pocket expenses (besides premiums). But there are out of pocket maxes. At least in CA, Platinum has a $4000 max; the other plans have a $6350 max. (for one person). Admittedly, this is not 0, but...compared to the cost of cancer Tx, it's pretty good. (I don't know about you, but I stopped counting when my costs hit 6 figures...and "only" had a lumpectomy and rads). And there's none of that funny stuff from a few years ago, like lifetime maxes, etc.

    NancyD, I'm not an expert but I think it's the cost per family. If your daughter is covered elsewhere, I don't think she'd count. If you have a roommate who is not part of your family, I don't think they count. (if two single people rent an apartment, are they a family? Probably not) But I agree, it's best to call the experts to know for sure. FWIW, I read somewhere that it's based on your income for that year. (so 2014's income). It's tricky if your income changes; what I read is that if you estimate low and then your income goes up, you have to pay back the subsidy. 

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  • JaneB1
    JaneB1 Member Posts: 47
    edited September 2013

    Wow, a $4000 annual max is great. Mine was $8000 last year which felt like a lot, especially since we were also paying $1100 a month for COBRA (for two).



    I worked 31 years with full health coverage and never had more than $1000 or so in claims in any of those years. Then I got diagnosed with cancer less than 6 months after I was laid off. I was so grateful I had elected COBRA and could afford it. But the worry about what I would do after COBRA ended made the cancer struggle incredibly more stressful. I also made decisions based on possibly not having insurance after COBRA, eg, bilateral MX and immediate reconstruction.



    I am fortunate to be back to work now with employer coverage, including for pre-existing conditions. But I know all to well the terror of cancer without insurance.



    I am reading lots of positive press about the Affordable Care Act. So far the word is that premiums will be lower than expected for many and coverage will be better. My company plan has 80/20 copay, making the California exchange plan better than my employer coverage.



    I have high hopes that Obamacare will be the answer to the prayers of many of us!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2013

    I was just looking at my email and saw that I had received something from www.livestrong.org regarding an online seminar on the Affordable Care Act and insurance issues specifically for cancer patients.  If anyone would like this info PM me.  I think you have to join livestrong (free) to participate, but it is titled: Understand the Health Insurance Marketplace, looks pretty all-encompassing.  Topics include:

    - Identifiy elegibility criteria

    - Understand enrollment process

    - Recognize options for those with limited income

    - Locate resources  

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