ACA enrollment numbers

Uninformed, I am using my real numbers for a bronze plan (it is $389 not $350). It is only for me and my two children not a spouse. I am 50 and my children are 23 and 13.

Maybe you need to plug in El Paso County and maybe our insurance rates are a little lower than elsewhere in the state. I did notice that California rates are significantly higher than El Paso.
 
For a 45 year old with 2 children in Williamson or Travis County, it appears that the cheapest PPO plan is about $600/month. For a 4 person family with no pre-existing conditions, it is about $900/month. This is with about a $12,000 deductible so it is useful only for catastrophic coverage. It really doesn't matter what the plan covers other than catastrophic because that deductible will only be met if something bad happens. Basically, what that means is that it costs a healthy person $11,000 per year to insure against cardiovascular diseases and cancer and maybe Type 2 diabetes if you believe that in most cases it can't be controlled by exercise and diet.
 
Here is what it would cost me if I were to enroll. I don't have to since I am in the military and about to retire. I will have Tricare when I retire, so I won't need the exchange then either. Based on my premiums, I wouldn't want to get healthcare and I would just pay the penalty. I would then hope that my family had no major medical issues between the sign up periods.

In reality, I would more than likely do the Gold plan with the $0 deductible. To me that is expensive but I would rather pay $12,000 a year than to pay $6,000 a year and have to constantly worry about having $12,700 readily available to pay extreme medical bills.

On top of that, from the way I understand deductibles and such, you would end up paying for all your medical costs up to the deductible amount anyway. Not only would I foot most of the bill most of the time but the insurance company would get $6,000 a year from me to pay my own way.

I would much rather pay the $12,000 a year and let them pay for my medical cost throughout the year. At least I would feel like they are keeping all of my $12,000. Anywho, that is how I see it.

Healthcare_zps88fa6532.jpg
 
People when making decisions on a plan need to understand 1) the monthly premium 2) the deductible 3) the annual max out of pocket and 4) the co-pays both prior and post meeting the deductible. To truly do a cost benefit analysis you'd have to calculate all 4 of those items. From experience I know that until I was in a situation where the family was going to hit the deductible and the annual max out of pocket I didn't fully understand my costs and the different plans available. Once I was put in a situation where it was imperative to understand these I've made much better decisions on what plans I put my family on.

I'd be concerned that there are a lot of low information people out there that thought they were getting free health care or very cheap healthcare and are going to end up in a world of hurt over how much is going to be expected of them when a family member gets seriously sick. There are several plans out there that you could easily pay $1,000 a month and still have a $5,000 deductible and $10,000 max out pocket per indivdual and double that for a family. Thus if a family has a major illness in their family they could pay or be expected to pay $22,000 in a year. Cheaper than if they don't have insurance but my guess is that number would still shock a lot of people.
 
Yeah, I don't really know the difference between the deductible and the max-out-of-pocket expenses. Anyone care to enlighten us?
 
military Horn
that is a good question
the deductible is the amount you must pay on your own before the insurance company will pay anything. This is in addition to your monthly premiums. The exception to that is preventive exams like a mammo or prostate. IIRC those kinds of preventive exams are free.

Your maxiuml our of pocket expenses are the combinded total of your deductible and co pays
most deductibles look like they average 5-7K
it looks like the average max out of pocket is around 10-12K
So people really need to consider all expenses when choosing a plan.
Sadly most people do mot understand this and are going to be shocked when they learn of it.
In todays news there was a woman who went to a Va hospital for a chest Xray thinking she had insurance.
She didn't have a card so they told her it would be $500.
even if she had her card it would have been $500 since she would first have to meet her deductible.
How many average lower or middle class families can afford $500.00 in premiums PLYS another 8-10K in deductibles?
 
That is what I thought it was but wanted to hear it from someone else.

Based on that, I would definitely do the Gold option of $1,066 a month with no deductible and have $12,700 in savings. That way when I go to the hospital, I show up and pay my copay or whatever fee for a fee dollars and let the insurance pick up the rest. Then when the times that I have a major medical bill I have the $12,700 in reserves to pay my portion and let the insurance pick up the rest.

Overall this is the best route, at least the $1,066 would actually be used instead of sending money to the insurance and then having to pay for most of the visits myself (with $12,700 deductible).
 
MH
If you think you are going to have lots of medical expenses that is the way to go
OTOH if you and your family are relatively healthy and have been healthy it would make sense to get the highest deductible you could afford to pay which also means your monthly premiums would be lower.
Everyone needs to look at the big picture and make the choices that work for them
Most people don't and most people have not had to deal with deductibles
so they are getting sticker shock and in some cases foregoing medical care.
 
I did another quick search so I could post deductible info. family of 3, 36, 35, 2 years old, williamson county.

BCBS gold plan
$964/ month
500/1500 deductibles
4000/12000 out of pocket max

more than I pay now for my work offered plan but less than what I and my employer are currently paying combined.

There are more high deductible plans out this year since this is the first year of ACA and there are so many unknowns. Everyone has a different situation and there is not a one size fit all approach. if you expect to incur significant medical costs then go with a lower deductible plan. if you are mostly healthy then you cam opt for a higher deductible plan and hope for the best. I usually opt for a mid range to lower deductible and then do a $2500/ year FSA account. that works out to about $200 per month or $48 per week before tax dollars. I use this to pay the deductible and copays until it runs out. helps me better budget my spending and saves me from paying $500 tax on that $2500 dollars. currently my family pays about $4,000 a year in premiums and then $2500 for the FSA. so we are out $6500 at least every year.

What we should also recognize is how much in other taxes we are currently paying to subsidize those who do not have insurance and just show up at the ER when they are sick. We are all paying taxes at the local, state, and federal level to foot that bill.
 
From USA Today:


The premiums for bronze-level plans are generally the least expensive, but "the deductibles are simply not affordable," says Laura Stack, a former financial analyst looking for full-time work and using her 401k to pay for health insurance. "Many will not be able to afford the per person deductibles before insurance begins to pay. What are you really paying for?"

About 4.4 million people in the individual insurance market are not eligible for the subsidies and tax credits that can help cover premiums and out-of-pocket costs, including deductibles.

Insurance brokers and "navigators" helping people apply for insurance say there are shockingly high prices for some consumers who aren't eligible for subsidies. Without much competition in some states and because they know so little about their new customers, insurers may have priced higher than they would have otherwise.
The Link
 
First, hospitals do accept cash payments as settlement that are lower than the negotiated insurance rates. Sometimes, it just makes good business sense from a cash flow perspective.

R35 makes yet another stupid statement. Governors are not medical providers and ACA does not provide healthcare either. It is insurance reform.

I know PharmD checks and know his facts. I asked a question earlier and hope you have a source or link. What is the net amount of people now insured (not medicaid enrollees)? I did not ask, but someone else did. Do we know how many have paid their premiums?
 
Why does the President keep changing the law and delaying portions until after the elections if people are lying about it? It seems to me like the president would like to implement things right away so that we could see the truth. This would serve two purposes as it save him from breaking the law and shows the people how great it is.
 
pharm?
Uh do you know of many insurance companies who, without being asked by Bo, would offer coverage without a single payment?

I see some states including calif who have extended the deadline for first payment until jan 15
so Pharm WHO pays if someone who signed up gets medical treatment now but then never pays?
 
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