Life after COBRA - selecting new health insurance
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Life after COBRA - selecting new health insurance
Edit: Updated in reply far below.
Edit: Noticed copy/paste error for lowest silver ACA plan
All things must come to an end, and that includes my COBRA insurance from MegaCorp. I received a letter reminding me that it runs out 8/31 and to tell me that this also allows me special enrollment in retiree medical if I want. I didn't know that. I have to make a decision within 60 days of COBRA ending, which I interpret to mean 6/30, so I better decide.
I'm in St. Louis County Missouri, so any specific experience with this area is welcome.
The retiree medical isn't cheap. I ran the numbers on the exchange, and the plans cost less but higher deductibles. Due to my pension and investment income I don't qualify for any subsidy. There are a bunch of "Silver" plans from the exchange, so I just put the high and low monthly cost ones in. I didn't list the "Gold" plans because they cost as much as MegaCorp with higher deductibles.
Currently I'm in pretty good health and haven't used much except exams and two prescriptions. Those right now cost me $11/month co-pay.
Here's a quick rundown. I can post more extensive information if necessary, let me know. It's a lot of stuff.
MegaCorp (network/nonnetwork) options:
UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000.
UHC-Choice Plus - CCP: $1,515.27; deductible: $0/$500; OOP: $1500/$3000.
UHC-Choice - HMO: $1,339.06; deductible: $0/$0; OOP: $650/not covered.
Exchange:
Bronze:
Low - Cigna Connect 7000: $729.73; deductible: $7000; OOP: $7900.
High - Cigna Connect 6400: $884.01; deductible: $6400; OOP: $7900.
Silver:
Low - Ambetter Balanced Care 5: $945.78; deductible: $7,350; OOP: $7,350.
High - Ambetter Balanced Care 3: $1073.30; deductible: $3000; OOP: $6750.
Edit: Noticed copy/paste error for lowest silver ACA plan
All things must come to an end, and that includes my COBRA insurance from MegaCorp. I received a letter reminding me that it runs out 8/31 and to tell me that this also allows me special enrollment in retiree medical if I want. I didn't know that. I have to make a decision within 60 days of COBRA ending, which I interpret to mean 6/30, so I better decide.
I'm in St. Louis County Missouri, so any specific experience with this area is welcome.
The retiree medical isn't cheap. I ran the numbers on the exchange, and the plans cost less but higher deductibles. Due to my pension and investment income I don't qualify for any subsidy. There are a bunch of "Silver" plans from the exchange, so I just put the high and low monthly cost ones in. I didn't list the "Gold" plans because they cost as much as MegaCorp with higher deductibles.
Currently I'm in pretty good health and haven't used much except exams and two prescriptions. Those right now cost me $11/month co-pay.
Here's a quick rundown. I can post more extensive information if necessary, let me know. It's a lot of stuff.
MegaCorp (network/nonnetwork) options:
UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000.
UHC-Choice Plus - CCP: $1,515.27; deductible: $0/$500; OOP: $1500/$3000.
UHC-Choice - HMO: $1,339.06; deductible: $0/$0; OOP: $650/not covered.
Exchange:
Bronze:
Low - Cigna Connect 7000: $729.73; deductible: $7000; OOP: $7900.
High - Cigna Connect 6400: $884.01; deductible: $6400; OOP: $7900.
Silver:
Low - Ambetter Balanced Care 5: $945.78; deductible: $7,350; OOP: $7,350.
High - Ambetter Balanced Care 3: $1073.30; deductible: $3000; OOP: $6750.
Last edited by Earl Lemongrab on Mon Jul 01, 2019 5:01 pm, edited 2 times in total.
Re: Life after COBRA - selecting new health insurance
Is there a Bronze HSA-eligible plan offered?
Which plans do or don't cover out-of-network expenses? Is this important to you? Travel much?
Which plans do or don't cover out-of-network expenses? Is this important to you? Travel much?
Re: Life after COBRA - selecting new health insurance
How did you like UHC from megacorp? If it worked well I would go with it - better the devil you know.
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Re: Life after COBRA - selecting new health insurance
If it is only a few years until you are Medicare-eligible and the premiums aren’t a budget-buster, I would be tempted to stay on the retiree plan (and review decision annually) to avoid having to rely on ACA coverage being available until Medicare.
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Re: Life after COBRA - selecting new health insurance
Those are the two plans offered. I don't know about HSA eligible. Does anyone know?Is there a Bronze HSA-eligible plan offered?
I don't travel. I have always been in-network. Too much hassle otherwise.Which plans do or don't cover out-of-network expenses? Is this important to you? Travel much?
My COBRA was with the 2018 provider, BCBS-IL. I had very few problems with them. I assume that MegaCorp is able to force good service in general. That's something to consider.How did you like UHC from megacorp? If it worked well I would go with it - better the devil you know.
I'm 62 as of last April, so about three years out. There something to that. Plus open enrollment is only a few months away.If it is only a few years until you are Medicare-eligible and the premiums aren’t a budget-buster, I would be tempted to stay on the retiree plan (and review decision annually) to avoid having to rely on ACA coverage being available until Medicare.
- Artful Dodger
- Posts: 1952
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Re: Life after COBRA - selecting new health insurance
Hi Earl,
I'm on the Illinois side, but in the St. Louis metro so am familiar with the area. I work in employee benefits, so know about the plans employers buy, but not so much about the individual exchange offerings. I did take a look at the ACA marketplace in Missouri, however.
One question I had was the type of coverage. The retiree rates you show look really high for individual coverage. Is that right, or could they be for member and spouse coverage. The ACA rates you show are for individual coverage. If the retiree rates are for individual coverage only, I would at least consider the ACA rates if you're comfortable with the network hospitals and doctors.
Regarding networks - The UHC choice plus network is the one I see most often. It includes almost all local hospitals and doctors, including the BJC / Wash U providers as well as the St. Louis U / Mercy providers. I expect the PPO is the same, but has broader national coverage. I'm not familiar with the Choice HMO plan, but your old HR dept should be able to direct you to a provider directory. As you note, the HMO plan limits coverage to only those in their network with no out of network benefits.
The Cigna and Ambetter plans all appear to be EPO (Exclusive Provider Option) plans. There would be no out of network benefits. This is similar to an HMO plan, but normally doesn't require a primary care physician election and have requirements for specialist referrals. The Cigna plan has most of the providers affiliated with BJC, but doesn't look to include the St. Louis U / Mercy providers.
Unfortunately, none of the ACA plans I saw on the Marketplace qualify as high deductible health plans, which would allow you to set aside money into a health savings account.
You could certainly elect to continue the retiree plan at the higher rates until the next ACA open window for Jan. 1, 2020, either the Choice Plus (with broader network), or HMO (if you're comfortable with the network and PCP / referral requirements). If you did have a hospital claim, the retiree plan's lower out of pocket limits will offset the six months premium savings from the ACA plans.
I would revisit the decision next fall during the 11/1 to 12/15 open enrollment for ACA coverage effective 1/1/2020. At that point you're likely looking at enough premium savings to fully cover whatever out of pocket limit you'll find in the ACA plans. Based on the medical use you've reported, I'd go with the highest deductible plan, and pocket the savings for use if your medical expenses pick up. As I stated above, just confirm the docs and hospitals in the network are acceptable to you.
And, double check the retiree plan rates to confirm they're individual coverage only.
Hope this helps.
I'm on the Illinois side, but in the St. Louis metro so am familiar with the area. I work in employee benefits, so know about the plans employers buy, but not so much about the individual exchange offerings. I did take a look at the ACA marketplace in Missouri, however.
One question I had was the type of coverage. The retiree rates you show look really high for individual coverage. Is that right, or could they be for member and spouse coverage. The ACA rates you show are for individual coverage. If the retiree rates are for individual coverage only, I would at least consider the ACA rates if you're comfortable with the network hospitals and doctors.
Regarding networks - The UHC choice plus network is the one I see most often. It includes almost all local hospitals and doctors, including the BJC / Wash U providers as well as the St. Louis U / Mercy providers. I expect the PPO is the same, but has broader national coverage. I'm not familiar with the Choice HMO plan, but your old HR dept should be able to direct you to a provider directory. As you note, the HMO plan limits coverage to only those in their network with no out of network benefits.
The Cigna and Ambetter plans all appear to be EPO (Exclusive Provider Option) plans. There would be no out of network benefits. This is similar to an HMO plan, but normally doesn't require a primary care physician election and have requirements for specialist referrals. The Cigna plan has most of the providers affiliated with BJC, but doesn't look to include the St. Louis U / Mercy providers.
Unfortunately, none of the ACA plans I saw on the Marketplace qualify as high deductible health plans, which would allow you to set aside money into a health savings account.
You could certainly elect to continue the retiree plan at the higher rates until the next ACA open window for Jan. 1, 2020, either the Choice Plus (with broader network), or HMO (if you're comfortable with the network and PCP / referral requirements). If you did have a hospital claim, the retiree plan's lower out of pocket limits will offset the six months premium savings from the ACA plans.
I would revisit the decision next fall during the 11/1 to 12/15 open enrollment for ACA coverage effective 1/1/2020. At that point you're likely looking at enough premium savings to fully cover whatever out of pocket limit you'll find in the ACA plans. Based on the medical use you've reported, I'd go with the highest deductible plan, and pocket the savings for use if your medical expenses pick up. As I stated above, just confirm the docs and hospitals in the network are acceptable to you.
And, double check the retiree plan rates to confirm they're individual coverage only.
Hope this helps.
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Re: Life after COBRA - selecting new health insurance
Yeah, it's costly. I went back through to make sure, I selected no coverage for dependents. There were similar lines for children, all "Not Applicable".
It's only four months of coverage, the new plan would take effect 9/1. One of the problems with switching plans in mid-year is a new deductible to work on.
Code: Select all
Cost to Employee
UHC-HDHP-PPO UHC-Choice-CCP UHC-Choice-HMO
Cost
You Only $1,616.32 $1,515.27 $1,339.06
You + Spouse Not Applicable Not Applicable Not Applicable
Re: Life after COBRA - selecting new health insurance
Since Medicare is not too far down the road, I might also investigate whether any of the Medicare Advantage plans available to you (when you are eligible) have similarities to plans you can get now.
As one example, if you have Kaiser available in your area - then if you enroll in Kaiser now - you can seamlessly transition to a Kaiser Medicare plan.
There might be other plans like this as well - such as Humana.
As one example, if you have Kaiser available in your area - then if you enroll in Kaiser now - you can seamlessly transition to a Kaiser Medicare plan.
There might be other plans like this as well - such as Humana.
Re: Life after COBRA - selecting new health insurance
What a coincidence. I just finished my ACA application with Anthem, as my COBRA insurance, also with Anthem, was due to end on 6/30/19. Mine will be $1201 and change per month. IIRC the deductible is just under 6k. The plans quoted started in the $800 range. I was able to sign up outside the open enrollment period because COBRA ending is a "qualifying event" and required proof in the form of a letter from Megacorp. I photographed the letter on my iPad and uploaded it to the Anthem software, along with the card payment.
"My bond allocation is the amount of money that I cannot afford to lose." -- Taylor Larimore
Re: Life after COBRA - selecting new health insurance
Don’t take my word on it for your plan, but my understanding of the 60-day limit is that you have until 10/30 to sign up and be covered retroactively.
At least you should ask to know for sure.
At least you should ask to know for sure.
"So, what would have been so terrible if I had a small fortune?"
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Re: Life after COBRA - selecting new health insurance
You might be right on that. That's the way COBRA works. I should contact them.
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Re: Life after COBRA - selecting new health insurance
Kaiser isn't in our area. I didn't find any off-exchange plans in my very non-exhaustive search. Are there usually ones available?dm200 wrote: ↑Tue Jun 18, 2019 3:21 pm Since Medicare is not too far down the road, I might also investigate whether any of the Medicare Advantage plans available to you (when you are eligible) have similarities to plans you can get now.
As one example, if you have Kaiser available in your area - then if you enroll in Kaiser now - you can seamlessly transition to a Kaiser Medicare plan.
There might be other plans like this as well - such as Humana.
- sleepysurf
- Posts: 887
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- Location: Florida
Re: Life after COBRA - selecting new health insurance
You might want to consult an Independent Health Insurance Broker, before deciding.
I was in the same boat, as my HSA (high deductible) Cobra plan (BC/BS) ends 6/30, and I needed coverage for 6 months until starting Medicare 1/20. I checked the ACA website, and was SHOCKED by the high premiums for Bronze HSA plans for myself + DW (we don't qualify for subsidy), despite $6000 deductible ea, which doesn't carry over from prior policy.
I ended up calling a local Health Insurance Broker, and found out he could research various policies for us, with no additional out of pocket cost, as premiums would be identical regardless if plan is purchased via ACA vs. broker. His expertise proved useful, as he suggested DW select a lower-premium/tier plan, since she's in relatively better health, and her regular physicians are all on that plan. That saved us ~$500/mo!
I was in the same boat, as my HSA (high deductible) Cobra plan (BC/BS) ends 6/30, and I needed coverage for 6 months until starting Medicare 1/20. I checked the ACA website, and was SHOCKED by the high premiums for Bronze HSA plans for myself + DW (we don't qualify for subsidy), despite $6000 deductible ea, which doesn't carry over from prior policy.
I ended up calling a local Health Insurance Broker, and found out he could research various policies for us, with no additional out of pocket cost, as premiums would be identical regardless if plan is purchased via ACA vs. broker. His expertise proved useful, as he suggested DW select a lower-premium/tier plan, since she's in relatively better health, and her regular physicians are all on that plan. That saved us ~$500/mo!
Retired 2018 | currently ~64/33/3 (partially sliced and diced, with a slowly rising equity glide path)
Re: Life after COBRA - selecting new health insurance
According to this, four insurance companies are offering individual health plans for 2019 in Missouri both on and off the exchange. Kaiser isn't listed.Earl Lemongrab wrote: ↑Tue Jun 18, 2019 5:30 pmKaiser isn't in our area. I didn't find any off-exchange plans in my very non-exhaustive search. Are there usually ones available?dm200 wrote: ↑Tue Jun 18, 2019 3:21 pm Since Medicare is not too far down the road, I might also investigate whether any of the Medicare Advantage plans available to you (when you are eligible) have similarities to plans you can get now.
As one example, if you have Kaiser available in your area - then if you enroll in Kaiser now - you can seamlessly transition to a Kaiser Medicare plan.
There might be other plans like this as well - such as Humana.
Re: Life after COBRA - selecting new health insurance
One thing that has not been mentioned is that since you are not going to get a subsidy you should also look at health plans that are sold off the exchange, ie not on healthcare.gov or your states equivalent. Sometimes these can be less expensive and you may be able to find plans with different options. Just to be clear I am talking about regulator insurance plans with good coverage and not some alternative group that is not only limited coverage.
Also be sure to dig into the details of the plans you are looking at. When my COBRA was ending I had Blue Cross/Blue Shield and there was an ACA BCBS plan so it looked like I could switch to that and not to have to worry about changing doctors.
When I looked into it more the ACA BCBS network was very limited and none of my doctors were in that network. In addition to checking the doctors in the plan you also need to check to see which primary care doctors are taking new patients. In the ACA BCBS plan very few of the primary care doctors were listed as taking new patients.
Also be sure to dig into the details of the plans you are looking at. When my COBRA was ending I had Blue Cross/Blue Shield and there was an ACA BCBS plan so it looked like I could switch to that and not to have to worry about changing doctors.
When I looked into it more the ACA BCBS network was very limited and none of my doctors were in that network. In addition to checking the doctors in the plan you also need to check to see which primary care doctors are taking new patients. In the ACA BCBS plan very few of the primary care doctors were listed as taking new patients.
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Re: Life after COBRA - selecting new health insurance
You might also want to look at reviews for the ACA providers offering plans in your area. In my area, there were many plans (multiple bronze, silver, and gold), but only two actual providers offering the different plans. One provider had really terrible reviews about delaying and refusing payments and the other one had better reviews. I called my doctor's office (covered by both providers) and the business manager also said they had issues getting payments from the provider with the terrible reviews. I chose to use a plan from the provider with the better reviews - I was already leaning that direction because of other reasons (it was HDHP, cost was a little lower), this just confirmed it for me.
Re: Life after COBRA - selecting new health insurance
Businesses can also stop offering retiree health insurance buy-in.HomeStretch wrote: ↑Tue Jun 18, 2019 1:34 pm If it is only a few years until you are Medicare-eligible and the premiums aren’t a budget-buster, I would be tempted to stay on the retiree plan (and review decision annually) to avoid having to rely on ACA coverage being available until Medicare.
A large local employer did so a couple years ago, and it was a huge local news story. They said, in effect, "There's no need to offer this now since ACA is available to everyone. "
Time is what we want most, but what we use worst. William Penn
Re: Life after COBRA - selecting new health insurance
Yes! It is not uncommon that some very popular PCPs are not accepting new patients.Watty wrote: ↑Tue Jun 18, 2019 6:45 pm
When I looked into it more the ACA BCBS network was very limited and none of my doctors were in that network. In addition to checking the doctors in the plan you also need to check to see which primary care doctors are taking new patients. In the ACA BCBS plan very few of the primary care doctors were listed as taking new patients.
Re: Life after COBRA - selecting new health insurance
I was looking into this for my state, so some details may differ, but for the most part we seem to be faced with similar ACA options.
ACA is generally not HSA eligible (there are exceptions), no out of network coverage, but I also found the in-network coverage varies greatly from provider to provider. Some ACA options in my area have terrible in-network list of providers and some have a decent list. Given no out-of-network coverage, this is crucial. Also note that ACA in my area has a list of in-network ONLY IN MY AREA, so when I travel there is NO in-net NOR out-of-network coverage. This is the worst part of ACA, which I say not to be political but rather to say I am biased towards staying on a good employer plan as long as possible. I used to have UHC and it was great, would not switch if I had the choice to stay. No point in having cheap/useless coverage. Get coverage that is useful even if it costs more.
ACA is generally not HSA eligible (there are exceptions), no out of network coverage, but I also found the in-network coverage varies greatly from provider to provider. Some ACA options in my area have terrible in-network list of providers and some have a decent list. Given no out-of-network coverage, this is crucial. Also note that ACA in my area has a list of in-network ONLY IN MY AREA, so when I travel there is NO in-net NOR out-of-network coverage. This is the worst part of ACA, which I say not to be political but rather to say I am biased towards staying on a good employer plan as long as possible. I used to have UHC and it was great, would not switch if I had the choice to stay. No point in having cheap/useless coverage. Get coverage that is useful even if it costs more.
Re: Life after COBRA - selecting new health insurance
I believe emergency care is covered by ACA plans when you are traveling within the US. This is true even if your plan has no out of network coverage. When traveling internationally. some ACA Blue Cross plans appear to cover emergency care.beyou wrote: ↑Wed Jun 19, 2019 12:49 pm I was looking into this for my state, so some details may differ, but for the most part we seem to be faced with similar ACA options.
ACA is generally not HSA eligible (there are exceptions), no out of network coverage, but I also found the in-network coverage varies greatly from provider to provider. Some ACA options in my area have terrible in-network list of providers and some have a decent list. Given no out-of-network coverage, this is crucial. Also note that ACA in my area has a list of in-network ONLY IN MY AREA, so when I travel there is NO in-net NOR out-of-network coverage. This is the worst part of ACA, which I say not to be political but rather to say I am biased towards staying on a good employer plan as long as possible. I used to have UHC and it was great, would not switch if I had the choice to stay. No point in having cheap/useless coverage. Get coverage that is useful even if it costs more.
- FelixTheCat
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Re: Life after COBRA - selecting new health insurance
I checked ACA and I don't qualify for subsidies. I found out that high paid people (no subsidies) pay for the subsidies. For example, my silver care plan was $150 a month more from ACA then it costs directly from my hospital group. Check to see if your local hospital group provides health care plans.
I also know a few people that went the Medi-Share route (not insurance) https://mychristiancare.org/medi-share/
I also know a few people that went the Medi-Share route (not insurance) https://mychristiancare.org/medi-share/
Felix is a wonderful, wonderful cat.
Re: Life after COBRA - selecting new health insurance
Could you (or someone) elaborate on this? Maybe I am missing something, but this $150 per month difference means high paid people pay for the subsidies.FelixTheCat wrote: ↑Wed Jun 19, 2019 3:36 pm I checked ACA and I don't qualify for subsidies. I found out that high paid people (no subsidies) pay for the subsidies. For example, my silver care plan was $150 a month more from ACA then it costs directly from my hospital group. Check to see if your local hospital group provides health care plans.
I also know a few people that went the Medi-Share route (not insurance) https://mychristiancare.org/medi-share/
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Re: Life after COBRA - selecting new health insurance
Or it could mean that the local hospital group has higher compliance costs for ACA plans and can offer the same/similar plan outside of the ACA-exchange directly to consumers at a lower premium due to lower cost.dm200 wrote: ↑Wed Jun 19, 2019 3:51 pmCould you (or someone) elaborate on this? Maybe I am missing something, but this $150 per month difference means high paid people pay for the subsidies.FelixTheCat wrote: ↑Wed Jun 19, 2019 3:36 pm I checked ACA and I don't qualify for subsidies. I found out that high paid people (no subsidies) pay for the subsidies. For example, my silver care plan was $150 a month more from ACA then it costs directly from my hospital group. Check to see if your local hospital group provides health care plans.
I also know a few people that went the Medi-Share route (not insurance) https://mychristiancare.org/medi-share/
Re: Life after COBRA - selecting new health insurance
There was an article in the WSJ months ago about this.Pam01 wrote: ↑Wed Jun 19, 2019 2:34 pmI believe emergency care is covered by ACA plans when you are traveling within the US. This is true even if your plan has no out of network coverage. When traveling internationally. some ACA Blue Cross plans appear to cover emergency care.beyou wrote: ↑Wed Jun 19, 2019 12:49 pm I was looking into this for my state, so some details may differ, but for the most part we seem to be faced with similar ACA options.
ACA is generally not HSA eligible (there are exceptions), no out of network coverage, but I also found the in-network coverage varies greatly from provider to provider. Some ACA options in my area have terrible in-network list of providers and some have a decent list. Given no out-of-network coverage, this is crucial. Also note that ACA in my area has a list of in-network ONLY IN MY AREA, so when I travel there is NO in-net NOR out-of-network coverage. This is the worst part of ACA, which I say not to be political but rather to say I am biased towards staying on a good employer plan as long as possible. I used to have UHC and it was great, would not switch if I had the choice to stay. No point in having cheap/useless coverage. Get coverage that is useful even if it costs more.
East coast resident travels west (Colorado). Gets sick and goes to emergency room.
Believes his healthcare covers "out of network" and emergency care (as opposed to just emergency care,so better than ACA policy).
Yes some of the bill will be paid, but he ended up with a huge debt.
Issue was that he was very ill, needed more than emergency room care, and all out-of-network.
Customary and Reasonable costs caused huge differences between hospital and insurance carrier, and his % customary was a tiny % of total.
So even WITH out-of-network you have issues when traveling without a good national network.
Emergency room visits could be only the beginning of your costs.
My employer has employees globally and in many US states, so they try to stick with the major national providers that have extensive networks.
I will only use Cobra when the time comes, not ACA. But when Cobra runs out my coverage will be assumed zero when traveling, IMO.
It may be a bit more than zero, but you have to hope you are healthy enough to at least travel home when truly ill, if you are on any plan
without a great national network.
Re: Life after COBRA - selecting new health insurance
It would be hard to really explain that well without getting into politics which is not allowed here. You can search on "silver switcheroo" to get some more background.dm200 wrote: ↑Wed Jun 19, 2019 3:51 pmCould you (or someone) elaborate on this? Maybe I am missing something, but this $150 per month difference means high paid people pay for the subsidies.FelixTheCat wrote: ↑Wed Jun 19, 2019 3:36 pm I checked ACA and I don't qualify for subsidies. I found out that high paid people (no subsidies) pay for the subsidies. For example, my silver care plan was $150 a month more from ACA then it costs directly from my hospital group. Check to see if your local hospital group provides health care plans.
I also know a few people that went the Medi-Share route (not insurance) https://mychristiancare.org/medi-share/
Dancing around the politics in a nutshell someone made some last minute changes to the ACA rules which were not well thought out. Many states saw a huge loophole because the ACA subsidy is based on the second lowest cost silver plan in the healthcare exchange so if that just "happens" be high in a state then the people in that state will get bigger subsidies even if they have a bronze or gold plans if they qualify for a subsidy. In some situations a gold plan can even be less expensive than a silver plan so no one would buy a silver plan. Those same, or other silver plans can be sold outside the exchange at a lower price. The high income people who do not qualify for a subsidy would then buy their healthcare outside the state marketplace or heathcare.gov.
- Earl Lemongrab
- Posts: 7270
- Joined: Tue Jun 10, 2014 1:14 am
Re: Life after COBRA - selecting new health insurance
I'm back with more information. I had a talk with a benefits rep. Here is what I learned.
1. People above were correct. I have until 60 days after COBRA ends to elect retiree medical through MegaCorp. So the deadline is in October, although I wouldn't wait that long.
2. Retiree medical is only available when you lose workplace coverage. So if I elected to take an exchange plan I would not have a chance in the future to switch to retiree medical unless I got another job and then left it or something.
Based on #2, and some other factors, I think it makes the most sense to take one of those retiree plans. That gives me a chance to evaluate things.
Thoughts on that and input on which plan makes the most sense would be welcome.
1. People above were correct. I have until 60 days after COBRA ends to elect retiree medical through MegaCorp. So the deadline is in October, although I wouldn't wait that long.
2. Retiree medical is only available when you lose workplace coverage. So if I elected to take an exchange plan I would not have a chance in the future to switch to retiree medical unless I got another job and then left it or something.
Based on #2, and some other factors, I think it makes the most sense to take one of those retiree plans. That gives me a chance to evaluate things.
Thoughts on that and input on which plan makes the most sense would be welcome.
Re: Life after COBRA - selecting new health insurance
OP, when you participate in COBRA, it's possible to sign up for just one of the benefits in order to keep COBRA eligibility open down the road. That is, sign up for dental or vision insurance as that is usually cheaper and during next enrollment opportunity sign up for medical, if required. Worth checking if your retiree insurance offers a similar feature. If so, you can elect ACA now if you prefer and have retiree medical as a backup option down the road.
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Re: Life after COBRA - selecting new health insurance
Since this has HDHP in the title it is HSA eligible, right?UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000
Looks like you are about 2 years ahead of me in this process, I'm following closely. I'm planning now to stick with the option that looks the most like this one - big network of coverage, good coverage for catastrophic care, insanely expensive for the small amount of actual health care we consume. Life is full of choices.
Re: Life after COBRA - selecting new health insurance
Yes, indeed! Very, very difficult to understand all of these options and plans.NotWhoYouThink wrote: ↑Wed Jun 26, 2019 11:20 amSince this has HDHP in the title it is HSA eligible, right?UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000
Looks like you are about 2 years ahead of me in this process, I'm following closely. I'm planning now to stick with the option that looks the most like this one - big network of coverage, good coverage for catastrophic care, insanely expensive for the small amount of actual health care we consume. Life is full of choices.
I suppose those high costs are supposed to be to reduce/control our risks!
Very glad we are on Medicare now!
Re: Life after COBRA - selecting new health insurance
HDHP does not necessarily mean HSA eligible.
There are apparently other criteria besides high deductible to be HSA eligible.
All the ACA options in my area are very high deductible but not HSA eligible, per the exchange.
There are apparently other criteria besides high deductible to be HSA eligible.
All the ACA options in my area are very high deductible but not HSA eligible, per the exchange.
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Re: Life after COBRA - selecting new health insurance
Is this $1,600+ a month in premiums? I guess the OOP max at $2k isn't all that bad I just haven't seen the monthly premium nearly match the annual OOP maxNotWhoYouThink wrote: ↑Wed Jun 26, 2019 11:20 amSince this has HDHP in the title it is HSA eligible, right?UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000
Looks like you are about 2 years ahead of me in this process, I'm following closely. I'm planning now to stick with the option that looks the most like this one - big network of coverage, good coverage for catastrophic care, insanely expensive for the small amount of actual health care we consume. Life is full of choices.
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Re: Life after COBRA - selecting new health insurance
I don't know. The HDHP for employees was, but I don't know about this. As it was the most expensive (why?), I didn't really worry about that.NotWhoYouThink wrote: ↑Wed Jun 26, 2019 11:20 amSince this has HDHP in the title it is HSA eligible, right?UHC-HDHP - PPO: $1,616.32; deductible: $1,500/$1,500; OOP: $2000/$4000
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Re: Life after COBRA - selecting new health insurance
That's what it says. I can understand the HMO being cheaper than PPO, but why the HDHP is highest I can't really figure.deltaneutral83 wrote: ↑Wed Jun 26, 2019 1:20 pm Is this $1,600+ a month in premiums? I guess the OOP max at $2k isn't all that bad I just haven't seen the monthly premium nearly match the annual OOP max
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Re: Life after COBRA - selecting new health insurance
More time will get you more info.Earl Lemongrab wrote: ↑Tue Jun 25, 2019 4:16 pm I'm back with more information. I had a talk with a benefits rep. Here is what I learned.
1. People above were correct. I have until 60 days after COBRA ends to elect retiree medical through MegaCorp. So the deadline is in October, although I wouldn't wait that long.
2. Retiree medical is only available when you lose workplace coverage. So if I elected to take an exchange plan I would not have a chance in the future to switch to retiree medical unless I got another job and then left it or something.
Based on #2, and some other factors, I think it makes the most sense to take one of those retiree plans. That gives me a chance to evaluate things.
Thoughts on that and input on which plan makes the most sense would be welcome.
DW and I have retiree insurance, and although we enjoy the benefits, we have the same issue as you. If we decide to go elsewhere, we can't come back. That single issue would glue us to the retiree insurance even with an increase in premiums. At some level we might have to peel off, but we might get lucky. All premiums for retiree plans were lower this year than last, and two were actually zero premium. That was a shocker to us. DW had to on retiree Medicare insurance, worked out OK. She had been on Blue Cross Anthem, but fortunately all her doctors take Humana so we are good.
Does your retiree insurance options include Medicare plans when you become eligible? Hopefully they have some cheaper plans for you when you get Medicare eligible.
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Re: Life after COBRA - selecting new health insurance
Yes, there is a Medicare supplement plan, currently $86/month. I don't know much about its features.Broken Man 1999 wrote: ↑Wed Jun 26, 2019 2:41 pm Does your retiree insurance options include Medicare plans when you become eligible? Hopefully they have some cheaper plans for you when you get Medicare eligible.
Re: Life after COBRA - selecting new health insurance
Or - probably an even less expensive medicare advantage plan..Earl Lemongrab wrote: ↑Wed Jun 26, 2019 5:11 pmYes, there is a Medicare supplement plan, currently $86/month. I don't know much about its features.Broken Man 1999 wrote: ↑Wed Jun 26, 2019 2:41 pm Does your retiree insurance options include Medicare plans when you become eligible? Hopefully they have some cheaper plans for you when you get Medicare eligible.
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Re: Life after COBRA - selecting new health insurance
That is good to hear. At least there is a glimmer of hope your cost might be substantially lower at Medicare age. Of course the kicker is you would have to pay high retiree non-Medicare plan rates for some time.Earl Lemongrab wrote: ↑Wed Jun 26, 2019 5:11 pmYes, there is a Medicare supplement plan, currently $86/month. I don't know much about its features.Broken Man 1999 wrote: ↑Wed Jun 26, 2019 2:41 pm Does your retiree insurance options include Medicare plans when you become eligible? Hopefully they have some cheaper plans for you when you get Medicare eligible.
Broken Man 1999
“If I cannot drink Bourbon and smoke cigars in Heaven then I shall not go." - Mark Twain
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Re: Life after COBRA - selecting new health insurance
Happened to notice that I had the Bronze lowest plan numbers repeated for the Silver lowest plan. Fixed that.