What Obamacare means to my family

The anticipated and dreaded letter from my health insurance company arrived yesterday.

Dear Member:

We are writing to let you know about some important changes to your individual health insurance coverage … Your health insurance plan will no longer be available after December 31, 2013.

We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different price.

Wow. You bet it does. Looking at the enclosed rate sheet, I found my family’s new monthly premium for the cheapest available plan (Bronze HSA, non-smoker) for 2014 will be a whopping $1,024.59!

We currently pay $563 a month, so that new premium is a rate hike of 82%. Ouch. I knew it was going to hurt, but now I know how much.

Better coverage for the price?

One proponent of Obamacare likened the new, “more benefits” plans to trading up from a Prius to a Mercedes. Sure, it’s more expensive, but it’s a better car, isn’t it? Enjoy the ride!

Well, maybe I spent a lot of time shopping around for the best car to fit my family’s budget, ideology and lifestyle. Maybe I loved my Prius and wanted to keep driving it forever.

But let me look at the new list of covered benefits (included in my letter) to see what driving a Mercedes health plan would be like:

  • $10,000 family deductible (my current deductible is $7,500)
  • $12,500 out-of-pocket maximum (my current OOP is $10,000)
  • Pre-paid preventive care (included in my current plan)
  • No annual or lifetime limit (included in my current plan)
  • Maternity care (don’t need it)
  • Pediatric dental (don’t need it)
  • Pediatric vision (don’t need it)
  • Substance abuse counseling (don’t need it)
  • Mental health counseling (hmm, might need it)
  • No adult dental (now that I could use)
  • No adult vision (ditto)

So am I really trading up for a better value for money? Actually, I will be paying 82% more for less financial protection.

Rather than a Mercedes, I feel I am being forced to drive a tank. Sure, it’s got bullet-proof windows and a cool machine gun, but it’s not really suited to my family’s needs.

What are my options?

Very few, unfortunately. On October 1, I can shop around for a new plan on my state’s (Washington) health insurance exchange. But I have already looked at the available plans and prices on the insurance commissioner’s website, so I know that the bronze-levels plans are comparable in price. I might be able to reduce the monthly premium by $200, but not much more.

The best reason to buy insurance on an exchange is if you qualify for a subsidy. I don’t.

Prices for plans outside of the exchange are also pretty similar. Because all the insurance carriers have plans on the exchange as well, their off-exchange plans are “metalized” and ACA-compliant. That is, they adhere to mandated “essential benefits” and cost-sharing guidelines, and actuarial values.

What would I really like? More freedom of choice to pick the benefits I need at a price I can afford.

Unless another option presents itself, I will be forced to leave the insurance company I have been with for over 20 years, and try to find a plan that is at least a little less expensive.

I understand that the premium hikes are necessary to provide broader coverage to more citizens, including those with pre-existing conditions.

As a nurse, I have long advocated for better coverage — universal coverage — for all Americans. But helping one group of people by causing financial harm to another cannot be a workable solution to our health care crisis. Can it?

“Frugal Nurse” is a nurse who blogs at her self-titled site, Frugal Nurse.

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  • Anthony D

    If you can use Google and do some basic research you will find out for
    yourself just how bad it is and come January 01 just how much worse it
    is going to get.

    But to get you started, a 2700 page bill backed by 13,000 pages – and
    climbing – cannot be good. Add in the IRS who is going to be handling
    the enforcement of Obamacare….what could possibly go wrong!

    • user225937

      Fifty Million uninsured Americans with nation wide medical bankruptcy was no peach either.

      • Jess

        There were not fifty million Americans who were without health insurance either because they could not afford it or because they had a pre-existing condition. A lot of the uninsured were uninsured by choice, either because they wanted to spend their money elsewhere or because they failed to sign up for government programs they were eligible for.
        And the “medical bankruptcy” furphy has been debunked countless times. If you are a binge shopper and rack up $60,000 in credit card debt, and you decide to declare bankruptcy to clear it, and you also report in your insolvency filings a $10 unpaid medical bill that you want to welsh on, they counted that as a “medical bankruptcy”.

  • querywoman

    Do the politicos think the American public is dumb enough to fall for this? Most of us would do better to pay for our care ourselves out of own pockets.

  • NewMexicoRam

    This will be a disaster.
    I believe we will only be hearing more stories like this very soon.
    The 2nd Tuesday of November 2014 could be very interesting.

  • http://www.dpsinfo.com LaurieMann

    Sounds like yet another argument for single-payer…which, of course, we’ll never have.

    • Mengles

      As long as you’re ok with not getting certain treatments bc it’s too expensive, then single-payer is what you’ll get. There is NO FREE LUNCH.

      • http://www.dpsinfo.com LaurieMann

        I’ve heard fewer complaints from friends in the UK and Canada than I’ve heard from Americans about their healthcare…

  • Ron Smith

    Just out of curiosity…did you or anyone you know in your profession vote for Obama?

    If so, can you tell me what the others who did are experiencing with their health insurance coverage and rates?

    Also do you know of people that don’t know what Obamacare is or possibly even have never heard of it? (There was a network news report on this CNN that I heard about that you can check out on www (adot) hotair (adot) com which shocked me.)

    Ron Smith, MD
    www (adot) ronsmithmd (adot) com

    • http://frugalnurse.com/ Frugal Nurse

      I work part-time and my husband is self-employed, so we are somewhat unique among our friends in that we do not have employer-sponsored health care. I think those of us with individual plans have been following the implementation of the ACA with a more critical and anxious eye because we are the most immediately affected with these premium hikes.

      I have been constantly surprised over the last three years how little the other doctors and nurses I work with know about the specifics of the ACA. They tell me, “Oh, we’ll count on you to keep us informed,” and they don’t bother to inform themselves. Of course, most of the health care providers I work with are also suffering from burn out brought on by increasingly long hours, lower take-home pay, more paperwork, and incredibly frustrating electronic health records implementation!

      Non-medical friends, also, unless they are directly affected by the changes, have no idea what the ACA entails other than some of the broad talking points, such as coverage for pre-existing conditions.

    • EE Smith

      I know two college students who are of the belief that come January 1, “everyone” is going to get “free” healthcare. Everyone. Free. They’re both 21 and as such are still covered under their parents’ plans for four or five more years, so I don’t think they really think very much about health insurance. They will if their parents lose their policies, or can’t afford the new premiums.

      Like Frugal Nurse, I have an individual policy, so it’s something I’ve followed quite closely. Because I’m in good health and only see a doctor once every one or two years, I’m half-thinking of becoming a cash patient, and if I ever get cancer or develop some other expensive condition then I’ll go ahead and sign up, since they can’t exclude you for any preexisting condition anymore. I haven’t seen what my new rates will be yet, but I’m assuming there will be a big jump.

      • ninguem

        I’m getting the same thing. Not only that it will be free, but I will HAVE to see them as patients, no matter what crappy plan they may have.

        They have said that, to my staff answering the phone, in so many words.

        • Mengles

          Seriously? People are now threatening that you MUST see them no matter what they’re plan is?

          • ninguem

            Seriously Mengles.

            I’m not really surprised. We got the same thing when Hillary was trying to sell her healthcare plan.

      • SarahJ89

        “I’m half-thinking of becoming a cash patient, and if I ever get cancer
        or develop some other expensive condition then I’ll go ahead and sign
        up, since they can’t exclude you for any preexisting condition anymore.”

        I’m on Medicare now, but that’s what I would do if I weren’t. I have to go once a year, to get my hand stamped so I can get my levothyroxin renewed and I hate doing even that. I have no other reason to see a doctor so I’d be better off self insured now that the pre-existing condition clause is no longer in effect.

      • Judgeforyourself37

        If you do not sign up by March 31, 2014 you will have to wait for the next enrollment period. Check again, if young people, who are healthy….at the moment, do not sign up then they may be “out of luck” if they become ill.
        Check again, you CAN keep your insurance, if you like it, but that insurance CAN cap your benefits if you become seriously, or chronically ill, or are in a devastating accident that renders you with life long consequences.

        • Disqus_37216b4O

          “If you do not sign up by March 31, 2014 you will have to wait for the next enrollment period.”

          Only if you want to go through an Obamacare exchange. Different insurance companies have different enrollment periods.

          “Check again, you CAN keep your insurance, if you like it…”

          That simply isn’t true. If your insurance isn’t ACA-compliant, you CAN’T keep it: your policy will not be renewed, and you will have to find a new policy. As happened to the author of this article, and has happened to me.

          “…but that insurance CAN cap your benefits”

          That isn’t true either. Under the ACA, insurance companies CANNOT cap your benefits anymore.

  • http://frugalnurse.com/ Frugal Nurse

    Yes, however upset I am about the plans and premiums, I’m not sure I can overcome my fear of ruinous medical bills. If costs (waste, fraud, unnecessary treatment, egregious profit, etc.) could be controlled, health insurance would be more affordable and universal coverage closer to reality.

    • guest

      Loved your article. you have hit the nail on the head. THe fundamental flaw with Obamacare is that he only addressed every American getting insurance NOT confronting the industry, Medicare FDA, AMA (RUC) etc.

  • guest

    ……..Speaking of which, I just got a letter from my insurance company. I thought OMG here its coming. And it sort of did. My insurance is “renewed” for 2014. But will be re evaluated each year.
    Makes me feel very stable. What the &#$%!!!! Have never had an insurance policy where it was decided yearly if the plan will continue to be offered.

  • guest

    You know I can see why people are unhappy with the ACA. I would guess that Obama was busy bartering with the healthcare industry to get the ACA. I would guess that is where the EHR craze started. In conjunction with “HIPAA” he both got “protection” for pts at the same time behind the scenes HIPAA laws opened up new laws to legalize marketers from healthcare industries to use patient data for marketing purposes. All legal. And just encourages the corruption and spiraling healthcare costs all at the same time.

  • EE Smith

    But with Obamacare, there’s nothing to stop you from waiting until you’re facing an expensive medical situation and THEN getting insurance. What’s to stop people from just paying cash for ordinary medical needs (you can buy a lot of routine healthcare for $1000+ a month), and waiting till something catastrophic comes up to go ahead and sign up?

    • http://frugalnurse.com/ Frugal Nurse

      You will only be able to sign up during open enrollment, which after this year will run from about mid October to mid December. So if you have an accident or fall ill during the rest of the year, you can’t just sign up.

      I would love to return to the days of paying cash for routine medical care and having a truly catastrophic health insurance plan in case of, well, something catastrophic.

      Kathleen Sibelius dismissed such plans as “mortgage insurance.” What’s wrong with that??

      I would like people with pre-existing conditions to find affordable coverage. But I don’t think eliminating one of the simplest and most affordable forms of health insurance for everyone else is the answer.

      • EE Smith

        Is the “open enrollment period” only for the exchanges, or for all health insurance? I don’t stand to get taxpayer subsidies for my insurance, so there’s no real advantage for me to go through an exchange. But the ACA regulations regarding preexisting conditions applies to all health insurance policies, from all companies, so unless all insurance companies in my area are going to have limited enrollment periods, there may not be a problem.

        • http://frugalnurse.com/ Frugal Nurse

          It might vary from state to state, but in general the ACA allows companies off the exchange to also use open enrollment periods (to limit what you are suggesting). The enrollment periods just cannot be shorter than those on the exchange.

          • EE Smith

            Good point, it’s worth looking into.

      • ninguem

        I haven’t checked yet, Frugal.

        Do HDHP’s still exist under “Obamacare”?

        HDHP = “high-deductible health plan”, which is the plan intended to be paired with Health Savings Accounts (HSA)

        • http://frugalnurse.com/ Frugal Nurse

          That’s kind of funny, actually. The bronze plans in our state, on and off the exchanges, almost all have a HSA option. The deductibles are close to the out-of-pocket max, about $6,000 for an individual and $10,000 to $12,500 for a family. That is normal for a HDHP plan.

          However, all the ACA-mandated benefits must be included and so the premiums are significantly more.

          In short, we are still getting a HDHP, but at the cost of a comprehensive plan (that still doesn’t include adult dental or vision).

          With lower premiums, we could save enough money to put into the HSA to use against the high deductible, in case of a medical catastrophe. Now, because of the huge premium increase, we will not be able to, so we will probably drop the HSA.

          Comprehensive plans have never been affordable on the individual market, and I don’t think that has changed.

          • Jess

            It’s the Medical Loss Ratio (MLR) requirement under Obamacare that’s hiking up the price of High Deductible + HSA policies.

            Google obamacare+mlr+hsa.

          • http://frugalnurse.com/ Frugal Nurse

            Yes, partly. But Washington already had a strict MLR requirement in place, which is why our state did not get any of those much talked about rebates last year.

            Other than the extra benefits, I think premiums and OOP costs are going up because the insurance companies simply don’t know how many people with expensive pre-existing conditions will buy health insurance, and how much they will have to pay out next year.

            My fear (rationally based, I think, on recent history of health care costs) is that it will be a lot, and our premiums will be even higher in 2015.

            Thanks for your comments!

  • EE Smith

    It’s good for people with pre-existing conditions, but that’s about it. Did we really need to nuke the whole system for everyone else, just to find a way to get them covered? People are having their hours cut and even losing their jobs over this. People are being hit with doubling of insurance premiums over this. People are going to have their choice of doctors drastically reduced over this. Surely there had to have been a simpler (and less expensive) way to help the relatively small number of Americans who “fell through the cracks” in the system as it was. 85% of people were happy with their existing health insurance.

    • SarahJ89

      “Did we really need to nuke the whole system for everyone else, just to find a way to get them covered?”

      Sadly, the answer seems to be yes. Of course there are better ways, but we lack the will. So we pay the price.

  • Lisa

    I get insurance through my employer, which costs over $600 a month (my employers contribution and my contribution). My husband is not on my plan. Insurance through my state’s exchange would cost about the same if I used a bronze plan. Considering the fact that I would be unable to obtain insurance on the open market as I have a history of cancer, I consider that a bargain.

    I doubt the figures quoted in by Frugal Nurse. When I log onto the Washington State exchange and looks for quotes, i get a price of about $660 for a silver plan (not a bronze plan). This is based on two adults and no stipends. If you add in two children, the price is still under the $1,000 a month she mentioned.

    • EE Smith

      I’m glad that you’ll be able to get insurance on the open market now, and that it will be affordable for you (if $7,200 or more a year per person is affordable for you), but I’m curious, how does the “Bronze” plan you could get on the exchange compare to what you currently have, in terms of provider network, copays, out-of-pocket, deductibles, etc? If it’s exactly the same and doesn’t limit you in terms of provider networks or saddle you with higher OOP/Deductible expenses, that’s great. It also doesn’t seem to be very common.

      (2) You write, “I doubt the figures quoted in by Frugal Nurse.” It’s pretty bold to imply that the original poster is lying. She did say that after shopping around, “I might be able to reduce the monthly premium by $200, but not much more”, so that would take it to under $1000/month. But still, given that her current rate is just $563/month (unless you think she’s lying about that too), and given the new plans have higher deductibles and out-of-pockets (unless you think she’s lying about that too), it’s still not a pretty picture.

      • Lisa

        As I have a relatively high income, I won’t get a subsidy under the ACA. While I wouldn’t like it $7,200 is affordable for me. A hell of a lot better than being without insurance. The Bronze plans on my state exchanges are not as good as my current plan, but my current plan costs more than the bronze plans in my state exchanges. As I’ve had relatively high medical costs in the past, I chose a plan with higher monthly costs and lower copays and deductibles.

        I said I doubt frual nurse’s figures and gave my reasoning: The quote of likely cost from the Washington state exchange is $660 for a silver plan (two adults, no children) without subsidy. That doesn’t jibe with what she said, so I don’t think I am being all that bold.

        • http://frugalnurse.com/ Frugal Nurse

          I will give you the numbers straight from the rate chart included in my letter: Adult, age 53: $411.45; child, age 22: $201.69. Total: $1024.59. If you still don’t believe me, look on Regence’s website.

    • http://frugalnurse.com/ Frugal Nurse

      Well, it all depends on the age of the adults on the plan, doesn’t it? My husband and I are both 53, so on average a bronze plan premium for each of us is about $400, or $800 total. Our son is 22, and his premium will be $200, on average. That adds up, on average, to $1,000. I am not making up the numbers, I assure you.

      • http://frugalnurse.com/ Frugal Nurse

        I just went on the Wash state exchange and plugged in my family’s ages. The price for a silver plan (without subsidy) comes up as $1,173.

  • petromccrum

    Many of us are in the same position. I also received this letter. I thought my increase was bad at 50+%. I also will be paying more for less.
    I feel for you. I just hope that all of those individuals that thought this program was a good thing will get the same letter and have to pay more.

  • Eric Thompson

    The insurers are limited in charging older people more than younger and those sicker than the healthy not more at all. Plus, being unable to deny anyone coverage, the prices have only just begun to increase. This ought to be interesting.

  • http://frugalnurse.com/ Frugal Nurse

    Our insurance has been relatively cheap because it is a catastrophic plan/HSA. We have lower premiums but a high deductible. As we are healthy, and savings in the HSA can cover the deductible, that works for us. And yes, our premiums would have gone up regardless, but not so much. Over the last four years (as insurance has been mandated to cover more and more, and health care costs just keep rising) our premiums have gone up 12%-20% every year.

    I like that Obamacare means people with pre-existing conditions can buy insurance. I have always advocated for that. What I don’t like is that we are forced to buy (at a much higher price) comprehensive plans with benefits we will never need. I’d like to have a wider choice of benefit options so we can find a plan that fits our budget without having to spend more than 10% of our income.

    • Jess

      When my husband was putting me through med school, we just about lived on ramen noodles and last-afternoon-of-the-farmers-market (when they mark down everything that hasn’t sold yet) fruit and vegetables. We chose to do that so that we’d have as little college debt as possible. I would have been angry if the government had forced us to buy filet mignon and organic asparagus tips instead.

  • ninguem

    ^^^ What Mengles said ^^^

  • StefanoNBelinda

    Obama is blamed for much of what the Republicans did to eviscerate the effectiveness of any health care reform, with the sole purpose of discrediting him. Calling this disaster “Obamacare” only exacerbates that. Obama’s “sin” was that he capitulated to insurance companies and to the right wing nut jobs who are running the middle class into the ground.

    • http://frugalnurse.com/ Frugal Nurse

      Both political parties have had a hand in creating this complicated and expensive law. And current political grandstanding is not helping anyone (except, perhaps, the politicians). True health care reform will only happen when the needs of the American people are put before the wants of the political parties and special interest groups.

      • Robert Luedecke

        I was reminded yesterday of something that might help you. If you really like the insurance you have now, some companies will let you renew your policy in December of this year, which will let you keep the lower premium until December of next year. Insurance brokers believe the price on the exchanges will come down more in 1-2 years once the companies are more sure of their risk.

        • http://frugalnurse.com/ Frugal Nurse

          Thanks for the suggestion, but I believe those offers are only being made to small businesses with group plans. Besides, my plan is being cancelled as of Jan 1 because it is not considered ACA-compliant; no chance at all of keeping it for another year.

          • Robert Luedecke

            Sorry to hear that.

  • Robert Luedecke

    I am sorry to hear of your experience. The cost can be very different depending on how strictly insurance was already regulated in your state. If insurance companies were allowed to sell policies that had big holes that allowed them not to pay if you actually developed a serious illness, it makes sense you could buy that for a low price. You would be quite happy with that policy unless you were the unfortunate one to get that serious illness and find that your policy didn’t cover it. I developed a serious problems with my neck. Believe me, it seems like much less of a bargain when your insurance doesn’t cover you. You will never have that problem with the new plans.

    • http://frugalnurse.com/ Frugal Nurse

      Looking at other state’s average premiums, I think Washington’s costs will be middle of the road. We already had partial community rating–insurers couldn’t deny you, but they could impose a 9-month waiting period on coverage for a particular diagnosis.

      And our current plan worked just fine when our family did experience a major illness three years ago. We hit our out-of-pocket max of $10,000 (paid for with funds in our HSA) and the insurance company paid 100% from that point, just as we expected them to. No problems. I’m going to miss that plan!

      My overarching point is that insurance and health care will continue to be a major financial and emotional drain on families, even with the ACA. We need more health care cost reform, not just health insurance reform.

      • Robert Luedecke

        I agree with you 1000% that we need lower healthcare costs in the US. We are currently at twice the cost per person of the next most expensive country. The reforms that begin Jan. 1 are only the first phase of many more steps that must happen. I have to get my health insurance through my wife because insurance for self employed is expensive and doesn’t cover much. She works for a large employer that has great insurance and three years ago when she checked to see how much our insurance would cost if she retires before we are both 65, it was $2000 per month! I definitely agree with unaffordable!

        • http://frugalnurse.com/ Frugal Nurse

          Yes. It makes me crazy that Americans seem held hostage by health care and health insurance. Despite affordability claims on the exchanges, the out-of-pocket costs will still be high, there will be no coverage for adult dental/vision, and premiums will still be paid with post-tax dollars.

          Overall, employer-sponsored care is much better coverage for the money (pre-tax dollars!), and people will still suffer angst about finding/keeping/losing their employment.

          Thanks for your comments!

          • Robert Luedecke

            For my wife and I (age 56 and 60) the silver plan on the new exchange is $11, 983 per year with no subsidy. This is still not peanuts, but $1,000 per month on the exchange is better than $2,000 per month from her employer upon retirement.

          • Tammy

            That’s because the ACA decrees that young, healthy people be charged extra so that older and sicker people can get cheaper insurance. Next time you see a healthy non-smoking 30-year-old male, thank him for paying double so that you could get cheaper insurance.

          • Robert Luedecke

            Tammy, I understand why some people might think it is unfair that my premium went down, but anyone who is fortunate enough to live to be older will get the same benefit as me. I also do not smoke, exercise regularly, and eat right. I did not know I needed to be doing anything special to prevent my chronic neck problem.

            Did you know that whatever your age, under the old system all women paid higher premiums than men the same age? I think that was unfair and I don’ t mind paying a little more so you can pay less.

          • Jess

            “Did you know that whatever your age, under the old system all women paid higher premiums than men the same age?”

            That is actuarially based. Women use more healthcare dollars than men, that is a fact. They are statistically going to be making a lot more claims, so they were (very fairly) charged more.

            It’s no different to the way that under-25s are charged higher car insurance premiums than over-25s are, and men of all ages are charged more for car insurance than women of all ages are. Older people make fewer claims than young people do, and women make fewer claims than men. It’s all based on actuarial risk. If we followed your logic, my car insurance premiums should go up so that you can get cheaper car insurance premiums.

            Under Obamacare, men are being forced to pay more in order to subsidize women. As a paleo-feminist, I don’t like the idea that the government thinks I need them to go around forcing men I don’t even know to foot my bills.

          • Robert Luedecke

            Jess, I am sorry you feel upset about men and women now paying the same health insurance premium. I understand that the difference in the past was actuarially based, just as charging more to sick people was actuarially based. Neither is necessary for a health insurance plan to work well and I think it is more fair under healthcare reform. If it helps you feel better, I know you are not forcing men to foot your bills, it is just part of the rules.

  • querywoman

    Soon the American masses will face a rude awakening to their apathy about healthcare!

    • Jess

      Yeppers, there was just an article in a California paper where many people were shocked that they were actually going to be PAYING for this.

      This is an actual quote from one Cindy Vinson, Bay Area resident:

      “Of course, I want people to have health care. I
      just didn’t realize I would be the one who was going to pay for it personally.”

  • querywoman

    There will be a lot of exemptions for people who pay attention!
    If our tax dollars are covering the ACA, why are the premiums so expensive?
    Direct care probably best for you. I hope $4 meds will cover most of your family’s needs.

  • Anthony D

    No it simply forces an individual to buy health insurance. That is
    something that should not be tolerated at all. Unions have no power and
    are forced to give their employees under 30 hours or else be fined by
    the government. So businesses coup by giving less hours with more work,
    or just hiring more people. So the economy of the middle class and lower
    class will always be non-existent.

    His health insurance scheme is no different than the previous ones. All
    that matters is a persons income, low income means no health insurance,
    or very bad coverage, middle income means decent health coverage, and
    those with high incomes….well you can no doubt guess their position is
    just dandy.

    A shame really how the US has become what it had once fought against. We
    claim to stand for liberty and democracy but all we have done is spread
    our imperialism to other countries and neglected our own people, and
    that is the greatest crime of all

  • http://frugalnurse.com/ Frugal Nurse

    I wanted to provide a short update to my story. I went onto our state’s health exchange plan finder to compare new plans. Overall, the rates are similar to rates of off-exchange plans, BUT the provider networks are much, much smaller. I thought the larger companies, such as Premera and Lifewise, would have the same provider network whether you bought a plan on or off the exchange, but I found this is not the case. In fact, none of my family’s doctors are “in network” for Premera, Lifewise, Molina or Bridgespan (Regence). Most of the major hospitals in the area are not in network, either.

    Not only must I change my plan and my insurance carrier, but also my health care team, as well. Sigh.

    If you qualify for a subsidy, and you need to purchase a plan on the exchange, be sure to check the providers network (especially if you like your doctor and want to keep him/her).

    • Jess

      There are at least twenty counties in Florida (where my parents live) where there is only ONE insurance company offering health insurance through the Obamacare exchange. And their provider network is incredibly narrow.

  • Anthony D

    Well, it can’t afford itself, so, in that regard, it will fail.

    I can only presume that a system that cannot afford itself will,
    eventually take a toll on the medical industry at large, especially if
    it is virtually the ONLY system available.

    So, ultimately, the government will become a funding unit for a smaller
    and smaller amount of projects, which will actually decrease the demand
    for doctors in America, especially high quality specialty docs, even
    though there may potentially be spikes of “insured” people who need
    doctoral care.

    At least, that’s how I presume it will play out.

    Most liberals argue that folks like me aren’t considering the compassion
    involved in allowing everybody free healthcare, but, just like
    communism fails because people stop giving a crap about their work, the
    doctors are going to be less and less likely to risk massive college
    debt and doctoral degrees that vacuum up years of their life, which
    would be followed by the horrible potential for the shame of malpractice
    after attempting organ surgery or even diagnosis when the pay becomes
    smaller and/or nonexistent as the government struggles to pay docs or
    starts auctioning medical care to the lowest bidding health care

  • Michael Wasserman

    It looks like my insurance will go up about 30% here in California. Clearly, if you’re healthy, your insurance premiums will go up. I’m a little surprised as to the degree…one thing is certain, the marketplace will ultimately respond to increases like this…as will the voters. Thanks for sharing!

  • SarbaniC

    I pay little more than $1000/month now for my family through my employer provided healthcare plan. My employer does subsidize that, but that’s part of the benefits package that I get from them. So $1000/month for a family coverage is not extraordinary at all. Now, with the ACA, a family of four is eligible for govt. subsidy if their monthly income is <= $94,200, which, I believe, is a generous limit. In the UK, citizens pay almost 1/3rd of their income in taxes, including National Insurance.

    I think ACA is a good first step in providing a basic right. Is it perfect? Of course not, but nothing this large can be. It takes years of tweaking and honing to get it to where we want it to be. I've no doubt we'll get there.

    • http://frugalnurse.com/ Frugal Nurse

      There are some major differences between paying $1000 for an employer-sponsored plan and an individual plan.

      -my insurance is not subsidized; my family makes slightly more than 400% federal poverty level. $1000/month is 12% of our income.
      -my insurance is not paid for with pre-tax dollars

      -my insurance does not include adult dental or vision
      -my insurance has a very high deductible ($10,000)
      -my insurance has (or will have next year) a very limited network of providers to choose from

      Our country desperately needs health care reform to make it available and affordable to everyone. I simply don’t think the ACA does that.

      • SarbaniC

        I disagree. The ACA is a first step, as I mentioned, and I’m looking for it to improve over the years. Single Payer would have been preferable, but with no votes to pass it through and healthcare overhaul being such anathema to most politicians, it’s a small miracle we were able to do this.

        BTW… the $1000 I noted also does not include dental or vision. Costs go up a little more with that addition.

        • Jess

          It’s not a “healthcare overhaul”. It’s a health insurance overhaul. There’s a big difference.

          • SarbaniC

            I agree is is health insurance overhaul, but it’s aimed at benefiting those who couldn’t afford or were denied healthcare in the past. So for the greater good.

          • Jess

            No, it’s for those who couldn’t afford or were denied health insurance in the past.

          • http://frugalnurse.com/ Frugal Nurse

            That is the aim, I agree. But based on 30 years experience as a nurse dealing with all forms of insurance (and no insurance) I truly don’t believe that aim will be met by the ACA. Even with insurance, people can face bankruptcy. Insurance companies are middlemen that further inflate already high health care costs.

          • SarbaniC

            It’s going a long way to help that. In fact, many have been helped already with the removal of lifetime caps. We have an actual test case in Massachusetts.

            Anyway, good luck to you and your family.

  • SarbaniC

    Thanks for sharing your story, but I think your case is unusual. Your existing health insurance company was providing a plan that was not compliant with the basic requirements (as defined by ACA and agreed to by the medical community), hence the change. My company’s health insurance plans are already compliant and/or have to be tweaked slightly to be compliant, so I have no changes. So thankfully, I get to keep my insurance company, plan and doctors.

    • http://womanfoodshinyobjects.wordpress.com/ Brian Stephens MD

      not unusual…. I have had 5 patients in just the past week come to me with similar complaints and “letter.”

    • http://frugalnurse.com/ Frugal Nurse

      It’s really not that unusual. Many people who buy individual plans have high-deductible catastrophic plans because they are affordable. Making these plans ACA compliant has simply made them much more expensive, and it will be a financial hardship for families who do not qualify for a subsidy but will be expected to pay more than 9.5% of their income on premiums.

    • Jess

      “I think your case is unusual”

      What would be unusual would be for a person with individual health insurance NOT to have their policy cancelled.

      Seriously, I don’t know anyone who purchases their own health insurance who is going to be allowed to keep their old plan.

      I have a catastrophic policy tied to an HSA, and it’s gone as of next year. Next year I will have to take out and pay for a comprehensive “soup to nuts” policy whether I want to or not.

      • SarbaniC

        I think people who have employer covered insurance, which is my case, and that of 85%, will not see much of a change. Yes, our premiums will probably go up, but they’re been doing that every year anyway.

        • Jess

          I hope your employer doesn’t decide to drop your health insurance, as has happened for so many tens of thousands of others. Your smug attitude that it’s “only” 15% of American (nearly 48 million of us?) who are not allowed to keep the plans we liked, and not allowed to keep the doctors we liked, and are having our premiums hiked to stratospheric levels, so who cares… might not survive it.

          • SarbaniC

            Unfortunate that you let your argument devolve into a personal attack. Good luck to you.

  • Rob

    Why do you feel allegiance to your insurance company?

    • http://frugalnurse.com/ Frugal Nurse

      Because they have worked very well for me for 20+ years. All my claims have been paid promptly and without question. I would rather stay with them then move to another company with which I have no experience.

  • Sarah Williams Mueller

    Our family is dealing with the same. We tried to renew/attain a policy effective Dec/2013 to keep a somewhat lower rate but were denied for random “conditions” that previously have never been an issue. The insurance companies are sure winning in all of this while those of us in the middle class & self employed are the losers.

    • http://frugalnurse.com/ Frugal Nurse

      I’m sorry that you are in the same boat! I’ve heard from so many people who are early retirees or self-employed, and we are certainly not alone. If that’s any consolation…

  • http://frugalnurse.com/ Frugal Nurse

    Because catastrophic plans are no longer available. That is why ours is being cancelled as of 1/1/2014. Such plans are not ACA compliant as they do not include the “essential” benefits and do not meet the minimum actuarial value of 60%.

    Since 2010, catastrophic plans have been increasingly expensive because of adding “free” preventive care and removing annual and lifetime limits.

    In 2014, all individual plans will be comprehensive (although with a deductible of $10,000, our plan still seems catastrophic!)

    We have considered a direct-pay doctor, but honestly with our new premiums at $1000+/month, we can’t afford the additional monthly fee. Besides, we rarely see a doctor and our annual exams will be included in the price of our insurance.

  • http://frugalnurse.com/ Frugal Nurse

    They are probably a little preoccupied right now…but I could add my letter to the growing number posted on Facebook, Instagram and Twitter!

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