I am not employed, not eligible for Medicare and don’t qualify for an ACA subsidy. I am in good health. Last year I paid about $200/mo for a high deductible policy that basically protected me from any huge medical expenses but didn’t pay much for routine care. This year they want $500/mo to renew that policy. The cheapest thing I’ve found on the exchanges or open market is about $365/mo.
I have found some short-term (6 month) policies for less than $200, but apparently they don’t qualify in some way (that I don’t understand) and I’d have to pay the penalty.
Can anyone point me to some affordable healthcare? All I really want is something that would cap my out of pocket expenses and protect me if I should develop a costly condition.
Individual plans pool people together based on age, tobacco use, etc to establish rates. The reason it’s expensive to buy individual coverage is that it’s not being subsidized by your employer or the government.
Short term policies are meant just for that, don’t meet ACA standards, and don’t exclude pre-existing condition. In my state at least you may not buy more than two consecutive policies.
High deductible, catastrophic coverage doesn’t really exist anymore. I’m assuming if the premiums more than doubled they increase the benefits to bring it into compliance.
I am in the same boat as the OP. I have found some urgent care plans that cover the small stuff like “cuts and bruises” type things for a buy in of a couple hundred bucks and 30 bucks a month, are these ripoffs? I know this is not an ACA thing.
But just until i get a new job, and can afford a plan?
What state are you in, how old are you, are you covering anyone else? For example, I’m looking at plans for myself only in California at age 39. Individual plans start at $200 and even the most expensive one available is under $500. So I’d need a little more info to help you find a good direction to go.
(Although I am a licensed insurance agent, I’m not giving you advice in a professional capacity)
The thing is, with these ACA plans, especially the low end bronze plans, you still have to pay the full deductible before you get a break. People don’t realize that. They think it’s like an HMO/PPO with a copay. The low end plans aren’t like that.
This is true, and what i am trying to say is if your deductible is 5k, you have to pay 5k, then you might get a break goin to the doc, until that you pay full price.
That is what the lower end plans are, just catastrophic plans at 50/50 it doesnt help ppl goin to the doc for a broken arm
Are you sure you don’t qualify for any subsidy on the healthcare exchange?
I averaged my annual income to about $16,400 (for the purposes of the exchange) and that got me a $157 credit toward my premium.
I ended getting a Blue Cross PPO silver plan that normally costs about $300/month for a monthly premium of $137/month. NO deductible, national provider network. Any generic brand prescription is free.
I think you should go back to healthcare.gov and do some research on what is available. Unless you have a high income there is probably some credit available. If you do have a high income, then you can probably find a solid plan in the $300 range.
Just to be clear, you’re in a state that didn’t expand Medicaid, correct?
The OP is unemployed, so the problem sounds like an income that’s too low. There is a floor below which subsidies are unavailable, as the Affordable Care Act assumes that every state will change Medicaid to allow eligibility based on income alone. The Supreme Court decided that states could choose not to do this, and many did not, so there are roughly 4 million people who make too little to get an insurance subsidy but don’t qualify for old-style Medicaid (which was limited to people with an additional qualifying factor such as a disability, old age, childhood, or pregnancy).
You don’t pay full price; you pay the insurance company’s negotiated price, which is typically quite a bit lower than full price. I have one of these types of plans. As an example, I just pulled up a bill for some lab work. The Lab billed $318, my insurance company’s negotiated price for the work was $149.75. If I have not met my deductible, I pay $149.75, not $318.
Not as good as not paying at all, but still, you do get a benefit even if you haven’t met the deductible. A lot of the time it’s a substantial difference between the billed rate and what you actually pay.
If you and the OP are in different states, you can receive wildly different results. My friends in Florida with lower incomes who get insurance on the exchanges are getting a terrible deal because Florida didn’t expand Medicaid.
This is correct. I had a cheap policy like this and if it had a “metal” designation I would call or a “lead level” policy because I probably would have been sunk had I had a catastrophic health issue.
In that case they probably would have either declined to renew it, greatly raised the premium or capped the payout. At least with the ACA they are blocked from doing that.
One other point about ACA policies is that on the high deductible policies, by the time you meet the deductible, often you are close to the out of pocket match. Some of my friends who are still getting employer coverage tell me that their deductibles are rising too. It is a general trend, not just an ACA thing. Companies want employees to realize that healthcare is not free.
My last few employers have only offered high deductible plans - with $6,000 family deductibles and $2,000 per person deductibles. The current one is back to a small deductible, but I almost wish they’d go with a HDHP and a HCA.
About four or five years ago, I got quoted for a catastrophic plan with high deductible ($10,000) from Blue Cross which was just a little over $200 a month. It’s now almost $500.00 a month for the same plan. There is nothing affordable about affordable health care in America.
I, like so many others are just going to pay the tax penalty.
I would recommend small city hospitals and clinics. There is one in my small city hospital I could go to in case of an emergency that is affordable enough for me to pay cash for now. After that, if it was still serious enough, I’m opting for health care in Costa Rica or outsourcing to another country.
My increase was not quite as extreme but it did go up significantly.
However, it was not the same policy and I strongly doubt that yours would be either. Post ACA, it was impossible for insurance companies to get away with many of the limitations in the older policies. Just as one example, lifetime caps on benefits were universal and are now prohibited.
What about Medicaid? Why are you not eligible for Medicaid?
When I browsed the marketplace they had catastrophic plans that were cheaper than the bronze plans. I found one for about $200 per month. Is catastrophic coverage an option for you?