I don’t care enough to research any further. If you want to risk that a car accident or cancer diagnosis will count as a qualifying life event, you can. I wouldn’t care to do so, though.
Yeah, really. For a similar plan, the ACA premium is 90% higher. $1,188 per month. And before anyone chimes in that I have a “lousy” plan, that’s not true. My plan matches up most closely with a “gold” ACA plan. I even have no lifetime maximum with my current plan.
It may be cheaper, but how does the coverage compare to your old plan? I’m going to be saving money next year, but the coverage isn’t nearly as good. What I currently have almost certainly equates to a gold-level plan. We don’t have any comparable option for next year, and the most expensive (ie, least worse) option costs more than what pay now. I’m going with a lower option, because if I have to accept higher out-of-pocket costs, I want to get lower premiums as a trade-off.
I’m honestly confused: does your current plan meet ACA requirements? If so, then you just stay on it, right? No premium increases for you.
If it’s missing required things, then the ACA plans aren’t really comparable are they?
My current plan does not cover pregnancy, which is not a problem as we’ve already had our kids. I believe our plan also isn’t ACA-conforming regarding mental health coverage. I know it has no lifetime maximum, as that was removed a couple of years ago. I’ve been notified that I can keep my plan through 2014 but it will then be eliminated. I looked at the ACA plan thinking I might find an alternative, but none are remotely affordable to me. I can’t understand how the pregnancy and mental health coverages translate to a 90% increase.
As noted, such coverage could also be useful if your kids are under 26, still on your plan, and might be having additional kids themselves.
Perhaps your old coverage was medically underwritten, excluding those more likely to get sick, and the carrier for your new coverage (not medically underwritten) is scared they might get lots of sick people, so they’re starting with very high rates until they see. (They’ll have to refund some money if their payout estimates are way off; they can’t just keep all of it as profit.)
I’ll sign up as soon as the ACA web site is fixed, or by phone if it’s still too buggy by early December. My group health coverage is going away, and comparable coverage from the same insurance carrier via the marketplace web site should save me a few thousand dollars a year, without getting any subsidy.
Actually, after 2016 the penalty is indexed to cot of living. But insurance premiums have consistently outpaced inflation.
So as the years go by there will be a stronger and stronger incentive to not participate and just pay the fine. Cite(skip to item 3)
It absolutely was medically underwritten, and we fought to get one family member changed from Tier 2 to Tier 1 to save some money. They refused to change another member from Tier 2, so he (one of my sons) has his own policy. It only costs $87 a month; the new ACA charge for him is $144. So, even though he is rated as higher risk than the rest of my family, the ACA premium for a similar policy is still 66 percent higher.
I’m guessing the insurance companies are “guessing” with extremely high rates so they don’t take a bath during the first year. At least I’m hoping that’s the case before I have to sign up next year.
Maternity coverage for a dependent daughter isn’t necessarily the same as maternity coverage for the policyholder or the policyholder’s wife. It’s not uncommon for insurance to only cover the latter and not the former; in which case your only options are to get your daughter her own policy or on Medicaid. It’s not something that even occurs to most people to ask about until they get a claim denied and AFAIK it’s not something the ACA changed.
You know that the children of these under 26-year-old dependents aren’t covered by grandma and grandpa’s policy, right?
I hadn’t considered that, but looking around, I can’t find anything specific about dependent maternity coverage and small group or individual plans. There’s a lot of information about requirements for maternity coverage, much about a loophole where employer plans covering more than 15 people were required to provide maternity benefits pre-ACA* but only to the employee and spouse , and reports of complaints filed against employers alleging that excluding dependent daughters from maternity coverage violates a section of the ACA which bars sex discrimination ( even though it doesn’t violate the Pregnancy Discrimination Act)
Pregnancy is the only issue I can think of that might be covered for policyholders but not dependents, and the lack of specific information about such an exclusion makes me think ACA does require dependent maternity coverage in individual plans.
Those three links back up Doreen’s point. None of them explain the situation with individual or small-group plans, only large-group plans. So they’re not really relevant in a thread on people signing up on the ACA marketplace, since those are all individual plans.
It could be the situation is the same for individual plans under the ACA, but I’d like to see a cite on that specific issue, if anyone can find one.