My search for health insurance has been interesting to say the least. Until this year, it’s been a relatively easy task; place a call to my broker, have her provide me with quotes, review the plans, pick a plan, pay the bill each month, and forget about it for another year. All that changed this year with the Affordable Care Act.
My journey started in September of this year when Blue Cross Blue Shield (BCBS) of Texas sent me a letter. It arrived two weeks after my 2013 to 2014 renewal and announced my plan would be cancelled. I would have the opportunity to accept a replacement policy that would be compliant with the Affordable Care Act, or shop for my own coverage through the federal exchange as Texas chose not to set up a state specific exchange.
The federal exchange went “live” on October 1 but has been virtually non-operational for much of the past 6 weeks. Due to the problems that have plagued the system from the beginning, I’ve been unable to get onto the system until tonight (11/14/13). While waiting to see what will be available through the exchange, I have been gathering information on my options outside of the exchange:
- I had my current broker pull all new plans that were compliant with the ACA. These plans include both HSA and non-HSA plans through the carriers she works with.
- I also had a new broker pull together some options to compare. The plans he provided also include both HSA and non-HSA plans with different carriers.
- I called BCBS after the new plans were released on October 1and had them provide me with their options.
On October 30th, I received a letter from BCBS introducing the “new” and ACA compliant version of my current plan. Here’s a comparison between my current plan that will expire on November 30th with BCBS and the replacement plan.
|
Plan Description |
Current Plan |
Replacement Plan |
| Plan type |
BCBS Blue Edge HSA 90/70 |
BCBS Blue Edge HSA 90/70 |
| Deductible |
$2,500 |
$2,500 |
| Monthly Premium |
$428.00 |
$460.00 |
| Dental |
$34.70 |
$34.70 |
| Total Monthly Premium |
$462.70 |
$494.70 |
The monthly premium for the replacement plan includes $20.00 worth of ACA fees which the federal government is assessing all health insurance companies. Most of the insurance companies are passing them on directly to their policy holders. The good news about this plan if I choose to pay the additional $32.00 a month is I can continue to use my current physicians and my preferred hospitals.
Now that I know what my replacement option is with BCBS, I then compared it with the options my current broker provided me with.
|
Plan Description |
BCBS Replacement Plan |
BCBS HSA Plan VI |
BCBS HSA Plan VII |
Aetna PPO HSA 3500 Plan |
Aetna PPO HSA 5500 Plan |
| Mo. Cost |
$460 |
$435 |
$411 |
$397 |
$301 |
| Dental |
$34.70 |
$34.70 |
$34.70 |
Unknown |
Unknown |
| Annual Deductible |
$2,500 |
$2,500 |
$3,500 |
$3,500 |
$5,500 |
| Annual Out of Pocket Limit |
$3,000 |
$3,000 |
$3,500 |
$5,950 |
$5,500 |
There are differences between all 5 options on the office visit co-pays after the deductible (the higher deductibles have $0) as well as on medications. All 5 plans keep my care more affordable if I stay within network. If I go out of network, the deductibles and out of pocket maximums jump significantly. The deductibles range from $6,000 to $7,000 on the BCBS policies and $7,000 to $12,500 for Aetna. Total out of pocket maximum charges are even higher running $12,000 or $14,000 for BCBS and $25,000 for Aetna.
The new broker I consulted with provided me with options from Humana. The premiums for the health insurance are more attractive ranging from $264 to $282, but the dental coverage is $52.36 extra. I am having this broker confirm what hospitals are on the plan along with what physicians. My initial understanding is Humana will probably change these and then I’ll be faced with the decisions of monthly premiums versus maintaining long term relationships.
Up to this point, I was weighing keeping my existing plan versus migrating to the BCBS HSA Plan VII or the Aetna 5500 plan. Today that changed when President Obama announced the old plans could be kept for an additional year based on the difficulties with the system and public concern over his campaign promise.
As an insurance agent I recognize the difficulties between saying we can do this and implementing it, especially now that we’re so close to the end of the year. In order to have the older plans reinstated, each state insurance department will need to approve that, and if they do decide to do that, there’s no guarantee the premiums will be the same. They could be or they could be higher.
Where all this leaves me is focusing on what I have in front of me while comparing that with what I find on the exchange. How about you? What have you found and what are the decisions you’re making? Share them with me along with your comments and questions in the comments section of our blog or on my Google + and Facebook pages. I’d love to hear from you!
