Health Insurance for Family of 3

[3Owls]

Hi.  I'm recently new to this forum and recently read Mr. M's advice on health insurance and even went online at ehealthinsurance.com.  The lowest rates I've found for a family of 3 (age 44,40 & 3) is $520.  Much like Mr. M, we have disposable income for a high $5-10k deductible.  We may not be as healthy (wife has controlled but medicated asthma).  We are moving to Boulder in January and are downsizing our lifestyle to life more meagerly.  Any suggestions on insurance plans?  Curious to know what plan Mr. M's family has as we may need similar.  Thank you in advance!

[geekette]

Check healthcare.gov.  Depending on your income, you may qualify for subsidies.  Price depends on your location and your ages, not your health (except they will be higher if you smoke). 

Next year's rates should be available 11/15, I believe.

[retired?]

We enrolled in a BCBS plan in September.  High deductible - two reasons, a) open enrollment is soon, i.e. can correct if we choose and b) perhaps I'd go back to work with an employer plan.

Big caveat - you will be charged more by presenting insurance than if you did not.  I.e.  you need to visit a doc or 24 hour clinic.  In our experience, presenting no insurance might cost 125, but if presenting insurance we'd be charged 230.  Ridiculous.  You want these charges to count towards your deductible amount, but I'd choose to not present and pay 125 than pay 230. 

Likewise for Rx.  Check out Walmart, Costco, Walgreen's, etc.

[retired?]

btw - ours is 534 per month.  The amount MMM paid (from his earlier post) of <300 seems unlikely today.  Not sure.

[geekette]

I haven't had the same experience with insurance that you have, Retired?, and I have BCBS (albeit in NC). 

The stated price is not what you end up getting charged, in general.  Some recent stuff - CT scan, charged: $1188, amount allowed $540.  Office visit, charged: $254, amount allowed $149.  Labs, charged: $35, amount allowed $3.18.

Apropos of nothing, they're also flat out paying for a lot of stuff and I haven't met my deductible, so I'm very confused by that (not complaining, mind you!)  I had over a $1000 worth of visits, ultrasounds, and biopsies, and they paid for those in full.  VERY confused, and bracing for when they realize their mistakes and the bills start rolling in...

Ours, for 2 in (53 and 54), is over $900/month (silver level).  We qualify for subsidies, but will let that shake out come tax time.

As for Rx - check out goodrx.com.  They sometimes have good prices if you have a high deductible and don't think you'll meet it.

[retired?]

Yeah, odd.  My experience, and we've only been on the private BCBS since beginning of Sep, is that my wife was feeling ill.  We had not chosen new PCPs (our old ones were now out of network), so my wife called the local clinic.  She asked what the cost would be.  Was told $125.  I told her that perhaps bcbs had worked out a better deal (granted, like you, this would all be pre-deductible limit being met). 

She gets there and presents the insurance and asks the cost.  Response - $230.  She says "ok, then I'll choose to not use the insurance".  Reply "sorry, once insurance is presented it is our policy to use it and charge based on it".  She walked out.  Thus, we didn't get to truly see it in action.  Afterwards, I called bcbs, and the initial rep had no clue.....to her, it was entirely possible and she was in no position to judge what had happened.

[Heart of Tin]

btw - ours is 534 per month.  The amount MMM paid (from his earlier post) of <300 seems unlikely today.  Not sure.

As geekette said, health insurance rates are highly variable by location. According to this Kaiser health article: http://kff.org/health-reform/press-release/premiums-set-to-decline-slightly-for-benchmark-aca-marketplace-insurance-plans-in-2015/ the premium for the benchmark plan (second lowest cost Silver plan) decreased by 15% in Denver. This may indicate a downward trend for rates in Colorado this year. And as you can see from this compilation of rates from last October: http://www.marketwatch.com/story/the-50-states-of-obamacare-2013-09-27 Colorado had about average rates last year. This is good news for 3Owls since it indicates that rates might be lower this year than last depending on where he or she moved from.

[forummm]

https://www.healthcare.gov/find-premium-estimates/

Open enrollment starts 11/15.

[Exflyboy]

so are the plan rates (subsidies) calculated based on your Gross income or your adjusted income?

Cover Oregon simply asks what you income is but does not specify what they mean by that. If you have an after tax savings stash you can wipe out $13k of your income by simply contributing to your traditional IRA (if over 50)

Frank

[retired?]

Subsidies will be calculated based on your household’s MAGI (modified adjusted gross income), which is the total of your adjusted gross income (Line 37 on your Form 1040) and any additional tax-exempt interest income you may have.

http://www.businessweek.com/articles/2013-06-03/how-to-calculate-eligibility-for-health-insurance-subsidies