I'm sure I'm not the only one here who is counting on the plans in the ACA-Exchange in order to allow for me to retire early with health insurance.
As I'm getting closer to my retirement targets, I have been looking through the healthcare.gov website, and have been looking at the 2016 plans so that I can get a reasonable estimate about how expensive these plans are, and a reasonable estimate about the network of healthcare providers that are part of the networks for the plans.
I really am not liking what I see. (For reference, I'm looking at the plans near where I live, in Chicago, which does seem to have a lot of different plans and insurance companies listed.)
First of all, I don't see any mention on the plans for any coverage of "out of network" doctors. On the surface, this seems reasonable -- that you stay within a list of cost-effective doctors/facilities. However, when I actually drill down and search the list of providers, I'm shocked that some of these companies are allowed to sell these plans and pretend that they will actually cover you for anything. On one of the listed companies, I tried their website's "in-network provider search", and literally zero doctors that I had ever used in my more-than-a-decade in Chicago were on their lists. Furthermore, Chicago is chock-full of medical schools and cutting-edge medical facilities, but the actual facilities that are in-network to these plans are the hospitals that are on-par rating with the general county hospital (Stroger.)
Secondly, even though there are a LOT of plans listed, the pricing model of premium and deductible basically puts them into two general categories:
1) Somewhat lower premium, but the (maximally allowed?) astronomical deductible near $6-$7000 per person
or
2) A premium that is much higher, with a little bit lower deductible -- but that deductible is completely (almost exactly dollar-for-dollar) offset by the increase in premium.
I honestly don't see why anyone would choose the higher-premium-with-lower-deductible plans, since: if you have a lot of expenses in the year, you will essentially be paying the same either way... but if you didn't have a lot of expenses in the year, you would come out ahead with the lower premium plans. Why would anyone pay the higher premiums in order to have a lower deductible in this case? They seem to offset one-another dollar for dollar. The fudge-factor if you can "guess ahead of time" and pin down exactly what your medical expenses for the year will be, might save you a couple hundred dollars either way... But the "choice" seems ridiculous.
Third (and corollary to #2), I would consider all of these plans to just be very-expensive-catestrophic-coverage plans. For someone in my early-30s who doesn't smoke, why pay $400/mo premium for a plan that is just going to ding me with a $6000 deductible anyway? Over $10K out of pocket in a year before the insurance starts to pay for anything other than an annual physical? Seems to me, it would make a lot more sense (economically speaking) to go without insurance and pay the tax penalty every year, and pay for medical costs out of pocket.... and if some costly medical procedure was needed, just hope I could delay it until the next enrollment period at worst, or contrive a "qualifying event" in order to get onto one of the plans. With the extreme-narrow networks on the cheaper plans, I wouldn't even feel like it is worthwhile to pay the premiums, because I think mentally I would feel as if I wasn't even insured anyway...
I guess my question to "Ask Mustachians" is, what are your experiences with the exchange plans you have in your area? Do you notice the nonsensical cost structure of the plans too? Have the very-small networks of doctors been an issue for you?
P.S. Please don't turn this thread into a political debate... We all have our own opinions on it, and that's fine. I'm just