The other day I posted about it making the most sense for young healthy people, under Obamacare, to choose the lowest premium plan possible, tied to a health savings account, looking strictly at the numbers involved, and not worrying about what plan had what coverage, and also asked how that might effect the stability of the insurance system in general.
I've since looked at the follow up information that BlueCross-BlueShield sent me regarding my plan options moving forward, so I figured I'd make the comparsion to my current plan.
My current plan is called Blue Edge HSA 100%. Under this plan, I am given access to either BCBS's PPO network of doctors, or their BlueChoice network of doctors. My individual deductible on this plan is $1,750, and my coinsurance is 100%, meaning I pay nothing after my deductible. For this plan, my monthly premium has been $246.08. This amount includes dental coverage that I tacked on, which if I remember correctly, is about $25/month of this amount. So if we're comparing health insurance to health insurance, my premium just for health insurance is roughly $221/month. This has been an individual insurance plan, and so I will compare this to the individual rates of the new plans being offered. Rates in my article from the other day were quoted for both myself and my wife, and so differ from the rates in this post.
My current plan has been cancelled, and BCBS has sent me a letter indicating that the most similar plan to my current plan is the new Blue PPO Gold 001 plan. This plan runs $376.40/month, and has a deductible of $3,250. So for the most similar plan, the monthly premium has increased roughly 170%, and the deductible has also nearly doubled. I am also limited to only the PPO network. Even better news, this plan is also not eligible to be used with an HSA. Here is what this plan offers:
I am also told that Blue PPO Bronze 005 is the most similar in price to what I have today. This plan is $239.43/month, so they've managed to offer a plan at a similar price. This plan has a $5,000 deductible, and a coinsurance of 80%, with an out of pocket max of $6,250. This means that even after I've paid $5,000 in deductibles, I'm still paying 20% of the bills until I've hit $6,250. This plan does qualify for use with an HSA, and here is what this plan offers, compared side-by-side with the plan above, so we can see how much worse it is on the surface.
There's really not a lot to like about that picture, since what it's really saying is that I might more or less count on coming out of pocket to the tune of $6,250 just about no matter what, because of the 80% coinsurance. Basically with this policy I'd be cutting checks to BCBS to the tune of $2,873.16 a year for the right to have them tell me I'm paying for everything myself until I've spent $5,000, and then I'm also still paying 20% until I've shelled out another $1,250. At least I get to have an HSA with this one. Yay!
Bottom line is, for me, that I'm either paying almost double in premiums, with almost double the deductible, to get similar coverage to what I already have, but can't use an HSA, or I can buy much, much worse coverage for a similar price.
Given the fact that they have another plan called Blue Choice Bronze PPO 006, that turns that litany of 80% coverage into 100% coverages, with a $6,000 deductible and $6,000 out of pocket max, and for only $160.09/month, also HSA eligible, I'm not sure why anyone would bother with something like the Blue PPO 005 above. At least not a young, healthy person in a big city like me anyway. If my doctor isn't in the Blue Choice network, I can find one that is.
This obviously becomes much more problematic where people live more spread out. If someone is stuck with the Blue PPO network of doctors, they're stuck with something like that awful Blue PPO 005, or else instead, for some terrible reason, double the premiums.
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In fairness it looks like your current plan has an actual OoP maximum of $4,750 since not everything is covered at 100%. Your plan also doesn't cover some things like preexisting conditions for 365 days, some routine visits and tests, most medical equipment, ongoing physical therapy, etc.
ReplyDeletehttp://www.bcbsil.com/PDF/benefits/ind_blueedge_hsa_ooc_il.pdf
Whether you like it or not, those things are all included in your new coverage. As a healthy young male, you are definitely far on the subsidization end of subscribers. Its unlikely you will be taking advantage of these new coverage items you are paying more for.
I would agree that most healthy people are crazy to not take a HDHP with HSA. I'm happily on a plan similar to the Bronze PPO 006, but fortunate to have a company contributions to the premium and HSA incentives (getting screened, BMI value, no smoker) that basically zero out my cost.
Understood about the pre-existing conditions for 365 days, and knew that going into the plan. It's also my perspective that health insurance should not be covering routine visits and tests. My reasoning for this has always been the comparison that your car insurance doesn't pay for your oil change. I think the whole idea behind purchasing the HDHP with HSA program in the first place was that I'd eventually be able to save up enough money in this program to not have to worry about deductibles, medical devices, etc. This came into play this year when a root canal I'd had done a few years ago failed, and I had to get a shiny new fake tooth. Insurance only covered the extraction. Everything from the bone graft up through the new tooth itself was considered cosmetic, since, quite frankly, it is. I was able to pay these costs out of the HSA, which was the point.
DeleteI don't really even think this scenario that I'm facing right now hits me all that very hard (especially since the HSA I do have provides the option of putting some of your money into the market, if you wish, to compound it faster), and I kind of assume other people are getting hit harder than this in a lot of cases.
I'm facing a very similar situation for my BCBS HSA health plan. OTOH, I'll be saving hugely on my 22-year-old daughter's plan. Would be even without the subsidies.
ReplyDeleteYou and your readers might be interested in this calculator app I built to compare what health plans will cost, total?
http://health-plan-compare.com
This analysis is really hard. Way too many variables for any human to do in their head. I built a spreadsheet for myself a few years ago, just put it up as an app.
Start plugging in some numbers, and you see that some plans are just obviously better deals. No way to suss that out without something like this.
Full disclosure: if the page gets some traffic, I'm hoping to generate some ad revenue. To that end, I've just tried to provide the best app and information I could.
Thanks for listening,
Steve