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Michigan ACA rate approval increase set at 26.9% on average
A time line link regarding data by state. Note that this site info has not been updated for about 10 days. Scroll to the near end of the page for most current comments. One may suspect that this area of data gathering is quite time consuming, eh?
My ACA premium increased 25%. My subsidy nearly doubled. This seems to be bringing my out of pocket premium costs down (less) by about 66% for a Bronze level HSA eligible plan when compared to last years out of pocket premium costs.
@bee Thanks for the concrete example. This is what I was trying to explain in an earlier thread about NY slightly reducing net premiums to subsidized policy holders net year. For most people, the rack rate ACA premiums are meaningless because their premiums are subsidized.
Getting rid of the CSRs causes premiums to go up (so that the insurers cover the lost gov funding). In most states, that means increasing premiums on silver plans only.
Since the subsidies are based on silver plan rates, subsidies go up a lot. But other metal plans (bronze, gold, platinum) don't go up due to the loss of CSRs. So the supersized subsidies more than make up for the increase in premiums on other metal levels.
Net result - cheaper plans (after subsidies) for other metals, little change (after subsidies) for silver plans, and a whole lot more cost to the government to subsidize the premiums for these now higher priced plans. The only losers are the relatively few who buy individual plans and are not subsidized.
Unfortunately, there are many people who don't get a subsidy, so the increase in premiums /deductibles is a direct hit.
Like me.
When the information is available November 1 for my specific carrier, I may take direct actions to deduct my 2018 expense money from my IRA in December of this year, to minimize taxable income within 2018 to qualify for a subsidy.
I'm not quite sure what you mean by deduct 2018 expense money from 2017 IRA. My best guess (likely wrong) is that you're paying some expenses (medical?) with IRA money, and if you do that this year, the IRA distribution income will show up in 2017 instead of 2018.
Regardless of exactly what you're doing, accelerating income into 2017 from 2018 will reduce your 2018 AGI and potentially lower your income sufficiently to qualify for the 2018 tax credits.
Only 7% of the US population is covered under individual (nongroup) insurance. Of those, only 1/3 do not qualify for premium subsidies (tax credits). So while the absolute number is sizeable (about 6M, see below), just 2% of the population are affected by these rates. Small comfort though when you're part of that 2%.
Figures are from an HHS report, cited in this article.
Just checked the NY State HC exchange and my silver plan for 2018 looks like it is increasing 13%. I guess that isn't too bad considering all the turmoil that has been generated by you know who.
One more year until medicare kicks in. Unless of course... anything, everything can change.
Hi @MikeM You've always shown to be a pretty sharp thinker and likely are aware of the below; but I will add a few blips. If you do not obtain a separate RX plan or inclusive via a Medigap plan, OR stop and then restart an RX plan, you will have an ongoing penalty (being $ increase) going forward forever. Keep in mind that you will want either a Medigap or supplemental plan + RX plan; as Medicare will not cover everything. These prices are all over the $ spectrum. $50,000 at the hospital doesn't travel very far these days, eh? A short article regarding Medicare: http://www.wbir.com/article/news/nation-now/health-insurance-options-for-michigan-medicare-users/465-fd5f5bdf-e872-43c2-807c-9a044f0835f4
A few side notes: Part A carries a $1,316 annual deductible (as of 2017). Supplemental insurance (a type F plan) cost about $150/month (varies, of course). The Medicare Part B cost is at least $134/month and will be pulled from SS or paid direct by you, if you have not started SS.
I stand to be corrected about any of the above. Anyone please verify or submit corrections.
@davidrmoran noted below about Medigap.....I intended to note about Medicare Advantage plans which can include RX, vision, dental, etc.
Medigap and supplement are the same thing, are they not?
No need to make this more confusing than it is.
So yes, you want medigap-supp (you can see any docs), along w pdp (drug plan) unless you take no rx meds at all and anticipate never doing so.
Else you want an all-in-one HMO-type plan, which typically includes drug coverage and can be a really cheap premium. These limit you to in-network physicians.
Hi @davidrmoran Yes, I didn't intend to note MediGap, but Medicare Advantage plans. As the retired population of Michigan has a large % of retired former union employees, I find a fairly common mix is: ---Medicare Part A and B ---a supplemental plan ---a RX plan Retired union folks (not our household) have a variety of provided plans via some form of retirement healthcare that include various goodies; including dental, supplemental and some with vision insurance. Generally, these include a co-pay formula. MikeM will discover what he needs, as a lot of data exists on the internet, yes?
Just checked the NY State HC exchange and my silver plan for 2018 looks like it is increasing 13%. I guess that isn't too bad considering all the turmoil that has been generated by you know who.
There's a reason why the CSR fiasco didn't significantly impact NY and likely Minn. Those two states provide a Basic Health Program for people under 200% of federal poverty level (FPL).
"The reason for the fairly nominal CSR factor is that the vast majority of NY's CSR-eligible population (those earning 138-200% FPL) is instead enrolled in the state's Basic Health Program. As a result, only 26% of New York's exchange enrollees receive CSR assistance, and the 200-250% FPL recipients only receive a fairly skimpy amount of CSR help anyway." Emphasis in original.
As @Catch22 pointed out, for retirees in MI (comme moi et ma femme) who worked as represented employees our entire careers, our health, Rx, dental, vision and hearing plans are subsidized. We pay Medicare premiums and premiums of about $150 to the state retirement system for these coverages. The sneaking fee increases each year are disheartening: $900 per family member deductible for medical; $65/$100 co-pay for urgent/emergency visits; out of pocket Rx increased to $1500 from $1000 per annum; hearing aid cut back to $799 per instrument; lens co-pay upped to $25. In summary: our premiums remain the same, but what we really pay goes up quite a bit. Paying 40% for tier 3 drugs translates to an increase because drug prices go up, for instance. It goes without saying that going outside the networks of docs, dentists, emergency rooms will cost even more. One other kicker: as retirees with an adopted teen-aged student, we may have to pick up her medical premiums from age 20. Plan won't pay birth control either because we're all OLD, right?
Thanks @catch22 and others for the information. Catch, I won't be 65 until January of 2018, but my wife is a few years older so we have done the research. There are plenty of seminars by the providers explaining their policies every enrollment period.
There are some pretty affordable supplemental plans around here. The range, depending on the bells and whistles you what, is around $0 - $200 per month. The zero isn't a typo. You can get a basic supplemental 'bronze' type plan with a high deductible of course.
For clarity, and to reiterate what davidrmoran wrote, what you are talking about is a Medicare Advantage plan, aka Medicare Part C. That is a private insurance plan that replaces Medicare Parts A (hospitalization) and B (services, doctors), and usually Part D (drugs), unless you have a separate retirement drug plan.
These are not really comparable to metal level plans. All Medicare Advantage plans must provide at a minimum the same benefits as traditional Medicare, albeit with networks (HMOs, PPOs, EPOs, and POSs) and somewhat different copay/deductible schedules. They are also required to cap out of pocket costs, unlike traditional Medicare. The closest analogs are "traditional" employer-provided health plans.
Within network, there are no deductibles just copays for office visits, basic lab tests. The deductible to go out of network or for major services is $1,000. Separate $250 drug deductible (for brand name only). That's no bronze plan. It might be closer to a gold plan. The 'standard' NYS gold metal plan has a $600 deductible for everything. Of course in NYS there are no PPO metal plans, even that gold plan doesn't compare.
Supplemental or "Medigap" plans are plans that are purchased in addition to rather than in lieu of Medicare Parts A, B, and D.
Side note: Aetna had already switched its preferred drug provider from Walgreens to CVS for 2018. Prescient?
A time line link regarding data by state. Note that this site info has not been updated for about 10 days. Scroll to the near end of the page for most current comments. One may suspect that this area of data gathering is quite time consuming, eh?
The ACAsignups page has been updated for the final Mich. figures (now 26.8% increase vs. the 28.9% previously reported (also in the DFP article)
Here's KFF's article this morning showing the impact, insurer by insurer, of stopping CSR subsidies. It serves as a nice followup to the ACAsignups link I gave above explaining how premium tax credits increase as a result of stopping CSR subsidies:
From @msf linked article this seems to be what I am experiencing:
Marketplace enrollees with incomes 250-400% of the poverty level – who are eligible for premium subsidies but not cost-sharing subsidies – could in some instances be better off. They will receive bigger premium subsidies, and could use those to pay less than they would now for a bronze plan (with higher patient cost-sharing) or a gold plan (with lower patient cost-sharing).
Comments
Getting rid of the CSRs causes premiums to go up (so that the insurers cover the lost gov funding). In most states, that means increasing premiums on silver plans only.
Since the subsidies are based on silver plan rates, subsidies go up a lot. But other metal plans (bronze, gold, platinum) don't go up due to the loss of CSRs. So the supersized subsidies more than make up for the increase in premiums on other metal levels.
Net result - cheaper plans (after subsidies) for other metals, little change (after subsidies) for silver plans, and a whole lot more cost to the government to subsidize the premiums for these now higher priced plans. The only losers are the relatively few who buy individual plans and are not subsidized.
Here's an extremely long, complex article on ACAsignups explaining this better and with tons of figures:
http://acasignups.net/17/10/25/four-sons-csr-loading-how-millions-can-save-thousands-silver-load-silver-switcharoo-states
Like me.
When the information is available November 1 for my specific carrier, I may take direct actions to deduct my 2018 expense money from my IRA in December of this year, to minimize taxable income within 2018 to qualify for a subsidy.
Regardless of exactly what you're doing, accelerating income into 2017 from 2018 will reduce your 2018 AGI and potentially lower your income sufficiently to qualify for the 2018 tax credits.
Only 7% of the US population is covered under individual (nongroup) insurance. Of those, only 1/3 do not qualify for premium subsidies (tax credits). So while the absolute number is sizeable (about 6M, see below), just 2% of the population are affected by these rates. Small comfort though when you're part of that 2%.
One more year until medicare kicks in. Unless of course... anything, everything can change.
You've always shown to be a pretty sharp thinker and likely are aware of the below; but I will add a few blips. If you do not obtain a separate RX plan or inclusive via a Medigap plan, OR stop and then restart an RX plan, you will have an ongoing penalty (being $ increase) going forward forever.
Keep in mind that you will want either a Medigap or supplemental plan + RX plan; as Medicare will not cover everything. These prices are all over the $ spectrum. $50,000 at the hospital doesn't travel very far these days, eh?
A short article regarding Medicare:
http://www.wbir.com/article/news/nation-now/health-insurance-options-for-michigan-medicare-users/465-fd5f5bdf-e872-43c2-807c-9a044f0835f4
A few side notes: Part A carries a $1,316 annual deductible (as of 2017). Supplemental insurance (a type F plan) cost about $150/month (varies, of course). The Medicare Part B cost is at least $134/month and will be pulled from SS or paid direct by you, if you have not started SS.
I stand to be corrected about any of the above. Anyone please verify or submit corrections.
@davidrmoran noted below about Medigap.....I intended to note about Medicare Advantage plans which can include RX, vision, dental, etc.
Take care,
Catch
No need to make this more confusing than it is.
So yes, you want medigap-supp (you can see any docs), along w pdp (drug plan) unless you take no rx meds at all and anticipate never doing so.
Else you want an all-in-one HMO-type plan, which typically includes drug coverage and can be a really cheap premium. These limit you to in-network physicians.
Yes, I didn't intend to note MediGap, but Medicare Advantage plans.
As the retired population of Michigan has a large % of retired former union employees, I find a fairly common mix is:
---Medicare Part A and B
---a supplemental plan
---a RX plan
Retired union folks (not our household) have a variety of provided plans via some form of retirement healthcare that include various goodies; including dental, supplemental and some with vision insurance. Generally, these include a co-pay formula.
MikeM will discover what he needs, as a lot of data exists on the internet, yes?
From ACAsignups.net:
"The reason for the fairly nominal CSR factor is that the vast majority of NY's CSR-eligible population (those earning 138-200% FPL) is instead enrolled in the state's Basic Health Program. As a result, only 26% of New York's exchange enrollees receive CSR assistance, and the 200-250% FPL recipients only receive a fairly skimpy amount of CSR help anyway." Emphasis in original.
There are some pretty affordable supplemental plans around here. The range, depending on the bells and whistles you what, is around $0 - $200 per month. The zero isn't a typo. You can get a basic supplemental 'bronze' type plan with a high deductible of course.
These are not really comparable to metal level plans. All Medicare Advantage plans must provide at a minimum the same benefits as traditional Medicare, albeit with networks (HMOs, PPOs, EPOs, and POSs) and somewhat different copay/deductible schedules. They are also required to cap out of pocket costs, unlike traditional Medicare. The closest analogs are "traditional" employer-provided health plans.
For example (I don't know what county of NYS you're looking at - the plans vary on a county basis), Aetna (or should I now say CVS?) offers this PPO plan across the NYC metropolitan area (NYC, LI, Westchester and Rockland counties) for 2018:
https://www.aetnamedicare.com/documents/individual/2018/summaryofbenefits/SB_2018_H5521_120_EN.pdf
Within network, there are no deductibles just copays for office visits, basic lab tests. The deductible to go out of network or for major services is $1,000. Separate $250 drug deductible (for brand name only). That's no bronze plan. It might be closer to a gold plan. The 'standard' NYS gold metal plan has a $600 deductible for everything. Of course in NYS there are no PPO metal plans, even that gold plan doesn't compare.
Supplemental or "Medigap" plans are plans that are purchased in addition to rather than in lieu of Medicare Parts A, B, and D.
Side note: Aetna had already switched its preferred drug provider from Walgreens to CVS for 2018. Prescient?
Here's KFF's article this morning showing the impact, insurer by insurer, of stopping CSR subsidies. It serves as a nice followup to the ACAsignups link I gave above explaining how premium tax credits increase as a result of stopping CSR subsidies:
"How the Loss of Cost-Sharing Subsidy Payments is Affecting 2018 Premiums"