zulu said:
Still another group are the "immortals" -- young people, not in their 50's & 60's. In under 65 healthcare discussions, people would often use full timer Becky of
Interstellar Orchard fame (
https://interstellarorchard.com/2018/05/30/health-insurance-for-full-time-rvers-2018-edition/) as an example of someone getting by very very cheaply on health insurance. Right. Becky is in her early 30s. Her SD ACA plan is
incredibly inexpensive -- because she's
incredibly young.
Actually, I'm pretty sure her plan is inexpensive because she gets a big subsidy because she makes only about $15,000/year. From her site: "I've made less than $30,000 a year my whole adult life, and since hitting the road I've thrived on about $16,000 a year."
In the page you linked to, she says, "My plan is through Avera Health Plans, called Avera 5000, and this is the third year I?ve had it. The
yearly cost would be in the neighborhood of $450 (it went up about 22% again over last year), but because of my lower income level, I qualify for a subsidy that makes this plan similar in cost to what my high deductible private plan use to be before the ACA went into effect in 2015."
I'm certain the "yearly" is wrong, and she actually meant "monthly," because there's no unsubsidized health plan that would cost less than $40/month. I used healthsherpa to run numbers for a 33-year-old female in Box Elder, SD, and the premiums for Avera policies were around $380 for Bronze plans, $490-$530 for Silver plans, and $580 for a Gold plan. So surely she meant "monthly" and not "yearly." Kind of important if you ask me, and I'm surprised nobody noticed it (she said she closed comments on it, so people were obviously doing some commenting).
So her health insurance is incredibly inexpensive not because she's young but because she's low income. Subsidies depend on the person's age, and a 33-year-old who makes $16,000/year in Box Elder gets a subsidy of $398, while a 60-year-old gets a subsidy of $936. The result is that they both pay $0 for either of the two Bronze plans Avera offers on the Exchange.
I'll note that her Avera 5000 plan isn't listed in the results, and according to Avera's website it isn't sold on the Exchange. But the only way to have the subsidy apply is to buy it on the Exchange. Maybe it was on the Exchange during last year's open enrollment and isn't available during the special enrollment period? Or maybe it's still considered on the Exchange for people who already had it? Who knows.
But more troubling is that she has a Bronze plan, and I wonder if someone in that income range who chooses a Bronze over a Silver plan actually understands the coverages. At the very least, that person views financial risk very differently from how I do.
And, from the numbers I ran, she could pay a similar premium in Florida AND have access to a nationwide network. That's one thing that terrified me about having an HMO or local-only PPO with no out-of-network coverage. Yes, emergencies are covered, but once the emergency is over and you're in Maine needing continuing care but your network is in South Dakota--you have no coverage at all unless you get back to South Dakota. And there's no way of knowing what your insurance company considers an emergency until after it's happened.
She did say that she goes through South Dakota "pretty regularly" on her way to and from visiting family in Wisconsin, but for someone who doesn't do that, South Dakota is a really really poor choice, especially when you can get much better coverage with a Florida address for about the same money. For the time being, anyway.
zulu said:
Or, people with military healthcare or company/government health plans would say how cheap health insurance was. Sure, cheap for them because their former company or government agency was picking up most or all of their plan's cost (like SargeW).
Actually, SargeW never mentioned how much his plan costs. What was shocking to me was that a Blue Cross nationwide PPO plan was available in South Dakota
at any cost, never mind cheap. And of course it turned out it wasn't.
zulu said:
Also, we work camped in CA in 2016. Because my wife had an AZ PPO plan that only had a network in AZ, we had to schlep back to AZ several times (800 miles round trip) for her chemotherapy treatments. This is why you want a health plan with a nationwide network.
If you were living in California, shouldn't you have changed her insurance to California, if the ACA is concerned only with where you're living and not where your domicile is?
