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Any reason I shouldn't sign up for ObamaCare? (Assurant - Cigna)

Discussion in 'Parents of Children with Type 1' started by DavidN, Apr 1, 2014.

  1. DavidN

    DavidN Approved members

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    So I'm about to pull the trigger on an ObamaCare plan - Assurant Cigna Platinum. Our BCBS Group (single member) policy is costing me $3,000+ a month and the Cigna quote is $1,600. I've checked and all of our family's key physicians are in the plan, but something about bailing on my group plan and going with an individual/family plan under ObamaCare makes me nervous. Can anyone give me a reason not to switch? Or does anyone have any experience with Assurant Cigna? The last think I need to check on is Dexcom coverage. Not sure about that one. Thanks for any feedback.
     
  2. Nancy in VA

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    You mean outside the fact that sign ups ended last night at midnight?
     
  3. nanhsot

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    Biggest thing to look for are what your personal and family deductibles AND caps are. Do the math on how much supplies cost per month and how many months before you've met that deductible amount. Add that to the monthly insurance payment (in both cases). Many times it turns out that higher deductible plans appear cheaper but are not in reality because it takes so long for insurance to kick in. Look also at MD visit copays and DME limits. Some insurances throw all pump and CGM supplies into DME but cap it at $1000 per year or whatever.

    So for example I once looked closely at a dental plan that cost 100/mo (made up numbers) but the cap on what they'd pay for annually was 1000. So in essence I was paying MORE in my payments than they'd ever pay out.

    I'd mostly just look closely at your limits and OOP expenses and make sure they won't add up to being more than you pay for current coverage.

    I have personal reasons not to sign up, but it's more political than medical, so we won't go there!
     
  4. DavidN

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    Officially they did, but as long as you "started the process", you have a few more days, depending on the carrier.
     
  5. DavidN

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    Thanks. Yes I'm doing all of the important comparisons, and of course we've already eaten into a chunk of this year's deductible and that'll be lost. There's just something about signing up for insurance through a government program that strikes me as the policy having some sort of vulnerability or exposure. So what if ObamaCare is repealed? And then I go try to go back my group but am not allowed due to pre-existing conditions or something. I don't know. I'm probably thinking too much about this. Just feel like I'm missing something.
     
  6. nanhsot

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    I dunno what to say. I do not believe this program is sustainable, so I understand and agree with your reservations. When I saw the degree of invasiveness into my life that was required to even find out even basic information I knew it wasn't for me.

    That's likely a different topic and not one I'd be willing to debate online.
    What will happen when/if it falls apart, no clue.
     
  7. Sarah Maddie's Mom

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    You are not joining a "government program", you are buying private insurance in a public marketplace. It's not going to be repealed - no matter what the tea party wants. Preventing ANY insurance company from excluding people with pre-existing conditions is one of the pillars of the ACA so if that's what has you freaking out, you can relax. You're not thinking too much, you're just worrying about the wrong things. What matters? Limits, co-pays, deductibles, prescriptions, DME, annual and lifetime caps.
     
  8. rgcainmd

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    Agree 100% with Sarah Maddie's Mom.
     
  9. Nancy in VA

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    I'm a little surprised that a group plan is more expensive than an individual plan, so definitely check for premiums, deductibles, co-pays, DME. Total cost is the only way you can compare - you need ALL the estimated total costs for one year in both plans and see what the bottom line is.
     
  10. DavidN

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    While it's a group policy, it's a single employee group and I am getting hammered for pre-existing conditions, for more than one member of my family. One pro of ObamaCare, I think, is that it eliminates the medical "bad luck" tax.
     
  11. DavidN

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    I know its private insurance and I'm not joining a government program. I think the words I used were "signing up through a government program". My premiums are getting cut in half. Like everything else in life, I'm conditioned to wonder "what's the catch?" Free lunches make me nervous. If the catch is I'm no longer getting pummeled for pre-existing conditions, then that's great.
     
  12. zoomom456

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    The things that come to mind for me, are 1) is the exchange price including any subsidies? To qualify for subsidies your employer based insurance must be considered unaffordable, or more than 9.5% of your income and 2) is your employer coverage pre-tax dollars? If so I would double check how this will affect your paycheck and tax scenario.
     
  13. Don

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    "is your employer coverage pre-tax dollars? If so I would double check how this will affect your paycheck and tax scenario."

    Good point, the cost of the exchange plan would be effectively higher according to your Fed and state marginal tax rates. I compared my options and stayed with the employer-sponsored plan because of the pre-tax advantage. In your case, the difference in premiums is so big, I bet the exchange plan still works out better for you. If you do switch plans, the first time you have labs done, you may want to confirm with your doc that it goes to an in-network lab.
     
  14. Toterra

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    The free lunch is because everyone else who happens to not have pre-existing conditions pays a tiny bit more. Welcome to how insurance works in the rest of the world.
     
  15. quiltinmom

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    My first thought is, follow your gut. If something seems unsettling, or a little too good to be true, you may want to follow your feeling.


    I am not an expert, but I am of the understanding that the subsidy is not a month to month setup; rather you pay the full amount up front, then get the money back after you file your taxes. So if your estimated costs include a subsidy, you will want to figure that out for sure. I'm not 100% sure how that works.

    It does seem odd to suddenly pay less for things like this...but if it works out well for you, that would be great. Healthcare costs are altogether way too high. Good luck.
     
  16. Lakeman

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    I use an insurance broker for all my insurance needs. They do all the legwork of researching plans and present what they think is best for you (from their list) to choose. The best part is that the broker is your go to guy for all questions and support. If you can choose a plan whether in an exchange or not and have a live person that you can talk to easily that you will trust then that is cool - but IMO never accept a plan in which you can not talk to a person for help.

    As was said before make your decision based on your needs evaluating deductibles, premiums, etc. I personally hate the plan for political reasons but admit that as an individual you need to make this one decision based mostly on what is right for you. I would be willing to pay more not to be a part of one of these plans but you might need to pay less (though I think there is not as much reason to think you will actually pay less as you may have been lead to believe).

    I do not think the plan will be repealed as many of the Pubs like the control the plan gives congress as much as the Dems do. But it might be gutted or changed beyond recognition. Even so if it is gutted they will give you time to get out because none of the spineless congressmen want to be blamed for you losing a benefit even if it xxxxx xxxx xxxx xx xxxx. (edited to remain at least somewhat neutral)
     
  17. swellman

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    TINSTAAFL - Robert A. Heinlein

    I'm no expert but the entire ACA hinges on the fact that everyone plays and pays. If you do the math and all the numbers work out in your favor then go for it. The pre-existing condition exclusion is awesome.

    Here's the rub as far as "free lunch" is concerned ... healthy people will pay more for the better good. I'm OK with that.
     
  18. RomeoEcho

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    I had a similar response when my insurance got much much better under the ACA. There had to be a catch. In the end, after all the research, and now being on it, I still can't find a catch other than the fact that my previous plan was the unfair one. (which was still grandfathered against all the intermediate steps over the past couple years) Also remember that it's not free. You're still paying damn good money for it, it's just not as much as you were unfairly paying before. The system has been becoming increasingly biased towards people who really need and use it today, and plans that were increasingly providing worse coverage.

    A lot of the publicity around the ACA has lead people to assume that it was going to screw them, and everyone. But in the majority of cases it's just not true. I thought I was going to be in the group that paid more for less in order to benefit the whole, and I was ok with that. But in the end, I'm doing much better too. Do the math to adequately compare plans, but overall this isn't your steriotypically "free lunch" scenario.
     
  19. obtainedmist

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    This is incorrect. The subsidy is taken off the premium price monthly and not given as a "rebate". However, you do need to jump through some hoops (pay stubs, etc.) to prove your income in order to be eligible for the subsidy!

    We currently have Cigna (switched from Anthem) and they are great! If you've done your research, checked on deductibles and copays and what is covered and you are still ahead, I would say go with it! Obamacare ROCKS!
     
  20. Don

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    " If you've done your research, checked on deductibles and copays and what is covered and you are still ahead, I would say go with it! Obamacare ROCKS!"

    Agreed, I couldn't beat the pre-tax advantage of my employer-sponsored plan but I was salivating over the exchange plan's 20% DME copay and no deductible!
     

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