[quote=no_such_reality]I’m still worried about the expense curve between ages 55-65.
That silver/enhanced silver/gold plan is a little squirrely. If you’re really expecting a hospital visit, then Platinum may be more cost effective. The silver has a deductible and the gold doesn’t and the cost difference is the amount the deductible. Silver has a higher primary care visit but a lower brand drug expense after a $250/deductible. Then there are minor difference in the cost of certain coverage items.[/quote]
I looked at this also, nsr, I’m in that age group and the details are a bit sketchy at this point. The SD broker I talked to back at the end of June told me that I may very well qualify for the Platinum Plan for $212-$222 mo out-of-pocket based upon the cursory data I gave him. I’ve got to look at the “Enhanced Silver” (not sure if I can borderline-qualify), Silver, Gold and Platinum plan differences a little more closely.
I don’t really know if the two CA premium PPO carriers, Anthem Blue Cross and Blue Shield of CA will be administering the “Enhanced Silver” Plans, which are just a step up from MediCal/CMS (which will be administered my Molina Healthcare). In addition, I cannot use Sharp Health Plan or Anthem EPO because they do not have out-of-network coverage and I am in rural areas out of state for several days or weeks each year. We do not yet know which of the plans on Covered CA these two plans will administer. In any case, I will only choose a PPO and am less concerned about the deductible as ALL of them on CoveredCA are lower than my current deductible plus coinsurance.
I’ve recently had to fill two prescriptions where I was prescribed brand names but due to the brand names going to cost me 10-15 times as much as the “equivalent” generic, I had the pharmacist try to get permission from my drs to fill it generic. My drs did not want to write the generic prescription but verbally did so to the pharmacy at my request. I don’t really know if generics are inferior or not. I guess it depends on what it is. And of course, for many drugs, there is no substitute generic.
I was paying just $318 earlier this year out-of-pocket for my healthcare premium until I decided to formally “retire” to get my healthcare allowance started. After I did so, my premium went wa-a-a-ay up. So $212 to $222 after tax credits and HC allowance (versus ~$80 for an “enhanced silver plan”) won’t kill me and will likely be worth it in the long run.
It has been my experience that you pay for exactly what you get in this life.
