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bearishgurl.
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April 8, 2016 at 4:32 PM #796558April 8, 2016 at 4:52 PM #796560
bearishgurl
ParticipantThe carriers on Covered CA have made Gold and Platinum (esp Platinum) plans very unpalatable for the 55-64 yo set by jacking most of their premiums up $200-$300 month beginning 1/1/16. They are insidiously trying to get this group to “dumb down” their plans to silver and bronze and from my experience, it seems to be working … especially for the planholders still in relatively good physical health.
Hence, we’re not seeing any carriers outside of the exchange offering any individual plans except for Bronze. Because they can no longer pick and choose their planholders, they just don’t want to stick their necks out … for any amount of money :=0
April 8, 2016 at 5:15 PM #796561ParticipantFive of the six carriers who left the CA individual market at the end of 2013 are just sitting back and chilling while Cigna sticks it’s toe in the water in SD for 2016. They want to see how Cigna’s “experiment” with offering high-deductible, high OOP plans to the masses fares before venturing back in themselves … to “select markets” with a plan or two … or none at all … as the case may be :=0
This (and the horribly incompetent Covered CA in combination with the active “estate-recovery laws” on CA’s books) is why the ACA doesn’t really work … esp for the over-55 set who doesn’t have access to an affordable employer-provided (or a Federal govm’t-provided) healthplan.
My retirement association DOES offer ONE PPO to its members but it costs ~$2200 month … no matter WHAT your age! That’s more than double my monthly pension :=0
April 8, 2016 at 6:44 PM #796562flyer
ParticipantIt’s true that health insurance costs are only predicted to get higher over time as demand increases. It’s estimated that the average couple will need to budget around $240K for healthcare costs alone during retirement (65+) even when they are on Medicare–due to rising premiums and supplemental insurance needs–not to mention the huge costs for healthcare they could incur from age 55-65 should they be unemployed, etc.
Although I’m not yet retired, our pilot’s union negotiated hard for pensions and health insurance for retirees in my age group. Younger pilots are facing an entirely different scenario, so retirement planning on all fronts is definitely a must if you want to enjoy that period of your life.
April 8, 2016 at 7:15 PM #796563Participant[quote=flyer]It’s true that health insurance costs are only predicted to get higher over time as demand increases. It’s estimated that the average couple will need to budget around $240K for healthcare costs alone during retirement (65+) even when they are on Medicare–due to rising premiums and supplemental insurance needs–not to mention the huge costs for healthcare they could incur from age 55-65 should they be unemployed, etc.
Although I’m not yet retired, our pilot’s union negotiated hard for pensions and health insurance for retirees in my age group. Younger pilots are facing an entirely different scenario, so retirement planning on all fronts is definitely a must if you want to enjoy that period of your life.[/quote]Yes, flyer, hurray for your strong pilot’s union (at the time you “retired” or took deferred retirement). Our unions negotiated hard (and rec’d) monthly health insurance reimbursements (HIRs) for us (for those who retired in my “tier”). They range from about $200 to $400 month, depending on years of service. Our Ret Assn pays $393.50 month to a Medicare recipient to assist with their part B and D coverage (or a MC Advantage Plan). HOWEVER, our union did NOT negotiate good prices for the 3 healthplans our retirement assn offers us, forcing the vast majority of us to obtain coverage elsewhere. A UHS Nationwide PPO similar to the one you have would cost me ~$2200 month, and the premium goes up every year! That is ridiculous and I doubt even a handful of retirees in the system have even signed up for it. Those who “retired” after 3/31/02 are not eligible for HIRs. For a few years, the newer tier of retirees were paid a fraction of our HIRs as an “allowance” to use for health premiums (I think around $75 to $115 mo) which were never guaranteed. I believe these allowances have now been discontinued. I could get a Kaiser plan for just under $800 month from my assn but I don’t want it.
flyer, you are fortunate to have gotten the health benefits you did upon “retirement.” Otherwise, you probably wouldn’t have been able to “retire” when you did (or at least “retire” with the same level of security you have today).
April 8, 2016 at 7:30 PM #796564ParticipantYes, BG, I am very grateful things worked out the way they did, and wish more people had these options.
The world has changed, and fewer companies offer pensions and health insurance to retirees, and nothing even close to the job security that was once available.
Most employment today is “at will,” which is all to the benefit of the employer, and offers employees very little job/life security.
Even with pensions and healthcare provided, I still believe it’s wise to build other sources of income, if possible. We all have to plan way ahead to make sure we’ve done all we can to prepare for the years when we are 50+.
April 8, 2016 at 8:08 PM #796565Participant[quote=flyer]Yes, BG, I am very grateful things worked out the way they did, and wish more people had these options.
The world has changed, and fewer companies offer pensions and health insurance to retirees, and nothing even close to the job security that was once available.
Most employment today is “at will,” which is all to the benefit of the employer, and offers employees very little job/life security.
Even with pensions and healthcare provided, I still believe it’s wise to build other sources of income, if possible. We all have to plan way ahead to make sure we’ve done all we can to prepare for the years when we are 50+.[/quote]In my case, I think everything would have been a lot more predictable had I been able to keep my “grandfathered plan” (Aetna Advantage) who very stringently “medically qualified” me ~12 years ago and priced my premiums accordingly. Since that carrier (and 5 others) left the state at the end of 2013 (in the wake of “obamacare”), it left many thousands of us CA individual policyholders swinging in the wind with little to nothing to choose from except the state exchange. And monthly premiums for a similar-but-worse-in-every-category plan to the HDHP plan I had (current bronze-level plans) now cost over twice as much as I was paying Pre-ACA. Back when I decided to take “deferred retirement,” I didn’t “bank” on the fact that in “retirement,” healthcare premiums would be so high and provider choices would be so thin. I thought I could skate by on my relatively low-cost HDHP plan (which let me have my choice of the top providers in the country) until I was eligible for Medicare and then my new HIR would almost cover my part B and D premiums. I never in a million years thought I would be “lumped in” with the masses (who mostly DIDN’T take care of themselves) and my premiums “age-ranked” with everyone and their brother who mostly couldn’t medically qualify for any healthplan. I resent this because most of these people are where they are healthwise today due to poor choices they made throughout life and I’m now being forced to subsidize their premiums in the form of my now doubled++ premiums and rising :=0
Who would have known 10-15 years ago that it was going to come to this?
April 8, 2016 at 8:47 PM #796567no_such_reality
ParticipantThis is an interesting study synopsis. http://cclponline.org/wp-content/uploads/2013/10/Identifying-the-causes-of-rising-health-care-costs_DOC-4.10.13.pdf
Basically utilization doesn’t drive cost increases. Branding is and provider market leverage.
That intuitively makes sense when you think about something like prostrate cancers and the all the ads for proton treatment at named place xyz. Regular therapy is expensive at $18k average. Proton runs $38k average.
Care to guess were the demand is?
Diabetes is expensive too, average $80k lifetime charges for someone in their 50s when diagnosed. Add in the percentage of population with diabetes from ’97 to 2013 went from 2.5% to 7.5% and we have a formula for disaster.
April 8, 2016 at 8:58 PM #796570spdrun
ParticipantI wonder how many of those dipathetics are fats who’d stand to lose 100 lbs or so.
April 8, 2016 at 9:25 PM #796573Participant[quote=no_such_reality]This is an interesting study synopsis. http://cclponline.org/wp-content/uploads/2013/10/Identifying-the-causes-of-rising-health-care-costs_DOC-4.10.13.pdf
Basically utilization doesn’t drive cost increases. Branding is and provider market leverage.
That intuitively makes sense when you think about something like prostrate cancers and the all the ads for proton treatment at named place xyz. Regular therapy is expensive at $18k average. Proton runs $38k average.
Care to guess were the demand is?
Diabetes is expensive too, average $80k lifetime charges for someone in their 50s when diagnosed. Add in the percentage of population with diabetes from ’97 to 2013 went from 2.5% to 7.5% and we have a formula for disaster.[/quote]Uh, yeah. The demand is with the boomers but I believe that Gen Y and even children are starting to become susceptible to diabetes. I can’t believe how big a lot of the middle-schoolers are around me!
Cancer treatment in pill form is now about $5-10K month, infusions are $20K and up per month. The newer biologic and “targeted therapies” could run as high as $40-70K month. Unfortunately, chemo does not even work in so many cases and instead shortens the life of the patient and destroys the quality of what little life they have left.
The above expense doesn’t even take into account the cost of surgery before chemo, which could run $20 – $100K. OR the cost of the cancer coming back after a period of remission.
Cancer is probably the most expensive disease because many forms of it are so virulent, hard to eradicate and stubbornly return after a remission.
Prostate cancer is slow-growing so the patient has more time to plan how they want to be treated or in most cases, watch it and wait to be treated for it at a later date.
I’ll look at the report from CO that you provided. CO has thin air which can cause enlargement of the heart in sucseptible longtime inhabitants, especially those who live at the higher elevations.
April 8, 2016 at 9:28 PM #796574Participant[quote=spdrun]I wonder how many of those dipathetics are fats who’d stand to lose 100 lbs or so.[/quote]Let’s not go there, spdrun. Suffice to say that there are many, many more of them now than in generations past. All due to smartphones, ipads and texting while munching. Most parents today are too afraid to let their kids play outside with the neighbors so they hang around inside playing video games and munching in their spare time :=0
April 8, 2016 at 9:56 PM #796575ParticipantBack to your “branding theory,” NSR … the vast majority of chemo drugs are still “brand name” only and exorbitant in price. I notice there are a lot of Big Pharma commercials during primetime shows after 9 pm (such as ABC 20/20) which are targeted to boomers. A lot of these advertised drugs are just discretionary, imho. I’m probably going to catch flak for saying this but there are a lot of “Lyrica” and seritonin reuptake inhibitors (mood elevators) commercials during these time slots as well. One would think it is common to want to take all this stuff … even in combination with other drugs.
“Tell your doctor what other drugs you are taking,” and, “ask your doctor if XYZ is right for you.”
These long commercials are essentially telling viewers to ask their doctors about those drugs and request to try them because of a TV commercial they saw!
Why would someone want to get on more drugs instead of explore other (non-pharmaceutical) ways to address their chronic pain??
April 9, 2016 at 6:54 AM #796576ocrenter
Participant[quote=La Jolla Renter]bearishgirl,
I looked at my policy online. Looks like I have a $40 copay, and 70% in network and 50% out of network for most items.
My wife and kid’s grandfathered kaiser plan is 600 something a month. I looked into getting on her plan but it wouldn’t save me much. I think we are happy with the care at Kaiser for my son, and she is happy personally, but I hate the idea you have to go see your primary to go see a dermatologist etc.
It just seems that there is a better strategy out there. For example, maybe get the highest possible HSA detectable plan, join a concierge doctor group, get an executive physical over at sharp every other year ($2,500), see the specialists you want and negotiate cash rates. Obviously, the above is not cheap. I’m okay with spending $750 a month, but I want something for my money.
Right now, I’m spending 10k a year in premiums for myself and I can’t get into an urgent care.
I learned years ago that it was cheaper to negotiate cash for an mri on my knee, than go through my insurance.
They average family was suppose to save money on Obama care. What happened? Doctors, insurance companies, and hospitals are all crying they aren’t making any money.
Who is making all the money??? I think the industry could use some transparency.[/quote]
if you have an issue with your skin, snap a picture with good resolution and e-mail to your Kaiser primary. If he or she isn’t sure about the rash, they can message the dermatologist to look at your photo. The dermatologist can directly book you if they feel the rash is worth a look in person, or offer treatment recommendations.
no need to go in just for a rash, that’s silly.
April 9, 2016 at 2:02 PM #796586Participant[quote=bearishgurl][quote=no_such_reality]This is an interesting study synopsis. http://cclponline.org/wp-content/uploads/2013/10/Identifying-the-causes-of-rising-health-care-costs_DOC-4.10.13.pdf
Basically utilization doesn’t drive cost increases. Branding is and provider market leverage.
That intuitively makes sense when you think about something like prostrate cancers and the all the ads for proton treatment at named place xyz. Regular therapy is expensive at $18k average. Proton runs $38k average.
Care to guess were the demand is?
Diabetes is expensive too, average $80k lifetime charges for someone in their 50s when diagnosed. Add in the percentage of population with diabetes from ’97 to 2013 went from 2.5% to 7.5% and we have a formula for disaster.[/quote] . . . I’ll look at the report from CO that you provided. CO has thin air which can cause enlargement of the heart in sucseptible longtime inhabitants, especially those who live at the higher elevations.[/quote]I reviewed the report and even though two of AK’s main hospitals are “for profit,” I feel that is the only state (of the three in the report) that CO can realistically compare itself to. Part of the healthcare cost problem in CO has to do with proximity to medical care. 5/8 to 2/3 of the state is mountainous and of that portion, the majority of those mtn residents are 25-80 miles from the nearest hospital and up to 375 miles (up to 8-9 hrs drive in the winter and may not be immediately reachable by air) to the nearest trauma center. Most of the small mtn towns only have 0-2 doctors in residence (and one or more of them may be “retired”). If there is a medical emergency in a town which is more than 25 miles from the nearest hospital (on often snowy/icy mtn roads which may be fully or partially closed), then that patient has to be transported by the nearest fire dept or search and rescue vehicle/helicopter to the nearest hospital. “Ambulance” charges can easily be over $2K one way to the nearest hospital just ~25 miles away if the patient cannot be safely transported timely enough by family members or friends. Thousands of (mostly well-heeled) “retirees” from all over the country and world live in these towns. I feel one needs to be in good health to move up there in the first place and also make the decision to “be at peace” with “dying doing what you wanted to do, where you wanted to do it” if you’re hiking or jeeping remotely or even in town when an emergency strikes and you can’t immediately get help. Senior citizens who live up there and develop chronic conditions needing constant medical attention end up having to move to a town (of >15K pop) with a hospital (or even move to a city).
The above (and the likelihood of extreme sports injuries) are reasons why healthplan premiums are very costly in the rocky mtns. I looked into it myself last year and was shocked at CO’s PPO premiums in the rockies, which were $200-$350 month higher than in SD. But CO offers 4-5 different PPO individual plans in that region which is more than double what is offered here.
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