Health Care Choices, 2020 Edition
When the Affordable Care Act, known as the ACA or more commonly "Obamacare", passed years ago I estimated what the cost of coverage for my family would be. We didn't need to use the public marketplace created by the ACA since we had subsidized coverage through our employers, but at the time, for 2014, it would have cost us about $900/month for comparable benefits in the open market.
Recently I wondered what the costs would be now so I went back to Covered California (external site) and checked again. Coincidentally open enrollment for 2020 ends Sunday. Here are 5 things about what health insurance we could buy on our own for 2020.
TL;DR: The costs are alarming.
1) We still have a decent range of choices, at least on paper. 23 plans are available in our area. 13 are HMOs, 5 are PPOs, and 5 are EPOs. 7 plans are Bronze tier, 5 Silver, 6 Gold, and 5 Platinum. I note the choices are varied "on paper" because these plans are really just variations of 5-6 basic plans across 4 insurers.
2) Which plan level, Bronze through Platinum, best corresponds with the employer-subsidized insurance we've had for many years, is hard to determine. Six years ago I decided we had the equivalent of Gold. This time around, looking at the details of the plans, I see that Platinum is the closest match to what we've got right now. I think that's because we've actually got better employer sponsored coverage now. ...And that's a good thing, BTW, because as all medical costs have been climbing it's nice to be better covered than before.
3) HMO, PPO, EPO; these sound like an alphabet soup. If you don't live in the US you probably don't know what they mean. Be thankful you probably don't have to! An HMO is a Health Maintenance Organization. You're covered if you go to their clinic but nowhere else. A PPO is a Prefered Provider Organization. They've got a network of clinics large and small. You've got more coverage in-network and less coverage if you go out-of-network. An EPO is an Exclusive Provider Organization. It's like a PPO except with zero coverage out-of-network. We've always chosen PPOs through employer sponsored insurance even though they cost more because we don't want the limitations or risks of in-network-only coverage.
4) Platinum PPO coverage is expensive. For the two of us it'd cost more than $33,000 annually. 😱 And that's just for the premiums; we'd still have out-of-pocket expenses for basic care. Dropping to a Gold PPO lowers the cost to "only" $25,000 annually. Dropping to a Gold EPO we're down to a little under $17,000 per year. That's half the cost of the best plan but still "Holy @#$%!" expensive.
5) These numbers explain why a lot of my peers feel they are locked into working corporate jobs. Even when they seemingly have enough money to retire, these mind-boggling costs of buying insurance on the public market keep them working jobs that offer subsidized health care benefits. It's "health care handcuffs".
Recently I wondered what the costs would be now so I went back to Covered California (external site) and checked again. Coincidentally open enrollment for 2020 ends Sunday. Here are 5 things about what health insurance we could buy on our own for 2020.
TL;DR: The costs are alarming.
1) We still have a decent range of choices, at least on paper. 23 plans are available in our area. 13 are HMOs, 5 are PPOs, and 5 are EPOs. 7 plans are Bronze tier, 5 Silver, 6 Gold, and 5 Platinum. I note the choices are varied "on paper" because these plans are really just variations of 5-6 basic plans across 4 insurers.
2) Which plan level, Bronze through Platinum, best corresponds with the employer-subsidized insurance we've had for many years, is hard to determine. Six years ago I decided we had the equivalent of Gold. This time around, looking at the details of the plans, I see that Platinum is the closest match to what we've got right now. I think that's because we've actually got better employer sponsored coverage now. ...And that's a good thing, BTW, because as all medical costs have been climbing it's nice to be better covered than before.
3) HMO, PPO, EPO; these sound like an alphabet soup. If you don't live in the US you probably don't know what they mean. Be thankful you probably don't have to! An HMO is a Health Maintenance Organization. You're covered if you go to their clinic but nowhere else. A PPO is a Prefered Provider Organization. They've got a network of clinics large and small. You've got more coverage in-network and less coverage if you go out-of-network. An EPO is an Exclusive Provider Organization. It's like a PPO except with zero coverage out-of-network. We've always chosen PPOs through employer sponsored insurance even though they cost more because we don't want the limitations or risks of in-network-only coverage.
4) Platinum PPO coverage is expensive. For the two of us it'd cost more than $33,000 annually. 😱 And that's just for the premiums; we'd still have out-of-pocket expenses for basic care. Dropping to a Gold PPO lowers the cost to "only" $25,000 annually. Dropping to a Gold EPO we're down to a little under $17,000 per year. That's half the cost of the best plan but still "Holy @#$%!" expensive.
5) These numbers explain why a lot of my peers feel they are locked into working corporate jobs. Even when they seemingly have enough money to retire, these mind-boggling costs of buying insurance on the public market keep them working jobs that offer subsidized health care benefits. It's "health care handcuffs".