Health Insurance Nightmares

[chopsaw]

Go you got it fixed up .

 

[sandyut]

Go you got it fixed up .

Finally, day one of recovery is not as smooth as anticipated...hoping it speeds and pain subsides quick. this morning was fine, till I put my feet down and walked. Last time 3 years ago I dont recall much pain at all. Goes how it goes, so I ride it out.

 

[pineywoods]

Hope it gets to feeling better quickly

 

[sandyut]

Hope it gets to feeling better quickly

Many thanks! Hoping for quick.

 

[DougE]

Finally, day one of recovery is not as smooth as anticipated...hoping it speeds and pain subsides quick. this morning was fine, till I put my feet down and walked. Last time 3 years ago I dont recall much pain at all. Goes how it goes, so I ride it out.

Praying for a quick recovery.

 

[sandyut]

Praying for a quick recovery.

Many thanks Doug

 

[thirdeye]

I had a tele-consult scheduled for today with my Medicare Part D advisor, but she could not login to Medicare (dot) gov. However she did mention that pricing for several Part D plans is increasing. I currently have CIGNA for $16.50/month. For 2026, the price changes to $66.50. Guess it's time to go shopping....

 

[sandyut]

I had a tele-consult scheduled for today with my Medicare Part D advisor, but she could not login to Medicare (dot) gov. However she did mention that pricing for several Part D plans is increasing. I currently have CIGNA for $16.50/month. For 2026, the price changes to $66.50. Guess it's time to go shopping....

that sucks. my ACA ins is sure to rise. estimates are all over the place, I have a meeting with my consultant in a couple weeks to see what the damage is going to be.

 

[Torch&Tone]

but she could not login to Medicare (dot) gov

Log-in is still currently unavailable, probably because of the government shutdown. There appears to be a solid consensus that all health insurance rates are going to to go up, just a question of how much. At this rate, the only reliable way to afford healthcare will be to invest in health insurance companies.

 

[thirdeye]

that sucks. my ACA ins is sure to rise. estimates are all over the place, I have a meeting with my consultant in a couple weeks to see what the damage is going to be.

I started ACA when there was an income cap and penalty. Then my last 18 months fell into the less than 8% of your MAGI provision. But you are correct... many expect a rise. And, if I read it right, the current subsidies expire at years end, and if not renewed, the old version of ACA still kicks back in.

Log-in is still currently unavailable, probably because of the government shutdown. There appears to be a solid consensus that all health insurance rates are going to to go up, just a question of how much

Could also be the Amazon Web Service going down this morning.

These last 2 years of fires and floods might contribute to rising rates too.

 

[sandyut]

I started ACA when there was an income cap and penalty. Then my last 18 months fell into the less than 8% of your MAGI provision. But you are correct... many expect a rise. And, if I read it right, the current subsidies expire at years end, and if not renewed, the old version of ACA still kicks back in.

I read that if your AMAGI is less than 4X poverty level, some subsidies would remain. Current subsidies are quite nice, but I am not counting on them...sad.

 

[Elf@shore]

I read that if your AMAGI is less than 4X poverty level, some subsidies would remain. Current subsidies are quite nice, but I am not counting on them...sad.

HI ALL!
Medicare : Here's what my agent explained to me !
Advantage plans offer a lot of perks: But!? IMO: I think there is a lot of unnecessary perks?
When you need serious healthcare ,its very weak !
Like I heard, the coverage is limited and Out of Pocket kicks in !
If you get a Supplemental plan that fits you ,its more beneficial ,especially for long term care.
These plans differ State to State.
I am in NJ.
My last job, Humana was offered Thru the Union.
They Dropped it , Union Shop steward : They SUCK! So? They dropped them !
If you have an existing condition that needs care ?
Do not mess around !, Get a GOOD Supplemental plan.
Might costs more, but you are covered!?
Good Luck !
ELF

 

[DougE]

For the first time in a long time, I'm going to meet with an agent I trust fairly well and review my options before I renew my current Medicare Advantage plan.

The plan I'm on served me pretty well until I developed heart rhythm issues that had to be looked into deeper with a complete workup ........ stress test, echo, visit to an electrophysiologist, etc, and the cancer radiation treatments. I got jammed with a lot of out of pocket expenses.

My best option seems to be staying with Humana Advantage but on an updated plan, which will save me a little and give me a few more perks.

As far as getting jammed with an over $2K bill out of pocket for my part of the radiation treatments, the agent said that all the companies only cover 80% of cancer treatments.

 

[sandyut]

My best option seems to be staying with Humana Advantage but on an updated plan, which will save me a little and give me a few more perks.

As far as getting jammed with an over $2K bill out of pocket for my part of the radiation treatments, the agent said that all the companies only cover 80% of cancer treatments.

I am curious to see what my ACA options look like on Saturday...

this year my out of pocket was $9200. next year that is is set to rise about 10% if I have anything major done.

 

[jcam222]

I just finished signing up for Anthem Medicare Advantage PPO 3. Paying an extra $46 a month premium but it's includes decent dental, vision, hearing and quarterly OTC product allowance. That along with being a PPO and a company I've insured with for over 30 years makes me feel pretty good about it

 

[jcam222]

I am curious to see what my ACA options look like on Saturday...

this year my out of pocket was $9200. next year that is is set to rise about 10% if I have anything major done.

I'd anticipate huge premiums without having credits available. I have been paying $532 a month and that's with a credit close to $500 with an income towards the upper cutoff. I lean right but something does need to be done to give credits to those who aren't gaming the system.

 

[sandyut]

I just finished signing up for Anthem Medicare Advantage PPO 3. Paying an extra $46 a month premium but it's includes decent dental, vision, hearing and quarterly OTC product allowance. That along with being a PPO and a company I've insured with for over 30 years makes me feel pretty good about it

Nice! That is ACA coverage right? My estimated premium doubled. CO uses their own exchange so I cant log in till Saturday to see the options. All things considered Anthem has been good, and I am really dont want to find all new providers since I have accrued quite a few.

 

[jcam222]

Nice! That is ACA coverage right? My estimated premium doubled. CO uses their own exchange so I cant log in till Saturday to see the options. All things considered Anthem has been good, and I am really dont want to find all new providers since I have accrued quite a few.

No that plan is Medicare Advantage which I qualify for begining Dec 1. I'll cancel my current ACA effective end of November.

 

[thirdeye]

I am curious to see what my ACA options look like on Saturday...

I have a handful of friends that are in the same boat. There are some preliminary numbers out there and prices without subsidies come with some sticker shock for some states.

Questions to any and all: When I had ACA coverage, we shopped the various Marketplace plans, made a selection... then locked in.

What if you lock in with the current premium (based on no subsidies) then later, Congress extends the subsidies... Will the insurance company lower your rates? Or will you be able to start over and shop all plans?

 

[sandyut]

What if you lock in with the current premium (based on no subsidies) then later, Congress extends the subsidies... Will the insurance company lower your rates? Or will you be able to start over and shop all plans?

Here is how I see it. Its not fully locked in till open enrollment ends. I have messed around on the CO marketplace after my consultant and I met and chose a plan (in previous years) to just check a few things and make sure I was solid on the decision. In CO I can change it as many times as I like till Dec 15.

If the government decided to extend the tax credits before open enrollment ends, I assume the market places will need to correct/reduce the monthly billable amount based on the additional credits. If they cant get it together till after Dec 15 then who knows. =MESSY AF.

My estimated costs for 2026 on my current plan just doubled to $334/month! The tax credit is pretty much identical ($15 less). Seems messed up that the plan cost went up so much. But given all that has happened in 2025 - I just cant go without ins.