Can you keep your high-deductible plan?

A reader of this blog recently wrote that he has a high-deductible health insurance plan and he wants to keep it.  To keep his monthly premium low, he chose a $10,000 deductible. This means he pays 100% of his medical bills until they reach $10,000.  Then he pays 40% of his medical bills until his out-of-pocket costs total $5,000.  If he stays healthy, he wins.  If he gets sick, he loses.

Under Obamacare, only people under 30 will have access to this kind of high-deductible plan.  The blog reader is older and will have to find another, more expensive plan.  The plan will be more expensive because Obamacare rules say deductible plus out-of-pocket costs cannot exceed $6,350 for an individual and $12,700 for a family.

The lowest-cost plan for our dear reader (whose age I do not know) will be a bronze plan that will be structured a lot like his current insurance – except it won’t have as high a deductible as he now has.  If the reader qualifies for a subsidy (based on his income), his actual premium might not be too much higher than he pays now.  But if he makes more than $62,040 (as a married couple) he will get no help paying a higher premium than he now pays.

I have a number of clients who are under 65 and enrolled in individual health insurance.  My clients did not choose a super high-deductible plan, but rather the more “normal” deductible of $5,000.  Yes, $5,000 is pretty much the “standard” deductible for people who are over 50 and healthy. Most people choose a $5,000 deductible to get a premium in the range of  $200 – $250 per month. Of course, the older they are, the higher their premium.

I’ve started calling my clients to see how they will be affected by Obamacare rules and to ask them how much money they make.  Their income is key because they might qualify for a premium subsidy.  I don’t have any details about plans to be offered in Arizona or costs, but if they qualify for a subsidy, that means they will be getting better health insurance for the same price, or maybe a lower price.

So far I’ve talked to  two clients who will be “winners” under Obamacare. They are in their 60’s and will get a big subsidy and better coverage.  But I’ve also talked to a client who makes too much money to get a subsidy. She will likely pay more for her insurance in 2014, but it won’t be much better than what she has now.

I am a big supporter of Obamacare because I see so many people who will benefit from better coverage and premium help.  There will be many “winners” with Obamacare.  But I also see there will be “losers” with Obamacare because their premiums will go up and their coverage (if they choose the lowest-cost bronze plan) will not be that much better than what they have now.  These are people who have good health and good income. They have been responsible and paid for not-so-great health insurance and it has worked for them – because they are healthy.

I’ve got to make a few more calls now.  It’s kind of awkward asking people how much money they make. But it’s not so awkward when I can tell somebody they will be an Obamacare winner. It is definitely uncomfortable telling someone they will be on the losing side….but I’ve got to force myself to make the next call.



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