The 2016 plans and costs can be viewed on healthcare.gov now.

JumpinJack said:

A day in the life of a purchaser of an ACA individual insurance policy.

The plans came out on healthcare.gov today. So we get a first look. Yay. However, open enrollment begins on November 1st, so it's possible that some things will change.

After a preliminary look, it looks bad. Not only did my co., BCBS, withdraw its PPOs from the state (it lost milllions), there are PPOs from only one company, now. It's really a hospital that sells coverage for its own hospital and the drs. that practice there (Scott & White...Baylor). If I recall from last yr, it doesn't cover other hospitals or have providers or pharmacies not affiliated with its hospital. It's also pretty pricey. The lowest cost HMO it has is $721. So I move on.

The other plans:

I notice a new company called OSCAR. A startup out of New York, it seems. ??? A look at its provider list: only drs associated with one out of the seven or so hospitals we have in my city. Hmmmm.

I then looked at Molina's provider list. Either their provider directory doesn't work at all, or it doesn't actually HAVE any doctors or hospitals signed up in my city. So I move on.

Last year, I had the lowest cost PPO available. ($655/mo.) It was BCBS, bronze, $6k deductible. As mentioned above, it doesn't look like I'll be able to get a good PPO this year. So I move on.

I'll check on a BCBS HMO for 2016, then. Since I can't get a PPO:

The LOWEST COST HMO for BCBS last year was Plan 005, for about $455/mo. ($5k deductible, OOP $6,600)
This year's BCBS HMO 005 is about $558 ($6,750 deductible, OOP $6,850).

That's an increase in BCBS's lowest cost HMO of about 22%, coupled with an increase in the deductible of 35%, and an increase in the OutOfPocket of 3.7%. So I move on.

I will check on United Healthcare's EPOs next (that's UNH's version of HMOs...it doesn't offer any PPOs in my area, as mentioned above).

Welcome to the world of an ACA insurance policy purchaser. I've spent about 2 hours so far researching plans. I have to spend some more time before I can get all the facts to buy a policy.

It's best for purchasers to review the provider lists for drs (specialists and PCPs) and hospitals, AND the drug lists for the plan you're considering.

(Note: If I end up moving to the mid-size Texas city I'm considering, my only choice will be one of six BCBS HMO plans, two plans per level.)

BTW, BCBS sent me a letter recommending this HMO to replace my $6k deductible $655/mo. PPO from 2015: It recommends an HMO Bronze with a lower deductible ($4,500), but has coinsurance requirements (for those in the know, this would add greatly to any catastrophic illness cost.) The coinsurance is 30% (20% is standard). New OOP $6,450 (from previous $6k). This is inferior and much less inclusive coverage than my 2015 PPO, is accepted by far fewer providers, and yet has an increase in premium to $672.87/mo., according to BCBS's letter to me. (the gov site says its a bit less, so we'll see.)

Here's the deal on "low" premium increases. The insurance companies and government will say that the increase is only 2% or 4% or 10%. The BCBS letter to me says the increase for me for 2016 for the new plan it recommends is only 2.6%! Wow, isn't that great? No, it's not. It's not the same policy, it covers far less, it has many restrictions (being an HMO), it has far higher costs for the insured (prohibitively so for some people), will be accepted by far fewer providers than the PPO it is comparing this new plan to, and has a much smaller list of drugs that it will approve.

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