Farewell, Terrible Health Insurance

I got a letter in the mail from Blue Cross Blue Shield over the weekend that my $184/mo. calamity health insurance (EmpireBlue Hospital Plus, to be exact) will no longer be offered in the new year.

I was initially disappointed to lose my sad compromise between paying $761/mo. for COBRA and going without the way I did when I was 22 (and 23, and 24), but I am taking its new prohibition under the Affordable Care Act as a sign that it is probably a complete rip-off. Mother Jones’ “The Real Story Behind the Phony Canceled Health Insurance Scandal” confirms my suspicions:

The ACA was designed specifically to prevent insurance companies from peddling lousy insurance plans and to force these firms to replace these subpar products with affordable plans providing better and effective coverage. The plans being canceled are ending because they offered insufficient coverage—and only a few years ago both Rs and Ds were upset about these kinds of plans. But there’s been collective amnesia about the shoddy plans that GOPers have happily exploited in recent days. Perhaps Obama should have said, “Those of you who obtain insurance on the individual market can keep your plans unless it’s the sort of rip-off plan the ACA will forbid. Otherwise, you will be offered new options that actually give you decent coverage at a decent price.”

I never did use my calamity insurance—mostly because you can only use it if you get hit by a car or your appendix bursts or something else “life-threatening” happens that sends you to the hospital—and god-willing, I won’t in the next two months either. That means I’ll have paid a total of $1,472 this year for what amounts to a very relative peace of mind (I say relative because sure, my ER visit would be covered, but I fear for anyone with this insurance who needs long-term care). Maybe it’s worth it, but regular old health insurance, even at double the cost, sure will be nice.

Photo: leoncillo sabillo


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Looks like you can probably get a catastrophic plan on the exchange for $186/mo. The slightly better Bronze plans are around $280 after subsidy and more resemble a real insurance plan (i.e. you can go to the doctor for things and just pay a small copay.)

Spendat (#5,198)

Your ER visit would be covered under your current plan, but not your surgeon or other specialists costs/medications/labs/or any other non-hospital costs incurred in an emergency. I looked into that plan and decided to forego insurance because my father, a surgeon himself, said it covered so little in the even of an emergency that it wasn’t worth it (I still need help navigating life after many years of adulthood.) It only covers the costs that the hospital itself incurs by treating a patient, and possibly a few other things, but in general my bills would still be astronomical/probably force me into bankruptcy if I needed emergency treatment with that plan, so why still pay $184/month?

Meaghano (#529)

@Spendat Would that my father was a surgeon and I ever asked him for advice!

qwer1234 (#4,140)

In New York you’ll probably be able to get real coverage for about that amount if you’re eligible for subsidy, which from your posts, it sounds like you probably are.

qwer1234 (#4,140)

By “about that amount” I meant about as much as you’re currently paying. Maybe a little more, maybe a little less, depending on how much you make. It’s real health insurance, though.

I went in the other direction and went with COBRA (620/mo) because I was in the same position, but need to go to the doctor a lot for various weird things that are wrong with me (nothing serious, I’m actually very healthy). I’m EXTREMELY fortunate in that mother had the means and offered help paying for it. I would be otherwise uninsured, and just had a little health scare that would have been upwards of $15,000–for just surgery and one night in the hospital, which doesn’t include the tests and office visits that led up to it.

I get a little emotional when I think about the fact that I have CHOICES now. My price range for plans on the NY State of Health marketplace ranges from $150-$527. The most expensive one is still less than what we’re paying now. I feel so lucky to live in a state with a governor that opted to do this on the state level.

Meaghano (#529)

@qwer1234 I went in to try to brave “the marketplace” a couple weeks ago when it was still down all the time and eventually gave up, but I think it is time to dive back in. Also I am glad to hear that there is good stuff in there. I think I am putting it off because this just might solve my health insurance woes and I’m afraid it’s too good to be true!

qwer1234 (#4,140)

@Meaghano haha I did the same thing. I just finished today and called to resolve an issue I had. Everyone I’ve talked to at the New York State of Health is shockingly friendly and helpful!

terrific (#1,532)

@qwer1234 @Meaghano I went through and looked, and it will definitely be about a $100 — at least — increase in your insurance unless you’ve got a badass subsidy. I’ve got the Blue Cross catastrophic plan too, and I’ll be paying at least $295 a month now.

qwer1234 (#4,140)

Hot tip if you’re on COBRA (at least in NY): If your plan termination date is beyond 1/1/2014, you will be “ineligible” for federal subsidy, even if you’re within 400% of the poverty line. You would qualify if you changed the termination date to 12/31/13. But you’ll still be able to see how much you’d pay with the subsidy, without having to commit to cancelling your current plan, by using the Tax Credit and Premium Estimator on the resources page! I called them so you don’t have to!

Greenbeans (#3,048)

@qwer1234 I’m really glad I read this thread, because I am on a COBRA plan from a NY employer! I will be making some phone calls, pronto, especially because I don’t live in NY and don’t know how that might play out.

qwer1234 (#4,140)

@Greenbeans you’ll probably have to go on the exchange in your state of residence or on the federal exchange if your state opted not to create their own. But I am not an a expert, so don’t listen to me.

qwer1234 (#4,140)

@Greenbeans and good luck with alllllll that!

WayDownSouth (#3,431)

It’s lovely to see such wide-eyed trust in a federal program. Previously the president said that if you liked your health plan, you could keep it. Period. Now that this statement has been proven untrue, only bad health plans from bad insurance companies are being cancelled. I wait to see the reaction when this turns out to be untrue as well.

FancyMachine (#4,401)

America, I commend your braverism. This stuff looks so complicated! My health care is $64/month, and my office covers it for me.

I needed an MRI a couple years ago and paid NOTHING. Sure, I had to wait a little while and go at like 10:30pm but it wasn’t an URGENT matter and I said that I didn’t mind a late appointment. Yay Canada!

qwer1234 (#4,140)

@FancyMachine you are correct about this being complicated.

garysixpack (#4,263)

My health insurance was cancelled too, so I’ll be shopping for a new policy as soon as I get around to it.

Unlike Meaghan, I was perfectly happy with my old insurance. It covered the things that I thought it should cover, and it didn’t cover what it wasn’t supposed to. I haven’t done a detailed comparison, but the glaring difference was that my old policy did not cover maternity care. There is absolutely no reason why I would need an insurance policy that covers maternity care.

There’s no way I will qualify for a subsidy, and I have trouble believing the new policy will simultaneously cost less, cover more, and be more convenient. I guess that makes me a loser under the new regime.

Eric18 (#4,486)

For alot of people, it’s “Farewell, Great Health Insurance.”

ShermMcCoy (#3,777)

We needed insurance that covers collision and damage to the major parts (and does something to the rising prices of all components).

But we demanded a warranty that covered all the above + oil changes, windshield wipers, brakes, and tires (and does nothing to bend the cost curve downward). But hey, “free” stuff! Yay.

pokeable (#4,933)

“Shoddy plans?”

My wife and I purchased a catastrophic policy in the 3 month bridge from when I finished fellowship until I started my current job. Granted, we have no pre-existing conditions, but it covered MD visits with a $40 copay, and had a $5K deductible. It covered ER, and God forbid, therapy if something were to happen. It cost $90 a month for the both of us.

Guess what: THIS IS ALL WE NEEDED. We didn’t need maternity coverage, Psy coverage, etc. etc. Birth control she was on was a cheapo $4 generic. Paying for any more benefits would be completely unnecessary…because all we needed was a catastrophic policy for the proverbial ‘bus out of the blue’.

And please spare me the “You don’t know what you may need”, we are both physicians, we damn well know exactly the degree of coverage we required.

Any young person who makes >$45K is getting robbed with the ACA. Your premiums are paying for those who are sick, are old (and wealthier than you), or those who make less.

Of 30 people I am seeing today, I have two patients under 30, three patients under 40. That gives you an idea about utilization of medical services.


Any young person who makes >$45K is getting robbed with the ACA. Your premiums are paying for those who are sick, are old (and wealthier than you), or those who make less.

Isn’t that the point of a risk pool?

pokeable (#4,933)

@bowtiesarecool The term ‘risk pool’ has been antiquated by ACA: insurers cannot adjust for risk because: a) they can’t limit “risk” (ie pre-existing conditions) from the pool, and b) they can’t raise rates to compensate for elevated risk (charge old people x% more than the young).

Thus, they charge the young and healthy for more than they need to help underwrite the diabetics, the cancer patients, the vasculopaths who are now in the risk pool.

There is no free lunch. Increasing access for a sick group that will utilize a significant chunk or resources will cost a ton of money. For the CBO to rate this as a net neutral (or even save money); where do you think the funding for this increased medical utilization will come from? Insurers are going to have an extremely difficult time getting doctors and hospital systems to sign up anyways; they can try to cut reimbursement rates…or they will raise premiums on the young and healthy.

viewfinder (#5,201)

How ACA is playing out is just fascinating. If people (in general) support policies that benefit them, you’d expect that young people would be absolutely opposed to this law. Conversely, you’d expect older people, especially ones with chronic medical issues to be supportive.

I’ve found almost the opposite to be the case with young people generally supporting and older people generally opposed to it. One big exception in the “young camp”seems to be information rich consumers with specific needs that they were able to address in the pre-ACA marketplace (garysixpack and pokeable.) Other than these people who were inclined to research what is optimal for them, most reactions and attitudes toward the ACA from a consumer perspective is baffling to me.

Some may argue that young people are uniformly altruistic and have a preference to subsidize older folks and that maybe the older people are too proud to take the handouts from their children’s generation. But most arguments from young and old alike tend to be economic ones. Both groups almost invariable talk about the ACA in terms of economic impact to them long term.

Just fascinating…

garysixpack (#4,263)

At the end of the day, young people will have to sign up for insurance for the scheme to work. Will they pay money for insurance or is it all talk? We’ll find out.

Penelope Pine (#2,808)

How about we just make everyone over 60 fight each other Hunger Games style, and the winners can sign up for the health exchange?

Meaghano (#529)

@Penelope Pine ha, i mean that is KIND OF how the current model works, like the Hunger Games of getting a full-time job with benefits.

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