Health Insurance 2018

Woof. Finally made my decision on which plan to go with through healthcare.gov. Always stressful.

Continuing with my “current” plan would’ve been a 75% increase in unsubsidized premium, though it’s actually a better plan. The cheapest bronze plan is 9% above my current plan (which is silver). Quite an increase. I don’t think that’s where inflation is at.

Luckily, the subsidy available seems to have increase quite a bit as well. I didn’t take it last year because being self employed leaves some variability in my annual income and I don’t want to risk fees in April for underpayment. I don’t remember what subsidy was available last year, but it seems like it has to be at least double this year, possibly 3 or 4 times. I decided to use about 60% of it, figuring that as a reasonable compromise of risk and reward.

I’m never sure what number to use for my annual income. For one thing, it’s a guess based on this and previous years. Also, they aren’t specific, whether it’s raw gross or AGI or what.

The amount doesn’t matter as much for the subsidy, because it gets reconciled at the end of the year. But there’s the cost sharing reduction, which could have a significant impact on care costs over the year. I don’t think there’s anything to reconcile this on the tax forms.

I switched from my current provider, Ambetter, to CareSource. Ambetter seemed alright, but the price difference was pretty extreme: I could’ve gotten a CareSource gold plan for less than the updated version of my silver plan.

The CareSource plans looked really good compared to others “on paper”, but it’s hard to tell the real differences between the plans from different companies. Like:

  • Will doctors skimp on care if they see I’m using the provider?
  • Will the provider not pay for certain things or count them towards deductibles or anything like that?
  • Will the provider make it difficult to do schedule appointments, get payments taken care of, etc.?
  • Does some other provider offer some services that would make things a lot easier for me, make me more likely to actually get proper care, anything like that?

I always worry about insurance, have a general feeling like they’ll try to provide as little as they can.

I don’t know much about CareSource, but they are Ohio based, which is always a plus in my book. They seem to have a stronger presence in Medicare / Medicaid. I hope they’re alright.

I went with an HSA plan this year. I’m considering putting the difference in premiums from the silver plan I was considering into an HSA account. In theory, it seems like a really good deal, since no taxes are ever payed on contributions if they’re used for medical expenses, and in theory almost everyone will have medical expenses at some point.

However, providers seem hard to find. They seem to charge fees that would seem to make it hard to actually make it worthwhile. And considering how quickly health expenses seem to be increasing, the better copays seem like the better choice if I’m actually spending on health care.

It was tough to decide between the silver and bronze plan. With the difference in premiums, the bronze plan would be the best fiscally near the minimum and maximum care cases, but in the middle, the silver would definitely win out. Silver would’ve given me immediate copays for visits and a 25% lower deductible (for the plan I was leaning toward), meaning I would actually get benefits without major care. That could also make it more likely for me to actually get care.


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