Health Insurance in 3 Minutes (opens in new tab)

(My startup helps companies navigate healthcare reform, so I'm a bit of an expert on this)

The key to your question are the terms "guaranteed issue" and "age bracketing." I'm going to guess that you're pretty young and at least at the time that you enrolled in your health insurance, you'd never had any health problems. They way that individual health insurance worked prior to 2014, insurance companies would offer extremely low rates to individuals, and keep their expenses down by refusing to insure anyone with even the most dubious "pre-existing condition." So if you'd gone to the doctor complaining about a pain in your side, that would be considered a disqualifying event, and they'd turn you down. Or, much worse, you'd get the insurance, pay premiums for years, then if you ever developed cancer, they'd later comb through your health records, find where your doctor wrote down that you'd had a pain in your side, cite it as an undisclosed medical issue, and refuse to cover your cancer treatment.

Needless to say, that's a very effective way of keeping the cost of coverage down: only insure healthy people who never go to the doctor. As you aged, the insurance company would start jacking up your rates to cover their increased exposure. If you ever developed an illness, you'd have no choice but to pay what they asked, because you wouldn't be able to get insurance from another company since you now had a pre-existing condition.

Healthcare reform's two boldest and most popular changes are guaranteed issue (health plans must accept you, regardless of pre-existing conditions) and outlawing "recission," or retroactively searching for disqualifying health records to deny claims. So what that means is that insurance companies can't cherry-pick the healthy people anymore, which means that the young, healthy minority is going to see higher prices for individual health plans.

Second, the ACA reduced the number of allowable age brackets, meaning that plans for the oldest people can only cost 3x what the youngest people pay. So that hits younger people again, since they have to be roped in with an older age contingent than before.

You may have heard Obamacare proponents worrying about getting enough young people into the risk pool so we don't end up with "adverse selection." They're not worried about that just because young people are feckless and think they're invincible. It's also because they know that they're the ones that are seeing the biggest rate hikes. Of course, while someone like you have to pay $200/mo instead of $90, the flipside is that a family that used to be unable to afford $1500 per month and can now be insured for $250, and that seems like a decent tradeoff, especially since, in general, young people will eventually get older and have families themselves, and they'll benefit from the changes.

The good news is that at least for the time being, you'll still have cheaper insurance, until your insurance company starts with the shenanigans and starts jacking up your rates or discontinues that line (and blames it on Obamacare whether it's true or not).

And by the way, if anyone out there is involved in a business that's having a hard time with health benefits costs, my startup is taking advantages of lesser-known provisions of the new healthcare law to save companies a lot of money. Let me know and I'll hook you up with the details. We're called Benefitter.

In addition to what others have mentioned, your old plan had a lifetime maximum payout - maybe $1M, maybe $2M. That is removed by the ACA, and that costs extra too.

Also, there is extra cost because insurers now need to cover existing conditions - allowing you to change providers if you are already sick.

All of these extra things make it more expensive for some, but a better overall coverage - if you have catastrophic illness, you may have not been covered at the top end for all of these costs on your old plan.

Younger people tend not to think about catastrophic issues like 3+ years of cancer treatment, because new treatments are a) expensive and b) may extend your life significantly, so you may actually hit your $2M lifetime maximum, and then you are on your own, until you're bankrupt, and then the state (i.e. taxpayers) would help you out.

So, taken over 50+ years (not just this year's numbers) these new plans actually provide much better coverage, and may even take pressure off the Taxpayers for those that are under covered for their medical issues.

How about these "features":

* Your insurer can decide not to cover a treatment because, after digging through your medical history, they find something that lets them claim it's a preexisting condition.

* Your insurer can cancel your plan, and not let you sign up for a new one.

Not only that but they send bills for services that you thought your insurance covered. For example, I went in for a flu checkup and they charged me $90 for lab tests. This is not including $50 for copay, and $129 for the medication.

Don't ever pick kaiser as your health provider. They're very expensive. I'm still a student without a job and my parents have a normal 5-9 job that hardly pays much.

I don't know what to say when just a flu checkup costs $269 in a visit.

Dan- one of the provisions of the Affordable Care Act is that 64yr olds can't pay more than 3x the premiums of 20-somethings. Prior to the ACA the difference was on the order of 8-11x - so younger, healthier people are paying more and older & sicker people paying less. Don't be surprised if your cheap grandfathered plan does get canceled - this happened to me!

I'm going to take your post at face value. But I once was an Aetna employee several years ago, with very similar personal and insurance plan attributes as those listed in your first four bullets, but my premium was quite a bit more expensive than yours. I'm a little incredulous at how low your premium is.

Aetna is not in the business of losing money on the policies it issues. I can only think that either (1) you have failed to mention attributes of your health plan that are less than ideal (e.g., coverage cap of $25,000, but you claim that you have no coverage limit(?)), (2) that you have been placed in a very low risk pool, or (3) that you have a significant subsidy that allows to you to purchase a plan that would seem to be actuarially unsound for a for-profit company like Aetna.

Because you are not only paying for your plan, you are also paying for the plans of those who are receiving subsidies.

It seems more like a tax, somewhat similar to social security. You pay a lot when you're young so that you can get expensive treatments when you're older.

The $12000 out of pocket is only if you use it because you need medical help. You don't actually spend the whole $22K unless you have a lot of medical issues, and then you'll be happy that you only pay $22K per year!

When I left my last employer, I had the same company plan under COBRA. It started at ~$1000, and then went to ~$1300 at the next new year. It had lower out of pocket expenses, but those came at the cost of more monthly payment.

My current Gold medical plan (2 years later) is $820, plus dental at $120 or so. ~$950 for Gold plan, vs $1300 for my COBRA plan (in between, I had a really crappy personal plan that covered almost nothing for ~$600)

People who have employer payed medical have no idea how expensive their plans actually are

Might make sense for routine/planned services, but what would one do for catastrophic events?

I ask because 474 doesn't sound so bad to be protected against 100k in medical bills.

We can only sign people up that are in one of the 36 states on healthcare.gov -- otherwise we rely on our partners to help get people signed up

Whatever you do, do not give any information to that site unless you want unsolicited calls and emails for months.

Co-founder of the website. It appears all the licenses to sell insurance are in his name instead of the company's.

The rules for health insurance brokers are a little antiquated. If you're going to sell health insurance online, someone in your company needs to be a licensed broker, and that person's name needs to be "on the building" so to speak.

We're what is called a 'Web-Based Entity'. This means we have been given the right to integrate with hc.gov on the backend.

We do as well! Coverage networks (physicians) and actual costs are at the top of our minds. Check out sorting by 'worst case' -- while this isn't actual medical costs, if you have one or more chronic conditions, this is likely the cost you'll pay rather than just the premiums. Physician networks are harder, but we are working on it!