Today, I met with a corporate representative from SelectHealth who came to my office to introduce herself as our agency liaison and relationship manager with SelectHealth. We talked for quite a while about how solid SelectHealth is and how SelectHealth continues to be solvent and keep their customer’s interests in mind. Our conversation came to the recent letter many people have received and rate increases and the reasons why, and I wanted to share what she shared with me. I think it will open people’s eyes.
She shared with me that one of the large reasons for the double digit rate increases is prescription costs. I think we’ve all seen commercials on TV for Humira used to treat many issues from rheumatoid arthritis to Crohn’s Disease to a long list of other conditions. There is no generic for this prescription, and no alternative for what it does and it is the single most expensive prescription by amongst those insured by SelectHealth. I do not imagine it would be any different for Molina or any other carrier participating both in and out of the ACA (Affordable Care Act). This single prescription costs the insurance carriers $65,000 per year, and thousands of SelectHealth enrollees are using it because it is being advertised everywhere.
Understanding the Insurance Changes
Many people are scared and upset about the 2017 rates that were listed in the letters received. Your insurance carrier, whichever one you are currently with (i.e. Molina, SelectHealth, Humana, BCBS, etc.) is only aware of your 2016 advanced premium tax credit (APTC) a.k.a SUBSIDY. These letters that everyone are receiving are simply stating that if you do nothing and do not talk to your agent and update your information with the marketplace, your subsidy will remain at the 2016 rates and your premium will have a double digit increase to $X amount (insert expletive!). This is why it is so important to review your 2017 options by calling into the marketplace and waiting on hold for 3 hours and probably getting hung up on by someone that doesn’t speak English, or setup a time with your insurance agent and review your options. Your 2017 insurance premiums are all based on the size of your household and your estimated 2017 income.
So, don’t freak out. Talk to your health insurance agent, or make sure your phone is plugged in and make the 3-hour phone call to the Marketplace and update your information. Your subsidy will more than likely increase to compensate for the increased premium and your overall out of pocket shouldn’t be as drastic as originally believed. Stay calm and just breathe.