Most People Should Go For The Bronze, Says Scott Gottlieb On Obamacare
For most people, anything else is a waste of money, writes Scott Gottlieb at Forbes on Obamacare:
For those who find themselves shopping for health coverage through Obamacare, here's a general tip: save cash on your premiums and buy the bronze health plan. For most consumers, the gold and platinum options will be a waste of money.We analyzed dozens of Obamacare plans, and found one striking result. The networks of providers, and in many cases the drug formularies, are the same whether you're buying a particular insurer's bronze plan, or purchasing the same insurance option in a gold or platinum offering. My American Enterprise Institute colleague Kelly Funderburk and I posted some of our data here.
The bottom line is this. When you're choosing a particular insurance offering, you typically can't trade up to a better benefit by buying the gold or platinum variety of that plan. It's usually the exact same benefit regardless of the metal you choose.
So what varies between these different metal plans? Typically, just the co-pay structure and deductibles. As you pay higher premiums for a gold or platinum plan, your deductibles and co-pays will decline. The insurer will typically cover 60 percent of expected medical expenses in a bronze plan, 80 percent in a gold plan and 90 percent in a platinum plan. So, by buying the costlier plans, all you're doing is fronting a higher premium to buy down your anticipated out of pocket costs. You're not getting a better network of doctors or a better formulary of drugs.
This is great to know. I'm going to have to downgrade my now unaffordable care by March. I don't see the doctor often and seem very healthy but I do see my shrink for my ADHD and need my prescription (generic Adderall) to not suddenly cost like it's generic gold bullion.
Where are you filling your Adderall prescription?
All pharmacies are not the same price. If you have one close, I suggest Walmart or Sams club. Our Sams Club pharmacy does not require you to have a membership, and their pharmacy charges are much lower than Kroger's for example. They also don't have the lines that Walmart does.
Calling around is always wise. Sometimes for generic drugs paying out of pocket is actually cheaper than trying to get insurance to cover it.
Isab at January 25, 2014 6:27 AM
No, you should not "go for the bronze".
These are not "gold","silver" or "bronze" plans. They are all "Arsenic", designed to take your money without providing any service to you. Just take a look at the deductibles.
You should ask yourself,"Why in the hell am I paying for a service I do not get!?"
Radwaste at January 25, 2014 7:21 AM
Um, Isab, Kaiser, where I pay $10 or $30 on my now-unaffordable plan. There is not a pharmacy in the universe that can do better.
I paid into healthcare thinking I'd be in in my 20s and have it later in life without having to be judged for whether I was healthy or not. All those years I paid in when I could have had catastrophic care only and then paid for doctor and other visits now sicken me, now that the game has been changed by Obama, now that the free market aspect has been removed and my care is now unaffordable, thanks to how I'm paying for all the people who gambled and didn't get into a health insurance situation in their 20s.
And Radwaste, if you don't choose one of these plans, what do you do? You have to choose one and I will have to, losing my grandfathered Kaiser plan and giving up my personal private information to the government because I can't afford to go on with my plan and its current cost, thanks to Obamacare: the "Affordable" Care Act.
Amy Alkon at January 25, 2014 9:29 AM
"Um, Isab, Kaiser, where I pay $10 or $30 on my now-unaffordable plan. There is not a pharmacy in the universe that can do better."
You don't actually know that unless you call around frequently.
Isab at January 25, 2014 11:05 AM
Amy Alkon
https://www.advicegoddess.com/archives/2014/01/most-people-sho.html#comment-4220638">comment from Isab$30 for an eight-month supply? That's what I've been paying. Sorry, there's not a pharmacy on earth that can do better.
Amy Alkon
at January 25, 2014 11:09 AM
Well the interesting one is that I'm an honorably discharged vet in 1993.
The only thing that I ever used any of my VA benefits was about three semesters of the G.I. bill about 15 years ago. I haven't dealt with them in anyway since then and have moved many years ago.
I just got a letter and application to enroll for my VA medical benefits. They say that would automatically cover me under the unAffordable Care Act.
How did they track me down and why now?
Jim P. at January 25, 2014 11:11 AM
Amy Alkon
https://www.advicegoddess.com/archives/2014/01/most-people-sho.html#comment-4220644">comment from Amy AlkonThat's 800 pills. Here's the price for 90 pills:
http://www.goodrx.com/adderall#/?filter-location=&coords=&label=amphetamine+salt+combo&form=tablet&strength=5mg&quantity=90.0&qty-custom=
$59.95 is the cheapest. For 90. I get 800 for $30.
Please tell me again how I can surely get this cheaper if I just waste my time on the phone. Please also tell me how someone will sell me a brand new Smart car if I just call around and offer them $50 and promise to smile nicely when I sign the papers for the title.
Amy Alkon
at January 25, 2014 11:14 AM
Amy Alkon
https://www.advicegoddess.com/archives/2014/01/most-people-sho.html#comment-4220645">comment from Amy AlkonOh, and those prices -- $59.95, etc. -- are the cash price, with a coupon. It's $136 for 90 if you just walk in and pay on a credit card.
Amy Alkon
at January 25, 2014 11:14 AM
Don't you just love it when elites try to run your life? Turns out that they're not geniuses, but quite possibly as dumb as a bag of hammers.
mpetrie98 at January 25, 2014 7:02 PM
Ninety-eight percent of the adults in this country are decent, hard-working, honest Americans. It's the other lousy two percent that get all the publicity. But then--we elected them. -- Lily Tomlin
Jim P. at January 25, 2014 8:48 PM
Kaiser must be exceptional to let you get an eight month supply. Most insurance will limit you to a 90 day supply, so I assumed that was the time period you were quoting. However, if your insurance plan with Kaiser is now over double or triple what you would pay out of pocket for a doctor plus medication, you are paying way more for that Adderall than you think you are. Those costs are just hidden, and I guarantee you Kaiser is not losing any money on your prescriptions. The price they pay for them is pennies on the dollar of what they tell you the list price is.
Radwaste is correct, in that going bare might be the smarter option. You are a renter with I assume not substantial assets to protect, which is really what insurance if for,
This is why the rich self insure, and the poor visit the emergency room, and then tear up the bills. They have no credit rating to protect, so not paying medical bills hurts them not at all.
Isab at January 25, 2014 10:02 PM
Amy Alkon
https://www.advicegoddess.com/archives/2014/01/most-people-sho.html#comment-4221282">comment from IsabThanks, I'm not leaving Kaiser or my psychiatrist.
Anyone have any helpful suggestions?
Amy Alkon
at January 25, 2014 11:24 PM
Amy, I wish I had a suggestion for you... I'm now having to pay cash price for a sustaining drug, at $400/month, until my deductable is met for the year. That will be three months. After that, it will be $120/month. So we're talking ~$2200 for the year. Three years ago it was $30/month.
Cousin Dave at January 27, 2014 7:37 AM
Amy Alkon
https://www.advicegoddess.com/archives/2014/01/most-people-sho.html#comment-4223205">comment from Cousin DaveThanks, Dave, I've figured that out. But my deductible doesn't make this worthwhile. I'm going to downgrade my care in the next month (thanks, Obamacare), and frankly, I resent having to worry about this at all. For decades, I just paid my bill. Now I have to figure out whether to go through Kaiser or the "marketplace," which will mean giving the government a lot of information and possibly making myself prey for identity thieves. (You think those sites -- or any of our information -- is secure? Hah!)
Amy Alkon
at January 27, 2014 7:58 AM
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