Blue Cross cut insurance rates, but some NC customers are experiencing sticker shock
Some
The Blue Cross reduction for 2019 averaged 4.1 percent statewide for individual health insurance, which are mostly plans sold through the Affordable Care Act marketplace. The rate cut was much more significant in some parts of the state: down 21 percent in the Triangle, and down 16.5 percent in the
But it didn't necessarily work out that way for all the insurer's customers. That's because the rate cut triggered a corresponding reduction in federal ACA subsidies for low-income and middle-income customers. And some customers didn't understand the implication until it was too late.
"It is complicated -- for most people, it's incomprehensible," said
One of those caught unawares was
"It just blew me out of he water when I saw that," Austin said by phone. "I'd have come out better if they had gone up on these, not lowered the price."
The cost increase stings, because Austin, 57, is financially limited. He stays at home to care for his severely disabled adult sister, for which he's paid an annual stipend through Medicaid. On top of the monthly premiums he has to pay, the annual deductible on his health insurance is
The form letter
"I can't be the only one this happened to," he said. "I definitely won't believe that letter again."
Austin's predicament stems from the formula used to calculate ACA subsidies. Each customer's subsidy is calculated off a single health plan offered in every ACA market: the second-lowest cost "silver" plan, no matter what plan the customer buys, said
What's more, the plan used to calculate the subsidy changes from year to year, as prices change. Austin let his
The only way to know for sure what your costs are going to be is to reapply for health insurance every year, and not to rely on an insurer's estimates. The estimates are unreliable because they are sent out in the fall, before ACA subsidy amounts are known.
"Never auto-renew," Pollitz said. "Just don't."
Vevurka, the
Deputy Insurance Commissioner
As for Austin, he's stuck in his plan. His only way out is an unusual event -- such as moving, getting married or divorced, having a baby or losing a member of his household -- that would qualify him to change his health plan in a "special enrollment."
"I've come to terms with it," Austin said. "It's not meaning I like it."
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