Yesterday the dreaded packet arrived from Regence BlueCross BlueShield of Oregon, just as it does almost every year. Regence tries to hide what it's doing, but the truth is apparent: us individual policy-holders are getting screwed over again.
OSPIRG lays out why Regence shouldn't get the big rate increases it asks for annually. I heartily agree. But a recent email from OSPIRG contains bad news that could have been even worse.
State officials decided to trim Regence BlueCross BlueShield of Oregon’s proposal to raise rates for more than 52,000 Oregonians with individual health insurance plans, according to documents made public by the Oregon Insurance Division. Instead of the 9.6% rate hike proposed by Regence, the Oregon Insurance Division approved an 8.9% average increase, with some consumers seeing increases as high as 15.6%. The decision will save Regence customers $9.3 million.
Regence doesn't have the guts to leave its individual policies alone and simply raise premiums by double-digit or nearly double-digit amounts each year. Gosh, that would be honestly transparent.
Which used to happen. But I guess Regence has decided that its policy-holders have reached the breaking point and won't tolerate openly paying 9% more each year when the rate of inflation and wage increases are so much lower.
So last night my wife and I looked over how the Evolve Core plan we're being forced to shift to is different from the Evolve Plus plan we have now. It didn't take long to figure out that even though our monthly premium for two people in their mid-60s actually will be about $50 less a month (5% decrease), Regence is dropping a lot of benefits.
Let's count some of the ways Regence is going to make us individual policy-holders pay more:
(1) Annual deductible per member for prescription medication coverage goes up from $1,000 to a freaking $3,500. My wife has some pretty expensive prescriptions, including a dry eye medication, Restasis, that Regence was forced to pay for after we won a lengthy appeal. (See my post, "Regence Blue Cross of Oregon: incompetent beyond belief.")
Now we'll have to pay $2,500 more out of pocket each year before my wife's deductible is fulfilled. That eats up way more than the $600 a year we'll save on the lower premium for the much crappier Evolve Core plan we're being forced into.
(2) No more coverage for routine eye exam. l guess Regence wants its policy-holders to go blind from undiagnosed/untreated glaucoma, or whatever. I have eyes which need contact lenses. Last year I had a bit of a scare when a screening test showed elevated pressure in my eyes. (Only good news was that I might be eligible for medical marijuana!)
A re-test showed normal pressure. Regardless, people should have regular eye exams, especially as they pass middle age. But Regence is dropping this important preventive benefit. "Not covered" is shown for the Evolve Core plan under "routine eye exam for adults/children and vision hardware." Very short-sighted, Regence.
(3) No more coverage for mental health care. Crazy, what Regence has done. Our Evolve Plus plan covered 6 days of inpatient care a year, and 12 outpatient visits a year (after deductible and coinsurance). My wife is a retired private practice psychotherpist. She was shocked to see that the new Evolve Core plan doesn't include any mental health benefits. OSPIRG, also, in this cogent analysis of what's being cut by Regence.
We both thought that "mental health parity" was the law for health insurance in Oregon. Well, it is. But only for group plans. Apparently us individual policy holders are supposed to go quietly insane without getting any treatment. After learning how shitty our new insurance plan is going to be, compared to our old one, my wife and I are mildly depressed. But we have to hold ourselves together, since Regence won't be any help to us if we fall apart.
There's more bad news, such as an increase from $25 to $35 in the co-pay for office visits. But I've hit the worst policy changes, from our perspective.
Thankfully, I've only got to put up with Regence of Oregon for a bit more than a year. Then I'll be eligible for Medicare -- six words which, when I was younger, I thought I'd never want to utter. Yet since I dislike Regence so much, getting on Medicare is going to be a joy.
Give me my government health care! There's no way it can be more annoying, bureaucratic, hard-hearted, and expensive than the private health care I get now (occasionally, when Regence is forced to provide it).
My immediate strategy to keep as much money as possible out of the hands of the highly paid Regence executives is to raise our deductible considerably. We can save around $5,200 a year by moving to a $7,500 rather than $2,500 deductible. That'll more than pay for the extra prescription drug costs Regence is forcing on us.
ABC News has a good piece on when it makes sense to get a high deductible health insurance policy. Basically, if you're in decent health, with no chronic conditions requiring predictably expensive medical care, and can afford whatever the deductible amount is should you have to pay it.
Here's another consideration: in our case, we'll save a total of $5,200 by my wife and I each moving from a $2,500 to a $7,500 deductible. So even if one of us needs $7,500 in medical care, we'll still come out a few hundred dollars ahead by getting a policy with a $5,000 higher deductible. Only if both of us need that much care will we lose money. And since we're pretty darn healthy, chances are neither of us will, so we'll come out $5,200 ahead.
There's no way Regence's rate increases can be blamed on the Affordable Care Act.
Regence has been increasing premiums by double-digits, or nearly so, every year for a long time. Wikipedia says that by 2016 individual policy holders likely would see a 10% to 13% total increase in premiums per person, and much of this would be offset by subsidies that, for lots of people, would make premiums less under the Affordable Care Act.
Since many provisions of the Affordable Care Act haven't been fully implemented by insurance companies yet (for instance, the annual limit minimum is now at $2 million, instead of the unlimited amount called for by the ACA) likely new benefits required by the ACA account for only a few percent of the nine percent rate increase Regence just inflicted on individual policy holders.
Lastly, here's what's really pathetic: two years ago I blogged about how bad the new Regence Evolve Plus plan was compared to the policy I had before. Now I'm justifiably complaining about how bad the new Regence Core plan is compared to the Evolve Plus plan.
Regence of Oregon just keeps offering crappier plans to its policy-holders. Higher costs, lower benefits.