Updated: 09/27/2013 6:58 PM
Created: 09/27/2013 5:39 PM WHEC.com
By: Berkeley Brean
A local man is fired up about a 90 percent increase in his wife's health insurance premiums, but he's not alone. There are tens of thousands of people like him in the Rochester area. They are facing potentially huge increases in their healthcare costs and insurances companies say it is because of the Affordable Healthcare Act.
The Sheehan's got a shock when they opened their health insurance information booklet from MVP Healthcare. The Sheehan's are MVP customers. The booklet shows John's monthly premium is going up 44 percent. For his wife, Molly, it's going up 90 percent.
John Sheehan, Kodak retiree, said, “I said, 'how the heck can you increase 44%? I thought that was against the law to go that much.'”
Why is this happening? The insurance companies say Obamacare cut the amount of money the federal government reimbursed the insurance companies for the kind of insurance the Sheehan's are on. It's called Medicare Advantage.
Patrick Glavey, Vice President, Medicare Programs, MVP Healthcare, said, “They're basically trying to bring down the payments to medicare advantage plans to what they think the fee for service Medicare costs are.”
Roger Van Baaren, Vice President, Medicare Sales, Excellus Blue Cross Blue Shield, said, “So we're just not getting as much per member as we expect to get.”
Then they pass part of the costs onto the consumers, but not every plan is costing more money.
A breakdown of cost increases for Medicare Advantage by the major local insurance providers. John Sheehan's increase is from $27 a month to $40.
But there's no consistency to the changes. MVP's Gold Value goes from $41 to $72 a month. Blue Choice Value Plus jumps from $74 to just $80.
Ron Brandwein, the Medicare expert at Lifespan, explains the difference.
Ron Brandwein, Lifespan Medicare expert, said, “Why does Wegmans charge differently than Tops? It's all internal to the organization.”
It's all pocketbook to the Sheehan's.
Sheehan said, Because at our age, we could have problems at any day. So you have to do that. It's a necessity.”
The fact is the plan cost differently because the benefits are different. Those are the decisions you're going to have to make during open enrollment. What kind of care do you need? What are you willing to pay? The number one warning if you decide to change insurance plans, make sure your doctor accepts the new plan.