Open Enrollment

Well, it’s that open enrollment time of year again! For those of you not sure, this is the one time of the year where you’re able to purchase or alter your current health insurance. It’s also the time of year when the insurance company notifies you that your existing insurance plan is no longer being offered and that if you do nothing, other than pay the higher premium, you will be automatically switched to the newest, most similar plan.


But it’s all bulls*#t. Anthem BlueCross notified me a couple weeks ago that I’ll be switched to the most comparable plan along with a monthly premium increase of 10%. However, they’re playing games with the term, “most comparable plan.” This new plan isn’t a plan with the same benefits. The benefits are worse. In exchange for me paying 10% more, I get a higher deductible, less prescription drug benefits and I, as the patient, am no longer in my, as a physician’s, network!


As theorized in this NY Times article about rising premiums during this 2nd open enrollment after the implementation of the Affordable Care Act, insurance companies are still dealing with rising costs of covering those with pre-existing conditions and subsidizing those that can’t afford the full price of health insurance. But how much of the increased costs are really due to the instability in the market?


From 2013 to 2014, my premium increased 90% ($266 more than the previous premium of $293). For the 2014-2015 transition, the premium is increasing 10% ($58 more than the previous premium of $559) to what the insurance company considers a comparable plan. But in truth, the most comparable plan is actually a premium increase of 36% ($201 more than the previous premium of $559). The insurance companies are supposed to have any premium increases reviewed by the respective state’s insurance commissioner to be sure premiums aren’t increasing too much. So what they do is show how premiums between two “comparable” plans are increasing by 10% or less. What the state regulatory agencies are missing is that the new updated plans aren’t comparable to the old plan. In other words, the premium increases to a truly comparable plan are much greater and the insurance companies hope you won’t notice.


I recognize that no one is sympathetic to a plastic surgeon’s complaints regarding rising insurance premiums, but this is the experience of many American’s. You too are seeing increases in your insurance premiums and there’s no end in sight. As far as I’m concerned, it just further proves how they gave the “Affordable” Care Act the wrong name!


Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.


“Dr. Kaplan is a true professional. He gave me extremely helpful and direct honest advice…I strongly recommend him.”– David S.

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