View Full Version : So how much is your insurance going up due to Obamacare?
I've been paying $110 a paycheck (twice a month) for the past year or so. Single, no dependents, PPO. HR gave us some estimates today, and it looks like I'm going to be paying $175 every paycheck. This is the biggest jump we've ever had. In the past, the increase has been no more than $20/paycheck.
ApatheticNoMore
10-28-13, 8:20pm
I've been paying a bit over $150 a paycheck for an identical situation. I can't possible know how much it will go up as benefits do not follow the calendar year and won't be known until into the new year (making switching to the exchange a not particularly practical idea even if for some reason I wanted to). It went up about $30 a paycheck to this current rate from last year. So big jumps are not new, but I suppose it might be even worse. It honestly wouldn't surprise me if I'm paying $200 a paycheck ($400 a month) soon - not even including what the employer contributes.
Mine stayed flat this year at $112/month for my portion. The high deductible option actually went down in price this year and the deductible and max out of pocket for it both went down as well.
gimmethesimplelife
10-28-13, 9:30pm
Interesting.....I was on yahoo news before I logged in here, reading about a married couple in their 50's who fled to Costa Rica for affordable health care. They spent two years there and then went to retire in Nicaragua, where their dollars stretched even further and health care cost yet less. I am of the opinion that with a few more rounds of price increases for health insurance, more and more people will be looking into leaving the US - it will become a more practical solution as more folks are priced out of access to health care. Part of me cherishes the day this happens as there's a part of me that's like, I told everyone so, and part of me dreads this happening as other countries will be overrun with Americans fleeing a bad deal. But I don't read the future, and who knows if what I believe will come to pass? There's nothing like being stretched to the limit with no room to give to make you think outside your personal box, though.
Back to Tradd's question - for me it will be different as I qualify this year for Medicaid under the new guidelines. It will be next to free with minor check in copays for services. I might still keep going to Mexico if the waiting time for an appointment becomes unreal, which I think may be a consequence. I have had a few people ask me lately for the name of my doctor in Mexicali, just in case. But for me ObamaCare is a different scenario than it is for others here, and like so many things in this country, it all boils down to social class and this fact does not get adequately addressed. Rob
iris lilies
10-28-13, 9:33pm
I've been paying $110 a paycheck (twice a month) for the past year or so. Single, no dependents, PPO. HR gave us some estimates today, and it looks like I'm going to be paying $175 every paycheck. This is the biggest jump we've ever had. In the past, the increase has been no more than $20/paycheck.
While I would love to pin this on The Prez (and who knows? maybe later I will!) I would not do it yet unless you have evidence from an objective source. Things to consider:
1) your company did poorly at negotiating health insurance this year and costs shot up
2) your Management decided to stop eating cost increases and just passed them on to you, conveniently scapegoating the Prez
I think 1600 Penn Ave should to hire me as an apologist for them.
iris lilies
10-28-13, 9:34pm
Back to Tradd's question - for me it will be different as I qualify this year for Medicaid under the new guidelines. It will be next to free ...
Score!
See Tradd, there are winners and losers. You need to finagle to get to the right side.
gimmethesimplelife
10-28-13, 9:42pm
Score!
See Tradd, there are winners and losers. You need to finagle to get to the right side.True, Iris Lilly, there will be winners and losers. Would you want to live at my income level to be a "winner" on this one? I'll go out on a limb here and guess that most people would not. But I also understand that people such as Tradd will be stretched yet more, meaning such people will have less disposable income, so there go more restaurant jobs and retail jobs down the drain.....
There really is no way to win in the game of American health care unless you are very well to do is my opinion. But ObamaCare at my level is indeed better than nothing. Too bad the government wont pay for me to go to Mexico for my care - they'd save money and I would experience higher quality - amazing how just crossing a border (after having done lots of research, mind you) can make this situation win/win - but staying in the US for health care aids and abets a system which creates health care "winners and losers". Doesn't say much for the American way, at least as far as health care is concerned, does it? Rob
..... But for me ObamaCare is a different scenario than it is for others here, and like so many things in this country, it all boils down to social class and this fact does not get adequately addressed. Rob
Rob, you're always mentioning social class as if it's some kind of caste system that you can never escape. Deep down, you know that's not right dontcha?
gimmethesimplelife
10-28-13, 10:01pm
Rob, you're always mentioning social class as if it's some kind of caste system that you can never escape. Deep down, you know that's not right dontcha?To some degree I do consider this a caste system. Yes, I truly do. When I say this I don't mean quite the extreme of how caste systems work in India - but Alan, you strike me as being well read and up to date on things. You probably are aware of recent research ranking the US dead last in the developed world for upward social mobility - and heavily socialistic countries like Denmark - which was #1 in upwards mobility in the developed world - come out on top. I think it's a good thing that not a lot of folks on my end of the scale are aware of this and how it affects them. Good thing - this is the stuff revolutions are made of.
Deep down for me anyway, much of how things are in the US don't work especially well, no. Not your point I guess but it is my truth. Rob
try2bfrugal
10-28-13, 10:03pm
I haven't signed up yet on the exchange, but it looks like our will go down over $2K a month for a much better policy.
I have paid up our current insurance through the end of the year and I hope that is the last premium I will have to make for 4 figures a month. We did have one family member have unusually high medical expenses this year, so my only consolation is even at our current premiums the insurance company will still be paying out much more than we paid in.
iris lilies
10-28-13, 10:08pm
To some degree I do consider this a caste system. Yes, I truly do. When I say this I don't mean quite the extreme of how caste systems work in India - but Alan, you strike me as being well read and up to date on things. You probably are aware of recent research ranking the US dead last in the developed world for upward social mobility - and heavily socialistic countries like Denmark - which was #1 in upwards mobility in the developed world - come out on top. I think it's a good thing that not a lot of folks on my end of the scale are aware of this and how it affects them. Good thing - this is the stuff revolutions are made of.
Deep down for me anyway, much of how things are in the US don't work especially well, no. Not your point I guess but it is my truth. Rob
I gotta point out, Rob, that in the victim game--you are a college educated white man. You are The Enemy as identified by any number of feminist and race thinktanks and sources that are embodied in gubmnt programs.
I, OTOH, am a downtrodden female. I am also in another protected class, older-than-40.
I. Beat. You.
so there!!!! hahaha. Where' my gubmnt money?
gimmethesimplelife
10-28-13, 10:14pm
I haven't signed up yet on the exchange, but it looks like our will go down $2K a month for a much better policy.I've noticed this, too. Some people who sign up on the actual exchanges and won't get Medicaid will be getting a better deal and some won't. I think (?) this may have to do with location to some degree - some markets such as Arizona are more competitive due to having to many insurers in the first place due to so many seniors living in the area. And I have even seen advertising here - I really have - get this - stating - YOU DON'T HAVE TO GO TO MEXICO We will work with you on fees. Wow. I was blown away when I saw this - to me it's proof the US system doesn't work when even advertising is addressing the insane costs.
But I'm digressing. It also seems that people who live in rural areas may be getting clobbered due to lack of competition, and also those with catastrophic policies will get clobbered as those rates with the skimpy coverage will be no more if you are over 30. I feel for the rural folks, I really do, as urban life is not for everyone, I have problems with it too after all these years in it. For the catastrophic coverage folks I'm 50/50 on - especially since if this policy is all they could afford, with the federal credits towards your policy based on income, some will be paying less for better coverage. Rob
ApatheticNoMore
10-28-13, 10:16pm
I've gotta point out, Rob, that in the victim game--you are a college educated white man. you are The Enemy as identified by any number of gubmnt programs.
I don't have any of that, not a degree, not a male. I'm definitely most oppressed-es.
Agree that we cannot say the rise in health insurance premiums is strictly due to Obamacare coming online. The inability to rein in costs, along with the amazing technological advances in medicine, is certainly two of the bigger factors.
Just anecdotally, I'm amazed at the people I know in my extended circle who have had hip and knee replacements, laser eye surgery, extensive fertility treatments, expensive pharmaceuticals for various ailments, extreme treatments for terminally ill family members in their last months, etc. etc. All these things that were mostly unknown to our parents and grandparents, yet are now expected to be provided and available to everyone. That costs money.
iris lilies
10-28-13, 10:21pm
I don't have any of that, not a degree, not a male. I'm definitely most oppressed-es.
La-dees and Gentlemen, we have a winner! ding ding ding!
gimmethesimplelife
10-28-13, 10:23pm
I gotta point out, Rob, that in the victim game--you are a college educated white man. You are The Enemy as identified by any number of feminist and race thinktanks and sources that are embodied in gubmnt programs.
I, OTOH, am a downtrodden female. I am also in another protected class, older-than-40.
I. Beat. You.
so there!!!! hahaha. Where' my gubmnt money?Funny thing IL is that I DON'T consider myself to be a victim per se - The same truth I am living and experiencing a great many others are, too. I am certainly not being singled out for anything - America is just like this for many of it's citizens now. But lol I'm also in your older than 40 protected class, I'll be 47 in a few weeks.
I'm actually flattered in a strange way that ANYONE could blanketly cast me in the role of the enemy. Seriously. I may be the college educated white male but whatever privilege that is supposed to mean or grant me just didn't pan out in my case. Those folks you refer to in the thinktanks may be making better money than I do - or at least in the area of my income. If anything I speak their language better than they do - my twist on it is that I don't really blame anyone but those at the very top who are completely above their actions having any consequences anyway. And as to your government money - did Missouri expand Medicaid? I'm not sure but I think it was one of the states that didn't? Make what I make and get yourself to a state with expanded Medicaid and you too can have this government money - no one is stopping you if this is your wish. Rob
iris lilies
10-28-13, 10:23pm
.... All these things that were mostly unknown to our parents and grandparents, yet are now expected to be provided and available to everyone. That costs money.
Well, no chit. Here is the crux of the problem.
Can hardly wait for the death panels to be assembled, yet--oh, wait. Here in the US of A no one will make those decisions. Do you actually see anyone in Congress supporting limits on ANY kind of health care? I do not.
....Just anecdotally, I'm amazed at the people I know in my extended circle who have had hip and knee replacements, laser eye surgery, extensive fertility treatments, expensive pharmaceuticals for various ailments, extreme treatments for terminally ill family members in their last months, etc. etc. All these things that were mostly unknown to our parents and grandparents, yet are now expected to be provided and available to everyone. That costs money.
The biggest expense for our company plan are all related to obesity, mainly knee & hip problems, and our workforce is relatively young, mostly 30's and early 40's. In order to save money, we invest quite a bit into wellness incentives, healthy eating, on-site exercise facility, cash payouts for involvement in regular exercise activities, on-site food subsidies in our cafeteria, etc. Our insurance provider gives us credits for all those things, but I'm not convinced they've helped much.
gimmethesimplelife
10-28-13, 10:40pm
Well, no chit. Here is the crux of the problem.
Can hardly wait for the death panels to be assembled, yet--oh, wait. Here in the US of A no one will make those decisions. Do you actually see anyone in Congress supporting limits on ANY kind of health care? I do not.Here I agree with you. All this care that was not available for earlier generations is now expected and it all costs money. To keep offering this level of care to those 65 and over, and to those entering the Medicaid system via the expansion, we have to burrow obscene amounts of money to finance the whole charade. This is yet another reason I feel uneasy about the future of the US - I may be a liberal but I also understand that this burrowing is not sustainable for the long term. What is the answer, seriously? The only sane answer I see is leaving the US - can anyone think of another one, really, this is practical and would work? I'm all ears and I mean it sincerely. Rob
...You probably are aware of recent research ranking the US dead last in the developed world for upward social mobility - and heavily socialistic countries like Denmark - which was #1 in upwards mobility in the developed world - come out on top.
No, I'm not aware of that "research". What I am familiar with is this country's fairly unique trait of allowing virtually everyone to rise from poverty to relative prosperity if they desire to do so.
gimmethesimplelife
10-28-13, 10:45pm
No, I'm not aware of that "research". What I am familiar with is this country's fairly unique trait of allowing virtually everyone to rise from poverty to relative prosperity if they desire to do so.By all means, google Denmark best for upward mobility and click on the first thing that pops up. Read the charts at the bottom of the page - it may open your eyes to some truths about the US.....along the lines of what I tend to discuss. Rob
ApatheticNoMore
10-28-13, 11:30pm
I'm actually flattered in a strange way that ANYONE could blanketly cast me in the role of the enemy. Seriously. I may be the college educated white male but whatever privilege that is supposed to mean or grant me just didn't pan out in my case.
yea how this is usually talked about is "intersectionality", the term is all the rage. That while you may not be in a particularly privileged position - as a white male you are still in a better position than say an African American male in the same economic situation. You are still less discriminated against say in hiring etc. than they would be. So there's still racial privilege there. Even in poverty there can be racial privilege. I don't wade deep into those discussions, because I view it as walking into a war zone. But that's how it's done, that there are various forms of privilege that exist as part of the social structure in existing society (race, class, even gender) and you can still have privilege even if your not a rich white hetrosexual non-trans male. Now the existence of privilege or being privileged in some way does not necessarily equal being "an enemy".
iris lilies
10-29-13, 2:18am
True, Iris Lilly, there will be winners and losers. Would you want to live at my income level to be a "winner" on this one? ... Rob
I don't know, but DH and I can get down and dirty frugal (especially him--I swear that man could lively richly on $12,00 a year) but for our extensive household of pets.
But I'll have to check out those states that expanded Medicaid as you said, my state isn't one of them.
Agree that we cannot say the rise in health insurance premiums is strictly due to Obamacare coming online. The inability to rein in costs, along with the amazing technological advances in medicine, is certainly two of the bigger factors.
Just anecdotally, I'm amazed at the people I know in my extended circle who have had hip and knee replacements, laser eye surgery, extensive fertility treatments, expensive pharmaceuticals for various ailments, extreme treatments for terminally ill family members in their last months, etc. etc. All these things that were mostly unknown to our parents and grandparents, yet are now expected to be provided and available to everyone. That costs money.
Yes. Health care costs have been rising for decades. The olden days when people paid the doctor in eggs and chickens and went to hospitals only to die are long gone. My late husband's cancer diagnosis cost $10,000 - just the diagnosis. I'm sure the treatment (VA) was in the hundreds of thousands.
How would I know? I'm not spending hours on the computer trying to get a quote. Maybe in a few months I'll have an idea. I'm sitting on quite a bit of cash right now, so I can show a lower income for several years and get a subsidy if I want.
And Rob, all I hear from you is excuses. My Father use to tell me if things didn't work out like I planned, I didn't plan well enough. No one is keeping you down but yourself. Do you really believe the Man is keeping you down all these years. Did you contact Bae and take him up on his offer? Are you looking at areas in the country that are hiring? Have you looked at work that pay's better? You can get a job in fast food in St. Louis and make more that $20,000 a year. You could probably be management material in no time.
I'm retired and pay a fixed percentage of former employer supplied insurance. My insurance cost went down slightly.
I was wondering if one of the reasons folks insurance is going up under the ACA is because their previous insurance did not meet requirements for coverage and the increase will provide a better plan with improved coverages or lower deductibles?
I received a letter from my private insurance carrier - Blue Cross - saying that my policy will be cancelled on Dec 31 and I needed to purchase a new policy on the Calif exchange. According to the news this morning over 2 million people in the US - 800,000 in New Jersey alone - are having their policies cancelled at years end and must buy new policies. In my case, a new bronze level policy will cost about 2 - 3 times what I am currently paying and have a much higher deductible - about $3000 higher than my current $4000 deductible. However, being lucky (or unlucky depending how you look at it), as a vet with a service-connected injury/disability I can use the VA healthcare system for a very low cost. So that is what I'll do while I try to find a more affordable private policy. I am also very lucky in that, while low income enough to qualify for Calif's expanded medicaid program (but don't intend to sign up), I have a fair amount of financial assets so that I can afford to pay for the increases in my private insurance since I don't qualify for any subsidies. And even more lucky that I am very healthily and very fit so can get a job doing anything (and I hear Bae is hiring ditch diggers :-) ) if I don't want to spend down my retirement savings. Of course going back to work may actually kill me after all these years off :-)
I'm retired and pay a fixed percentage of former employer supplied insurance. My insurance cost went down slightly.
I was wondering if one of the reasons folks insurance is going up under the ACA is because their previous insurance did not meet requirements for coverage and the increase will provide a better plan gwith improved coverages or lower deductibles? Yes, that is a big part of why rates are rising as many people, myself included, don't have ACA required levels of coverage. For example my policy doesn't cover maternity or childbirth stuff or mental illness - two thing I don't need but will have to have under the ACA. However, from what I've seen, the new plans are not only much more expensive for monthly premiums, but they have much higher deductibles and out of pocket expenses too. Also many of the bronze level plans only cover 60% of your costs even after your deductible of $6 k to $7k is met. So some people, even emloyed people, may see price increases that way too. Sometimes double what they pay now. At least that is in my case.
Another reason prices are increasing is that insurers now need to cover all those people who have pre existing conditions and need high cost medical care. So, according to the Blue Cross CEO, they need to raise rates for many people with previously low rates to compensate for that.
And a third reason I think prices are increasing is because there is nothing in place but the goodwill of private insurance companies to stop them from increasing costs. No provisions to keep costs low under the ACA. And with Uncle Sam willing to foot much of the bill, and a mandate that says you must buy insurance, you've taken away any incentives for insurers to keep rates low. Except out of the kindness and generousity of their hearts of course :-)
It occurs to me that the primary beneficiaries of the ACA might be the insurance companies.
I know that this is counter intiutiive, but I keep checking the prices at aetna, and they keep going down. The last time I looked, the one I would get for $335 before is now going for $260.
That being said, yes, I do have to cover things that I don't need, which increases the prices. But, we also qualify for the subsidies, so there is that. Well, technically, we currently qualify for medicaid. It's probably the only benefit I'll utilize until we're on our feet.
And DH and i are both looking for jobs, running business contracts, and also looking at "basic work" like working at the grocery store.
It occurs to me that the primary beneficiaries of the ACA might be the insurance companies.
Surprise! It's not like middle class America has big mover and shaker lobbyists in Washington.
iris lilies
10-29-13, 10:01pm
Idle curiousity: if there is little to no social "caste" in those Scandanavian countries, how can there be upward mobility? Are they counting side to side movement? In a country where everyone is alike, how does one measure mobility?
Inquiring minds want to know.
You probably are aware of recent research ranking the US dead last in the developed world for upward social mobility - and heavily socialistic countries like Denmark - which was #1 in upwards mobility in the developed world - come out on top. I think it's a good thing that not a lot of folks on my end of the scale are aware of this and how it affects them. Good thing - this is the stuff revolutions are made of.
I'm one of the first to think a little revolution is a good thing, but not sure how it would apply here. I may just be ignorant or distracted, but have not seen the research that pegged the USA last in upward mobility. Having come up from the bottom of the privileged barrel (white...yes....male...yes...trust fund?...6 bushels of corn and a sense of humor) I am somewhat satisfied with the opportunity available to US citizens willing to pay attention and put in some time. I've also had the chance to see a few other places around the world where I don't believe those same opportunities exist. Can we do better? Of course. Should we? Yup? Are we the worst? Not by a long shot.
Idle curiousity: if there is little to no social "caste" in those Scandanavian countries, how can there be upward mobility? Are they counting side to side movement? In a country where everyone is alike, how does one measure mobility?
Inquiring minds want to know.
I wonder if Scandinavian countries measure "upward mobility" differently - as a collective rather than an individual quality? Perhaps a situation where the entire populace receives small incremental benefits, so that the whole population is upwardly mobile as it becomes healthier and better educated compared to what it was X units of time previously? Scandinavian countries might have different societal values, hence would use different measures of success and mobility.
I heard a very interesting definition of Western economics in one of my classes last week: Society is either the hindrance to the individual maximising his/her personal wealth and privileges, or the medium through which the individual maximises her/her personal wealth and privileges!
Idle curiousity: if there is little to no social "caste" in those Scandanavian countries, how can there be upward mobility? Are they counting side to side movement? In a country where everyone is alike, how does one measure mobility?
Inquiring minds want to know.
People aren't all alike in those countries. :laff::laff::laff:
There are those who just work the bare minimum, and there are business owners, and all folks in between. Bakers, cobblers, waitresses, etc... They don't all get paid the same $5!
A far as upward mobility, it's just that those societies are more conducive to upward mobility if one so desires. Easier to start a business, easier to get the college education needed, etc...
It occurs to me that the primary beneficiaries of the ACA might be the insurance companies.
Spot on.
Yes, that is a big part of why rates are rising as many people, myself included, don't have ACA required levels of coverage. For example my policy doesn't cover maternity or childbirth stuff or mental illness - two thing I don't need but will have to have under the ACA. However, from what I've seen, the new plans are not only much more expensive for monthly premiums, but they have much higher deductibles and out of pocket expenses too. Also many of the bronze level plans only cover 60% of your costs even after your deductible of $6 k to $7k is met. So some people, even emloyed people, may see price increases that way too. Sometimes double what they pay now. At least that is in my case.
Another reason prices are increasing is that insurers now need to cover all those people who have pre existing conditions and need high cost medical care. So, according to the Blue Cross CEO, they need to raise rates for many people with previously low rates to compensate for that.
And a third reason I think prices are increasing is because there is nothing in place but the goodwill of private insurance companies to stop them from increasing costs. No provisions to keep costs low under the ACA. And with Uncle Sam willing to foot much of the bill, and a mandate that says you must buy insurance, you've taken away any incentives for insurers to keep rates low. Except out of the kindness and generousity of their hearts of course :-)
Heard on the news this morning another reason rates are going up to add to this. Not enough people signing up on the exchanges. Apparently the insurance companies, especially the smaller ones, expected a larger turn out then they are getting and all their projected rates were based on that larger turn out. Now that so few people are signing up, they have to raise rates for everyone, including their group rates for employer-funded insurance, to meet their profit margin or at least their break even point. This may change once the exchange websites are fu ctioning better and more people apply. Although it's doubtful insurance companies who have already raised their rates will drop them lower but who knows.
It occurs to me that the primary beneficiaries of the ACA might be the insurance companies.I'm not so sure. They are now required to assume a huge level of actuarily unsound risk in order to ensure that individuals don't have to. There's a cost associated with that and we may find out over this next year that it's currently too low.
Heard on the news this morning another reason rates are going up to add to this. Not enough people signing up on the exchanges. Apparently the insurance companies, especially the smaller ones, expected a larger turn out then they are getting and all their projected rates were based on that larger turn out. Now that so few people are signing up, they have to raise rates for everyone, including their group rates for employer-funded insurance, to meet their profit margin or at least their break even point. This may change once the exchange websites are fu ctioning better and more people apply. Although it's doubtful insurance companies who have already raised their rates will drop them lower but who knows.
I think one of the fears is that young healthy people will just choose to pay the penalty, which is less than $100 the first year. And the older people who are more prone to illnesses and the people with pre-existing conditions will sign up. Of course that will make things more expensive, if not unmanageable.
The news I heard today was that about 5% of the people who were previously insured would see an increase in their rates. It's such a mess so far I doubt if anyone really knows.
Yes. Health care costs have been rising for decades. The olden days when people paid the doctor in eggs and chickens and went to hospitals only to die are long gone. My late husband's cancer diagnosis cost $10,000 - just the diagnosis. I'm sure the treatment (VA) was in the hundreds of thousands.
But anyone want to bet how this is going to be spun on Fox News? "You're paying more because of Obamacare."
End of story.
The biggest expense for our company plan are all related to obesity, mainly knee & hip problems, and our workforce is relatively young, mostly 30's and early 40's. In order to save money, we invest quite a bit into wellness incentives, healthy eating, on-site exercise facility, cash payouts for involvement in regular exercise activities, on-site food subsidies in our cafeteria, etc. Our insurance provider gives us credits for all those things, but I'm not convinced they've helped much.
Our company is pursuing the wellness activities too. But I'm not ready to say the hip/knee replacements are mainly due to obesity. Again, anecdotally, the people in my extended circle really vary: maybe 2 due to obesity; a few due to accidents including falling off a roof, a motorcycle accident, and a car accident; the rest are due to participating in extreme sports after the age of 50. I mean doing things like marathons and parasailing in your 60s+.
All of that is fine, but again, in our parents or grandparents time, people in that age group weren't generally doing the risky type of sports, and if they did break a bone, they could expect to be using a cane, not getting replacement medical devices in expensive surgeries.
Finally, I'm not sure doctors would even do knee replacements for obese patients. A friend's mother was told she would have to lose 100 lbs before the doctor would operate. She did so, and only then did she have the surgery.
But I'm not ready to say the hip/knee replacements are mainly due to obesity. Again, anecdotally, the people in my extended circle really vary: maybe 2 due to obesity; a few due to accidents including falling off a roof, a motorcycle accident, and a car accident; the rest are due to participating in extreme sports after the age of 50. I mean doing things like marathons and parasailing in your 60s+.
. This is my experience too. Younger, healthy, fit people (including myself) that I know seem to have many more sports related injuries requirering expensive surguries and long rehabs then the older people (say in their 60's and above). Many older people don't suffer chronic illnesses until they are much older and often retired so probably doesn't effect an employers insurance coverage too much. Or they can be more easily forced into retirement due to illness when they are older. The only medical care I have ever needed was when I hurt myself badly on a motorcycle in my teens and then in my early 40's from a volleyball injury. That surgury and year long rehab was extremely expensive and covered mostly by my COBRA insurance I still carried from my previous employee. Oh yeah, and I was injured while in the military but dear Uncle Sam paid for that :-)!
jennipurrr
11-1-13, 5:09pm
I read an interesting article a year or so back about smokers and obese people...that they die so much earlier and of fairly quickly life ending diseases, that they rarely have all the drawn out health care costs of aging, assisted living, etc. The study was not from the US but I did think it was an interesting perspective, counter to what the general prevailing thought is on the topic.
Now, my employer is gung ho on the wellness/anti-smoking stuff as smokers and obese folks cost them much more health care wise month to month. I guess if the cost savings of early death are actually true, it is probably saving Medicare rather than employer insurance.
My insurance cost is staying the same I believe. Irislillies, I also wondered if the raises this year were amounts employers would normally eat some of to prevent employee backlash, but now have "obamacare" to blame it on, so they took advantage of the opportunity to charge it all to the employees.
I've been paying $110 a paycheck (twice a month) for the past year or so. Single, no dependents, PPO. HR gave us some estimates today, and it looks like I'm going to be paying $175 every paycheck. This is the biggest jump we've ever had. In the past, the increase has been no more than $20/paycheck.
I'm not sure - we haven't had our renewal yet. My husband's has gone down!
MMM's most recent blog article is called "Obamacare, Friend of the Entrepreneur and Early Retiree" which I found interesting.
http://www.mrmoneymustache.com/author/eminem/
try2bfrugal
11-3-13, 5:23pm
I just got the letter our current policy is being cancelled. Their suggested replacement policy is $800 per month cheaper. We will actually do better than that on the exchanges because we can get subsidies next year.
Simpler at Fifty
11-3-13, 6:15pm
http://www.kaiserhealthnews.org/Stories/2013/October/21/cancellation-notices-health-insurance.aspx
I read this information last week. It is also referenced in the MMM article Rogar has in his post.
I just got the letter our current policy is being cancelled.
http://www.youtube.com/watch?v=JCUpJDzyRnY
try2bfrugal
11-3-13, 8:17pm
Bae, I'm being offered a better policy for $800 less a month, and that is without any subsidies. I don't know what our income will be next year between being self employed and maybe doing some 401K draw downs, but with insurance from the exchanges our premiums will be from $4 to maybe a couple hundred a month.
I'm going to save $25K in premiums alone in 2014.
That may be, but you are not able to keep your current one :-)
gimmethesimplelife
11-4-13, 1:06am
That may be, but you are not able to keep your current one :-)I rather think in this case that Try2bfrugal is celebrating the reduction in insurance costs and embraces fully the new policy thanks to ObamaCare.....Saving 25K is nothing to sneeze at, that's two years of my life expenses (roughly) since food and beverage declined starting in 2008. I'm glad to hear someone with a positive outcome, not just negative stories from people who are losing their bare bones plans. Rob
That may be, but you are not able to keep your current one :-)
Presidents have not exactly been known for their veracity and rectitude.
[QUOTE=bae;158905]That may be, but you are not able to keep your current one :-)[/QUO
:doh:
So, in my case, my family has an existing policy, which isn't a very good one, and is pretty expensive. It took a bit of time to locate and negotiate this policy.
I am now told it's not "good enough", yet I can't easily purchase a new policy yet, because of the superb job they did rolling this scheme out on such short notice...
So I'm going to have to invest more time and worry to get coverage. I'd been relying on "you can keep your current policy" to get me through until the dust settled on the new programs, but that's not really possible. I would have been happy to keep it for "a while". Can't. Obama lied.
Once the dust settles, at least I'll know that Alan will be paying for my New Improved Policy out of his tax dollars, so at least that's something.
gimmethesimplelife
11-4-13, 6:58pm
So, in my case, my family has an existing policy, which isn't a very good one, and is pretty expensive. It took a bit of time to locate and negotiate this policy.
I am now told it's not "good enough", yet I can't easily purchase a new policy yet, because of the superb job they did rolling this scheme out on such short notice...
So I'm going to have to invest more time and worry to get coverage. I'd been relying on "you can keep your current policy" to get me through until the dust settled on the new programs, but that's not really possible. I would have been happy to keep it for "a while". Can't. Obama lied.
Once the dust settles, at least I'll know that Alan will be paying for my New Improved Policy out of his tax dollars, so at least that's something.And provided that I make some money on Etsy from low end jewelry I'm making, my tax dollars too. Only difference is I won't be complaining about this - I'll actually be cheering it as progress. Rob
gimmethesimplelife
11-4-13, 6:58pm
[QUOTE=bae;158905]That may be, but you are not able to keep your current one :-)[/QUO
:doh:Totally agreed with you here Peggy LOL. Rob
Our insurance has been going up every year for some years now, so I can't blame it on Obamacare.
Our insurance has been going up every year for some years now, so I can't blame it on Obamacare.
Several of the CEO's of some of the bigger insurers who are now part of the calif exchanges(BlueCross, Kaiser, Healthnet) have been on TV news reports saying that they are raising rates because of Obamacare - and not just for those with bare bones plans that are being eliminated, but for employer-funded group plans as well. They said that because they have to cover those with preexisting conditions now, and at lower rates, they have a higher risk pool and potentially more costs they have to account for. So basicly some people will see rates rise and some will see them drop and some will get subsidies and some will get medicaid and some will get nothing (and go wee wee wee all the way home :-) ) - all due to obamacare.
Well, don't sign on the insurance dotted line just yet. Surprise surprise..the insurance companies are using fear and ignorance of the ACA to gouge people even further.
http://www.addictinginfo.org/2013/11/05/insurance-companies-obamacare-scam/
And many are still against the ACA which is, at it's core, just a set of regulations to keep the insurance companies from ripping off customers. Oh the irony!
But don't cry for the poor, poor insurance industry. They still have, and apparently always will have, plenty of people who, with a completely straight face, will jump up in sanctimonious chest beating outrage..OUTRAGED that people will have the HUMILIATING (and completely socialist I'm sure) experience of saving 2..3..4 hundred dollars a month.
Obama didn't lie. By the law, you could keep your policy...if you didn't have a soul sucking, greedy insurance company trying to gouge you for every dime it could. It's not Obama's fault that your insurance company saw a mark, and decided to go for it, just like any con.
The real show will be to see how many people who are being conned by their insurance company will say "See, I caught you.." and still buy from THE SAME COMPANY!
Don't go to restaurants that spit in your food, and don't buy insurance from a company that 'spits' on your health care!
Pretty simple, really.
I agree Obama didn't lie but he was duped. And he should have had the foresight to see this coming. Even knuckle headed and uninformed little ole me asked the members here a year ago what was in place to keep insurers from raising rates - especially if it was legally mandated that you must buy insurance and the feds would be paying a large portion of those costs right to the insurance companies directly via subsidies? Or changing policies? Or even joining the exchanges in the first place? Or employers dropping employee coverage and having them buy their own? Or reducing workers hours to avoid the employer mandate? If these were things I saw as a possibility, then surely someone in the Obama admin saw it as well and made accomadations for those possibilities. But doesn't seem they did. Lied? No. Naive? Maybe.
And Some of us may have no choice it to buy from the same insurance company even when theychange rates as that may be the only affordable option.
I agree Obama didn't lie but he was duped..... If these were things I saw as a possibility, then surely someone in the Obama admin saw it as well and made accomadations for those possibilities. But doesn't seem they did. Lied? No. Naive? Maybe.
http://www.forbes.com/sites/theapothecary/2013/10/31/obama-officials-in-2010-93-million-americans-will-be-unable-to-keep-their-health-plans-under-obamacare/
I suppose if someone really wanted to, they could convince themselves that the President didn't intentionally mislead the country all those dozens (hundreds?) of times he told us "If you like your policy, you can keep your policy. Period!"
Personally, I have trouble buying that since it's been well documented that his administration has been aware for the past three years that an estimated 93 million people with existing policies would not be able to keep them.
So, if you want to go with the "he was duped" defense, I suppose that it's possible. He's told us on many occasions that he didn't know about most of his administrations most embarrassing revelations until he heard it on the news. I don't believe that, but who am I to disagree with his inadvertent admissions that he is out of touch?
It is interesting to see the numbers the news estimates for people who will have/had cancelled policies. 93 million seems awfully high to me. That's almost a third of the country This article says 2 million. Maybe I am missing something in semantics. http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/ I saw other articles estimating 3.5 million and the highest one I found besides the Forbes article was 15 million.
It still doesn't get Obama off the hook, but doesn't add much credit to the Forbes article either.
And now this - they did a bad job on the security... Who would have guessed?
http://www.cbsnews.com/8301-505263_162-57610825/obamacare-website-security-tests-never-finished-before-launch/
"White House Press Secretary Jay Carney said, "Consumers can trust that their information is protected by stringent security standards."
Lies.
Lied? No. Naive? Maybe.
Apparently it is just too much to ask that our leaders be both honest and competent.
http://www.forbes.com/sites/theapothecary/2013/10/31/obama-officials-in-2010-93-million-americans-will-be-unable-to-keep-their-health-plans-under-obamacare/
I suppose if someone really wanted to, they could convince themselves that the President didn't intentionally mislead the country all those dozens (hundreds?) of times he told us "If you like your policy, you can keep your policy. Period!"
Personally, I have trouble buying that since it's been well documented that his administration has been aware for the past three years that an estimated 93 million people with existing policies would not be able to keep them.
So, if you want to go with the "he was duped" defense, I suppose that it's possible. He's told us on many occasions that he didn't know about most of his administrations most embarrassing revelations until he heard it on the news. I don't believe that, but who am I to disagree with his inadvertent admissions that he is out of touch? While I also find it hard to believe he didn't see the potential things that could go wrong with the plan, I don't think he intentionally lied to cover up those potential problems - although Sebilius and his staff probably knew apparantly. I think he was a well-meaning and sincere guy who was just naive to the pitfalls and just assumed that for-profit insurance companies would be happy about the ACA and keeping it's current policy holders in their same plans without raising rates or eliminating those plans. Naive and over competent sure, but lied directly? I really don't think so. Of course I may actually be the naive one to believe my own spin :-) .
What I'm wondering is what happens if obamacare isn't up and running by the time all these policies are canceled? What if people can't buy policies on the exchanges, apply for possible subsidies or medicaid, or employer policies are cancelled like Greg 44's was due to increaced costs? Will people have to go without insurance enmass? Last I heard it was going to be 6 million current policies that will be cancelled not counting rate increases for employer's group policies and the potential cancellation of those policies forcing more people to buy their own policies.
What I'm wondering is what happens if obamacare isn't up and running by the time all these policies are canceled? What if people can't buy policies on the exchanges, apply for possible subsidies or medicaid, or employer policies are cancelled like Greg 44's was due to increaced costs? Will people have to go without insurance enmass? Last I heard it was going to be 6 million current policies that will be cancelled not counting rate increases for employer's group policies and the potential cancellation of those policies forcing more people to buy their own policies.
I read somewhere this morning that in California, insurance regulators are pressuring Blue Shield of California to extend their expiring policies through March 31st. What wasn't mentioned in the story was whether that would put Blue Shield in violation of federal law for allowing possibly non-compliant policies to remain in effect.
That situation would also bring up the possibility that extended policies with high deductibles would result in some policy holders being on the hook for large deductible payments twice during the year.
All I can say is if the law itself didn't present enough problems for some demographics, it's implementation is ensuring that as many people as possible will feel the pain.
edited to correct a mistake in my recollection. Hey, it happens...
I read somewhere this morning that in California, insurance regulators are pressuring Blue Shield of California to extend their expiring policies through March 31st. What wasn't mentioned in the story was whether that would put Blue Shield in violation of federal law for allowing possibly non-compliant policies to rem in effect.
That situation would also bring up the possibility that extended policies with high deductibles would result in some policy holders being on the hook for large deductible payments twice during the year.
All I can say is if the law itself didn't present enough problems for some demographics, it's implementation is ensuring that as many people as possible will feel the pain.
edited to correct a mistake in my recollection. Hey, it happens...
I just read the same thing online in today's Wall Street Journal. Blue Shield said it will extend cancelled policies for 115,000 people in Calif until March 31, 2014
The article also said that, because the new policies will cost so much more than the current ones, that "the extention of existing policies will save those policy holders as much as $28.6 millon dollars in premiums". That's a lot of moolah for just 3 months! The article also said that other states and insurance companies are expected to have extent ions themselves. I'm sure that's a huge relief for many. Can't post the link to the article from this dang blasted tablet computer but you can Google it.
It also said that cancellation letters are expected to be sent to over 10 million people in the US - I'm one of them - over the next few weeks. So hopefully other insurers besides Blue Shield in Calif will allow extensions until things are worked out. I wonder how much money that will save if extending policies for only 115,000 policy holders saves over $28 million, imagine what extending policies for 10 million people for 3 months will save.
....The article also said that, because the new policies will cost so much more than the current ones, that "the extention of existing policies will save those policy holders as much as $28.6 millon dollars in premiums". That's a lot of moolah for just 3 months!...
Yeah, I saw those numbers as well. That's approximately $250 per person for one fiscal quarter. Now I'm not a rocket scientist but by my ciphering that's an average of $1000 per person over the course of a full year. What happened to the $2500 in savings we've been promised for the past couple of years?
What happened to the $2500 in savings we've been promised for the past couple of years?
I think we spent it on missiles, bailouts for bankers, NSA spying on American citizens' emails, and other essentials.
If you do a little investigating, you find that many of these letters are sent out to try to get folks locked into a higher cost policy BEFORE they get a chance to compare on the exchanges. Especially those in states where the powers that be decided it was in their citizens best interest to NOT be able to comparison shop. Ignorance is bliss, I suppose, in republican held states!
The thing is, now insurance companies will be held to standards of coverage (no more junk insurance), but can rape and pillage their policy holders as much as they want UNLESS they offer policies on an exchange. See, policies offered on the exchange must meet the standards, including spending a percentage of the policy cost on actual health care.
This is why most companies have policies on the exchanges where states have set them up and policies outside the exchanges where states haven't set them up. And why you have the price differences. So, the policy holders in republican held states will see increases in costs without the benefit of an exchange. Certainly NOT Obama's fault, and completely the republicans fault. Completely!.
This is also why these insurance companies are sending out these letters now, in all states, taking advantage of ignorance of the law/rights to try to lock people into these higher cost plans (often the exact same plan that is on the exchange for less cost) before the customer knows what is what.
For those who live in red states without exchanges, please put blame where blame is due. We have the internet, we have phones, we can talk with people, friends, family, in states with exchanges. Know how you are being ripped off and WHO is to blame. It's not just a coincidence that folks in states with exchanges are largely finding their health care is coming down, as the quality of the coverage is going up.
Plus, those who had junk policies, ones that didn't really cover anything, will find that even if their costs go up a bit, the benefits do too. Several wellness tests/visits are included. You have to look at the whole package.
.....please put blame where blame is due....
OK, it's the law itself.
Blaming Republicans or the insurance companies can only go so far. First of all, the administration wrote the rules that set the conditions under which plans lose their grandfather status. But more important, the law has an effective date so far in the past that it virtually guaranteed that the vast majority of people currently in the individual market would end up with a notice saying they needed to buy insurance on the Obamacare exchanges.
Any effort to pin the blame on others is a classic case of misdirection. The vast majority of the problem stems from the effective date, which was imposed by the administration. Given the problems which stem from it, it is easy to see why loyalists must attempt to keep the focus elsewhere.
iris lilies
11-7-13, 9:47pm
Today President Obama apologized to Americans who are losing their health insurance. I'm glad that he did that, he should have.
Today President Obama apologized to Americans who are losing their health insurance. I'm glad that he did that, he should have.
That was nice of him.
gimmethesimplelife
11-8-13, 1:11pm
That was nice of him.I don't understand why some people are so down on Obama - from a historical perspective, I have read that there were problems when Medicare rolled out in 1965, and also when Bush signed into law the D part of Medicare involving prescription drugs. I agree it is VERY annoying that the exchange website is not working but take a poll of any restaurant worker I know struggling to find a better job in this economy making 12 to 14K a year with no health coverage and you will find someone very grateful for ObamaCare and Obama..... Rob
iris lilies
11-9-13, 11:02am
I don't understand why some people are so down on Obama ...
Because the guy is a liar. It makes me mad that he didn't even apologize for his lies or "misspeaking" as I read the interview transcript. I take back what I said in the above post, I was trying to give him some credit. Here's my favorite pundit's take on it. I quote because Goldberg is a talented wordsmith and I don't want to paraphrase:
"Last night, Obama said again that he and his administration could have been "more clear" about what would happen under Obamacare...The White House didn't tell the truth unclearly, it told a lie very clearly. This is a huge distinction. It's the difference between mumbling "Don't drink that; it's poison" and "Drink up!"
I don't understand why some people are so down on Obama
In this context I'm way south of the line on our President simply because he stated, hundreds of times, that, "if you like your policy you can keep it". We now know that is completely false. The only two real possibilities are that 1) Mr. Obama and the team he assembled are so inept they were incapable of predicting the response of companies that make up more than 1/6 of our GDP, or 2) they lied. Since the roll out was squarely in the best interests of BIG insurance I know were my vote falls, but everyone is free to decide for themselves whether or not the end justifies the means.
gimmethesimplelife
11-9-13, 1:37pm
In this context I'm way south of the line on our President simply because he stated, hundreds of times, that, "if you like your policy you can keep it". We now know that is completely false. The only two real possibilities are that 1) Mr. Obama and the team he assembled are so inept they were incapable of predicting the response of companies that make up more than 1/6 of our GDP, or 2) they lied. Since the roll out was squarely in the best interests of BIG insurance I know were my vote falls, but everyone is free to decide for themselves whether or not the end justifies the means.So much of America boils down to social class - it amazes me that so few will admit to this or are even willing to see it when I realized this when I was 12. I will admit it does seem as if Obama lied - or did not understand/realize what was going to happen when ObamaCare rolled out - I'll grant this much if other will grant me this or at least chew it over - If your income is 14K or less and insurance is out of the realm of possibility of you and you therefore realize how little human life means in America - do you honestly believe you are going to criticize any mechanism that delivers you insurance and makes you less of a 2nd class citizen? Seriously?
So yes there are issues with what Obama claimed was going to be the case - in my social class however this is not an issue for the reasons stated above. Once again, social class lines very starkly drawn. And what is even more sad about America - if I prove successful in going back to school and becoming self employed as is my goal - I will still see things this way. I have lived with the 24/7 fear of not being worth health care in America for far too many years to ever see it differently at this point. Money wouldn't make this reality go away - and for this I very much like and respect myself. Rob
ApatheticNoMore
11-9-13, 1:51pm
In this context I'm way south of the line on our President simply because he stated, hundreds of times, that, "if you like your policy you can keep it".
that's just a politician's lie. No I don't think it's wonderful that some people are losing policies, but I find the lie itself utterly unremarkable, it's a politicians lie, it's what they do. In other breaking news: zebra still has stripes, water still wet, dogs still barking. One could very well say something about the electorate not wanting the truth as well (cause is there really the willingness to hear it when it's not upbeat?), but they aren't the one's in charge so it's not *primarily* their fault (maybe some slight secondary responsibility). The Obama administration has recently said 3 or 4 people will benefit for every 1 harmed or something, it's probably not too far off (except with the caveat that those benefits aren't all they appear either if they are deductibles too high to use and narrow networks etc. and that the ratio of those harmed by having this medical system will likely continue to increase in the long term if nothing is done to restrain medical costs - more employers will drop plans, more and more people will switch to lower quality plans etc..).
The Obama administration has recently said 3 or 4 people will benefit for every 1 harmed or something, it's probably not too far off
Heck, I could probably help 10-20 people in my county for every person I harmed, if I put my mind to it...
Let's hear it for ethical thinking!
Even as one in favor of a more communal outlook, I can't find much to like about ACA.
I keep likening our public policy to a very stupid person's approach to their life circumstances: if you have an $8000 electric bill each month and half a brain, the first thing you do is not to take a second job to pay the bill, OR ask your neighbor to pay some of it for you. You look at the bill and see why on earth it's so high. You turn out lights and put on a sweater. In fact maybe you even go down to the electric company with a cattle prod.
The question of "how shall the country pay its healthcare bill" should be absolutely secondary to, "where on earth did this bill amount come from, are they nuts?"
ETA: I'm not suggesting that each of us can take on the task of analyzing our health care / health insurance costs on our own, but that if our administration is actually for the people, that should be the first order of business, not paying some insane fee and then casually asking why when the money's already gone.
iris lilies
11-10-13, 2:08pm
Even as one in favor of a more communal outlook, I can't find much to like about ACA.
I keep likening our public policy to a very stupid person's approach to their life circumstances: if you have an $8000 electric bill each month and half a brain, the first thing you do is not to take a second job to pay the bill, OR ask your neighbor to pay some of it for you. You look at the bill and see why on earth it's so high. You turn out lights and put on a sweater. In fact maybe you even go down to the electric company with a cattle prod.
The question of "how shall the country pay its healthcare bill" should be absolutely secondary to, "where on earth did this bill amount come from, are they nuts?"
ETA: I'm not suggesting that each of us can take on the task of analyzing our health care / health insurance costs on our own, but that if our administration is actually for the people, that should be the first order of business, not paying some insane fee and then casually asking why when the money's already gone.
Everyone who has a medical treatment knows why things costs so much--because the patient takes no active role in consuming the service, there is a disconnect between the service and paying the bill. Patients don't have enough skin in the game to work toward reducing costs. That's is a mistake and we all need to take more responsibility in non-emergency situations and just say "no."
The last medical treatment I had was for a dog bite on my knuckle. I probably could have got by with no treatment at all, but DH urged me to go get stitches, so I did. As it turns out, the bite never became infected.
But the urgent care doc who sewed me up then sent me to the hand doctor in the same building. That was completely unnecessary and I should have said "no, unnecessary" but the hand doctor has got to get his cut for this small event. He told me that I didn't need to come back a second time, he wanted to save me the $50 co pay. That's nice of him but $50 is nothing, what was the insurance company paying him? I don't even know, and that is wrong.
Our medical event before this was when DH fainted--twice--at a party. We were surrounded by medical professionals who urged him to go to the hospital. 24 hours later and god knows how many thousands of dollars later, he was fine, tests revealed not one bloody thing wrong with him. Two years after this event later he is completely fine and nothing has ever come of that.
Ugh, it's all a racquet.
ApatheticNoMore
11-10-13, 2:54pm
I don't believe I'd be in any position to negotiate or say no if they were prescribing chemo or something and I wouldn't. And even the end of life stuff is being paid for mostly by Medicare rather than insurance. So there's really very little excuse for pre-Medicare healthcare being the ripoff it is. As for the scam that is much of modern pharma, maybe they should just reduce demand by banning t.v. advertising haha. Leave the doctors and patients free to seek what they want as far as prescriptions (whether insurance covers ah well that's another can of worms), but no direct to consumer advertising.
To make consumers more responsible for paying for their own healthcare is actually one of the GOALS of Obamacare, whether or not they state it that way. They tell the lies they think we want to hear, but it's definitely in the economic structure that is emerging. It's a very conservative plan in many ways (it's trying to force a marketbased solution). It's why many of the plans on the exchanges are high deductible which is only bad if you 1) dont' have the deductible in cash savings - if you don't then why the heck are you going for a high deductible plan you can't use anyway? maybe because it's the only one you can afford and you have to get insurance :\ 2) need years of expensive medical treatment which will wipe out most people's savings. These plans are going for premiums that are really too high for barely cover anything plans ... they're fairly high deductible plans with non high-deductible premiums.
Another way that Obamacare will make consumers more responsible for paying for their own healthcare is that employers will continue to drop healthcare (especially those "Cadillac" plans which if healthcare inflation continues is pretty much going to be all the PPOs, but employers will also continue to drop even the non-"Cadillac"). So hooray they'll no longer be an employer middleman, we'll all be liberated from our health insurance! (which mostly reminds me of the joke about Iraqis being liberated from their lives - although I really don't regard it as at all comparable in scale - that was genocide afterall, this is just crummy insurance policies). So consumers will be left to buy their own health insurance. But if employers have minimal bargaining power with insurance companies, what kind of bargaining power will consumers have? Competition in the oligopoly world of health insurance will solve everything? The consumers will be cost sensitive but this may lead more to penny wise and pound foolish than actual good decision making (ie go with the cheapo plan with cheap premiums and go bankrupt should you have medical emergency).
Maybe one of the major objectives of Obamacare is to get the cost of healthcare off employers. Because employers in the U.S. have trouble competing with all those countries where employers don't have to pay for healthcare. They solve it by socialized medicine. We'll solve it by everyone having to buy their own expensive HMO insurance policies that pay for very little until you reach some high deductible and that still leave you open to medical bankruptcy should you wind up in the hospital and see an out of network specialist. They'll sell fear more than actual product (one might say they already do, but at least the few decent plans remaining actually cover some routine things and provide *some* protection). As less and less is covered they'll be selling pure protection from fear itself with a mandate.
Ha. At the eleventh hour, after *many* frustrating days/hours on the web site and the phone, my wife finally managed to get us signed up for "something".
The nice lady on the other end of the phone didn't know *exactly* what "something" was, what was covered, what deductibles or co-pays were, or if our local doctors would take "something" (or if we'd have to travel an entire day and spend $100+ to see a non-local doctor), but heck, progress, right?
And the good news is, it appears "something" will be completely free, courtesy of Alan, so thanks there, Big Guy! Mind you, we have no clue what we are getting for "free". I wonder if it is as good as the plan we had selected of our own free will and bought with our own hard-earned dollars, which our government informs us we are too child-like to select on our own, and arranged to be cancelled for us?
So, if January 1st I get hit by a bus, heck, "something" will be covered by "someone" "somewhere".
I guess I'll have to use it to see what's in it....
Simply Divine
12-23-13, 11:19pm
My insurance is increasing by $4 a month and a 3-month supply of a generic drug prescription is going up from $10 to $12. We are also getting a new vision plan. It doesn't look like much else has changed.
The latest plan I am considering is a Blue Cross bronze level plan that is $464/month with a $6000 annual deductible, a 20% co-insurance and $60 co-pay for doctors visits (I forget how much meds co-pay is but ER and hospital co-pays are $250). That's approx. $300/month more for premiums than my previous catastrophic plan was and I had a lower deducible of $4000 and I had no co-insurance costs before. But it's the lowest price plan I could find that has a reasonable co-insurance amount. A lower (the lowest I could find) plan wouldn't cost that much less (around $410/month with a $5,500 deductible) but it has a 40% annual co-insurance and higher co-payments. I don't qualify for subsidies so I'd be paying for the full premium - which is about 1/3rd of my monthly income. Guess I'll have to go off retirement and get one of those job-thingies :-)! Nah...will just dip into the rainy-day fund! Of course I am still contemplating just using the VA for all my medical care (very little needed fortunately). It's low cost to me and Alan will just pick up the rest. Thanks Alan :-)!
Alan, for the ~$15k/year you are paying for me, if you are ever in the area, I'll cook you a nice dinner, maybe take you out on the yacht to see some whales, get some fishing in. You let me know, Patrón! I mean, that's a good chunk of The Offspring's Oxford tuition. I owe ya!
gimmethesimplelife
12-24-13, 1:48am
Something I am noticing is that the costs of the plans available are not uniform across all 50 states, and here in Arizona one can get a Platinum plan in Maricopa County - i.e, the Phoenix metro area, for around $330/month with HealthNet. I am noticing this is cheaper than in many other states. The plan that Spartana refers to above sounds much more expensive and less patient friendly than what is on offer in Maricopa County, Arizona. This is one area in which I don't have much expertise in health care - I don't understand the rationale for some areas being so much cheaper for premiums and some areas being so much higher. Rob
It looks like the "plan" they may be offering me, Rob, requires me to travel an entire day to see a doctor, and spend $70 or so on travel to do so. Such a win over the "bad" plan they told me I couldn't have.
Still though, with the savings, I may be able to buy a plane to fly over there. Gotta crunch some numbers.
First World Problems.
Something I am noticing is that the costs of the plans available are not uniform across all 50 states, and here in Arizona one can get a Platinum plan in Maricopa County - i.e, the Phoenix metro area, for around $330/month with HealthNet. I am noticing this is cheaper than in many other states. The plan that Spartana refers to above sounds much more expensive and less patient friendly than what is on offer in Maricopa County, Arizona. This is one area in which I don't have much expertise in health care - I don't understand the rationale for some areas being so much cheaper for premiums and some areas being so much higher. RobI think they are age related - us "old" folks must pay more then you young uns (I think you said you were 40). Plug in the numbers in AZ for someone older 45 - 65 and the rates will likely be higher.
gimmethesimplelife
12-24-13, 2:39am
I think they are age related - us "old" folks must pay more then you young uns. Plug in the numbers in AZ for someone 50 - 65 and the rates will likely be higher.Spartana, thanks for replying. I will go to healthcare.gov and plug in the numbers for 50 years of age in Maricopa County AZ and see what turns up. Rob
gimmethesimplelife
12-24-13, 2:47am
To Spartana - I just went to healthcare.gov and plugged in the following for Maricopa County, AZ - two adults, household income 70K, looking for a Platinum Plan, 55 years of age and found that for $435/mo. I could have a Platinum HealthNet of AZ plan with 0 deductible, max $3000 out of pocket annually, 15/30 for PCP/Specialist visits. Ouch - pricey indeed but yet a much better deal it would seem than your Bronze plan in CA. Why the lack of uniformity in pricing is my question? Rob
I came back to add that I just plugged in the numbers for someone 47 - my age - two adults, Maricopa County, AZ, 70K household income and the premium magically decreased to $305/mo for each person on the same plan as above. It seem as if the magical age of 50 bumps you up on premiums.
Spartana
12-24-13, 12:47pm
To Spartana - I just went to healthcare.gov and plugged in the following for Maricopa County, AZ - two adults, household income 70K, looking for a Platinum Plan, 55 years of age and found that for $435/mo. I could have a Platinum HealthNet of AZ plan with 0 deductible, max $3000 out of pocket annually, 15/30 for PCP/Specialist visits. Ouch - pricey indeed but yet a much better deal it would seem than your Bronze plan in CA. Why the lack of uniformity in pricing is my question? Rob
I came back to add that I just plugged in the numbers for someone 47 - my age - two adults, Maricopa County, AZ, 70K household income and the premium magically decreased to $305/mo for each person on the same plan as above. It seem as if the magical age of 50 bumps you up on premiums.
Yeah I fiddled around with some of the ages myself (having an upcoming B-Day in Feb so will likely see a price increase then too). But I was using www.ehealthinsurance.com and not the Calif Exchange since I can't buy a plan off of that except Medicaid. So I didn't need to put in income at all - just looked at the full cost with no subsidies. The plans really varied widely (there were 45 of them) and when I looked into them individually there were often extra costs that were associated with the lower priced plans (around $425 for the lowest for me with a high deductible and co-insurance). I haven't bought a plan yet (still planning to just use the VA healthcare system until I do).
I'm wondering if other's have been able to buy a plan (or get Medicaid) as of today since that is the cut off. I haven't heard if the fed exchange was fully up and running so maybe some people who had their policies cancelled haven't been able to sign up yet. Has anyone besides Bae had any luck yet? Did you get a plan? An insurance card? Subsidies guareented? Or are you still waiting?
To Spartana - I just went to healthcare.gov and plugged in the following for Maricopa County, AZ - two adults, household income 70K, looking for a Platinum Plan, 55 years of age and found that for $435/mo. I could have a Platinum HealthNet of AZ plan with 0 deductible, max $3000 out of pocket annually, 15/30 for PCP/Specialist visits. Ouch - pricey indeed but yet a much better deal it would seem than your Bronze plan in CA. Why the lack of uniformity in pricing is my question? Rob
I came back to add that I just plugged in the numbers for someone 47 - my age - two adults, Maricopa County, AZ, 70K household income and the premium magically decreased to $305/mo for each person on the same plan as above. It seem as if the magical age of 50 bumps you up on premiums.
I went to ehealthinsurance.com, and plugged in Maricopa County. I'm 56, wife is 52, both non smokers. I only saw plans running from $880 to $1136 in the platinum level.
In St. Louis the rates run from $990 to $1323. I currently pay $1330 per month.
My worry is what do you think the rates are going to jump to next year. Obama keeps changing the rules daily. The insurance company's are not going to lose money.
I guess I could move to Sweden. But I'm pretty sure I wouldn't want to pay $75,000 or more a year in taxes so part time workers can coast along. Its bad enough here.
gimmethesimplelife
12-24-13, 1:49pm
I went to ehealthinsurance.com, and plugged in Maricopa County. I'm 56, wife is 52, both non smokers. I only saw plans running from $880 to $1136 in the platinum level.
In St. Louis the rates run from $990 to $1323. I currently pay $1330 per month.
My worry is what do you think the rates are going to jump to next year. Obama keeps changing the rules daily. The insurance company's are not going to lose money.
I guess I could move to Sweden. But I'm pretty sure I wouldn't want to pay $75,000 or more a year in taxes so part time workers can coast along. Its bad enough here.I'm not saying you are wrong, DMC, but if you go to www.healthcare.gov and plug in all the variables I did for Maricopa County, Arizona, you will see the rates I quoted. My question is this - why the difference between healthcare.gov rates and the rates you are being quoted on ehealthinsurance? I find this very scary - it's like whose quote is real? And under what circumstances? I do think I have one answer for why the quotes are so different. HealthNet of AZ is the plan with the lowest rates - Blue Cross and Meritus and others are much higher. I don't know is this is legal but it does seem to me that HealthNet of AZ has underpriced the market - they also were awarded a contract by AHCCCS - or Medicaid in Arizona - for providing Medicaid in Arizona, too. If you are interested, check out the difference between HealthNet plans and their competitors and you will see a difference, at least on healthcare.gov. Rob
PS I came back to add that I just priced the cheapest HealthNet Platinum Plan for Maricopa County for someone aged 56 and male and it came back at $455/mo. on healthcare.gov. With the same variables I mentioned before. I have a question - were the rates you were quoting for two people, yourself and your wife, or just for yourself? This would explain the big difference as I was quoting a rate just for one person - being single, this is going to be how I shop for insurance. Naturally if you are adding a second person onto the quote it is going to be much higher. Rob
gimmethesimplelife
12-24-13, 2:10pm
Yeah I fiddled around with some of the ages myself (having an upcoming B-Day in Feb so will likely see a price increase then too). But I was using www.ehealthinsurance.com and not the Calif Exchange since I can't buy a plan off of that except Medicaid. So I didn't need to put in income at all - just looked at the full cost with no subsidies. The plans really varied widely (there were 45 of them) and when I looked into them individually there were often extra costs that were associated with the lower priced plans (around $425 for the lowest for me with a high deductible and co-insurance). I haven't bought a plan yet (still planning to just use the VA healthcare system until I do).
I'm wondering if other's have been able to buy a plan (or get Medicaid) as of today since that is the cut off. I haven't heard if the fed exchange was fully up and running so maybe some people who had their policies cancelled haven't been able to sign up yet. Has anyone besides Bae had any luck yet? Did you get a plan? An insurance card? Subsidies guareented? Or are you still waiting?I have as of yet not received an insurance card and have read in the Arizona Republic (the Phoenix newspaper) that acceptance letters for Medicaid are being mailed out in January 2014. I will admit I don't like this. I'd much rather have the card earlier and have it not be valid until January 1st. I was told by the person who accepted my application over the phone that I qualified for Arizona Medicaid. Since so much time had passed and I had heard nothing, I also went to a local navigator a few weeks ago and reapplied and was also told there that I qualified for Arizona Medicaid. I am still waiting on DES confirmation, though, and my HealthNet of AZ card - this is the Medicaid provider I chose. Rob
OK, I went to healthcare.gov. A gold plan in Maricopa Co for @ family of 2 is $756 for a gold plan with $12,000 out of pocket, which is a HMO, or you can pay $853 for a HMO with a $6,000 deductable. If you want to go to a PPO with a $1500 ded, $2,500 OP you can pay $1032.
The insurance in Maricopa co. is cheaper than my area outside of St. Louis. The healthcare website pretty much agree's with ehealthinsurance.com.
I don't know why you are getting different results. Are you basing the premiums on just 1 adult? In your post above you said 2 adults.
I could buy a condo and claim residency in arizona for the $600 or so difference in insurance rates. And thats before I work on getting my income worked around for a subsidy.
gimmethesimplelife
12-24-13, 2:17pm
I don't believe I'd be in any position to negotiate or say no if they were prescribing chemo or something and I wouldn't. And even the end of life stuff is being paid for mostly by Medicare rather than insurance. So there's really very little excuse for pre-Medicare healthcare being the ripoff it is. As for the scam that is much of modern pharma, maybe they should just reduce demand by banning t.v. advertising haha. Leave the doctors and patients free to seek what they want as far as prescriptions (whether insurance covers ah well that's another can of worms), but no direct to consumer advertising.
To make consumers more responsible for paying for their own healthcare is actually one of the GOALS of Obamacare, whether or not they state it that way. They tell the lies they think we want to hear, but it's definitely in the economic structure that is emerging. It's a very conservative plan in many ways (it's trying to force a marketbased solution). It's why many of the plans on the exchanges are high deductible which is only bad if you 1) dont' have the deductible in cash savings - if you don't then why the heck are you going for a high deductible plan you can't use anyway? maybe because it's the only one you can afford and you have to get insurance :\ 2) need years of expensive medical treatment which will wipe out most people's savings. These plans are going for premiums that are really too high for barely cover anything plans ... they're fairly high deductible plans with non high-deductible premiums.
Another way that Obamacare will make consumers more responsible for paying for their own healthcare is that employers will continue to drop healthcare (especially those "Cadillac" plans which if healthcare inflation continues is pretty much going to be all the PPOs, but employers will also continue to drop even the non-"Cadillac"). So hooray they'll no longer be an employer middleman, we'll all be liberated from our health insurance! (which mostly reminds me of the joke about Iraqis being liberated from their lives - although I really don't regard it as at all comparable in scale - that was genocide afterall, this is just crummy insurance policies). So consumers will be left to buy their own health insurance. But if employers have minimal bargaining power with insurance companies, what kind of bargaining power will consumers have? Competition in the oligopoly world of health insurance will solve everything? The consumers will be cost sensitive but this may lead more to penny wise and pound foolish than actual good decision making (ie go with the cheapo plan with cheap premiums and go bankrupt should you have medical emergency).
Maybe one of the major objectives of Obamacare is to get the cost of healthcare off employers. Because employers in the U.S. have trouble competing with all those countries where employers don't have to pay for healthcare. They solve it by socialized medicine. We'll solve it by everyone having to buy their own expensive HMO insurance policies that pay for very little until you reach some high deductible and that still leave you open to medical bankruptcy should you wind up in the hospital and see an out of network specialist. They'll sell fear more than actual product (one might say they already do, but at least the few decent plans remaining actually cover some routine things and provide *some* protection). As less and less is covered they'll be selling pure protection from fear itself with a mandate.As your last paragraph gets worse and worse over time I do believe more people will find the courage to do the math and will start voluntarily leaving the US for at least permanent residency elsewhere with much less expensive healthcare. Countries like Ecuador, Nicaragua, Chile, Peru, Panama, Malaysia, Cambodia (I know someone who had fled there not due to healthcare but due to being priced out of the US in old age) etc. are all going to look more interesting and I would think these places will be able to be picky as to who they will accept as there will be so many people fed up and willing to run. Eventually the math is going to get to the point where denial isn't going to work for as many people any more. Rob
gimmethesimplelife
12-24-13, 2:20pm
OK, I went to healthcare.gov. A gold plan in Maricopa Co for @ family of 2 is $756 for a gold plan with $12,000 out of pocket, which is a HMO, or you can pay $853 for a HMO with a $6,000 deductable. If you want to go to a PPO with a $1500 ded, $2,500 OP you can pay $1032.
The insurance in Maricopa co. is cheaper than my area outside of St. Louis. The healthcare website pretty much agree's with ehealthinsurance.com.
I don't know why you are getting different results. Are you basing the premiums on just 1 adult? In your post above you said 2 adults.
I could buy a condo and claim residency in arizona for the $600 or so difference in insurance rates. And thats before I work on getting my income worked around for a subsidy.Please check platinum plans and look under the HealthNet HMO platinum choices and you will see the rates I have been quoting - are you only looking in the more expensive PPO plans? To get the rates I quoted yeah you are going to have to deal with an HMO - I thought this was understood? Rob
OK I found the answer. Yes I am basing the premiums on just one adult. If this was not clear then I apologize. As I stated a post or two above, if you add a second person on, yes it is going to be much more expensive. Yes indeed. Given that I am single, I only checked for the prices for one person. Rob
gimmethesimplelife
12-24-13, 2:46pm
I went to ehealthinsurance.com, and plugged in Maricopa County. I'm 56, wife is 52, both non smokers. I only saw plans running from $880 to $1136 in the platinum level.
In St. Louis the rates run from $990 to $1323. I currently pay $1330 per month.
My worry is what do you think the rates are going to jump to next year. Obama keeps changing the rules daily. The insurance company's are not going to lose money.
I guess I could move to Sweden. But I'm pretty sure I wouldn't want to pay $75,000 or more a year in taxes so part time workers can coast along. Its bad enough here.I agree with something you have stated in here. Obama does seem to change the rules daily and I can see why this lends less confidence to the ACA overall. I know that what I am about to state will never happen, I get this. But I often wonder that with US healthcare not working for so many US citizens, wouldn't it be more cost effective for the US government to give financial assistance to those wishing to leave to start over somewhere else with saner healthcare prices? Yes to me things are really getting that bad that this would be a sane and cost effective solution - as much as I appreciate the ACA it remains a fact that there is no mechanism in it that I can see anyway to keep health care costs from spiraling. Financial assistance to start over in another country for those interested would likely save the US government some cash over time, though it would be equivalent to admitting that the US doesn't work for a segment of it's population and I can't ever see such an admission taking place. Rob
PS I came back to add - maybe this would save the US government more money as they could scale future SS payments back in return for such financial assistance, so this could be win/win in a way.
ApatheticNoMore
12-24-13, 2:52pm
HealthNet of AZ is the plan with the lowest rates - Blue Cross and Meritus and others are much higher. I don't know is this is legal but it does seem to me that HealthNet of AZ has underpriced the market - they also were awarded a contract by AHCCCS - or Medicaid in Arizona - for providing Medicaid in Arizona, too. If you are interested, check out the difference between HealthNet plans and their competitors and you will see a difference, at least on healthcare.gov.
You get what you pay for. Now I don't know about AZ but in CA HealthNet has the most narrow networks of them all (it's been widely reported - they have negative brand recognition with me now due to this), I personally would actively warn people against Healthnet unless they have no other choice (might be better than no insurance).
"For example, Health Net will offer the lowest cost coverage options in Southern California, but policyholders who purchase a Health Net exchange plan will have access to less than one-third of the insurer's network of providers for employer-based plans. In addition, Blue Shield of California's exchange plans will include only 50% of the insurer's usual provider network". So even Blue plans have less providers than their employer provided alternatives (getting insurance through a job is still the most sensible choice) but I've read enough about Healthnet they have MUCH less providers than the Blues, even on the exchange:
http://www.californiahealthline.org/articles/2013/9/16/insurers-in-calif-health-exchange-limiting-number-of-providers
gimmethesimplelife
12-24-13, 2:58pm
You get what you pay for. Now I don't know about AZ but in CA HealthNet has the most narrow networks of them all (it's been widely reported), I personally would actively warn people against Healthnet unless they have no other choice.
"For example, Health Net will offer the lowest cost coverage options in Southern California, but policyholders who purchase a Health Net exchange plan will have access to less than one-third of the insurer's network of providers for employer-based plans. In addition, Blue Shield of California's exchange plans will include only 50% of the insurer's usual provider network". So even Blue plans have less providers than their employer provided alternatives but I've read enough about Healthnet they have MUCH less providers than the Blues, even on the exchange:
http://www.californiahealthline.org/articles/2013/9/16/insurers-in-calif-health-exchange-limiting-number-of-providersI have myself heard horrible things about HealthNet too, I will give you that. But when my mother had major neck surgery in January of 2012 with HealthNet Ruby Medicare as her insurance, I have to say I was impressed with the overall care she received and their willingness to pay for extended physical therapy. Dealing with HealthNet Medicare for my mother's fairly intense surgery was not the ordeal I expected it to be at all.
That said, Health Net does not have a good rep in Arizona at all. Rob Something that I don't feel is getting understood here though is that Health Net is better than no insurance at all - put yourself in my shoes for a minute or two if you'all would and you'll see I have a point. If something dramatic happens to you and you don't have the time needed to get to Mexico for care, Health Net will at least get you into a hospital and start some kind of care for you at pre-determined rates, so at least when you come to you have some idea of what a financial nightmare you will be facing and can then do your is it worth it to remain in the US math.
ApatheticNoMore
12-24-13, 3:13pm
More info on HealthNet:
"But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.
In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists [wait 2316 doctors TOTAL in Los Angeles COUNTY? Well I don't know their enrollment but this sounds completely insane]. That's less than a third of the doctors Health Net offers to workers on employer plans. In San Diego, there are only 204 primary-care doctors to serve Health Net patients.
Other major insurers have pared their list of medical providers too, but not to Health Net's degree. Statewide, Blue Shield of California says exchange customers will be restricted to about 50% of its regular physician network."
http://articles.latimes.com/2013/sep/14/business/la-fi-insure-doctor-networks-20130915
It's hard to say the quality of the insurance from any given experience, although if it's horrible that doesn't help, the question of narrow networks is: the more minor one 1) will you be able to see a primary care physician, what will the wait be etc..? 2) the more major one: if you get a major disease what specialists are covered? If you get cancer say, how many onocologists are there for instance, are there any, are there an adequate number? Or do you just consider cancer a death sentence anyway?
I agree with something you have stated in here. Obama does seem to change the rules daily and I can see why this lends less confidence to the ACA overall. I know that what I am about to state will never happen, I get this. But I often wonder that with US healthcare not working for so many US citizens, wouldn't it be more cost effective for the US government to give financial assistance to those wishing to leave to start over somewhere else with saner healthcare prices? Yes to me things are really getting that bad that this would be a sane and cost effective solution - as much as I appreciate the ACA it remains a fact that there is no mechanism in it that I can see anyway to keep health care costs from spiraling. Financial assistance to start over in another country for those interested would likely save the US government some cash over time, though it would be equivalent to admitting that the US doesn't work for a segment of it's population and I can't ever see such an admission taking place. Rob
PS I came back to add - maybe this would save the US government more money as they could scale future SS payments back in return for such financial assistance, so this could be win/win in a way.
Maybe if we had more people contributing we wouldn't be in this mess. Maybe if everyone payed something to the Feds, they would expect more accountablility. Instead its easier to vote for more stuff if you don't have to pay.
I don't understand why you havn't moved yet. I'm don't know how many other country's are out there willing to take care of you. But if you can find one that expects nothing in return, let me know, I'll come visit and check it out myself.
But since I can't get out of paying US taxes no matter where I am, I'm afraid it will make more sense to stay here. Healthcare is not my problem.
gimmethesimplelife
12-24-13, 3:19pm
More info on HealthNet:
"But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.
In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists. That's less than a third of the doctors Health Net offers to workers on employer plans. In San Diego, there are only 204 primary-care doctors to serve Health Net patients.
Other major insurers have pared their list of medical providers too, but not to Health Net's degree. Statewide, Blue Shield of California says exchange customers will be restricted to about 50% of its regular physician network."
http://articles.latimes.com/2013/sep/14/business/la-fi-insure-doctor-networks-20130915
It's hard to say the quality of the insurance from any given experience, although if it's horrible that doesn't help, the question of narrow networks is: the more minor one 1) will you be able to see a primary care physician, what will the wait be etc..? 2) the more major one: if you get a major disease what specialists are covered? If you get cancer say, how many onocologists are there for instance, are there any, are there an adequate number?Honestly? If I had cancer? I would probably end out going to Mexico for my care. I hope Iris Lillies sees this as I'm going to agree with something she stated on another thread. Going to Mexico in such a situation if I could swing it would mean retaining control over my health care more than I could in the US. I sure hope she sees this as I understand in this case how retaining control would apply and how much it would mean to me. Rob
And about the narrow networks and cuts to the number of providers - dead on. I'm just glad that when my mom entered rehab after her surgery using Healthnet, she was able to get into a clean and decent place. It was only rated three out of five stars locally but I went to visit almost every day and the quality of care I witnessed being delivered impressed me. Rob
gimmethesimplelife
12-24-13, 3:25pm
Maybe if we had more people contributing we wouldn't be in this mess. Maybe if everyone payed something to the Feds, they would expect more accountablility. Instead its easier to vote for more stuff if you don't have to pay.
I don't understand why you havn't moved yet. I'm don't know how many other country's are out there willing to take care of you. But if you can find one that expects nothing in return, let me know, I'll come visit and check it out myself.
But since I can't get out of paying US taxes no matter where I am, I'm afraid it will make more sense to stay here. Healthcare is not my problem.Just out of curiosity, are you aware that in Argentina anyone on Argentine soil is welcome to use their socialized healthcare system? Even tourists. Please google this and find out yourself. Now about the quality of care received, honestly, that I do not know. But google and compare how we do health care vs. Argentina's more compassionate and humane system. If nothing else, maybe you could then begin to understand why someone in my situation would post/feel the way I do. I guess to summarize - the American way is not the only answer out there nor does it work for all. Perhaps you could say this for any country - but not every country bills itself as such a role model for the rest of the free world to follow, either. Rob
I don't understand why you havn't moved yet.
And now he wants the remaining taxpayers to *pay* him to move. Priceless.
gimmethesimplelife
12-24-13, 3:31pm
And now he wants the remaining taxpayers to *pay* him to move. Priceless.Bae, stop and think for a moment if you would. Would not paying my way out save the US government money in the long term? As far as future health care payments and future SS payments? And did I not mention I was for scaling back any future SS checks in return for the financial assistance? Please, if you would, factor these statements in too. And Happy Holidays BTW! Rob
And now he wants the remaining taxpayers to *pay* him to move. Priceless.
Just part of the entitlement mindset in much of our country. We have politicians pushing class warfare every chance they get. If I was worried as much about healthcare as Rob, I would work on making enough money to pay for it.
I read where the unemployment rate in South Dakota was 2.6%. Plenty of work and good pay. My first job was in Wyoming, because thats where the work was at the time. But I didn't expect anyone to take care of me. And I wanted to make good money. If I was just getting out of school today I'm sure I would be heading there. The weather is brutal, but I would be self reliant.
Bae, stop and think for a moment if you would. Would not paying my way out save the US government money in the long term? As far as future health care payments and future SS payments? And did I not mention I was for scaling back any future SS checks in return for the financial assistance? Please, if you would, factor these statements in too. And Happy Holidays BTW! Rob
Maybe they could expect those that are healthy to work for their benefits. If you want to leave the country they could probably have you waiting tables for our troops in Afganistan or other posts. Or at least have them do something. For as much as I have paid in taxes, I should have someone mowing my yard and washing my car at least. If your on the dole at least you can help out those of us that have been paying in all these years.
gimmethesimplelife
12-24-13, 4:41pm
Maybe they could expect those that are healthy to work for their benefits. If you want to leave the country they could probably have you waiting tables for our troops in Afganistan or other posts. Or at least have them do something. For as much as I have paid in taxes, I should have someone mowing my yard and washing my car at least. If your on the dole at least you can help out those of us that have been paying in all these years.If you would be so kind, DMC, please go back through my posts. You will see that I have repeatedly stated that to get these benefits I so crave in Austria, you are expected to contribute something to society unless you are genuinely disabled. Even if it is just planting trees or picking up trash along the highway, you are expected to contribute something or your benefits get taken away eventually. And I have repeatedly posted that I am fine with that,and that I intend to volunteer somewhere at least one day a week once I get my Medicaid for sure - I am not comfortable with taking Medicaid for free and not giving something back.
My question is why make the assumption that I am unwilling to give something back and expect to be taken care of giving nothing in return? Why is this the reaction of so many Americans? Honestly, I will never understand the overall thought process and rhetoric in this country. But it is what it is. I invite you to click on my screen name and view my prior posts where I have explained how I feel the need to give something back to society if I am drawing out of it. Rob
gimmethesimplelife
12-24-13, 4:45pm
Just part of the entitlement mindset in much of our country. We have politicians pushing class warfare every chance they get. If I was worried as much about healthcare as Rob, I would work on making enough money to pay for it.
I read where the unemployment rate in South Dakota was 2.6%. Plenty of work and good pay. My first job was in Wyoming, because thats where the work was at the time. But I didn't expect anyone to take care of me. And I wanted to make good money. If I was just getting out of school today I'm sure I would be heading there. The weather is brutal, but I would be self reliant.Easy advice to give and not bad advice on the surface, DMC , but where would I find housing in the Dakotas? Please google housing shortage in the Dakotas and learn more about the shortage. Given that you admit the winters are brutal, where would I find housing where the wages are so high? This is a huge problem out that way, especially in North Dakota where unemployment is even lower. Rob
Easy advice to give and not bad advice on the surface, DMC , but where would I find housing in the Dakotas?
There's always something in the way, isn't there?
gimmethesimplelife
12-24-13, 4:52pm
Just part of the entitlement mindset in much of our country. We have politicians pushing class warfare every chance they get. If I was worried as much about healthcare as Rob, I would work on making enough money to pay for it.
I read where the unemployment rate in South Dakota was 2.6%. Plenty of work and good pay. My first job was in Wyoming, because thats where the work was at the time. But I didn't expect anyone to take care of me. And I wanted to make good money. If I was just getting out of school today I'm sure I would be heading there. The weather is brutal, but I would be self reliant.Hmmmm.....just curious. You don't see any logic then in going to where healthcare is not nightmarishly expensive to begin with? As much as you mention how steep your taxes are, surely you understand the logic in being where the costs are so much less to begin with? Rob
gimmethesimplelife
12-24-13, 4:54pm
There's always something in the way, isn't there?And my advice to you, Bae? Please take the short amount of time it would take to google this issue to learn more. If you are open to more than one side of the story? Rob
And my advice to you, Bae? Please take the short amount of time it would take to google this issue to learn more. If you are open to more than one side of the story? Rob
"Google this issue" - no, sorry Rob. I *know* people who work there. I was offered jobs there *myself*. I *know* how to arrange to live in such circumstances, working jobs that pay well.
It takes a certain amount of effort and dedication. Might want to Google that.
iris lilies
12-24-13, 5:03pm
And now he wants the remaining taxpayers to *pay* him to move. Priceless.
But as purely an economic decision it might be a good idea, depending on the price tag.
But as purely an economic decision it might be a good idea, depending on the price tag.
A bus ticket to Mexico, and revoking his passport can't cost much :-)
iris lilies
12-24-13, 5:06pm
.... I hope Iris Lillies sees this as I'm going to agree with something she stated on another thread. Going to Mexico in such a situation if I could swing it would mean retaining control over my health care more than I could in the US. I sure hope she sees this as I understand in this case how retaining control would apply and how much it would mean to me. Rob
...
Sure, I agree that in some situations it might make sense to go to Mexico for care.
gimmethesimplelife
12-24-13, 5:07pm
But as purely an economic decision it might be a good idea, depending on the price tag.Iris, I gotta give you credit. Thank You for seeing this. I was indeed speaking of this on an economic basis. Rob
gimmethesimplelife
12-24-13, 5:08pm
Sure, I agree that in some situations it might make sense to go to Mexico for care.Gotta give you credit once again, Iris. Rob
ApatheticNoMore
12-24-13, 5:11pm
Isn't housing just a matter of getting enough roommates if it's scarce? Mind you not my preference but is housing really so scarce anywhere that roommates doesn't solve the problem? But if there is no shelter of any kind to be found and one is going to die of exposure trying to live in a tent in sub-zero then ...
btw about the only thing I could see myself doing in south dakota is working for a credit card processing company :D, oh I know that's so evil, but less so than other stuff.
Teacher Terry
12-24-13, 6:24pm
I know from first hand experience that you have to move to where the jobs are located. When I finished graduate school I wanted to stay in the Midwest which I loved but no jobs in my field. I ended up with job choices in many states but not located in the Midwest. I moved alone where I did not know a soul for a job and made a life. Bloom where you and a decent job are planted>8)
My question is this - why the difference between healthcare.gov rates and the rates you are being quoted on ehealthinsurance?
I don't know why they are different but maybe they actually include the subsidies on the healthcare.gov site in the quoted rates and they don't on the ehealthinsurance site. I just looked at the Platinum plans on ehealthinsurance (there were 5) for one 55 year old female in Orange county (The O.C.!) Calif and they range from $722 for Blue Shield, $759 for Anthem Blue Cross, $800 for Kaiser, $814 for Cigna, and $923 for Healthnet. Healthnet also has a $600 platinum plan but didn't have the same coverage and had more out of pocket than the others. So maybe when you plug in your "pretend" numbers (age, income and family size) at the govmint website, they are including any subsidies you'd receive based on those things.
I read where the unemployment rate in South Dakota was 2.6%. Plenty of work and good pay. My first job was in Wyoming, because thats where the work was at the time. But I didn't expect anyone to take care of me. And I wanted to make good money. If I was just getting out of school today I'm sure I would be heading there. The weather is brutal, but I would be self reliant. Heck I might be heading there myself! Had thought about picking up a short term (spring to fall) gig up there even before all the ACA drama just to keep my skills up and earn some extra moolah for a bigger "healthcare cushion" in the future (can't let Alan pay for everything can we :-)!) but it seems that housing is very hard to come by there.
ApatheticNoMore
12-24-13, 7:13pm
Btw moving for work as ocassionally being necessary yea, I was resigned to do it if absolutely necessary if all other options were run out (but ahem not south dakota) because the CA unemployment stats were and are among the worst in the entire of the whole country (I would have been better off even hopping over the state border to Arizona and getting a job in Phoenix!). But South Dakota (never mind the credit card processing haha) is a boom that can't last. It's the last exploitation of resources over a country and world exhausted of them in the skelton of America's post-industrial economy. There's nothing particularly optimistic about it. More like tragic really, ghosts of what was a real economy. Last hurrah, last days of ancient sunshine, go for broke, party like there's no tommorow (because afterall there probably isn't, lets do our one last part to ensure that ...).
btw about the only thing I could see myself doing in south dakota is working for a credit card processing company :D, oh I know that's so evil, but less so than other stuff.
There is bar maid and bar tender. If that boom is anything like the Alaska oil boom then you can count on HUGE HUGE tips. I'm more of the "roughneck" type and want a dirty, dirty job out in the field - I actually miss that kind of work.....er...sort of :-)!
gimmethesimplelife
12-24-13, 7:19pm
I don't know why they are different but maybe they actually include the subsidies on the healthcare.gov site in the quoted rates and they don't on the ehealthinsurance site. I just looked at the Platinum plans on ehealthinsurance (there were 5) for one 55 year old female in Orange county (The O.C.!) Calif and they range from $722 for Blue Shield, $759 for Anthem Blue Cross, $800 for Kaiser, $814 for Cigna, and $923 for Healthnet. Healthnet also has a $600 platinum plan but didn't have the same coverage and had more out of pocket than the others. So maybe when you plug in your "pretend" numbers (age, income and family size) at the govmint website, they are including any subsidies you'd receive based on those things.Hi Spartana. The plug in pretend numbers included a household income above the point of getting a subsidy, and they were still much less than what you are facing in CA. I think there is truth to what APN has posted about HealthNet being cheaper due to very narrow networks and few specialists on board/accepting Health Net so that could be a factor driving down prices, yes. Rob
gimmethesimplelife
12-24-13, 7:22pm
Btw moving for work as ocassionally being necessary yea, I was resigned to do it if absolutely necessary if all other options were run out (but ahem not south dakota) because the CA unemployment stats were and are among the worst in the entire of the whole country (I would have been better off even hopping over the state border to Arizona and getting a job in Phoenix!). But South Dakota (never mind the credit card processing haha) is a boom that can't last. It's the last exploitation of resources over a country and world exhausted of them in the skelton of America's post-industrial economy. There's nothing particularly optimistic about it. More like tragic really, ghosts of what was a real economy. Last hurrah, last days of ancient sunshine, go for broke, party like there's no tommorow (because afterall there probably isn't, lets do our one last part to ensure that ...).Not to criticize you in the slightest - I think and am hoping many Americans now know better than to trust a boom of any kind as booms don't last - I'd hope anyone going to the Dakotas now would be in it for legal but quick cash and be ready to flee at the drop of a hat - shoot,it might not be a bad place to work for a summer if you could get by living in a tent. I don't know if there are ordinances against that kind of thing there but for the short summer there I can see how that might be a viable choice. Rob
Not to criticize you in the slightest - I think and am hoping many Americans now know better than to trust a boom of any kind as booms don't last -
You do realize that in the modern era very few careers in a single profession last?
The trick is to have skills and initiative, and be flexible. I've done everything from construction work to high-energy fusion research to Big Iron computing to computer networking to property management to running a school to winemaking to firefighting to ...
None of these jobs last forever, things change. My grandfather managed to have a lifelong career as a rural mail carrier, things just aren't like that anymore.
So, throwing up your hands and saying "oh, it's a boom, it won't last, I'd rather be a secret shopper" is full of fail sauce.
gimmethesimplelife
12-24-13, 7:35pm
You do realize that in the modern era very few careers in a single profession last?
The trick is to have skills and initiative, and be flexible. I've done everything from construction work to high-energy fusion research to Big Iron computing to computer networking to property management to running a school to winemaking to firefighting to ...
None of these jobs last forever, things change. My grandfather managed to have a lifelong career as a rural mail carrier, things just aren't like that anymore.
So, throwing up your hands and saying "oh, it's a boom, it won't last, I'd rather be a secret shopper" is full of fail sauce.Bae, don't keel over from shock, I think you have a valid point here. Things don't last and flexibility and having more than one skill to hustle seem common sense. I take it even further and see citizenship and residency as something to be flexible about too, so in my own way, I'm even more of a capitalist than you are.....think about it. But your first paragraph, dead on as far as I am concerned.
And FYI - secret shopping is not as easy as you seem to think it is. You need to pull of a scenario and have juggle details in your head and have a decent command of the English language if you want your reports to be accepted. Not only that, but that is only one of my income streams. I invite you also to click on my user name and read my prior posts - fairly recent ones - where I have posted how I earn my income. Rob
iris lilies
12-24-13, 7:36pm
... My grandfather managed to have a lifelong career as a rural mail carrier, things just aren't like that anymore.
...
Hey bae, my grandfather was a rural mail carrier, too! During the depression he had a job. My mother always said that sure they did not have much money but her father had A Job and that was the holy grail. She tells the story of her brother sneaking out late one night taking, the family car and nearly wrecking it, and her father was furious because that car represented their family's livelihood.
iris lilies
12-24-13, 7:39pm
I know from first hand experience that you have to move to where the jobs are located. When I finished graduate school I wanted to stay in the Midwest which I loved but no jobs in my field. I ended up with job choices in many states but not located in the Midwest. I moved alone where I did not know a soul for a job and made a life. Bloom where you and a decent job are planted>8)
I moved for my first job when nationwide unemployment was around 10% and I thought that's just what you had to do, and besides, I wanted to get out of Dodge (i,e, Iowa.)
iris lilies
12-24-13, 7:41pm
Gotta give you credit once again, Iris. Rob
But this is essentially a capitalistic idea: take your business to the place that offers you the best value. I don't see anything wrong with that as medical care is essentially a capitalistic endeavor. :) You won't like that, however. :) :)
gimmethesimplelife
12-24-13, 7:45pm
But this is essentially a capitalistic idea: take your business to the place that offers you the best value. I don't see anything wrong with that as medical care is essentially a capitalistic endeavor. :) You won't like that, however. :) :)I'm 50/50 on this one. I don't believe health care should be done on a for profit basis and on this one I doubt I'll ever budge. Given that I'm in a country in which human life is not automatically worth access to health care, I have no problem fleeing for health care to another country that gives me a much better deal. I don't see this as being hypocritical but instead as a). basic survival, and b). proof that I love and respect myself. Rob
iris lilies
12-24-13, 7:58pm
I'm 50/50 on this one. I don't believe health care should be done on a for profit basis and on this one I doubt I'll ever budge. Given that I'm in a country in which human life is not automatically worth access to health care, I have no problem fleeing for health care in another country that gives me a much better deal. I don't see this as being hypocritical but instead as a). basic survival, and b). proof that I love and respect myself. Rob
I don't see it as being hypocritical, I see you as being a Capitalist!
Back in 1980, when the unemployment rate was 10%, I went to WY and rented a trailer at the time. Many of the workers were living in travel trailers. No one was living in tents. Back then there were many places made available to park a trailer. I'll bet you could find a place in the Dakotas without much problem. But you would have to try.
I'm 50/50 on this one. I don't believe health care should be done on a for profit basis and on this one I doubt I'll ever budge. Given that I'm in a country in which human life is not automatically worth access to health care, I have no problem fleeing for health care in another country that gives me a much better deal. I don't see this as being hypocritical but instead as a). basic survival, and b). proof that I love and respect myself. Rob
You have stated this many times. When are you moving? I would be interested in reading about the process.
Back in 1980, when the unemployment rate was 10%, I went to WY and rented a trailer at the time. Many of the workers were living in travel trailers. No one was living in tents. Back then there were many places made available to park a trailer. I'll bet you could find a place in the Dakotas without much problem. But you would have to try.
The KOA in Williston, ND is leased through 2022. I know, I went there. Its a different scenario than when we were younger, similar, but different for a lot of reasons not the least of which is the regulatory environment.
I don't believe health care should be done on a for profit basis and on this one I doubt I'll ever budge.
And how would you feel if you just spent $400,000 and 8 years in medical school? What if you and a few of your buddies just spent $100 MILLION building a state of the art clinic to diagnose everything related to, say, heart disease? If there wasn't a financial reward for all that work or all that risk would you still do it?
gimmethesimplelife
12-25-13, 3:13pm
And how would you feel if you just spent $400,000 and 8 years in medical school? What if you and a few of your buddies just spent $100 MILLION building a state of the art clinic to diagnose everything related to, say, heart disease? If there wasn't a financial reward for all that work or all that risk would you still do it?This is yet ANOTHER issue of American health care I don't know that I'll ever be able to forgive. The necessity for this level of debt to get through medical school is just inexcusable and sets physicians up to think in terms of money and the game that AHC (American Health Care) now is. Rob
To answer your question though, if I had that much of a passion to be a physician, I would realize that it would be working against myself to remain in America for either school or practice at a later date. I would leave. Rob
ApatheticNoMore
12-25-13, 3:17pm
I don't think we want doctors whose major goal is financial reward. Of course noone expects them to become monks, but we're really not served if financial reward is a far more prominent reason for choosing the profession than helping people plus scientific curiosity plus ability to have a profession that allows autonomy, self-fulfillment in using your expertise to help human beings (that you live comfortably sure, but it was the total package - if money is your main goal in life it's the wrong profession). And I think that's more how it used to be and purely money is more how it's becoming, and it's not going to improve people's experiences with doctors. But if your paying off 400k in debt your not even talking about "reward" anymore. Blackmail or something maybe.
Rob, I know you said somewere that Argentina gives health insurance to everyone. It may give emergency care, just like here, but it looks like you would still need some sort of Insurance, or pay cash, it you need care.
Argentina doesn't look that good to me. I guess if you got a job the union insurance may be OK, but can you even get a job if your not a citizen? And who want's to work? I don't know the cost, but it looks like you will still be required to purchase health insurance.
http://en.wikipedia.org/wiki/Health_care_in_Argentina
http://healthgov.net/argentina.php
http://www.expat-blog.com/en/guide/south-america/argentina/1446-health-care-in-argentina.html
Teacher Terry
12-25-13, 5:15pm
DMC, those were very interesting articles. The articles stated that wait times were long even for an x-ray & the quality of care really varied. The bottom line is that nothing is free. We as a society have to decide what the majority is or is not willing to pay for.
Yossarian
12-25-13, 6:14pm
We as a society have to decide what the majority is or is not willing to pay for.
A couple of months ago I was preparing to travel to strange places and decided to get some immunizations against bad things. Called the county health clinic- soonest they could get me in was 5 weeks. Was traveling in 2 so called a private clinic. They got me in the next afternoon. I'm sure I paid for the convenience, but that is what we need. We can't have Cadillac services for everyone, but you also shouldn't make everyone ride the bus. I'm ok with free basic services as long we have the option to buy up on our own nickel.
I don't think we want doctors whose major goal is financial reward.
I really think there are very few MD's that have high incomes as their primary goal. Simply put, there are tons of ways to make that kind of money and almost every one of them is far simpler and less stressful.
This is yet ANOTHER issue of American health care I don't know that I'll ever be able to forgive. The necessity for this level of debt to get through medical school is just inexcusable and sets physicians up to think in terms of money and the game that AHC (American Health Care) now is. Rob
To answer your question though, if I had that much of a passion to be a physician, I would realize that it would be working against myself to remain in America for either school or practice at a later date. I would leave. Rob
The real trick isn't the money, its the time. You can always figure out a way to make money and pay off debt, but you can never get time back. How would you suggest we compensate someone for spending 10 years of their life learning to take care of us? Keeping in mind that the 10 years is very highly stressful, often involves 16 hour work days, long stints with no days off, etc.
I really think there are very few MD's that have high incomes as their primary goal. Simply put, there are tons of ways to make that kind of money and almost every one of them is far simpler and less stressful.
It is kind of limited to what you're good at - and what's marketable. Although if the goal was not money they really would not need another way to make that kind of money anyway.
It is kind of limited to what you're good at - and what's marketable. Although if the goal was not money they really would not need another way to make that kind of money anyway.
Medical providers have very well defined skill sets. Med school isn't something most people could fake their way through. As for supply and demand that part is true regardless of profession. If you can fill a niche where there is a low supply and a high demand (like the medical field) you can make a lot of money. Countless opportunities to do that exist in fields that don't require a decade of schooling and training. It would be silly to say that absolutely anyone could pull if off, but most people significantly underestimate how many can. I know very few people who don't have the skills, most of them just don't have the guts to start or the persistence to stay in the game long enough.
ApatheticNoMore
12-26-13, 2:32pm
I know very few people who don't have the skills, most of them just don't have the guts to start or the persistence to stay in the game long enough.
the skills to go to medical school? Well it does actually have to be something you are interested in (or else you truly are an utterly hollow person just pursuing money, my pure science friends looked down on the pre-med people this way as just in it for the money (because haha there is nothing but poverty in pure science) - but it's probably better to cut them the benefit of the doubt and assume that some truly want to help people). But what could I possibly know about medical school anyway, gee I don't know, my dad was in medical school for several years afterall, quit when he found out they were just toying with him to keep him on doing dirt cheap labor as a grad student and were going to pull every trick to keep him from actualy graduating. But he wanted to be a doctor? Well no, actually I don't think he ever did really (I don't think think he much liked dealing with most people in the particular, though he did want to benefit humanity in the abstract), ergo he wanted to do medical research. As for people in other fields and whether they pursue maximum money, maybe they just don't value money that much. I mean what will you sacrifice in the pursuit of money? I assumed it was a given you'd sacrifice other values in life if you really want to maximize money. So no they may see no path to riches anyway, but riches may not be their ultimate value anyway.
the skills to go to medical school?
No. The skills to earn a lot of money.
I assumed it was a given you'd sacrifice other values in life if you really want to maximize money.
You don't have to give anything up. Most people who make a lot of money are extremely ethical and start doing whatever it is they do because it was something that held value to them from the beginning. Those people just don't make for good press which is why you only hear about the bad apples.
Just found out my health insurance (purchased in the "individual market" as no one has a job with an employer that offers health benefits) is going up more than 50%, from $450 per month to $680 for our family of four. This is supposed to be a "catastrophic" policy, as our deductible is a whopping $15,000 per person. Of course, when we actually had a "catastrophe" this past year costing way more than $15K, they denied coverage. Unbelievable.
I have not yet read the fine print but hope that this premium increase will at least come along with some additional coverage. For example, I heard that high-deductible plans are not ACA compliant, so maybe my deductible has gone down . . . Will also be shopping on the "exchange" to see if those policies might be cheaper or better.
My insurance costs went to $0 at first, because my existing policy was cancelled. Yay!
Now I finally have a new policy, it claims to cost nearly $0, so a big savings off the $1200 a month or so I was paying before. Except it doesn't seem to cover much, if anything, and requires me to use a doctor who, well, let's just say few people in my community were lining up to see him before...
So who knows what the real cost savings will be, since I may have to pay even more out-of-pocket, and a higher deductible, and so on.
Thanks for letting me keep my plan, and my doctor. Not.
$1200 a month would cover a lot of office visits with your doctor of choice, I would think.
$1200 a month would cover a lot of office visits with your doctor of choice, I would think.
Though if I had anything serious, I'd then have to go visit Dr. Death to get into The System and get the treatment covered. Boo.
try2bfrugal
1-9-14, 7:23pm
My insurance costs went to $0 at first, because my existing policy was cancelled. Yay!
Now I finally have a new policy, it claims to cost nearly $0, so a big savings off the $1200 a month or so I was paying before. Except it doesn't seem to cover much, if anything, and requires me to use a doctor who, well, let's just say few people in my community were lining up to see him before...
So who knows what the real cost savings will be, since I may have to pay even more out-of-pocket, and a higher deductible, and so on.
Thanks for letting me keep my plan, and my doctor. Not.
Sorry to hear that and a bit surprised. We have a plan that includes our highly ranked regional hospital / trauma center and it seems like hundreds or maybe thousands of doctors in their network to choose from. We had about 20 different plan choices with a variety of insurance companies to choose from (Anthem, Kaiser, Blue Shield and a couple of smaller ones.)
Did you have a limited selection because of your location?
Did you have a limited selection because of your location?
I live in a remote rural area, on an island. Only a couple of doctors here. Anyone else is a day+ commute, and about $75-$100 in costs to get there/back.
I live in a remote rural area, on an island. Only a couple of doctors here. Anyone else is a day+ commute, and about $75-$100 in costs to get there/back.
Strangely enough, if there's a Walmart on your island and you're interested in becoming a greeter, you can get much cheaper insurance and a much larger network of doctors and hospitals under their employee plans than you can under Obamacare. http://washingtonexaminer.com/surprise-walmart-health-plan-cheaper-offers-more-coverage-than-obamacare/article/2541670
I hope Rob sees this...he could get a really nice policy with lower deductibles for as little as $40 a month.
$40/Month sounds pretty swell. Our final tally is in. For just DD2 and I (DW has employer provided) we went up $122/month from our old policy that got cancelled. That's the good news. The down side is that in order to keep the increase relatively reasonable our deductible went from $2500 to $6000. And we dropped from 5 office visits at $0 each to 3 at $20. Joy!
You have to be a lawyer just to figure out what the options are when reading the fine print, it seems. Heart breaking to read this. I had not realized that hospitals and doctors could opt out of providing care.
Ours went up to $1330 per month for the two of us. I havnt worked out our taxes yet to see how much Alan is going to chip in for mine.
I am buying a plan that will cost around $600/month (Silver).I won't get any subsidies. I'll use it combined with the VA hospital where I'll probably continue to get treatment (just found out I might actually have something wrong with me that the VA is in the process of checking out - UGH) and the insurance plan will reimburse the VA for any tests or treatment I receive there until I can find a Dr on the insurance plan. Am planning to use money from my savings rather than go back to work to pay the increased costs. Although working at Walfart for the $40/month insurance is looking good :-)!
Strangely enough, if there's a Walmart on your island and you're interested in becoming a greeter, you can get much cheaper insurance and a much larger network of doctors and hospitals under their employee plans than you can under Obamacare. http://washingtonexaminer.com/surprise-walmart-health-plan-cheaper-offers-more-coverage-than-obamacare/article/2541670
I hope Rob sees this...he could get a really nice policy with lower deductibles for as little as $40 a month.
So, if he goes to work for Walmart, they will increase the number of doctors AND facilities on his remote island? Wow! Who knew Walmart would go to SUCH lengths for their employees! ;)
ApatheticNoMore
1-10-14, 5:03pm
Although working at Walfart for the $40/month insurance is looking good :-)!
I am in the wrong field ...
maybe I should just quit and go work for walmart
try2bfrugal
1-10-14, 5:59pm
I live in a remote rural area, on an island. Only a couple of doctors here. Anyone else is a day+ commute, and about $75-$100 in costs to get there/back.
But how many doctors are in your network overall? How many different plans were you able to choose from?
THe ACA can't control where you live or the doctors on your island. Our subsidized exchange plan seems to have hundreds maybe thousands of doctors in network and we aren't assigned a particular doctor. We can go to any in network doctor we want. The intent of the ACA was not to place more doctors in rural areas, so I am not understanding the issue you are having with the ACA.
So, if he goes to work for Walmart, they will increase the number of doctors AND facilities on his remote island? Wow! Who knew Walmart would go to SUCH lengths for their employees! ;)No, they'd simply let him choose from a much larger field of doctors and hospitals than those allowed under the ACA approved plans.
Without going back to the original story to check, I believe the example given was Chicago where people with ACA approved plans were limited to something over 9000 doctors while those covered under the much cheaper Walmart plan are able to choose between around 25,000 doctors. Walmart didn't have to go to any lengths at all, they simply didn't restrict choices, which seems to be the antithesis of the government approved plans.
try2bfrugal
1-10-14, 7:21pm
No, they'd simply let him choose from a much larger field of doctors and hospitals than those allowed under the ACA approved plans.
Without going back to the original story to check, I believe the example given was Chicago where people with ACA approved plans were limited to something over 9000 doctors while those covered under the much cheaper Walmart plan are able to choose between around 25,000 doctors. Walmart didn't have to go to any lengths at all, they simply didn't restrict choices, which seems to be the antithesis of the government approved plans.
9,000 is still a lot of doctors to choose from! I think I would be able to find a few I like in that number.
Under one employer plan we had years ago we basically had no choice but to go to Kaiser. That is what I would call a severely limited choice of doctors and hospitals. Not all employer plans have 25,00 doctor networks to choose from. I am not sure that a plan with 25,000 or a zillion doctors is much better than 9,000. I probably won't go to even half the 9,000 or so doctors in our current plan as it is. :)
So pre ACA I could go back to paying $2300 a month for health insurance with high deductibles because that is the only plan we could get with pre-existing conditions and have additional doctors I don't use anyway in my plan, or post ACA save $2K a month on premiums and have lower deductibles and out of pocket maximums and simply pick a plan with the doctors we go to now in network.
I'm think I like the ACA plan better.
But how many doctors are in your network overall? How many different plans were you able to choose from?
There are lots of doctors in my network, true. They all, except for the one I was assigned by some faceless functionary, require 1-2 days' travel to get to, and perhaps $75 in travel expenses for ferry fares and whatnot. I might as well count doctors in Manhattan in my list...
The intent of the ACA was not to place more doctors in rural areas, so I am not understanding the issue you are having with the ACA.
I'm not asking for "more doctors in rural areas". I'm asking simply to be able to keep my *existing* doctor in my rural area, the one who has been treating my family for well over a decade, a doctor we have a happy personal relationship with.
So, the "issue" I am having with the ACA is it ended up with me having useless coverage, and told to use a doctor I wouldn't take a patient to with a splinter, much less trust with my own health.
So, yay. Rob and his progressive minions interfering with my existing health care solutions has resulted in me being hosed.
Again, you can go fee-for-service with the money you save, while a lot of people who were denied coverage now have it. I can't see a problem.
Again, you can go fee-for-service with the money you save, while a lot of people who were denied coverage now have it. I can't see a problem.
+1 Also, I've never seen the big deal about having one doctor your entire life. I go to a Cigna clinic and have a "primary care" doctor assigned to me, but if I just need someone to check out a rash or something and she's not available, I can get whichever doctor is available to exam me and prescribe something if needed. Then it's done and I'm out the door.
To me it's like having a good car mechanic - for most things a competent MD is able to exam and treat like most other competent MDs. I don't need a personal relationship with them.
Well, I *do* need a personal relationship with my doctor, as does my wife.
And while, sure, I can continue to see my existing doctor for minor stuff, for anything *major*, I'll apparently have to go through The Other Guy if I want things covered. I don't want to see The Other Guy. Ever. I deal with interacting with these doctors several times a week for medical calls for other people, I'm not going near The Other Guy. Some twit in an office decided he knew better.
My "bad evil" insurance policy I had, before The Powers That Be decided I was being swindled and could not be allowed to purchase such a poor product, allowed me to see *anyone*, and be covered, which was critical for our circumstances.
I don't have much polite left to say about the situation, if I had something truly life-threatening and was thrown into this situation, I'd be well and truly angry.
Cheers.
There are lots of doctors in my network, true. They all, except for the one I was assigned by some faceless functionary, require 1-2 days' travel to get to, and perhaps $75 in travel expenses for ferry fares and whatnot. I might as well count doctors in Manhattan in my list...
I'm not asking for "more doctors in rural areas". I'm asking simply to be able to keep my *existing* doctor in my rural area, the one who has been treating my family for well over a decade, a doctor we have a happy personal relationship with.
So, the "issue" I am having with the ACA is it ended up with me having useless coverage, and told to use a doctor I wouldn't take a patient to with a splinter, much less trust with my own health.
So, yay. Rob and his progressive minions interfering with my existing health care solutions has resulted in me being hosed.
Well, you're not exactly required to buy from that particular company, are you. Why don't you call your prefered dr. and ask them who they accept. Then shop that companies plans. It's not exactly like you're going hat in hand.
sheesh! It ain't rocket surgery!
Peggy,
You are welcome to spend a zillion hours on this state's web site and on the phone with their helpful representatives to try and accomplish that, as my dear wife did. We were lucky to get them to assign us *any* plan by the deadline, they didn't tell us what it covered, or who the company was even, "all that will be sorted out later".
Then again, they only had as much time to get this to work as it took to fight WWII. So maybe we should cut them some slack.
gimmethesimplelife
1-10-14, 9:43pm
Peggy,
You are welcome to spend a zillion hours on this state's web site and on the phone with their helpful representatives to try and accomplish that, as my dear wife did. We were lucky to get them to assign us *any* plan by the deadline, they didn't tell us what it covered, or who the company was even, "all that will be sorted out later".
Then again, they only had as much time to get this to work as it took to fight WWII. So maybe we should cut them some slack.Bae, I gotta say on this one I'm seeing it sort of kind of your way. Please don't go into cardiac arrest, ok? LOL.
I don't care for how Obama stated that if you liked your insurance you could keep it and your current doctors, too. There should have been some kind of warning to one and all that catastrophic plans would be eliminated and brought up to par with extensive plans. I myself would not prefer a catastrophic plan, to me that just begs bankruptcy, but then I am not you and you are (or should be) free to make your own decisions as to what constitutes adequate coverage. Oh, wow, I'm getting conservative here, or what? The flip of that is that I get to disagree with what you consider adequate and make my own choices, which I have a feeling that Bae here would be OK with (?).
I would also agree that when you were directed to this new plan, you should have been informed of all the distance from being homeless information - premiums, deductibles, co-pays, exclusions, any costs that could have you in financial upheaval. I don't like the way you say this transfer to this new plan was handled.
Personally, I can understand why you would want to keep the same doctor, too. I have a doctor in Mexicali that I trust and that has a large American and also Canadian clientele and his costs are very reasonable. This is what I have had to do given what American health care has become but I'm OK with it and I will keep this doctor, even with Medicaid. I do agree that for basic visits, I wouldn't need to see the same doctor on either side of the border, but I would keep track of all US visits and bring this information to Dr. Ramon next time I saw him. I do think it's good to have a doctor/patient relationship and I am seeing that some of these plans erode this. I can understand dissatisfaction with this, too. For myself, I am going to keep Dr. Ramon in Mexicali, but what do untold millions of others do who can't just hop into a bus and ride on off to Mexicali? This is not practical for most people due to geographic distances/work requirements.
Long and short of it, Bae, I do see where you have some valid points. And this comes from one of the board's liberals. Rob
gimmethesimplelife
1-10-14, 9:49pm
Strangely enough, if there's a Walmart on your island and you're interested in becoming a greeter, you can get much cheaper insurance and a much larger network of doctors and hospitals under their employee plans than you can under Obamacare. http://washingtonexaminer.com/surprise-walmart-health-plan-cheaper-offers-more-coverage-than-obamacare/article/2541670
I hope Rob sees this...he could get a really nice policy with lower deductibles for as little as $40 a month.Alan, I did see this.
Gotta say that I have not cared for WalMart much for years. I have the standard dislikes of the company - low pay, scheduling done by computers and not humans so you can't really make any plans/have another job/go to school while you work for them, increased reliance on government programs due to low Wal Mart pay, how this company tends to force mom and pop stores to close down as they can't compete with predatory pricing, do you want me to go on? I could for some time.
It is nice to see something POSITIVE about Wal Mart for once, and if this all is true, more power to them for being for once HUMANE in one area if in no others. I might not like admitting this but as I've said before, I do believe in giving credit where credit is due. Here in this one area Wal Mart deserves some credit in my book. Rob
try2bfrugal
1-10-14, 9:55pm
Peggy,
You are welcome to spend a zillion hours on this state's web site and on the phone with their helpful representatives to try and accomplish that, as my dear wife did. We were lucky to get them to assign us *any* plan by the deadline, they didn't tell us what it covered, or who the company was even, "all that will be sorted out later".
Then again, they only had as much time to get this to work as it took to fight WWII. So maybe we should cut them some slack.
California has a list of the doctors for each plan right on the Covered California site. It takes under a minute to check is a doctor if on a certain plan. Also we were not assigned a doctor. We can go to any one of thousands of doctors in the network for our chosen plan. I don't think assigned doctors are a requirement of the ACA. Maybe if you sin up for an HMO it is a requirement of the HMO?
Your post had me curious so I checked out the exchange for Washington state. It has detailed plan comparisons as well as doctor look ups. Did your wife use the plan at www.wahealthplanfinder.org? (http://www.wahealthplanfinder.org?)
I don't know where you live so I just used an Oak Harbor zip code on Whidbey Island. I found 27 different plans to choose from three different providers.
I am not sure where this no plan information available, lucky to get a plan or doctor assigned to you, or any of that is coming from. Your state exchange site looks very similar to the California exchange site with a wide variety of choices of plans and doctors available and easy to see and compare online. Have you looked at the www.wahealthplanfinder.org (http://www.wahealthplanfinder.org) site?
gimmethesimplelife
1-10-14, 9:59pm
California has a list of the doctors for each plan right on the Covered California site. It takes under a minute to check is a doctor is on a certain plan. Also we were not assigned a doctor. We can go to any one of thousands of doctors in the network. I don't think assigned doctors are a requirement of the ACA.
Your post had me curious so I checked out the exchange for Washington state. It has detailed plan comparisons as well as doctor look ups. Did your wife use the plan at www.wahealthplanfinder.org?
I don't know where you live so I just used an Oak Harbor zip code on Whidbey Island. I found 27 different plans to choose from three different providers.
I am not sure where this no plan information available, lucky to get a plan or doctor assigned to you, or any of that is coming from. Your state exchange site looks very similar to the California exchange site with a wide variety of choices of plans and doctors available and easy to see and compare online. Have you looked at the www.wahealthplanfinder.org site?I'm not 100% but I think Bae lives on one of those rural islands where you are closer to Canada than the United States (?). Whidbey Island is not too far from Seattle if I remember right, so there are of course going to be more doctors accessible there as there are more people in the area. I can see where being rural may work against you with some of these plans having narrower networks. Rob
try2bfrugal
1-10-14, 10:11pm
I'm not 100% but I think Bae lives on one of those rural islands where you are closer to Canada than the United States (?). Whidbey Island is not too far from Seattle if I remember right, so there are of course going to be more doctors accessible there as there are more people in the area. I can see where being rural may work against you with some of these plans having narrower networks. Rob
The plans available, doctor networks and plan comparison features for Washington State are all online on the state's exchange web site. I am not able to reconcile that with: "We were lucky to get them to assign us *any* plan by the deadline, they didn't tell us what it covered, or who the company was even, "all that will be sorted out later".
Correct, Rob, I can swim across the border to Canada if need be from here :-)
Luckily, I'm still young enough the friendly Canadians might just let me move there :-)
ApatheticNoMore
1-10-14, 10:29pm
The plans available, doctor networks and plan comparison features for Washington State are all online on the state's exchange web site.
interesting because I think that was precisely the feature that did NOT work in covered california, the doctor and hospital look up.
Yea this is an old article, but it hasn't worked even recently:
http://articles.latimes.com/2013/oct/16/business/la-fi-exchange-doctors-20131017
My task is the usual hopeless one: try to convince people to keep their existing plans rather than going with a covered plan and saving from $8-$20 a month - ie money spent on lottery tickets or something :~) I mean really for people that just simply waste money! But heaven forbid paying money for decent health insurance - oh noes, not that, better buy another shirt to add to your pile of 500 shirts or something - family >8)
try2bfrugal
1-10-14, 10:36pm
interesting because I think that was precisely the feature that did NOT work in covered california, the doctor and hospital look up.
Yea this is an old article, but it hasn't worked even recently:
http://articles.latimes.com/2013/oct/16/business/la-fi-exchange-doctors-20131017
My task is the usual hopeless one: try to convince people to keep their existing plans rather than going with a covered plan and saving from $8-$20 a month - ie money spent on lottery tickets or something :~) I mean really for people that just simply waste money! But heaven forbid paying money for decent health insurance - oh noes, not that, better buy another shirt to add to your pile of 500 shirts or something - family >8)
The doctor look up has worked fine for us on on different computers for Covered California since mid November.
I don't understand what you mean by "your task". Most of the inexpensive, older plans out there were kind of sham plans. We spent ~$50K on premiums, co-pays, etc last year in total health care costs.
Why is this your task? Are you an insurance agent or financial planner? What is your expertise in telling people what kinds of insurance plans to buy?
ApatheticNoMore
1-10-14, 10:40pm
It's my task because family members are morons who continually make horrible financial decisions. They are forever getting into financial trouble. My expertise is I'm not forever running up credit card debts I can't pay and so on, I don't get in the trouble they do. Still I could just tell them to F off!
try2bfrugal
1-10-14, 10:44pm
It's my task because family members are morons who continually make horrible financial decisions. They are forever getting into financial trouble. Still I could just tell them to F off! F off and die - does have a nice ring to it :)
So you give them recommendations without actually comparing coverage or plan attributes, like deductibles or out of pockets maximums?
ApatheticNoMore
1-10-14, 10:48pm
So you give them recommendations without actually comparing coverage or plan attributes, like deductibles or out of pockets maximums?
I give them advice like: research the size of the network, see what doctors and hospitals are in it, look at deductables and out of pocket maximums don't just pick a plan in order to save $8, because it might have a much smaller network, do a full comparison, PRICE (of premiums) IS NOT THE ONLY THING THAT MATTERS! It's not buying socks or something! I give them advice like this, trying to encourage fully informed decision making. It falls on deaf ears. You can lead a horse to water ...
9,000 is still a lot of doctors to choose from! I think I would be able to find a few I like in that number.
Under one employer plan we had years ago we basically had no choice but to go to Kaiser. That is what I would call a severely limited choice of doctors and hospitals. .
My sister has Kaiser thru her job and it is very severely limiting even in the LA/OC metro area. Not only the number of Dr's and hospitals to choice from, but the wait times to get an appt. or any kind of specialty tests like MRIs. They seem to make you wait 6 weeks for everything even if the person is in great pain or may have a serious condition. It took my sister over a year to find out of the mass in her knee which caused her excoriating pain was cancerous or not - mostly waiting 6 weeks between each appt (6 weeks to get an appt with her primary care dr., then another 6 weeks to get an MRI, than another 6 weeks to see her primary care dr again, than 6 weeks to get in to see a specialist, then 6 weeks for another MRI...etc...). It makes the VA hospital look down right speedy! And if she was unemployed then the policy would have cost $1200/month for the premiums (prior to the ACA but is high even with it). terrible!
I have a new Silver level plan (just got my card today) but haven't looked online to see how many doctors are in network or what choices I have, But being in a large population center I imagine it has many choices...or not. Probably many more than Bae has up there on his island of 50 souls (counting all the dogs too :-)!).
gimmethesimplelife
1-11-14, 4:10pm
My sister has Kaiser thru her job and it IS a very severely limiting. Not only the number of Dr's to choice from but the wait times to get an appt. or any kind of specialty tests like MRIs even if the person is in great pain or may have a serious condition. It took my sister over a year - mostly waiting for appointments - too find out of the mass in her knee which caused her excuriating pain was cancerous or not. At least 6 weeks wait for everything. It makes the VA hospital look down right speedy! And if she was unemployed then the policy would have cost $1200/month for the premiums (prior to the ACA but is high even with it). terrible!
I have a new Silver level plan (just got my card today) but haven't looked online to see how many doctors are in network or what choices I have, But being in a large population center I imagine it has many choices...or not. Probably many more than Bae has up there on his island of 50 souls (counting all the dogs too :-)!).Hi Spartana!
I had Kaiser years ago when I worked for Multnomah County, Oregon. Back then it was a pretty good plan, and when I got laid off - please remember this was in the early 90's - my Cobra cost 136.09 a month and I was able to keep it. I really liked Kaiser back then but from what you are posting there have been changes and not for the better. I have heard them called Miser Permanente - I have heard that when you call to make an appointment, the CSR's get a bonus if they can talk you out of making an appointment, and I have also heard that a quick way to get an appointment is to threaten litigation. I'm hoping this is not true.
I'm glad you got your card today! Still waiting on mine. Mid February is what I am hearing now. Rob
Hi Spartana!
I had Kaiser years ago when I worked for Multnomah County, Oregon. Back then it was a pretty good plan, and when I got laid off - please remember this was in the early 90's - my Cobra cost 136.09 a month and I was able to keep it. I really liked Kaiser back then but from what you are posting there have been changes and not for the better. I have heard them called Miser Permanente - I have heard that when you call to make an appointment, the CSR's get a bonus if they can talk you out of making an appointment, and I have also heard that a quick way to get an appointment is to threaten litigation. I'm hoping this is not true.
I'm glad you got your card today! Still waiting on mine. Mid February is what I am hearing now. Rob
My sister finally put in a whole bunch of complains about the waiting times being so excessive that now they seem to take her fairly quickly. So maybe that is what is people need to do. She liked Kaiser because it was a non-profit and likes not having to muck around with a PPO and all the various billing and pre-approval stuff you have to do with them to make sure you are covered for treatment (and often STILL not knowing if you are or not and getting billed). But yeah, they can be a pain to deal with.
try2bfrugal
1-11-14, 4:32pm
My sister has Kaiser thru her job and it is very severely limiting even in the LA/OC metro area. Not only the number of Dr's and hospitals to choice from, but the wait times to get an appt. or any kind of specialty tests like MRIs. They seem to make you wait 6 weeks for everything even if the person is in great pain or may have a serious condition. It took my sister over a year to find out of the mass in her knee which caused her excoriating pain was cancerous or not - mostly waiting 6 weeks between each appt (6 weeks to get an appt with her primary care dr., then another 6 weeks to get an MRI, than another 6 weeks to see her primary care dr again, than 6 weeks to get in to see a specialist, then 6 weeks for another MRI...etc...). It makes the VA hospital look down right speedy! And if she was unemployed then the policy would have cost $1200/month for the premiums (prior to the ACA but is high even with it). terrible!
I have a new Silver level plan (just got my card today) but haven't looked online to see how many doctors are in network or what choices I have, But being in a large population center I imagine it has many choices...or not. Probably many more than Bae has up there on his island of 50 souls (counting all the dogs too :-)!).
We had similar experiences here with Kaiser. I would not go to them again unless we lived some place with no other local option, and even then I'd probably move. It isn't worth saving any amount of money to me to get only some sort of half baked medical care, which is what happens when the waiting times are so long for appointments and the ER is always overflowing beyond capacity. It is like having no ER to go to at all.
Good luck on your silver plan. I hope you like it.
Peggy,
You are welcome to spend a zillion hours on this state's web site and on the phone with their helpful representatives to try and accomplish that, as my dear wife did. We were lucky to get them to assign us *any* plan by the deadline, they didn't tell us what it covered, or who the company was even, "all that will be sorted out later".
Then again, they only had as much time to get this to work as it took to fight WWII. So maybe we should cut them some slack.
Bae, I'm sorry you seem to be having trouble, but really, this isn't THAT difficult. As try2bfrugal pointed out, Washington has a pretty good website to consult. Also, as I suggested, why don't you simply call YOUR PREFERED doctor's office and ask his receptionist which insurance they accept. Then shop that companies plans.
I'm sure you aren't trying to suggest, as I know YOU know, that this isn't really a government takeover of health care. You don't have to wait to be assigned a plan, and if you like a particular doctor, then buy a plan HE will accept. This is free will, as we all know. It is really your choice. Buy a plan that suits you, which includes going to the doctor of your choice. Unless your doctor has suddenly decided to move from your island, or he is a pay as you go type of doctor (in which case he probably was before the ACA?) you shouldn't have a problem finding insurance he will accept.
Now, if you only have 2 doctors on your island, or your prefered guy refuses to take your calls, this isn't the fault of the ACA or Obama. Living in an extremely remote area isn't the fault of Obamacare.
And yet, previously I had a plan that met my needs for a cost I was OK with that allowed me to see the doctor I wanted. And now I don't.
Progress!
Simply Divine
1-11-14, 8:52pm
By all means, google Denmark best for upward mobility and click on the first thing that pops up. Read the charts at the bottom of the page - it may open your eyes to some truths about the US.....along the lines of what I tend to discuss. Rob
I haven't read the entire thread yet, so I'm sorry if this has been posted, but here is a link to what Rob is talking about:
http://money.cnn.com/2013/12/09/news/economy/america-economic-mobility/
gimmethesimplelife
1-11-14, 10:17pm
I haven't read the entire thread yet, so I'm sorry if this has been posted, but here is a link to what Rob is talking about:
http://money.cnn.com/2013/12/09/news/economy/america-economic-mobility/SD, thanks for posting this. Rob
This really does shed some light on the lack of upward mobility and the virtual caste system we have in the US now.
try2bfrugal
1-11-14, 10:19pm
And yet, previously I had a plan that met my needs for a cost I was OK with that allowed me to see the doctor I wanted. And now I don't.
Progress!
Have you looked at the Washington State web site yet? I entered my family data just to compare plans and it seemed quite informative, and the zip code I used had a wide variety of plans with large doctors networks to choose from.
You have a plan that doesn't allow you to see your current doctor because you can't be bothered to call him and ask what plans he is on or do a 3 minute check on the web site using the doctor feature.
No one assigned a plan to you. Your wife picked a plan. Why did your wife pick a plan your doctor wasn't on if this doctor is so important to you?
Is your doctor on any insurance plans? Do you even know or care enough to find out?
Did you expect to have one insurance plan for the rest of your life and never have to change insurance again, ACA or not?
Why in the world don't you call your doctor and find out what plans he is on? You don't have to even buy insurance through the exchange. Go to ehealthinsurance and ask them to help you find a current plan your doctor belongs to if calling the doctor yourself or using a web site designed for the masses is too complicated for you.
Tell us your doctors name and I'd be happy to help you find all the plans you can choose from that he is on, if he accepts any plans at all.
Most likely your old plan was a half baked, skimpy sham plan like we had with outrageous, multiple and assorted out of pocket maximums where one hospitalization and you are out $50K in total medical costs for the year.
The one thing the ACA ended was new plans called "insurance" that really weren't. Medical costs have been the number one reason for bankruptcy in the U.S. and most of those households had health "insurance".
See previous discussion about spending endless hours on the phone and website trying to sort things out before the deadline... When things weren't working all that well...
"Have you..." "Why don't you..." "Why did you..." "A website designed for the masses is too complicated for you..."
The day we complied with the law, no details were available on what we were getting, what it would cover, who we could use, or any of that. The system was in disarray, and we'd invested countless hours trying to comply.
So piss off.
I'm sure it'll all get sorted out.
gimmethesimplelife
1-11-14, 10:26pm
Have you looked at the Washington State web site yet? I entered my family data just to compare plans and it seemed quite informative, and the zip code I used had a wide variety of plans with large doctors networks to choose from.
You have a plan that doesn't allow you to see your current doctor because you can't be bothered to call him and ask what plans he is on or do a 3 minute check on the web site using the doctor feature. No one assigned a plan to you. Your wife picked a plan. Why did your wife pick a plan your doctor wasn't on if this doctor is so important to you? Is your doctor on any insurance plans? Do you even know or care enough to find out?
Did you expect to have one insurance plan for the rest of your life and never have to change insurance again, ACA or not?
Why in the world don't you call your doctor and find out what plans he is on? You don't have to even buy insurance through the exchange. Go to ehealthinsurance and ask them to help you find a current plan your doctor belongs to if calling the doctor yourself is too complicated for you.
Most likely your old plan was a half baked, skimpy sham plan like we had with outrageous, multiple and assorted out of pocket maximums where one hospitalization and you are out $50K in total medical costs for the year.I have a history here of not agreeing with Bae very often and I see your point Try2bfrugal. It seems like it would be very easy to call his doctor and find out what insurance the doctor accepts and then find a plan on the exchanges that his doctor would accept. As Peggy has said, this is not rocket science, and as I have said, I'd much rather have a more comprehensive plan than a catastrophic plan as the idea of bankruptcy should I get sick with something that can't wait for a trip to Mexico strikes me (heart attack, stroke, that kind of thing). At the moment I'm supposed to be in Medicaid but I'm still waiting, but if I were in the exchanges, I'd be shopping for the most comprehensive I could afford.
That having been said, I can see that Bae is not entirely without a good point. Bae feels his catastrophic plan was adequate for his needs, and who am I to judge that? It wouldn't work for me but then I am not Bae. And Bae was told he could keep his plan if he liked it - he's right about that much. Once again, I'd be thrilled to get off the catastrophic and into something more comprehensive but doesn't Bae have the right to decide what is adequate for him? I agree with Try2bfrugal's last paragraph but....if this is good enough for Bae, I do believe that should be respected......Rob
iris lilies
1-11-14, 10:36pm
No one assigned a plan to you. Your wife picked a plan. Why did your wife pick a plan your doctor wasn't on if this doctor is so important to you?
".
But why did he or anyone else have to pick a new plan to begin with when the Prez promised he would keep his plan, doctor, insurance, whatever. Why?
iris lilies
1-11-14, 10:38pm
The one thing the ACA ended was new plans called "insurance" that really weren't. Medical costs have been the number one reason for bankruptcy in the U.S. and most of those households had health "insurance".
Do you think that all of the new OBamacare plans with their $6,000 deductible and only 60% paid for coverage will solve the bankruptcies?
try2bfrugal
1-11-14, 10:40pm
Do you think that all of the new OBamacare plans with their $6,000 deductible and only 60% paid for coverage will solve the bankruptcies?
Our ACA plan has much better coverage than our old sham plan, and lower out of pocket maximums.
......but doesn't Bae have the right to decide what is adequate for him?
Not anymore. The entire redistribution scheme falls apart when people have the right to decide for themselves.
try2bfrugal
1-11-14, 10:41pm
See previous discussion about spending endless hours on the phone and website trying to sort things out before the deadline... When things weren't working all that well...
"Have you..." "Why don't you..." "Why did you..." "A website designed for the masses is too complicated for you..."
The day we complied with the law, no details were available on what we were getting, what it would cover, who we could use, or any of that. The system was in disarray, and we'd invested countless hours trying to comply.
So piss off.
I'm sure it'll all get sorted out.
I am happy to help if you want to find a plan your doctor is on. Just let me know.
It's my impression you could have kept your plan (the generic you) if the insurance companies had been honest brokers, offering legitimate plans. And didn't want to beat the clock by trying to strong-arm people into buying more expensive plan in the narrow sign-up window. As bae said, it will shake out.
try2bfrugal
1-11-14, 10:57pm
But why did he or anyone else have to pick a new plan to begin with when the Prez promised he would keep his plan, doctor, insurance, whatever. Why?
Here is a good article on that topic -
One of the provisions in the Affordable Care Act is a grandfathering clause, intended to exempt the employer-sponsored insurance plans that were in existence at the time of the Affordable Care Act's passage from having to follow the contours of the Affordable Care Act. The problem with the line, "If you like your plan, you can keep it," is that it suggests that what's being grandfathered, here, is the customer's possession of a plan. But what was actually grandfathered were the plans that existed at the time, themselves.
What that means is that everyone could retain their plans so long as no alteration was made to those plans by their providers. However, the very minute a provider made a tweak to those plans, they lost the grandfather protection, and compliance with the Affordable Care Act's new standards became necessary.
http://www.huffingtonpost.com/2013/10/30/if-you-like-your-plan-you-can-keep-it-_n_4175715.html
The insurance companies are the ones canceling the existing plans.
In the State of Washington, our insurance commissioner also threw his hat into the ring...
http://blogs.seattletimes.com/healthcarecheckup/2013/11/14/state-insurance-commissioner-rejects-obamas-proposal-to-extend-canceled-policies/
gimmethesimplelife
1-11-14, 11:17pm
Do you think that all of the new OBamacare plans with their $6,000 deductible and only 60% paid for coverage will solve the bankruptcies?IL, not all exchange plans are that skimpy. This one you refer to here I believe is a bronze plan. If I made enough to get on the exchanges in Arizona, I could swing a pretty good deal with Health Net of Arizona for platinum plan (with subsidies, of course). I understand that Arizona is one of the cheaper states as Health Net is here and they have plans with very narrow providers as Apathetic No More has posted that really drive the prices on down. I could score a much lower deductible and have 90% paid coverage and $10 doctor visits with some pretty good subsidies. But then again I live in Arizona - not all states have this deal and I also live in a huge urban area, whereas Bae seems to be getting clobbered as he lives somewhere rural. So there are many faces and factors here to consider is my point. Rob
However, the very minute a provider made a tweak to those plans, they lost the grandfather protection, and compliance with the Affordable Care Act's new standards became necessary.
http://www.huffingtonpost.com/2013/10/30/if-you-like-your-plan-you-can-keep-it-_n_4175715.html
The insurance companies are the ones canceling the existing plans.
And that was the plan all along. Allowing people to keep plans that did not charge for un-needed services would have upset the apple cart, just as the current fear that not enough young, healthy people will sign up, will result in a system collapse.
gimmethesimplelife
1-11-14, 11:23pm
In the State of Washington, our insurance commissioner also threw his hat into the ring...
http://blogs.seattletimes.com/healthcarecheckup/2013/11/14/state-insurance-commissioner-rejects-obamas-proposal-to-extend-canceled-policies/So basically Obama backpedaled and tried to finagle it so that you could have the insurance plan you were told you could keep and then your state insurance commissioner said Nope, not going to play in that sandbox.
I have to say that I don't like this and for once I'm agreeing a bit with you. I still believe in ObamaCare (basically) but with some reservations and I don't like how this is working for you so far, Bae. I will still say I'd much rather - if it were me - be on a more comprehensive plan from the exchanges but this does not change the fact that you were indeed told you could keep your policy, and here even your state insurance commissioner is saying you can't. Not what you were told, I agree. Rob
try2bfrugal
1-11-14, 11:57pm
Do you think that all of the new OBamacare plans with their $6,000 deductible and only 60% paid for coverage will solve the bankruptcies?
California has plans with no deductibles and assorted co-pays, 10% co-pays for major expenses on the platinum plan -
http://www.cahba.com/covered-california/standardized-plans.htm
Households up to 250% of poverty level get extra cost sharing subsidies and have relatively low out of pocket maximums -
http://www.huffingtonpost.com/nathan-newman/obamacares-secret-subsidi_b_4078125.html
So yes, the lowest income households have a much lower chance of going bankrupt under the ACA. In California a low income household will have no deductible and a maximum yearly out-of-pocket limit of $2,250.
Pre ACA, on average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point -
http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/
So does the ACA solve this issue entirely? No, but the maximum out of pocket costs now are $6,350 for an individual plan and $12,700 for a family plan.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
So insurance available for most (no more $27K bills due to lack of insurance), Medicaid for those below a certain income level, at least in the states that expanded Medicaid, and cost sharing subsidies for families at 250% of federal poverty level or below with low out of pocket maximums (varies by state, $2.3K California) are a big step forward, though obviously we are still not at the universal health care status of other countries, and our medical costs in general are way still out of control compared to every other country on the planet.
See previous discussion about spending endless hours on the phone and website trying to sort things out before the deadline... When things weren't working all that well...
"Have you..." "Why don't you..." "Why did you..." "A website designed for the masses is too complicated for you..."
The day we complied with the law, no details were available on what we were getting, what it would cover, who we could use, or any of that. The system was in disarray, and we'd invested countless hours trying to comply.
So piss off.
I'm sure it'll all get sorted out.
Humm...I"m sure if you give try2bfrugal your doctors name, they can help you with this. It can be confusing, I know, but try2bfrugal seems to have it figured out.
I'm sorry your insurance company scammed you by strong arming you into buying something sight unseen. This was the situation for a lot of folks who had their policies canceled with the threat of no coverage unless you bought quickly well before the exchanges were up and running.
FYI- in the future, if anyone tries to pressure you into buying something, whether insurance, furniture, or a car, it's time to step back and take a breath and see it for what it is. Letting them use 'the deadline' as a pressure tactic should have been a clue as of course we all knew 'they' weren't going to come to your home and arrest you, or shoot you if you signed one day late! And any company who told me I must buy from them RIGHT NOW or lose the opportunity to buy from them later would make me say, fine, I don't want to do business with you anyway.
But, that's all in the past. The first step, of course, is to call your doctor and see which plans he will accept.:)
So basically Obama backpedaled and tried to finagle it so that you could have the insurance plan you were told you could keep and then your state insurance commissioner said Nope, not going to play in that sandbox.
I have to say that I don't like this and for once I'm agreeing a bit with you. I still believe in ObamaCare (basically) but with some reservations and I don't like how this is working for you so far, Bae. I will still say I'd much rather - if it were me - be on a more comprehensive plan from the exchanges but this does not change the fact that you were indeed told you could keep your policy, and here even your state insurance commissioner is saying you can't. Not what you were told, I agree. Rob
Obama din't exactly backpedal, he just clarified the 'keep it if you like it' bit, and allowed those who LOST THEIR INSURANCE DUE TO GREEDY INSURANCE COMPANIES to regain that sham insurance if they wanted. The really interesting bit is that the insurance companies DIDN'T WANT TO REISSUE those policies. So, as we can see, it wasn't exactly the insurance companies being FORCED to cancel the plans, as they claimed. They just used the ACA as an excuse to sell you more insurance.
I'm guessing that people with big health problems AND sham insurance that doesn't really cover anything weren't 'forced' to up their insurance policies as then the insurance companies would be forced to actually cover those health problems.;)
Rob,
am wondering if you saw the AZ Republic article in today's paper regarding Medicaid here in AZ? Turns out that "because of a federal-state disconnect, Arizona officials urge applicants who believe they are eligible for Medicaid to apply directly through the state's website, healtharizonaplus.gov. .... despite the federal-state glitch, Arizona has enrolled 30,433 in Medicaid so far, according to figures released last week."
I'm posting this for all vs. an IM to Rob just in case there's similar federal-state issues where you are.
It wasn't my insurance company pressuring/selling us anything. It was the wonderfully "helpful" people at our State, trying to get us signed up before the deadline by which we were required to comply by law. They were in complete disarray at the time - website had been broken for weeks, people on the other end of the phone untrained/confused/uninformed, and so on.
But, my direct personal experience is clearly irrelevant, compared to the constructed story of "all is good, it's a success!". At the "successful" rate my state, one of the better ones, is signing people up, we're ahead of the birth rate, so math says sometime in the next decade or two or three, certainly by my grandchildren's time, we'll get people signed up.
Mission accomplished.
(I'm also curious about the narrative that says that the insurance policy I had before was "a sham". I bought it knowing what it covered, I was reasonably happy with it, and used it several times for big-ticket surgeries and such. But again, personal experience, and personal choice, have no part in this war.)
gimmethesimplelife
1-12-14, 5:42pm
Rob,
am wondering if you saw the AZ Republic article in today's paper regarding Medicaid here in AZ? Turns out that "because of a federal-state disconnect, Arizona officials urge applicants who believe they are eligible for Medicaid to apply directly through the state's website, healtharizonaplus.gov. .... despite the federal-state glitch, Arizona has enrolled 30,433 in Medicaid so far, according to figures released last week."
I'm posting this for all vs. an IM to Rob just in case there's similar federal-state issues where you are.Hi Lainey!
Indeed I did see this in today's paper. Luckily after applying over the phone the first week of October, in mid-November I went to Keough Health Foundation over to 3rd Avenue North of Osborn and applied a second time - this time through a local navigator who used the healthearizona site. So I am (?)somewhere in the state system, and I did get a letter telling me that the state will be reevaluating my application with the new Medicaid criteria and I'm told they have until 2/14 to give me a yes/no answer. Frustrating to no end as I was under the impression that coverage was to begin on January 1st if you signed up a certain date - was it 12/23?
Right now as I've said I'm just glad to be five hours away from Mexicali. I do have faith that eventually I will get the card in the mail but until that date, which may be far off for all I know, THANK GOD FOR MEXICO! Rob
....I'm also curious about the narrative that says that the insurance policy I had before was "a sham".
That's the political narrative that must be used to show that the ACA and it's sponsor's, the Democrats, are our saviors, protecting us from evil insurance companies, and ourselves. I find it amusing that people and their preferred political institutions can declare any policy that accurately accounts for a policy holder's risk, while limiting itself to those conditions the policy holder agrees to pay for, as "sham policies". As you might imagine, I'm frequently amused. :~)
iris lilies
1-12-14, 6:41pm
...I'm also curious about the narrative that says that the insurance policy I had before was "a sham". I bought it knowing what it covered, I was reasonably happy with it, and used it several times for big-ticket surgeries and such. But again, personal experience, and personal choice, have no part in this war.
Someday, perhaps, you will understand that Nanny G knows what is best for you. The Prez stated that these "independent" policies such as yours were changeable and complex and really, they did not serve you well.
bae when you finally give up and drink the koolaid, you will be happier for it. Resistance is futile.
iris lilies
1-12-14, 9:12pm
California has plans with no deductibles and assorted co-pays, 10% co-pays for major expenses on the platinum plan -
http://www.cahba.com/covered-california/standardized-plans.htm
Households up to 250% of poverty level get extra cost sharing subsidies and have relatively low out of pocket maximums -
http://www.huffingtonpost.com/nathan-newman/obamacares-secret-subsidi_b_4078125.html
So yes, the lowest income households have a much lower chance of going bankrupt under the ACA. In California a low income household will have no deductible and a maximum yearly out-of-pocket limit of $2,250.
Pre ACA, on average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point -
http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/
So does the ACA solve this issue entirely? No, but the maximum out of pocket costs now are $6,350 for an individual plan and $12,700 for a family plan.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
So insurance available for most (no more $27K bills due to lack of insurance), Medicaid for those below a certain income level, at least in the states that expanded Medicaid, and cost sharing subsidies for families at 250% of federal poverty level or below with low out of pocket maximums (varies by state, $2.3K California) are a big step forward, though obviously we are still not at the universal health care status of other countries, and our medical costs in general are way still out of control compared to every other country on the planet.
That's great that California can afford all of that, they are well known for fiscal responsibility. I know that Calif is funding my freind who is lying about his address to get on Calif Medicaid.
But for the majority of states that are using the federal exchange:
I get that $6,350 is cheaper than that average bankruptcy figure of $17,942. What I couldn't understand is how the bronze 40% payment works in conjunction with max out-of-pocket $6,350. I thought it was that someone paid $6,350 and then in addition 40% of whatever the medical bill is, and that seems like no improvement to me. But if the max is truly $6,350 and no more no matter what (annually) then the bronze plan sounds fine--for me. And most people.
try2bfrugal
1-12-14, 9:33pm
It wasn't my insurance company pressuring/selling us anything. It was the wonderfully "helpful" people at our State, trying to get us signed up before the deadline by which we were required to comply by law. They were in complete disarray at the time - website had been broken for weeks, people on the other end of the phone untrained/confused/uninformed, and so on.
But, my direct personal experience is clearly irrelevant, compared to the constructed story of "all is good, it's a success!". At the "successful" rate my state, one of the better ones, is signing people up, we're ahead of the birth rate, so math says sometime in the next decade or two or three, certainly by my grandchildren's time, we'll get people signed up.
Mission accomplished.
(I'm also curious about the narrative that says that the insurance policy I had before was "a sham". I bought it knowing what it covered, I was reasonably happy with it, and used it several times for big-ticket surgeries and such. But again, personal experience, and personal choice, have no part in this war.)
Are you getting ACA subsidies? I am surprised based on what you have posted about your income and assets you didn't just buy a policy through ehealthinsuance.com and avoid the state exchange altogether.
This is the Simple Living Forum. I "retired" early. I have almost no "income", and qualify for the full Alan subsidy. Thanks Alan!
This has been an interesting exercise though, as a major chunk of the residents of my county have very low incomes, and not always by choice, and they are all having to stumble through this process as well, except that they don't necessarily have the time to devote to the project.
try2bfrugal
1-12-14, 9:42pm
That's great that California can afford all of that, they are well known for fiscal responsibility. I know that Calif is funding my freind who is lying about his address to get on Calif Medicaid.
But for the majority of states that are using the federal exchange:
I get that $6,350 is cheaper than that average bankruptcy figure of $17,942. What I couldn't understand is how the bronze 40% payment works in conjunction with max out-of-pocket $6,350. I thought it was that someone paid $6,350 and then in addition 40% of whatever the medical bill is, and that seems like no improvement to me. But if the max is truly $6,350 and no more no matter what (annually) then the bronze plan sounds fine--for me. And most people.
The example was from California as rates vary state to state. Cost sharing is not limited to California:
"The exact way the limits on out-of-pocket expenses will be designed will vary from state-to-state and, in some cases, plan to plan, but to give you an idea of what this means, look at this breakdown from California's health care exchange..."
Iris lilies, if you want to give me a state and an example household to use, I would be happy to post some optimal plans with my best understanding of the deductibles and out of pocket costs. You can just make up any household type just to use as an example.
If I remember correctly you want to retire early? The ACA will most likely make it much easier for you to do so. There is a post on the MMM blog on the ACA and ER.
try2bfrugal
1-12-14, 9:48pm
This is the Simple Living Forum. I "retired" early. I have almost no "income", and qualify for the full Alan subsidy. Thanks Alan!
This has been an interesting exercise though, as a major chunk of the residents of my county have very low incomes, and not always by choice, and they are all having to stumble through this process as well, except that they don't necessarily have the time to devote to the project.
Prior to the ACA you were paying $12K annually in premiums alone for a catastrophic only plan, if I remember right? And now you can get a comprehensive plan with subsidized premiums for maybe a few hundred a month and probably much lower deductibles and out of pockets costs?
Still you don't have to get a subsidized plan if you don't like your choices. You could go through ehealthinsurance for an unsubsidized policy.
Prior to the ACA you were paying $12K annually in premiums alone for a catastrophic only plan, if I remember right? And now you can get a comprehensive plan with subsidized premiums for maybe a few hundred a month and probably much lower deductibles and out of pockets costs?
Well, my "scam" plan covered a few other odds-and-ends that were important to us, and allowed us free choice of doctors.
Still you don't have to get a subsidized plan if you don't like your choices. You could go through ehealthinsurance for an unsubsidized policy.
See previous discussion above of the train-wreck that was happening here if you attempted to comply with the law by the specified date....
But yes, I could just buy my own medical clinic, and hire a doctor out of petty cash if I wanted to, but that wasn't the point of the exercise really. That's not really an option for most of my friends and neighbors here.
try2bfrugal
1-12-14, 10:08pm
Well, my "scam" plan covered a few other odds-and-ends that were important to us, and allowed us free choice of doctors.
See previous discussion above of the train-wreck that was happening here if you attempted to comply with the law by the specified date....
But yes, I could just buy my own medical clinic, and hire a doctor out of petty cash if I wanted to, but that wasn't the point of the exercise really. That's not really an option for most of my friends and neighbors here.
If I were worth millions and millions and so unhappy with the ACA plan, I would just get an unsubsidized policy from ehealthinsurance and skip the exchange plans, at least for a couple of months. That is what some of the wealthy people on other forums have reported doing until the ACA process is smoother.
I'd also call my doctor and ask what policies he was on.
Just for grins I tried ehealthinsurance.com and looked for plans for a couple, mid forties with a college age daughter. I used an Oak Harbor zip. I found 28 plans, starting at $778 a month, for the lowest price Bronze plan and you wouldn't have to even go through the exchange! Isn't that a lower monthly premium than you were paying in 2013 and for a better policy?
iris lilies
1-12-14, 11:46pm
"The exact way the limits on out-of-pocket expenses will be designed will vary from state-to-state and, in some cases, plan to plan, but to give you an idea of what this means, look at this breakdown from California's health care exchange..."
There is this universality in all state exchanges:
Plans and Costs
Types of plans: All the insurance plans (http://www.webmd.com/health-insurance/protect-health-13/reform-options) on the Marketplace are sold by private companies or co-ops. They can offer four types of plans: bronze, silver, gold and platinum. These"metal level" plans all cover the same kinds of benefits in your state. What differs is how much they pay on average toward the costs of healthcare services. Here's how it works:
Bronze Plan: You pay 40% and the plan pays 60%.
Silver Plan: You pay 30% and the plan pays 70%.
Gold Plan: You pay 20% and the plan pays 80%.
Platinum Plan: You pay 10% and the plan pays 90%.
I'm not interested in details of the plans such as costs of premiums (since Alan's subsidies will greatly reduce whatever I pay) or what it all covers. I simply want to understand: In any given year, is my maximum out of pocket cost for medical care (beyond premiums) $6,350?
If I'm in a car accident and incur $600,000 of medical bills, will the most I pay as dictated by the law of Obamacare be $6,350? (Unless this incident covers two years then it would be double that.)
try2bfrugal
1-13-14, 2:31am
There is this universality in all state exchanges:
Plans and Costs
Types of plans: All the insurance plans (http://www.webmd.com/health-insurance/protect-health-13/reform-options) on the Marketplace are sold by private companies or co-ops. They can offer four types of plans: bronze, silver, gold and platinum. These"metal level" plans all cover the same kinds of benefits in your state. What differs is how much they pay on average toward the costs of healthcare services. Here's how it works:
Bronze Plan: You pay 40% and the plan pays 60%.
Silver Plan: You pay 30% and the plan pays 70%.
Gold Plan: You pay 20% and the plan pays 80%.
Platinum Plan: You pay 10% and the plan pays 90%.
I'm not interested in details of the plans such as costs of premiums (since Alan's subsidies will greatly reduce whatever I pay) or what it all covers. I simply want to understand: In any given year, is my maximum out of pocket cost for medical care (beyond premiums) $6,350?
If I'm in a car accident and incur $600,000 of medical bills, will the most I pay as dictated by the law of Obamacare be $6,350? (Unless this incident covers two years then it would be double that.)
"Under the law, the maximum amount a consumer with single coverage will pay out-of-pocket in 2014 will generally be $6,350 while a family could pay up to $12,700. Those totals include copayments and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law."
http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/061113-Michelle-Andrews-out-of-pocket-costs.aspx
There is one extension for 2014 that allows for some higher out of pocket costs, as explained in the article linked to above.
Your maximum out of pocket costs may be lower, depending on your income, state and plan choice, but the $6,350 / $12,700 are supposed to be the new highest out of pocket maximums for non-grandfathered, ACA compliant plans.
A family making 33K a year in California would have a silver plan premium of no more than $1,129 per year, no deductible and a maximum yearly out-of-pocket limit of $2,250 -
http://www.huffingtonpost.com/nathan-newman/obamacares-secret-subsidi_b_4078125.html
Before the ACA, insurance companies sometimes did not include the deductible in the out of pocket maximums or they would have separate out of pocket maximum for different types of costs, like medical and drug costs, which made it difficult to compare policies, as well as create actual, total out of pockets costs that many families simply could not afford to pay.
I simply want to understand: In any given year, is my maximum out of pocket cost for medical care (beyond premiums) $6,350?
I'd say yes and that is even including deductibles, co-pays (I think) and co-insurance. This was a BIG reason I went ahead and bought a new policy once I understood the co-insurance thing a bit better. But it still stings on my low income (by choice) level having to pay more than $600/month for premiums, and a $6500/year out of pocket on top of the premiums. That's almost my maximum annual income! Of course I doubt I ever pay much beyond the premiums but you never know. Compared to my old now-cancelled plan of under $200/month and a max out of pocket of $4000/year it's not good at all. But now I can get both a mammogram and a prostate exam included :-)!
This explains out of pocket expenses and out of pocket maximums:
Out-of-Pocket Expenses
Most health insurance plans don't pay 100% of the cost for absolutely everything related to your healthcare. Your plan probably requires you to pay part of the costs, such as a copay when you visit the doctor. All costs for covered services that you pay for are called "out-of-pocket expenses" because you pay for them out of your own pocket. These costs include copays, coinsurance, and deductibles.
Out-Of-Pocket Maximum
An Out-of-Pocket maximum is the most that you should have to pay for your healthcare during a plan period (usually one year). Before reaching the out-of-pocket maximum, you pay for part of your medical care, such as copays and coinsurance. Once you have paid the amount set by the out-of-pocket maximum, your insurance will pay 100% of the allowed amount for your covered healthcare expenses, up to a preset benefit maximum. Note that ineligible expenses -- such as elective plastic surgery -- aren't counted against your out-of-pocket maximum.
flowerseverywhere
1-13-14, 9:14am
Spartana, I thought a big part of all this was that you no longer had a preset benefit maximum. Your out of pocket max explanation says it does. Was that info from the new plans?
Spartana, I thought a big part of all this was that you no longer had a preset benefit maximum. Your out of pocket max explanation says it does. Was that info from the new plans?
That article I sited was pre=ACA. So yes, you are right that there is no longer a pre-set maximum benefit ceiling anymore. My bad :-)!
iris lilies
1-13-14, 11:43am
"Under the law, the maximum amount a consumer with single coverage will pay out-of-pocket in 2014 will generally be $6,350 while a family could pay up to $12,700. Those totals include copayments and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law."
...
Thanks. Knowing that $6,350 is the max medical expense I'd pay, I'd say this defiantly helps fund retirement. Thanks, Alan!
Thanks. Knowing that $6,350 is the max medical expense I'd pay, I'd say this defiantly helps fund retirement. Thanks, Alan!But don't forget to add in those premiums!! Mine will be $625/month so together (assuming I have to pay the full out of pocket each year) that could be almost $14K/year. But it's better than paying 40% of a few hundred thousand buck or more if you ever have a big injury or illness. But then you might actually qualify for some kind of subsidy of your premiums (courtesy of Alan of course :-)!) so may actually have a lot lower annual costs. I'll probably only keep this policy a short while and then cancel it and get something cheaper.
try2bfrugal
1-13-14, 1:53pm
But then you might actually qualify for some kind of subsidy of your premiums (courtesy of Alan of course :-)!) so may actually have a lot lower annual costs. I'll probably only keep this policy a short while and then cancel it and get something cheaper.
The HSA plans are worth considering for some. The contributions for the HSA lower your MAGI on your tax returns, which might help put a household in lower income bracket and mean more in subsidy payments.
To find the plan with the cheapest total cost, it helps to look at the plan premium, deductibles and co-pays, as well as the impact on taxes, especially subsidy tax credits.
gimmethesimplelife
1-13-14, 2:00pm
Seriously? I think the Obama Administration did a pretty poor job of getting the facts out as to how this all was going to work and what the costs overall would be.....at all levels, including mine at being eligible for Medicaid. In my case not the costs but the actual date coverage would start.....On the exchange level there needs to be more education as to costs, deductibles, co-pays, everything. I would have preferred this to all be rolled out more smoothly and dare I say more professionally. Rob
The HSA plans are worth considering for some. The contributions for the HSA lower your MAGI on your tax returns, which might help put a household in lower income bracket and mean more in subsidy payments.
To find the plan with the cheapest total cost, it helps to look at the plan premium, deductibles and co-pays, as well as the impact on taxes, especially subsidy tax credits.
I looked in into an HSA but found I can't use it in conjunction with the VA. Also can't get any subsidies if I want to continue to use the VA (it's an either or thing). But because I'm in too low of a tax bracket I can't get any subsidies or do an HSA at this time anyways. Although I do qualify for the states expanded Medicaid and can use that in conjunction with the VA but have chosen not to sign up for that at this time. But in lieu of subsidies, and if I use the VA for my care including emergency services, the VA will pick up a lot of my out of pocket expenses (as well as bill my insurance company for repayment of services) so I will only end up paying the VA's low co-pays and my premiums. But I may chose not to use the VA at all (except for service connected stuff) if I have a medical need and I can't get in to see them for a long while. I want the option to see a doctor or treatment asap if needed Same reason I don't want to get on Medicaid.
try2bfrugal
1-13-14, 2:23pm
Seriously? I think the Obama Administration did a pretty poor job of getting the facts out as to how this all was going to work and what the costs overall would be.....at all levels, including mine at being eligible for Medicaid.
I am not going to argue with you there. The initial web site issues were bad. But the ACA itself is not the web site. The Dems have been letting the Republican ACA dis-information campaigns go unchallenged, instead of touting all the benefits and correcting the outright fallacies and challenging unsubstantiated numbers about people losing health care.
We "lost" our old policy. We gained one that was $2.1k cheaper per month in premiums, with better coverage.
try2bfrugal
1-13-14, 2:25pm
I looked in into an HSA but found I can't use it in conjunction with the VA. Also can't get any subsidies if I want to continue to use the VA (it's an either or thing). But because I'm in too low of a tax bracket I can't get any subsidies or do an HSA at this time anyways. Although I do qualify for the states expanded Medicaid and can use that in conjunction with the VA but have chosen not to sign up for that at this time. But in lieu of subsidies, and if I use the VA for my care including emergency services, the VA will pick up a lot of my out of pocket expenses (as well as bill my insurance company for repayment of services) so I will only end up paying the VA's low co-pays and my premiums. But I may chose not to use the VA at all (except for service connected stuff) if I have a medical need and I can't get in to see them for a long while. I want the option to see a doctor or treatment asap if needed Same reason I don't want to get on Medicaid.
Those are all well thought out reasons you picked the right policy for you. The HSA may not be the right choice for every household.
Those are all well thought out reasons you picked the right policy for you. The HSA may not be the right choice for every household.
I did think they sounded like a good way to go too even if I can't use them at this time.
I am wondering, and maybe you know, when is the cut off to sign up for a plan on the ACA website and to sign up for subsidies? Say if someone like me already bought a plan directly from a company and wanted to switch policies at a later time (say my income increases if I went back to work mid year) and buy one off the exchanges (including subsidies). Is there a sign up/cut off time to do that? Are there open enrollment periods for the ACA or is it always open to apply for?
ApatheticNoMore
1-13-14, 2:56pm
Thanks. Knowing that $6,350 is the max medical expense I'd pay, I'd say this defiantly helps fund retirement. Thanks, Alan!
I wouldn't be so certain, that's the maximum in-network. If you go out of network I'm not sure there is a hard max at all. There's also catches like expenses that don't apply to the deductable. I like hard maximums too. If you're poor or lower middle class you care about whether doctors visits are paid (there are many people that with these high deductables plans out there won't be able to get medical care because they simply can't pay up to the deductable out of pocket). If you're middle class or above though, you'd pay out of pocket for the doctors visits if you had to, you care about bankruptcy protection because you know very well the U.S. medical system could do that and you have assets (maybe nothing fancy, a mortgage, a 401k, IRA etc. - I'm not sure what is protected from medical bankruptcy if anything).
try2bfrugal
1-13-14, 3:03pm
I did think they sounded like a good way to go too even if I can't use them at this time.
I am wondering, and maybe you know, when is the cut off to sign up for a plan on the ACA website and to sign up for subsidies? Say if someone like me already bought a plan directly from a company and wanted to switch policies at a later time (say my income increases if I went back to work mid year) and buy one off the exchanges (including subsidies). Is there a sign up/cut off time to do that? Are there open enrollment periods for the ACA or is it always open to apply for?
I think this answers your question -
The period of time during which individuals who are eligible to enroll in a Qualified Health Plan can enroll in a plan in the Marketplace. For coverage starting in 2014, the Open Enrollment Period is October 1, 2013–March 31, 2014. For coverage starting in 2015, the proposed Open Enrollment Period is November 15, 2014–January 15, 2015. Individuals may also qualify for Special Enrollment Periods outside of Open Enrollment if they experience certain events. (See Special Enrollment Period (https://www.healthcare.gov/glossary/special-enrollment-period) and Qualifying Life Event (https://www.healthcare.gov/glossary/qualifying-life-event))
You can apply for Medicaid or CHIP, at any time of the year.
https://www.healthcare.gov/glossary/open-enrollment-period/
try2bfrugal
1-13-14, 3:06pm
I wouldn't be so certain, that's the maximum in-network. If you go out of network I'm not sure there is a hard max at all.
You are right, you have to be careful to stay in network as much as possible -
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
(https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/)
.
See previous discussion above of the train-wreck that was happening here if you attempted to comply with the law by the specified date....
But yes, I could just buy my own medical clinic, and hire a doctor out of petty cash if I wanted to, but that wasn't the point of the exercise really. That's not really an option for most of my friends and neighbors here.
Well, that would be a mighty sloooow train wreck considering the LAW doesn't actually require you to have signed up until the end of March. And unless you are living in the future..Ha Ha Ha...this catastrophic! deadline hasn't even come yet. The earlier deadline was to get coverage by Jan 1st, and even that deadline was extended because of the sloppy roll out of the site. (and of course we ALL know ALL web sites run smooth as silk from day one!)
Oh dear bae, it would seem you missed the memo on all counts! The actual deadlines, the free will bit about being able to shop for the policy that suits your family/doctor, the entire effort you state has made to help you, etc...
Leaves me wondering...what exactly WAS the "point of the exercise"?
Good point Peggy, the system is flawless, and any problems that may have been seen were all George Bush's fault.
Well, that would be a mighty sloooow train wreck considering the LAW doesn't actually require you to have signed up until the end of March. And unless you are living in the future..Ha Ha Ha...this catastrophic! deadline hasn't even come yet. The earlier deadline was to get coverage by Jan 1st, and even that deadline was extended because of the sloppy roll out of the site. (and of course we ALL know ALL web sites run smooth as silk from day one!)
Oh dear bae, it would seem you missed the memo on all counts! The actual deadlines, the free will bit about being able to shop for the policy that suits your family/doctor, the entire effort you state has made to help you, etc...
Leaves me wondering...what exactly WAS the "point of the exercise"?Many states (Calif for one and maybe Washington as well) didn't allow for an extention of your current plans until March even if the ACA did. So for people who's policies were cancelled at the end of the year (like Bae's and mine) we had to either sign up by then or go uncovered. Unlike Bae however, I didn't sign up on the exchanges but bought an unsubsidized policy directly from the insurance company ya week or so after my policy was cancelled because I knew I could use the VA hospital in the mean time if something happened. So Bae and his family may have had to go without insurance coverage (or at least unsubsidized insurance coverage) if he didn't sign up for something on the exchanges before the end of the year - and maybe he had to do that in a rush as many others did and had to spend a lot of time just trying to get things sorted out (look at the hassle's and problems and time-spent on getting coverage Rob had in AZ even though he signed up in early Oct and constantly checked on his status). I don't know how easy it is to change plans once you have signed up for one on the exchanges, but it may not only be difficult, but in Bae's case hard to find a new MD/plan close to his home.
Simply Divine
1-13-14, 4:25pm
Good point Peggy, the system is flawless, and any problems that may have been seen were all George Bush's fault.
No, it's Clinton's fault :~)
I wouldn't be so certain, that's the maximum in-network. If you go out of network I'm not sure there is a hard max at all. There's also catches like expenses that don't apply to the deductable. I like hard maximums too. If you're poor or lower middle class you care about whether doctors visits are paid (there are many people that with these high deductables plans out there won't be able to get medical care because they simply can't pay up to the deductable out of pocket). If you're middle class or above though, you'd pay out of pocket for the doctors visits if you had to, you care about bankruptcy protection because you know very well the U.S. medical system could do that and you have assets (maybe nothing fancy, a mortgage, a 401k, IRA etc. - I'm not sure what is protected from medical bankruptcy if anything).
Many of the policies I looked at on ehealthinsurance.com didn't cover ANY out-of-network costs. Those were generally ther lower cost plans. Some only covered emergency out-of-network expenses. And those that did cover some or all of out-of-network costs often had much higher max. out-of-pocket costs for deductibles, co-insurance and co-pays than their in-network costs.
try2bfrugal
1-13-14, 5:34pm
Spartana, you seemed to have figured this all out readily, did a great job comparing your exchange and unsubsidized options, and decided to pay for an unsubsidized policy on ehealthinsurance because it suited your current medical needs exactly.
You go girl. Good for you!
Thanks for sharing your expertise and experiences. Maybe you can serve as an example to others who post here on how to obtain the best policy for their needs, especially the members where money doesn't seem to be a concern.
Well, at least it looks like we won't have to shut down our fire department, which seemed to be a looming possibility:
http://www.firerescue1.com/fire-department-management/articles/1647022-Volunteer-firefighters-EMTs-exempted-from-Affordable-Care-Act/?source=newsletter&nlid=1646652§ion_name=topStories
BECKLEY, W.Va. — Volunteer firefighters across the country can breathe a sigh of relief, as the U.S. Treasury has decided to make them and volunteer medical emergency personnel exempt from the Affordable Care Act mandate.
According to the IRS, volunteers who work at least 30 hours per week are considered full-time employees; therefore, under the ACA, volunteer fire departments would have been required to provide health care coverage had the Treasury not made this exemption.
Many fire departments said they would have been unable to pay and would have been forced to disband.
Sen. Joe Manchin and several other senators expressed their concern about this issue last month, and Manchin said Friday he applauds the Treasury's decision.
The new rule clarifies that volunteer fire departments will not be subject to the employer health care mandate, as volunteer firefighters and volunteer medical emergency personnel will not be counted as full-time equivalent employees.
"I am pleased that the administration listened to the concerns of fire departments across the country and clarified provisions in the tax code that make sure our volunteer fire departments and emergency response agencies will not be punished by a technical error in the health care law," Manchin said.
"Now that there is a clear distinction between full-time, paid emergency responders and volunteers, our emergency response teams can keep our communities safe without the threat of reducing necessary funding for training or emergency response hours."
According to a release from Manchin, approximately 750,000 volunteer firefighters serve in 20,000 all-volunteer and 5,000 combination career-volunteer fire departments throughout the U.S. Many volunteer first responders are nominally compensated, and most volunteer first responders have other paid, full-time employment. Many emergency response agencies do not have the resources to provide pay or benefits to volunteers, nor do most volunteer first responders expect to receive compensation or health coverage as a result of their volunteer public service.
Spartana, you seemed to have figured this all out readily, did a great job comparing your exchange and unsubsidized options, and decided to pay for an unsubsidized policy on ehealthinsurance because it suited your current medical needs exactly.
You go girl. Good for you!
Thanks for sharing your expertise and experiences. Maybe you can serve as an example to others who post here on how to obtain the best policy for their needs, especially the members where money doesn't seem to be a concern.Thanks. I won't say money isn't a concern (I am probably one of the "po'-folk" compared to others here) but I currently am able to tighten my belt a lot and use up some of my retirement savings to pay for it until I can find something that suits me (and my income level) better. Or get one of those dreaded job-thingies I keep hearing so much about :-)!! Of course if I didn't potentially have something wrong with me I wouldn't buy insurance right now and just use the VA in case of an emergency.
Well, at least it looks like we won't have to shut down our fire department, which seemed to be a looming possibility:
http://www.firerescue1.com/fire-department-management/articles/1647022-Volunteer-firefighters-EMTs-exempted-from-Affordable-Care-Act/?source=newsletter&nlid=1646652§ion_name=topStories
The ACA does exempt some groups of people from having to buy health insurance. I'm in that category as a low "taxable" income person (wouldn't have to buy it even if I didn't have the VA to use). But the problem is those groups of people, unless they are in expanded Medicaid states, are the least likely to be able to afford to buy even the lowest cost policy around unless they have other assets than their incomes to be able to afford it. So they have to live without any insurance coverage until they can (if possible) increase their income levels. I think that is the biggest failing of the ACA - leaving so many low income people no way they can get affordable coverage.
Spartana - note that it doesn't exempt volunteer firefighters, but someone in Treasury simply decided to "fix" it administratively.
Guess we had to pass this bill to find out what was in it after all...
try2bfrugal
1-13-14, 8:28pm
I think that is the biggest failing of the ACA - leaving so many low income people no way they can get affordable coverage.
Note that that the ACA was designed to have expanded Medicaid in every state. The Supreme Court made that optional, and it is only now not expanded in some Republican controlled states.
I wouldn't say it is a failing of the ACA. Look to the Republican controlled state politicians who are refusing federal funds for Medicaid expansion. If you want to see Medicaid expansion in every state, vote the politicians out of office who are blocking it.
I wouldn't say it is a failing of the ACA. Look to the Republican controlled state politicians who are refusing federal funds for Medicaid expansion.
Or, it could be that those Republican controlled state politicians are concerned about what will happen when the federal funds dry up and they're stuck with the bill, and are still required by their constitutions to balance their budget every year. I wonder why Democrat controlled state politicians don't seem to be concerned by the possibility.
Note that that the ACA was designed to have expanded Medicaid in every state. The Supreme Court made that optional...
And rightly so. Medicaid is a state controlled program, if the Federal government actually intended to fund programs in perpetuity, shouldn't they have done so in a federal program?
try2bfrugal
1-13-14, 9:59pm
Or, it could be that those Republican controlled state politicians are concerned about what will happen when the federal funds dry up and they're stuck with the bill, and are still required by their constitutions to balance their budget every year. I wonder why Democrat controlled state politicians don't seem to be concerned by the possibility.
And rightly so. Medicaid is a state controlled program, if the Federal government actually intended to fund programs in perpetuity, shouldn't they have done so in a federal program?
Study: States that reject Medicaid expansion lose money
"some Republican governors, such as Jan Brewer of Arizona and John Kasich of Ohio, have pushed to have their states expand the program. They said they realized their residents would pay taxes to expand the program in other states but not receive the benefits."
"There are no states where the taxpayers would actually gain by not expanding Medicaid," said Sherry Glied, lead author on the study. "Nobody wins.""
"The federal government pays 100% of the the expansion through 2016, and then 90% of the program's costs after that. If all states were to expand, 21.3 million uninsured people would gain coverage. This, they say, means that doctors and hospitals would have fewer uncompensated costs; which would mean lower insurance costs for everybody else."
"The Congressional Budget Office has estimated that the Affordable Care Act will reduce the federal deficit by $143 billion between 2010 and 2019, and programs like Medicaid expansion will be paid for with new taxes, such as for tanning salons and for people who make more than $250,000."
(http://http://www.usatoday.com/story/news/nation/2013/12/05/rejecting-medicaid-costs-states-more/3871811/)http://www.usatoday.com/story/news/nation/2013/12/05/rejecting-medicaid-costs-states-more/3871811/
(http://www.motherjones.com/mojo/2013/02/meet-governors-rejecting-expansion-medicaid)
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