Update on my Medicaid

[gimmethesimplelife]

Today I came home and checked my mail and found a letter from Arizona DES in regards to my Medicaid. It was a denial. I can't say how I felt but it was like the rug was pulled out from underneath me and I felt as if it had finally happened, that I had lost all faith in America and while I remained here I would be in a slightly zombie state going though the motions (though I kind of am already, truth be told).

Then I read the rest of the letter. Though I am very low on faith I do see a little hope. The letter went on to state that under the previous law I was ineliglibe but under the law starting 01/01/2014, the law will be changing and they will (supposedly) be rescreening folks under the new law. I feel a little hope but absolutely no trust and I guess I can relate to those who had their policies cancelled - it must feel something like this - little faith, little hope but no trust whatsoever.

I can't read the future but personally I don't believe I'll be getting the Medicare card - I don' t have enough hope for faith left to buy that, but we'll see. Rob

[Simply Divine]

What was the reason for the denial?

[Florence]

Rob, I am so sorry! Can you appeal the denial?

[iris lilies]

Perhaps you are not lying sufficiently.

My friend with the $400,000 paid for house in Mexico is using a California address to qualify for Medicaid. He did get his card, I asked him specifically. He no more lives in California than I do. Do you know anyone in CA to use their address?

[gimmethesimplelife]

What was the reason for the denial?What I am gathering is that Arizona DES ran my application through on the criteria for approval before expanded Medicaid started in this state. It does state on the back of the letter that my application will be put through based on the new criteria without my having to do anything - but I am going to request a hearing anyway as I have lost the ability to have faith in the government at this point. What really chaps me is that I qualify for Medicaid and don't get it - then I will owe $95 to the government for Tax Year 2014. This is beyond insane to me. Rob

[gimmethesimplelife]

Perhaps you are not lying sufficiently.

My friend with the $400,000 paid for house in Mexico is using a California address to qualify for Medicaid. He did get his card, I asked him specifically. He no more lives in California than I do. Do you know anyone in CA to use their address?I went over the qualifications with a fine tooth comb Iris. I qualify based on the guidelines for expanded Medicaid in Arizona. I'm not going to lie and use someone else's address, better that I find a way out of America. This is more than I am willing to deal with. Rob If anyone now asks me How's that Hope and Change working for ya? I don't think I'd give my usual answer rothfl. Rob

[gimmethesimplelife]

Rob, I am so sorry! Can you appeal the denial?Yes, I can appeal and will place the paperwork for the appeal in tomorrow's mail. This is one thing I can do I suppose. Rob PS Thanks for your kind words, Florence.

[Lainey]

What I am gathering is that Arizona DES ran my application through on the criteria for approval before expanded Medicaid started in this state. It does state on the back of the letter that my application will be put through based on the new criteria without my having to do anything - but I am going to request a hearing anyway as I have lost the ability to have faith in the government at this point. What really chaps me is that I qualify for Medicaid and don't get it - then I will owe $95 to the government for Tax Year 2014. This is beyond insane to me. Rob

I am sorry this happened to you, Rob. It's definitely insane, although I'm thinking it's 50-50 whether it's incompetence or standard process to deny people and force them to re-apply just to make sure they're serious.

[Tussiemussies]

So sorry that you are having to go through this Rob....chris

[Alan]

....better that I find a way out of America. This is more than I am willing to deal with....
Rob, I'm sorry if you've explained this previously and I simply missed it, but I've never understood why leaving the country is preferable to purchasing your own health insurance.
You seem to have the means and ability to support yourself, the federal government has decreed that it will redistribute your neighbors assets in the form of subsidies which should make your personal liability for coverage quite low, and you have told us that you own your own home in Arizona. Doesn't it make sense to just pay the premiums and be happy?

[gimmethesimplelife]

I am sorry this happened to you, Ro It's definitely insane, although I'm thinking it's 50-50 whether it's incompetence or standard process to deny people and force them to re-apply just to make sure they're serious.What's even crazier is that I have tried to reapply online and healthearizona doesn't recognize my SS # as being valid. What also scares me is that I'm nothing special, if this is happening to me it's happening to other people, too. I will reapply and I will go to a hearing if I am granted one (I don't have faith I'll get one, really) and I will do what I can but it's going to be just going through the motions once again. Rob PS Thank you for your kind words, Lainey.

[gimmethesimplelife]

Rob, I'm sorry if you've explained this previously and I simply missed it, but I've never understood why leaving the country is preferable to purchasing your own health insurance.
You seem to have the means and ability to support yourself, the federal government has decreed that it will redistribute your neighbors assets in the form of subsidies which should make your personal liability for coverage quite low, and you have told us that you own your own home in Arizona. Doesn't it make sense to just pay the premiums and be happy?Alan, I don't have the means to pay my own insurance. And the house I own half of? My half of the mortgage on it is $225 a month - this is why I stay, it is much cheaper than renting to stay there. I posted my monthly budget on another thread - detailing cash inflow and cash outflow. If you would click on my screen name and go back X number of posts, you would see it. I don't have the kind of money I would need to buy my own insurance. And I am starting to feel that perhaps this was all a big lie and that Medicaid is not going to be expanded in Arizona. Lie to me, I can't even fake loyalty of any kind. Better to lose me as a citizen and have someone from the third world take my place who won't hold the government to their promises. Rob

[gimmethesimplelife]

So sorry that you are having to go through this Rob....chrisChris, Thank You for your kind words. Appreciate them I do. Rob

[thinkgreen]

Rob, I hate that they are doing this to you. Surely this is not helping your blood pressure. Someday you must share your herbal tea secret with us.

My best wishes are with you for success on your appeal and the new expanded criteria. You certainly deserve to be approved in my humble opinion.

I will be thinking of you until we hear better news. Any idea how long we will wait in suspense?

[try2bfrugal]

I think you ultimately won't have any issues based on the 2014 eligibility rules. Good luck. We have had a screwy time signing up for coverage, too, with assorted twists and turns and set backs along the way. I suspect for political reasons the powers that be in Arizona are less motivated than other states to make it a smooth process for Medicaid recipients.

[flowerseverywhere]

I suspect for political reasons the powers that be in Arizona are less motivated than other states to make it a smooth process for Medicaid recipients.
What do you base this statement on? Do you really think the people who get up every day and put in their eight hours and work with the poor are screwing with people?

if you read about the history of Medicaid in Arizona, and indeed in most states healthy adults have the most difficulty qualifying.

[Simply Divine]

What do you base this statement on? Do you really think the people who get up every day and put in their eight hours and work with the poor are screwing with people?

if you read about the history of Medicaid in Arizona, and indeed in most states healthy adults have the most difficulty qualifying.
In Texas, they are refusing to expand Medicaid despite the fact that the state has the largest percentage of uninsured Americans in the nation. Judging from so many Texans' opinions of the working poor ("those lazy bums just need to work harder") I indeed think some of these people in power want to screw with the most vulnerable. It's been happening for a long time.

I find it ironic, though, that since the ACA depends on healthy young adults -- aka "young invincibles" -- to work, that they, as you say, are having the hardest time qualifying. Then again, if Rob is right, Arizona didn't screen him under the new rules, but under the old ones, which of course would create a denial, probably because he makes too much money -- next to nothing, rather than nothing.

Good luck, Rob. I once had to go through some similar hoops a few years back to attempt to qualify for Medicaid, but I have no children and make more than minimum wage, so I was denied as well. The saving grace for me is that I now have employer insurance. I would qualify for a subsidy under the new rules per the web site, but I didn't have to go through the process myself this year, so I'm not sure what would have happened.

-- SD

[gimmethesimplelife]

Well, here's an update. I have tried calling Medicaid and good luck getting through. I'm sure this has happened to many other people and it's going to be difficult to get through to even be on hold. I tried calling the organization that I went to in November to have a navigator do the application for me and I was able to leave a voicemail there. I don't know that that's going to be of any help, though.

Gotta say I am beyond disillusioned at this point. I'm willing to take back all the kind words I had for Barak Obama all this time - this to me does not represent hope and change but only more of the same America that I have learned to fear over the years. I see where it really matters there may be no hope and no change. Rob

[gimmethesimplelife]

What do you base this statement on? Do you really think the people who get up every day and put in their eight hours and work with the poor are screwing with people?

if you read about the history of Medicaid in Arizona, and indeed in most states healthy adults have the most difficulty qualifying.As of 2000, childless adults qualified in Arizona. A proposition to cover childless adults under a certain income level was passed by Arizona voters and I believe it began January 1st, 2001. So in the recent past, childless adults have been covered. In 2011, due to the economy, childless adults were no longer accepted and were not reapproved. As of January 1st, 2014, if we make under 15K plus some spare change, we are supposed to be covered once again. So much for having any faith at all in government.....

[gimmethesimplelife]

Rob, I hate that they are doing this to you. Surely this is not helping your blood pressure. Someday you must share your herbal tea secret with us.

My best wishes are with you for success on your appeal and the new expanded criteria. You certainly deserve to be approved in my humble opinion.

I will be thinking of you until we hear better news. Any idea how long we will wait in suspense?Thank you for your kind words. My herbal tea secret? Hibiscus flower tea. It has been shown to be as effective in lowering blood pressure as some prescription medications and is very easy to get at Hispanic markets and if you buy in bulk it is even cheaper in Mexico.

About how long I will have to wait, honestly, I have no idea. Rob

[try2bfrugal]

What do you base this statement on? Do you really think the people who get up every day and put in their eight hours and work with the poor are screwing with people?

if you read about the history of Medicaid in Arizona, and indeed in most states healthy adults have the most difficulty qualifying.

Covered California has been applying the 2014 Medicaid rules in 2013 for people who apply for coverage in 2014.

Arizona has expanded Medicaid, but from what Rob explained they applied the 2013 Medicaid rules for an application for 2014 policy coverage. I guess that could either be politically motivated or just outright stupidity, but based on news reports of Arizona politicians I was going with the political motivation. But then again, it could be either or both.

[gimmethesimplelife]

OK I have another update. I spoke with the navigator who helped me back in November 2013 with the forms and submission of the forms. She says that I was denied due to the eligibility criteria not having been changed as of the date of my application. She also stated that the state will be reevaluating my application (and it does say this on the denial letter) and that the state has until February 14th, 2014 to give me a yes/no answer. So I will be in limbo again for six weeks here. I don't like this but at least I received some solid information from somewhere - better than not having anything at all to go on. Rob

PS I'm also a trifle riled up as the denial letter does not have a date on it that the state needs to give me a yes/no by. How many people out there are going to just give up and lose all faith? The only reason I was able to pick up the phone and deal with this is that in many ways I am afraid of America - I am usually able to tap into this fear for the energy to keep myself going. Not everyone can flick this switch, though, I understand that.

[Simply Divine]

OK I have another update. I spoke with the navigator who helped me back in November 2013 with the forms and submission of the forms. She says that I was denied due to the eligibility criteria not having been changed as of the date of my application. She also stated that the state will be reevaluating my application (and it does say this on the denial letter) and that the state has until February 14th, 2014 to give me a yes/no answer. So I will be in limbo again for six weeks here. I don't like this but at least I received some solid information from somewhere - better than not having anything at all to go on. Rob

PS I'm also a trifle riled up as the denial letter does not have a date on it that the state needs to give me a yes/no by. How many people out there are going to just give up and lose all faith? The only reason I was able to pick up the phone and deal with this is that in many ways I am afraid of America - I am usually able to tap into this fear for the energy to keep myself going. Not everyone can flick this switch, though, I understand that.
What I keep on wondering about as I read your posts is: Why have faith at all?

[try2bfrugal]

OK I have another update. I spoke with the navigator who helped me back in November 2013 with the forms and submission of the forms. She says that I was denied due to the eligibility criteria not having been changed as of the date of my application. She also stated that the state will be reevaluating my application (and it does say this on the denial letter) and that the state has until February 14th, 2014 to give me a yes/no answer. So I will be in limbo again for six weeks here. I don't like this but at least I received some solid information from somewhere - better than not having anything at all to go on. Rob

PS I'm also a trifle riled up as the denial letter does not have a date on it that the state needs to give me a yes/no by. How many people out there are going to just give up and lose all faith? The only reason I was able to pick up the phone and deal with this is that in many ways I am afraid of America - I am usually able to tap into this fear for the energy to keep myself going. Not everyone can flick this switch, though, I understand that.

My husband and I both have computer type degrees and work at home, and this past year between COBRA and the ACA I can't even begin to tell you how many hours we have spent just keeping medical coverage in place for our family. It has been a huge amount of time that took away from work and family time.

Sorry to hear you aren't having a better time, but I do believe you will come out okay once they reprocess your application under the 2014 criteria. The ACA Medicaid criteria is only income based so I don't see how you could be denied again.

[bae]

My husband and I both have computer type degrees and work at home, and this past year between COBRA and the ACA I can't even begin to tell you how many hours we have spent just keeping medical coverage in place for our family. It has been a huge amount of time that took away from work and family time.


Same here, except my wife is an attorney who used to practice insurance law, and I'm an engineer.

We managed to get our policy cancelled (thanks Mr. "You Can Keep Your Plan"), and at the 11th hour, after countless hours on the phone and suffering through web sites, my wife finally managed to get us signed up for "something".

Well, some of the information for "something" arrived today - apparently we can't keep our current doctor either, they've assigned us pretty much the worst doctor in my community. So, yay! I'm still not sure about the co-pays, or the costs, or the deductibles, or any of that, the letter with the card promised that information "soon". When I went to the URL for "more information" contained in the letter accompanying the card, I got a phishing "buy a domain" website front not actually associated with my alleged plan provider.

I feel so much better now.

I *had* suitable coverage for my needs before, at a price I was willing to pay. Now I have....nothing but a useless card.

Well, at least I have the card, and Alan is paying for it. Hope this all works out for you, Rob, and you get what you truly want out of this system.

If I get some sort of fatal disease before this all gets sorted out, there's gonna be some...unintended consequences.

[gimmethesimplelife]

What I keep on wondering about as I read your posts is: Why have faith at all?Fair question. It helps to have some when dealing with insanity such as this. I don't know if I could if I didn't have some small little bit of faith left. Rob

[new2oregon]

Rob, sorry about your situation. Do you qualify for any legal assistance for this because it sounds like you are falling through the cracks. I can't afford insurance and I'm not going to bother about it right now. If life gets complicated make it simple, I sold my house and moved to a cheaper place. My rent is a little more than my property taxes were for the year in N.H. Like Alan says be Happy. Good luck to you.

[gimmethesimplelife]

My husband and I both have computer type degrees and work at home, and this past year between COBRA and the ACA I can't even begin to tell you how many hours we have spent just keeping medical coverage in place for our family. It has been a huge amount of time that took away from work and family time.

Sorry to hear you aren't having a better time, but I do believe you will come out okay once they reprocess your application under the 2014 criteria. The ACA Medicaid criteria is only income based so I don't see how you could be denied again.I'm sorry that you had to spend so much time keeping your family covered. That's crazy and I personally find this very frustrating, even though I don't know you. In any other country in the developed world you would not have had to spend this time to do this - time that you can never get back. I feel as if America owes you an apology - I doubt you'll ever get one but what it's worth, I am sorry you had to go through this. I'm just glad you made it to the other side? Rob

[gimmethesimplelife]

Same here, except my wife is an attorney who used to practice insurance law, and I'm an engineer.

We managed to get our policy cancelled (thanks Mr. "You Can Keep Your Plan"), and at the 11th hour, after countless hours on the phone and suffering through web sites, my wife finally managed to get us signed up for "something".

Well, some of the information for "something" arrived today - apparently we can't keep our current doctor either, they've assigned us pretty much the worst doctor in my community. So, yay! I'm still not sure about the co-pays, or the costs, or the deductibles, or any of that, the letter with the card promised that information "soon". When I went to the URL for "more information" contained in the letter accompanying the card, I got a phishing "buy a domain" website front not actually associated with my alleged plan provider.

I feel so much better now.

I *had* suitable coverage for my needs before, at a price I was willing to pay. Now I have....nothing but a useless card.

Well, at least I have the card, and Alan is paying for it. Hope this all works out for you, Rob, and you get what you truly want out of this system.

If I get some sort of fatal disease before this all gets sorted out, there's gonna be some...unintended consequences.Bae, I don't know what to say other than in my book you have the right to be royally po'ed. What you described about would not sit well with me, either. What use is the damned card anyway if you don't know the relevant information - i.e., what's this going to cost you? What a let down, and it's amazing to me that this one is crossing socio-economic lines and sifting upwards a bit. I wouldn't wish this on anyone but maybe the good to come of this will be more outrage towards American Health Care in general? It's all so emotionally charged as we are dealing with life and death issues here coupled with tinges of basic human rights and basic human dignity vs. turbo-charged-winner-takes-all-global capitalism. I'm thinking that one good thing to come of this is that there will be scattered folks here and there who come to the realization that this system is not working for them, and either flee or bravely try to change things. Rob

[gimmethesimplelife]

Rob, sorry about your situation. Do you qualify for any legal assistance for this because it sounds like you are falling through the cracks. I can't afford insurance and I'm not going to bother about it right now. If life gets complicated make it simple, I sold my house and moved to a cheaper place. My rent is a little more than my property taxes were for the year in N.H. Like Alan says be Happy. Good luck to you.NH does have crazy property tax, I remember that from living in Southern New Hampshire the first ten years of my life. Legal aid - not going to happen in this karma methinks. But supposedly, the state is reevaluating my - and a lot of other applicant's applications, and will apply the new criteria to these applications, with a yes/no answer coming by February 14th. Do I believe it? I'm 50/50 on this one - unwilling to get my hopes up any more but still in a generic way I'm hoping for the best.

I have to say one thing - I can see why there are folks here who are anti-government solving problems here. I'm no conservative but I can see where this has just been a fiasco, and not contained to just one social class but to a broad spectrum of people. I'm going to say I'm going to be a little more wary of government fixes to problems from this point on. In other countries, no, but in the US I can understand why some are very wary of any kind of government fix. Rob

[Spartana]

Rob - Sorry to hear about this. I really don't understand why AZ dropped the ball since, as Try2bFrugal pointed out, here in Calif they have had the new expanded Medicaid option available for sign up as of Oct 1st for it to begin Jan 1st 2014.. I believe that as long as you signed up for it by Dec 23rd you'd get it on Jan 1st. Seems to be no problem here from what I've heard on the news (except for those who's policies were cancelled but that's a different situation). So I don't think it's the fault of the ACA or Obama but AZ. It sounds like they (AZ) are working to correct that asap so you'll probably be covered soon. In the mean time you may try to up your income level to $16K level and apply for private insurance and subsidies. I currently am insurance-less myself except for the VA since my catastrophic plan has been cancelled. Still undecided which plan to buy.

[JaneV2.0]

For those with means, I think fee-for-service is the way to go. You can choose your doctor and bypass the insurance companies--which can't then dictate your treatment. A lot of people do that anyway--they see naturopaths or other practitioners who aren't covered, or they're medical tourists.

[try2bfrugal]

I'm sorry that you had to spend so much time keeping your family covered. That's crazy and I personally find this very frustrating, even though I don't know you. In any other country in the developed world you would not have had to spend this time to do this - time that you can never get back. I feel as if America owes you an apology - I doubt you'll ever get one but what it's worth, I am sorry you had to go through this. I'm just glad you made it to the other side? Rob

Yes, we have kept insurance. We have our cards for the new 2014 policy, our credit card has been charged, and one of us used it at the doctors already.

We have just accepted the fact that America is really just a corporatocracy these days. If health care costs weren't so crazy high in the U.S. compared to every other country on the planet, with the profits being sucked away to the powers that be in the health care industry and away from the middle and lower class families, we would be able to self insure and not have to worry about a month or two of no coverage leaving us potentially bankrupt.

[Simply Divine]

]We have just accepted the fact that America is really just a corporatocracy these days.
There's at least one conspiracy theory that says the United States is really a secret corporation. I don't quite believe it; but based on what I've seen about how government works, I can understand the logic.

[try2bfrugal]

There's at least one conspiracy theory that says the United States is really a secret corporation. I don't quite believe it; but based on what I've seen about how government works, I can understand the logic.

Look at who got government bailouts and who lost their homes during the great recession or look at health care costs in the U.S compared to every other country on the planet -

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

Look at the drug costs in the U.S. compared to all other countries. I don't think the corporations benefiting from these types of costs and policies are any secret.

[Simply Divine]

Look at who got government bailouts and who lost their homes during the great recession or look at health care costs in the U.S compared to every other country on the planet -

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

Look at the drug costs in the U.S. compared to all other countries. I don't think the corporations benefiting from these types of costs and policies are any secret.
When I say "the US is really a secret corporation (http://theunjustmedia.com/Banking%20&%20Federal%20Reserve/The%20united%20states%20Of%20America%20%20is%20a%2 0corporation%20owned%20by%20fore.htm)", I mean that the theory says the government no longer exists, and has been replaced by a secret corporation. The fact that the USA is pretty much run by Big Business is not a conspiracy theory, that's pretty much a fact. Again, I don't really believe in the theory about "United States Corporation." I'd say we're more of an plutocracy (http://en.wikipedia.org/wiki/Plutocracy) than anything else at the moment.

[gimmethesimplelife]

For those with means, I think fee-for-service is the way to go. You can choose your doctor and bypass the insurance companies--which can't then dictate your treatment. A lot of people do that anyway--they see naturopaths or other practitioners who aren't covered, or they're medical tourists.Jane, I think you have a very good point here. I am always amazed when I am in Mexico seeing a doctor how much more time they spend with you and how less hurried they seem. It boggles my mind that someone like me can even afford health care - though if it's something major credit will be a component of it, for better or worse - just by crossing a border. I'm of the opinion that more and more people will be voting with their feet and maybe not leaving the US but temporarily fleeing for the human rights possible by the leaving the US for health care. It's getting to a point where it is just too crazy and it amazes me that American health care has not collapsed under it's own weight yet. Rob

[JaneV2.0]

That was how medicine was practiced back in the day--before the insurance bloodsuckers got involved. Even when you get your Medicaid card--which I'm sure you will--I think you would be more satisfied with care in Mexico.

[catherine]

Jane, I think you have a very good point here. I am always amazed when I am in Mexico seeing a doctor how much more time they spend with you and how less hurried they seem.

Rob, that might be cultural. I did a market research study on multicultural healthcare practices, and I learned that Hispanic doctors spend time with patients--they are not thinking about the full waiting room. They let people wait in order to give the patient in front of them the time they want--unlike non-Hispanics who tend to me more cognizant of keeping on schedule. Both attitudes have pros and cons I'm sure. I am quite sure that, as Jane says, if the doctor's fee base is captitated, he/she may be much more likely to overschedule and see as many people as possible. But in general, if you have two doctors who work on the basis of capitation, the Hispanic doctor will still take his/her time.

[iris lilies]

For those with means, I think fee-for-service is the way to go. You can choose your doctor and bypass the insurance companies--which can't then dictate your treatment. A lot of people do that anyway--they see naturopaths or other practitioners who aren't covered, or they're medical tourists.

Isn't that pretty much what a high deductible policy is? You pay, you decide on treatment.

[JaneV2.0]

I'm not sure how it works, but I think with that idea you'd just want catastrophic coverage. With high-deductible, wouldn't you have to log all your appointments with the gatekeepers so that after you reached your deductible, you'd be covered? I'd want them out of my business completely for the most part.

[iris lilies]

I'm not sure how it works, but I think with that idea you'd just want catastrophic coverage. With high-deductible, wouldn't you have to log all your appointments with the gatekeepers so that after you reached your deductible, you'd be covered? I'd want them out of my business completely for the most part.

Oh yeah, I see. So with deductibles being high, you'd still have to work with the Dr's insurance handlers and for that reason couldn't negotiate fees. True.

[Spartana]

Oh yeah, I see. So with deductibles being high, you'd still have to work with the Dr's insurance handlers and for that reason couldn't negotiate fees. True. Plus, with deductibles being so high for the lower cost plans, you want to make sure you are applying the money you do spend on medical care each year toward deductible so it gets counted if you need higher cost treatment (as Jane pointed out). So you must work with an insurance company - and all their rules and regs - if you want that level of coverage if you need it. And it seems that most doctors charge more for people who pay cash for medical care instead of using insurance. Seems I read somewhere that because the insurance companies negotiate with doctors and hospitals they try to keep those rates lower than they do for non-insured patients. I also don't know too many people who could actually pay for their own care outright beyond basic stuff. Get hit by a car or have even a small injury or illness and you could owe $10's of thousands, if not $100's of thousands, in medical bills. Heck with the newer high co-insurance percentages many plans have (40%) you may still owe a lot even with insurance coverage!

[JaneV2.0]

I've been incredibly lucky with my insurance coverage. Up until the year before I qualified for medicare, I paid nothing (thanks to my union's mad negotiating skills) for an excellent plan. Then they instituted an eight dollar a month premium. (I could have easily paid for the amount of services I needed out of pocket, which totaled a few thousand dollars over forty years--mostly routine dental visits.) Now, with Medicare, I'm paying $150 a month. So I read about $1000+ premiums with a mixture of horror and relief. I don't know how people do it.

[ApatheticNoMore]

The $1000 premiums seem to be if your over 50 or so, not getting any employer subsidy and earn too much for the Obamacare subsidy. I agree. It is absurd! That's about what my rent is and when health insurance (not even healthcare, health insurance!) starts equaling rent, which is my largest expense after taxes, it's completely and utterly bananas.

That said I'm fairly unhappy with my situation, paying a bit over $300 a month (which will probably increase soon) just to have the PPO, which still has a deductible, coinsurance %s and everything. I think it's probably better than the HMO as I'm told you have to fight to get any care at all from the HMO (and I picture myself weakened with cancer trying to fight the HMO or something - yea right), but I feel imperfectly covered (hospitalization or something would still kill me) for a fortune (at least it's directly tax deductible with no itemization as it's an employer plan) - for healthcare I have very little reason to even use!! It seems like a scam. I mean at least I get something for my rent, I'm paying all this money just for theoretical benefits. But I do have to admit we have such a bad plan because this company simply doesn't care about attracting good employees with either pay or benefits (that is plenty obvious - luckily for them there is such a high unemployment rate), and tries hard to push them all into the HMO, and so doesn't bother to look for better plans or pay more of the cost etc.. So it's not entirely on the healthcare system. Employers can do much better for their workers when they want to.

[reader99]

What I keep on wondering about as I read your posts is: Why have faith at all?

That was my thought. Nations, states, cities and HOAs are all staffed by and run by human beings and thus I expect them to be fallible. As a healthy adult in Florida with a very low income I don't qualify for Medicaid, don't qualify for subsidies and can't afford insurance. Thing is, that was all true before ACA so I'm not especially disappointed. Since other countries are also run by human beings I can't see moving since even if they have a good health care system there will be something else that's flawed. Also, there probably aren't many countries that want an over-55 no money no special skills old lady anyway. Might as well let nature take its course here where I have affordable housing and friends.

[Spartana]

The $1000 premiums seem to be if your over 50 or so, not getting any employer subsidy and earn too much for the Obamacare subsidy. And they also apply for those who are too low income to get subsidies but live in states without expanded Medicaid. Most of those people will have to go without insurance at all or get the lowest cost bronze level plan they can afford (and with an income of under $16K/year even those plans would be hard to afford - especially once you consider the high out of pocket costs that must be met before the plan even starts to kick in and cover 60%). It still boogles my mind that people with higher income levels can first fully fund their 401Ks and Traditional IRA's and educational saving for their kids and all the other tax deductions they are allowed from their gross income and THEN use that lower income basis to get subsidies - often pretty high subsidies - for insurance coverage while the low income or working poor get no help what so ever. Unless they are in a position to increase their incomes then they are left in the dust.

[Spartana]

Thing is, that was all true before ACA so I'm not especially disappointed. .True but doesn't it kind of tick you off a bit that the ACA allows so many MUCH higher income earners to get much of their coverage paid for with taxpayer dollars while you are given no help at all? Sure does me. While I'm happy those people get subsidies, I definetly think the ACA should have just did subsidies based on a sliding income scale for everyone (and base it on gross income) so that low income people could also be included in the mix. Also, before the ACA, at least healthy lower income people could often afford a low cost catastrophic plan. My Blue Cross plan started at $90 10 years ago and was still less than $200/month 10 years later. And after the $4000K deductible was met everything was included - no co-insurance.

[reader99]

True but doesn't it kind of tick you off a bit that the ACA allows so many MUCH higher income earners to get much of their coverage paid for with taxpayer dollars while you are given no help at all? Sure does me.

Maybe because I have a lifelong history of metaphorical redheaded-stepchild, Cinderella-in-the-ashes type situations this situation feels more like same-old same-old than anything I have the energy to get angry about.

[peggy]

Rob, dude! You really need to learn to take a breath! You seem to spend so much of your time spun up about stuff that may or may not be true that you WILL need medical care unless you learn to just step back, and apply some common sense thinking.

YOu said that they processed your form under the old rules, and would re-process under the new rules. Hardly the fault of the ACA, or Obama. In fact, BECAUSE of the ACA, they will NOW re-process your claim under NEW rules that will probably be favorable to you. Really Rob, let's think about this. Before the ACA you were NOT eligible, or covered, and now under the ACA you probably WILL be covered. Where's the problem?
Pardon me if I don't make sounds of sympathy, and gee and shucks and all, but from where I'm sitting I say yeah!, Rob will FINALLY be covered! The fact that you have to put forth a little effort to get that (phone tag, form-filling-out, waiting) is nothing, unless the effort is SO great that you would rather do nothing and just be uncovered. Yeah, universal health care is great, but even in those countries that have it, you still have to fill out paper work, play phone tag, put forth a bit of effort.

Please keep in mind that there are actually people out there who are rooting for failure. Your failure, and failure of the ACA. Shocking enough, even some on this forum want you to fail. They want you to go on forums and moan about how DIFFICULT it is to get covered (even though you weren't covered before) or complain about higher premiums (although the majority of Americans aren't haven't higher premiums) or blame Obama for the republican legislatures who refuse to expand medicaid (even though the feds will pick up the costs). They want you to be miserable, and if you would be so good as to get sick and die, then they can use you as an example of the failure of the ACA.

Remember, it's all the fault of 'Mr. You can keep your insurance' that the greedy insurance companies canceled your policy, cause they certainly don't want you to know that in fact the ACA DID allow you to keep whatever sham policy your insurance company talked you into buying if you had that policy before the ACA went into effect. See, the dirty little secret is, the insurance company didn't have to APPLY the new rules to your EXISTING policy. However, greed is greed, and the insurance companies saw a way to force you to pay more, using the ACA as an excuse. Obama didn't force them to cancel your policy. The ACA didn't force them to cancel your policy. That is completely and 100% the doing of the insurance company, and since there is no push back from the republicans (see hope of failure above) they gleefully cancel away.

but, you know...if you think things were just dandy the way they were before, and wish to go back to the way things were, then you just might have to vote republican. Cause they have a plan.....!Splat!

[gimmethesimplelife]

Rob, dude! You really need to learn to take a breath! You seem to spend so much of your time spun up about stuff that may or may not be true that you WILL need medical care unless you learn to just step back, and apply some common sense thinking.

YOu said that they processed your form under the old rules, and would re-process under the new rules. Hardly the fault of the ACA, or Obama. In fact, BECAUSE of the ACA, they will NOW re-process your claim under NEW rules that will probably be favorable to you. Really Rob, let's think about this. Before the ACA you were NOT eligible, or covered, and now under the ACA you probably WILL be covered. Where's the problem?
Pardon me if I don't make sounds of sympathy, and gee and shucks and all, but from where I'm sitting I say yeah!, Rob will FINALLY be covered! The fact that you have to put forth a little effort to get that (phone tag, form-filling-out, waiting) is nothing, unless the effort is SO great that you would rather do nothing and just be uncovered. Yeah, universal health care is great, but even in those countries that have it, you still have to fill out paper work, play phone tag, put forth a bit of effort.

Please keep in mind that there are actually people out there who are rooting for failure. Your failure, and failure of the ACA. Shocking enough, even some on this forum want you to fail. They want you to go on forums and moan about how DIFFICULT it is to get covered (even though you weren't covered before) or complain about higher premiums (although the majority of Americans aren't haven't higher premiums) or blame Obama for the republican legislatures who refuse to expand medicaid (even though the feds will pick up the costs). They want you to be miserable, and if you would be so good as to get sick and die, then they can use you as an example of the failure of the ACA.

Remember, it's all the fault of 'Mr. You can keep your insurance' that the greedy insurance companies canceled your policy, cause they certainly don't want you to know that in fact the ACA DID allow you to keep whatever sham policy your insurance company talked you into buying if you had that policy before the ACA went into effect. See, the dirty little secret is, the insurance company didn't have to APPLY the new rules to your EXISTING policy. However, greed is greed, and the insurance companies saw a way to force you to pay more, using the ACA as an excuse. Obama didn't force them to cancel your policy. The ACA didn't force them to cancel your policy. That is completely and 100% the doing of the insurance company, and since there is no push back from the republicans (see hope of failure above) they gleefully cancel away.

but, you know...if you think things were just dandy the way they were before, and wish to go back to the way things were, then you just might have to vote republican. Cause they have a plan.....!Splat!Peggy, point taken.

What has me so bothered is that I was under the impression that expanded Medicaid would start January 1st. Given that we are talking about something I view as a basic human right and necessary for basic human dignity - access to health care - I'm going to get upset. Sorry. I have lived too long in the United States not to get upset about the rollout of Medicaid and also the rollout of the exchanges being botched up.

I do agree with you that insurance companies are greedy and I also see your point about the Republicans having a plan - status quo or worse - shudder - not a day doesn't pass when I am grateful that I live close to Mexico.

I am of the opinion that probably Arizona is overwhelmed with Medicaid applications and I don't know that additional help has been hired to process these applications, so I believe your points stands, Peggy. I just wish I and all the other low income people I know had our damned cards - and that all information gets correctly inputted so that there will be no need for legal advice if bills arrive that are supposed to be covered expenses. Another poster brought this up earlier - the possibility that information will not be inputted correctly in the rush to get these applications dealt with - that is something I could see happening, too.

So at this point I am resigned to seeing what happens, and expecting nothing, and always having bus fare to Mexico stashed away just in case. Supposedly the state has until 2/14 to give all of us Medicaid eligible folks in Arizona a yes or no so we'll see.....Rob