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Old 10-03-2014, 02:11 AM
 
106,114 posts, read 108,094,712 times
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Quote:
Originally Posted by shaker281 View Post
It sounds to me like you chose a lower priced plan to save premium dollars and really needed a more robust plan with lower out-of-pocket limits. Not really sure that has anything to do with AHCA. Had you not had any claims you would be ahead $3500 and happy? It is very important a person choose the right plan for their individual circumstances.

I have not seen any significant change in my companies health care offerings or premiums and I just signed up for 2015 benefits. Another year older and my family coverage went up $10 a month, just like the past 10 years.
we opted for the gold plan because we are in our 60's or we would have gone with bronze.

if you are healthy and younger the out of pockets are higher but the odds of maxing them are lower.

you need to be careful with these plans too as to where you have services done.

if i have an mri at a hospital i have to pay 20% of the entire bill until i max out the out of pocket. but if i use a lab instead of a hospital it is only a 75.00 copay and not 20% of the bill.
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Old 10-03-2014, 02:36 AM
 
Location: East Central Pennsylvania/ Chicago for 6yrs.
2,535 posts, read 3,265,264 times
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Quote:
Originally Posted by NickB1967 View Post
Actually *all* was not paid. The 80% rule applied.
Oh YES, ALLWAS PAID BACK THEN. With insurance of the 80s. Actually early 90s. My wife and I did fertility invetro fertilization then. I had blue cross blue shield. My company paid ALL the premium. I PAID FOR NONE OF IT after any hospital visits, IN WELL OVER A YEAR IN TREATMENTS.
AGAIN, all these 20% and now the new normal 30% your share? Was not in our pre-HMO era. They changed it all.

Try to find insurances that pay even a penny of fertility procedures today???
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Old 10-03-2014, 02:41 AM
 
64 posts, read 93,963 times
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One of my relatives was overjoyed with Obamacare. His monthly premiums dropped to a few bucks a month due to subsidies. However, he chose a high deductible plan. ***** happens* and he ended up in the ER and will now end up paying much more this year than if he had just paid a little extra for a better plan. He is also avoiding specialty visits necessary for his injury because he doesn't want to pay out of pocket for them either.

I do think it's a good thing that people are now paying a larger share of their health care costs though. It will probably help control health care costs more than if people were still getting everything for "free".
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Old 10-03-2014, 03:01 AM
 
106,114 posts, read 108,094,712 times
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usually the high deductable plans work out about the same once you include the out of pockets. when we had the high deductable plan the basic insurance was a fraction of regular insurance but if i maxed out the high deductables on my wife and i we ended up no worse than what full coverage would have cost us anyway.
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Old 10-03-2014, 03:19 AM
 
6,438 posts, read 6,886,711 times
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Quote:
Originally Posted by k374 View Post
Take a hypothetical situation. A 55 year old man is living in Los Angeles or San Francisco, he is able to earn $60,000/yr. works for a small company that does not offer health. He makes way too much money (over 400% of the poverty level) to qualify for any discount but $60k/yr is not a whole lot of money in LA. I see that even the Bronze plan is in the neighborhood of $450/month, is someone who makes $60k/yr mandated to spend $450/mo. on health insurance? The alternative is to pay the penalty but that's $1500 with nothing to show for it….
It helps a few people (within a narrow income range in the lower middle class) but you seem to have captured the gist of it.

P.S. if you have money and a pre-existing condition it's great.
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Old 10-03-2014, 03:38 AM
 
Location: Secure, Undisclosed
1,984 posts, read 1,693,438 times
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I make $60k per year, so in addition to paying for my family's insurance, I'm paying for your subsidy.


You're welcome.
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Old 10-03-2014, 03:40 AM
 
4,765 posts, read 3,717,256 times
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Quote:
Originally Posted by steeps View Post
Oh YES, ALLWAS PAID BACK THEN. With insurance of the 80s. Actually early 90s. My wife and I did fertility invetro fertilization then. I had blue cross blue shield. My company paid ALL the premium. I PAID FOR NONE OF IT after any hospital visits, IN WELL OVER A YEAR IN TREATMENTS.
AGAIN, all these 20% and now the new normal 30% your share? Was not in our pre-HMO era. They changed it all.

Try to find insurances that pay even a penny of fertility procedures today???
What you are describing here is the path from which we arrived where we are now. Long before AHCA, insurance companies began raising rates and eliminating coverages. And companies that paid employee premiums began setting limits and passing on costs to consumers.

We had a child in 1993 and with my wife and I both employed by different firms we may have actually made money based on overlap! Those days are long over! But, the expectation that we could all enjoy "free" health care (even though our employers were paying dearly) and the providers rush to capitalize on that, may have partly been responsible for our current predicament!

I should add, that my neighbors, who both work, just went through in vitro and paid almost nothing.
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Old 10-03-2014, 05:53 AM
 
2,441 posts, read 2,596,385 times
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Quote:
Originally Posted by NickB1967 View Post
Exactly.

This is also why nonsense like covering *birth control* on medical insurance, or other items that are routine and minor expenses on insurance, which are better paid for in cash and over the counter, will prove disastrous for the insurance system.

Insurance is for *major financial catastrophe*. Birth Control Pills, per month less than nearly all cell phone bills, are not a major financial catastrophe. Getting Breast Cancer--or hit by a truck--IS a major financial catastrophe.

What would your car insurance cost if oil changes were *required* to be covered by it? And what would the oil changes cost, without price competition and with a 3rd party paying for them? The answer is a hell of a lot more, both times.
For an insurance company, $20,000 for a normal easy complication free birth is a catastrophe, and the not infrequent complicated births that can cost half a million are insane, when they're both entirely preventible. Not to mention the financial and life catastrophe of an unplanned child.

IUDs, the most effective contraception, and most widely used, are up to $1000 up front. Amortised over the five year life span it's very cheap, but that $1000 is a doozy.
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Old 10-03-2014, 05:55 AM
 
106,114 posts, read 108,094,712 times
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iud's , isn't that those bombs they blow up the humvees with?
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Old 10-03-2014, 06:35 AM
 
Location: UpstateNY
8,612 posts, read 10,721,709 times
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LOL no those are IED's...........
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