Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Everyone is upset about Affordable Health Insurance for the working
people in this country.
That is what all this nonsense is all about.
Why can't hard working Americans have access to Affordable Health
Care? All the other industrialized countries have it, why can't we?
Why do we treat each other so cruely?
Why do we hate ourselves?
We deserve it.
If the Government can send billions of dollars to foreign countries
why do thousands of Americans have to die every year because they
can't buy health insurance?
These people who are dying, they are working people, many who had health
insurance through their employers, and because they got sick, they were fired.
When they are fired, they lost their insurance.
They died.
Get it?
Americans still won't have access to affordable healthcare. They may have health insurance but that is not healthcare. I don't see how that has escaped people. Now, when someone with one of the lower cost insurance plans with high deductibles and co-pays goes into the emergency room, taxpayers will still end up picking up the tab because the person won't be able to cover the deductibles/co-pays. And, on top of that, they will have less cash in hand because they had to purchase the insurance that isn't going to cover their bill. At least 50% of the medical bankruptcies were filed by people who had health insurance. This is about putting money in the pockets of the insurance companies who always would rather deny, deny, deny until they, if you are persistent, pay the bills. When we had health insurance, it took 3 calls every time to get them to pay something. I believe in socialized medicine, all getting equal care, eliminating the health insurance companies. Before health insurance, medical care was affordable. This isn't a boom for the people but to the insurance companies.
so i am still a tad confused about ACA. so, we all help out in some fashion to get ins into the hands of those who typically cannot afford it. so, the already strapped person is now mandated to have ins, so the person buys what they can afford and then uses it. the medical facilities then charge the person for anything above what ins pays for, possibly at higher than fees prior to ACA, then the person balks on paying. so in essence, ACA will make things much worse and here's why. most medical services are readily available to those with health ins vs not so much for those who dont have any coverage. so, the medical services will now have larger intake of patients because more people now have some health ins, yet, same % of those who didnt pay before will not pay what they owe above what ins paid.
so i am still a tad confused about ACA. so, we all help out in some fashion to get ins into the hands of those who typically cannot afford it. so, the already strapped person is now mandated to have ins, so the person buys what they can afford and then uses it. the medical facilities then charge the person for anything above what ins pays for, possibly at higher than fees prior to ACA, then the person balks on paying. so in essence, ACA will make things much worse and here's why. most medical services are readily available to those with health ins vs not so much for those who dont have any coverage. so, the medical services will now have larger intake of patients because more people now have some health ins, yet, same % of those who didnt pay before will not pay what they owe above what ins paid.
so how does ACA handle this issue?
If you have insurance, the provider (doctor or hospital) who participates with your plan agrees to accept an amount negotiated with the insurance company as full payment. You only have to pay your deductible and copayment, which you negotiate with the insurance company. The deductible is a fixed price per year. The lower the deductible, the higher your premium will be.
You owe the copayment for each visit to every doctor until you hit a maximum for your out of pocket cost.
Some plans have another patient share called coinsurance. That means you pay a percentage of the cost, again until you reach an out of pocket maximum.
In general, the more you are willing to possibly have to pay out of pocket, the lower the monthly premium will be. If you are young, healthy, and seldom see a doctor, a higher deductible usually means you will pay less in total per year when you add up premiums, deductible, and copayments. You would possibly pay more if you had something unexpected happen, such as a broken arm or appendicitis. What you have to decide is a comfortable compromise between premiums and deductible and copayments.
The bottom line is that if you have insurance and use providers which are "preferred" by the insurance company you will not be billed for the difference between what your insurance pays and the amount someone with no insurance would pay. In essence you get a discounted charge negotiated by your insurance company.
If you have personal doctors that you really want to see, check with them before you purchase a plan to make sure they are preferred providers for that plan. Do not take the insurance company's word - their lists are always notoriously out of date.
i thought negotiated price means just that, then there's the 80/20 (or whatever) split between what ins pays and what you pay. i have good ins, i still get bills from med places even after ins pays their portion of the "contracted" price.
i thought negotiated price means just that, then there's the 80/20 (or whatever) split between what ins pays and what you pay. i have good ins, i still get bills from med places even after ins pays their portion of the "contracted" price.
OK. Seems like you've got the concept down.
And the question "so how does ACA handle this issue? ", thats between you and your insurance company and the doctor. You have the insurance, visit the doctor, the insurance company pays its portion, up to you to pay your portion. ACA isn't in the insurance business, it doesn't issue policies, it provides an exchange and YOU enroll with the insurance company that you've found on the exchange.
And the question "so how does ACA handle this issue? ", thats between you and your insurance company and the doctor. You have the insurance, visit the doctor, the insurance company pays its portion, up to you to pay your portion. ACA isn't in the insurance business, it doesn't issue policies, it provides an exchange and YOU enroll with the insurance company that you've found on the exchange.
You are trying to make something out of nothing.
you are missing the point i made earlier.
before ACA some just didnt have ins, now ACA mandates you do. some med places would not take patients unless they had some form of ins (and it had to be one they deal with). so in essence, before ACA med places had limited patient intake. now, those who abused the system by not paying their share (w/o ins) all of a sudden get something through ACA ("exchanges", call it "mud" for all i care, its ACA), now these folks are readily accepted as patients to med places everywhere, but, they still wont pay their portion.
thus, ACA just overloaded med places with extra people who wont pay their share. is this good for med places? i suspect it makes the "abused service, did not pay" issue even worse, thus making medical service even more expensive vs pre-ACA times!
bottom line is, ACA is not well thought out, and in the end things will just be worse.
before ACA some just didnt have ins, now ACA mandates you do. some med places would not take patients unless they had some form of ins (and it had to be one they deal with). so in essence, before ACA med places had limited patient intake. now, those who abused the system by not paying their share (w/o ins) all of a sudden get something through ACA ("exchanges", call it "mud" for all i care, its ACA), now these folks are readily accepted as patients to med places everywhere, but, they still wont pay their portion.
thus, ACA just overloaded med places with extra people who wont pay their share. is this good for med places? i suspect it makes the "abused service, did not pay" issue even worse, thus making medical service even more expensive vs pre-ACA times!
bottom line is, ACA is not well thought out, and in the end things will just be worse.
No, they are not readily accepted everywhere. There are still networks of doctors for each plan on the exchange. It's possible a doctor is in every network but they might only be in one network. If you take an HMO option, you can ONLY see doctors in that HMO. Yes, some practices only took patients that had insurance but MOST took everyone and just required them to pay up-front for care. These people were hardly ever turned away because they paid more for the same services then people with insurance, even if they got some kind of a cash discount usually.
No, they are not readily accepted everywhere. There are still networks of doctors for each plan on the exchange. It's possible a doctor is in every network but they might only be in one network. If you take an HMO option, you can ONLY see doctors in that HMO. Yes, some practices only took patients that had insurance but MOST took everyone and just required them to pay up-front for care. These people were hardly ever turned away because they paid more for the same services then people with insurance, even if they got some kind of a cash discount usually.
right, so now more of those cash people will get ins via ACA, and then not pay, and as you noted, that means less $$ for the med place = higher rates for everyone else.
no matter how you supporters of ACA slice-&-dice it there's always a negative ending. i think its all bad, but let's revisit this mess in mid-2014.
right, so now more of those cash people will get ins via ACA, and then not pay, and as you noted, that means less $$ for the med place = higher rates for everyone else.
no matter how you supporters of ACA slice-&-dice it there's always a negative ending. i think its all bad, but let's revisit this mess in mid-2014.
Nope. You are discounting the effect of the insurance payments. After those insurance payments are made, THEN your payments are due. And its on you to make those payments. Plus, the amount that you do owe could be far less than your total medical bill.
As I previously wrote, ACA isn't involved in this.
Nope. You are discounting the effect of the insurance payments. After those insurance payments are made, THEN your payments are due. And its on you to make those payments. Plus, the amount that you do owe could be far less than your total medical bill.
As I previously wrote, ACA isn't involved in this.
I believe he is asking what will happen with people who have not had insurance decide not to pay their contracted share: deductibles and copayments.
One thing that will happen is that their doctors will drop them as patients. Not many practices can accept just the insurance, and if the doctor writes off the patient share, the insurance companies will cheerfully lower their reimbursement even further. They consider not getting the patient to pay the copay as a reduction in the customary fee.
The ACA is involved to the extent that there is a penalty for not buying insurance.
So the OP is justified in his concern.
The overall effect for many people is going to be an increase in what they pay for heath care: increased premiums and increased taxes to pay for premium subsidies.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
