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Criticism of big government inefficiencies is often valid, but in this case, the coverage is administered by the private health insurance industry.
the criticism is the law that was passed is mandating citizens to purchase private health insurance from for profit capitalist companies; and it's turning out to not be so affordable. Despite what some main stream media says, this is not socialized medicine. This is pure capitalism. If it were a real socialization of medicine, we would all have equal coverage. There would be no Bronze, silver and premium coverage.
See, this is what I don't get. If NC knows that the ACA is going to happen, then why refuse the expansion? I don't buy the whole "Medicaid is broke" thing, because the bottom line is that accepting the expansion would mean lower premiums for everyone else in the state and if there's seriously something wrong with Medicaid, it will have to be fixed at some point... but, why freak people out to make a point?
I swear... I hate politicians.
Exactly! In the end, it all comes down to people wanting to get re-elected and make happy a vocal faction of the base that sees the entire thing as socialism and evil incarnate.
I am no fan of Jan Brewer but have a huge amount of respect for her for realizing what you said above and participating.
I have zero respect for our legislature for putting us all in a horrible situation by pandering to (oh never mind I'm about to launch into a post that is better off in politics and other controversies)
After yesterday's layoffs at my company and a big change in expense reimbursement, I'm now fairly certain I'm going to be dumped into the exchange. Which is going to cost me a fortune without a subsidy for any sort of reasonable coverage that has a deductible making it worth it. I really, really wish catastrophic coverage were offered to those over 30. I do not want a policy with a $5000 deductible, or a $2500 deductible.
Ah, NorasMom, I don't think you understand what catastrophic coverage really is. It covers major issues like extreme trauma from an accident or cancer treatments, but routine expenses like office visits or x-rays are all paid out-of-pocket. (And auto insurance would kick in before the health insurance if an auto accident has caused the trauma.)
Under the ACA, those under 30 who select the catastrophic plan have a $6400 deductible. They premiums will be low; however, they are not eligible for subsidies.
Quote:
Originally Posted by adlnc07
Unfortunately, there won't be any non-compliant plans unless you were already on one and it was grandfathered in.
100% correct.
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Those of you who have followed my posts for several years may remember that I moved to North Carolina for one reason: To purchase individual health insurance. I was a long time resident of AZ and retired at 52. I had pre-existing conditions that caused a decline every time I applied for individual insurance since 1998. I started a small business for the sole purpose of getting health insurance through the AZ Small Business Association Group Coverage. In January, 2012, at 55 years old, I was paying $980/month for a $5,000 deductible policy (NOT HSA eligible). We were told that the group would probably be too small to qualify as a group in 2013, so no insurance would be offered. I spent weeks researching states that would allow me to purchase insurance, and the related costs and waiting periods. Within the states that had some way to keep me insured, we considered other quality of life factors (weather, community, leisure activities, cost of living, etc.)
NC offered a state run high risk pool which would accept me within 30 days of arrival (Inclusive Health NC). All I had to to was get declined by a regular insurance carrier. So, I did my little online application with BCBS- NC and guess what? They accepted me. $354/month for the $5,000 deduction (HSA eligible). In Jan 2013, they increased the rates to $391/month. Next year, under ACA, the bronze coverage will increase my deductible to $5,500 and my premium to $498. I do not expect that I am eligible for subsidies.
BTW, my total medical costs in 2011 and 2012 were, respectively, $750 and $550. FOR THE ENTIRE YEAR.
With pre-existing conditions I should be a cheerleader for Obamacare. I'm not. It's the wrong solution to a very bad problem.
Last edited by Jkgourmet; 10-10-2013 at 02:49 PM..
I found CoventryOne (Plan QHDHP 19A) for $127.50 per month, 43 year old female, non smoker, $5000 deductible, then 100%. This is about exactly what I have now with BCBS (that will double next year if I don't change anything), but I'm not 100% convinced what I am seeing is for 2014. Maybe this is a grandfathered plan?!
Honestly, that premium sounds way too low to be a 2014 plan. Plus I don't think the ACA plans cover 100% after the deductible, at least with the bronze plans.
Honestly, that premium sounds way too low to be a 2014 plan. Plus I don't think the ACA plans cover 100% after the deductible, at least with the bronze plans.
That's why I was thinking it was grandfathered in and didn't include all of the regulations....maybe? Or it's just a 2013 rate.
Honestly, that premium sounds way too low to be a 2014 plan. Plus I don't think the ACA plans cover 100% after the deductible, at least with the bronze plans.
they should pay 100% after the deductible is met, otherwise it would just be a 70/30 or an 80/20 with no deductible. Then you would always be responsible for the 20 or 30 percent.
the problem is the deductibles seem very high right now. I think for a family of 4 making 70k a year it's around 12k. The bronze plan is probaly an 80/20 or a 70/30. The only real way to know what it's going to cost you is to go on healthcare.gov, register, and look for coverage.
Ah, NorasMom, I don't think you understand what catastrophic coverage really is. It covers major issues like extreme trauma from an accident or cancer treatments, but routine expenses like office visits or x-rays are all paid out-of-pocket. (And auto insurance would kick in before the health insurance if an auto accident has caused the trauma.)
Yes I do. I was saying that the costs of full coverage are so outrageous that I wish I could just buy catastrophic, but I can't because of my age. I'd prefer full coverage, but I may be priced out.
What stops someone from purchasing insurance that is not BC/BS or on the exchange???? A lot of companies do business in the state-are they leaving or otherwise prohibited from writing new policies?
What stops someone from purchasing insurance that is not BC/BS or on the exchange???? A lot of companies do business in the state-are they leaving or otherwise prohibited from writing new policies?
Essentially, the answer is yes, they are prohibited from writing policies that do not conform to the minimum requirements of coverage under the new ACA law (unless the specific policy is grandfathered, meaning in force prior to March 23, 2010). Even the grandfathered plans are required to conform to certain ACA requirements. For example, they cannot enforce lifetime limits on coverage you can receive.
There are many additional variables and exceptions. But, as far as individual coverage goes, if you do not have a grandfathered plan, your choices are limited by what is offered on the exchange. Which means several plans offered by BCBS of NC or Coventry (which is only offering insurance in 8 counties, I believe).
Please note: Employer coverage (large and small business) has entirely different rules. I'm NOT referring to those, and enactment of the ACA has been postponed for them until 2015.
NorasMom: The bronze plans being offered on the exchange are as close are you are going to get to catastrophic care. $5500 deductible.
Essentially, the answer is yes, they are prohibited from writing policies that do not conform to the minimum requirements of coverage under the new ACA law (unless the specific policy is grandfathered, meaning in force prior to March 23, 2010). Even the grandfathered plans are required to conform to certain ACA requirements. For example, they cannot enforce lifetime limits on coverage you can receive.
There are many additional variables and exceptions. But, as far as individual coverage goes, if you do not have a grandfathered plan, your choices are limited by what is offered on the exchange. Which means several plans offered by BCBS of NC or Coventry (which is only offering insurance in 8 counties, I believe).
Please note: Employer coverage (large and small business) has entirely different rules. I'm NOT referring to those, and enactment of the ACA has been postponed for them until 2015.
NorasMom: The bronze plans being offered on the exchange are as close are you are going to get to catastrophic care. $5500 deductible.
JK--you say the bronze plan has a $5500 deductible. Did you go on the healthcare.gov site and get that quote? I would think that deductible will vary depending on how much money you make.
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