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I'm arguing because you are not looking at the plans correctly or looking at all the plans available. If you qualify for a premium subsidy, did you check to see if you qualify for an out of pocket subsidy?
I'm not getting paid by anyone to tout the ACA. I'm trying to get people to understand how it works because there are a lot of people that just don't get it, or choose to listen to some radical news story that is wrong to start with and then believe everything they say.
No, telling someone to get a job isn't lame, it's called being an adult and being responsible.
Just a brief screen shot of a plan from your area--with no subsidy:
Kaiser Permanente
Deductible Silver
KP CA Silver 1250/40
MONTHLY PREMIUM
$274.00
ANNUAL DEDUCTIBLE
$1,250
MAX OUT-OF-POCKET
$6,350
PREMIUM
Family breakdown
Self: $274.00
Monthly Premium:$274.00
Your cost:$274.00
OUT PATIENT SERVICES (Per visit or procedure)
Primary care office visit$40Specialty care office visit$40Most X-rays$40 after deductibleMost lab tests$25 after deductibleMRI, CT, PET$300 after deductibleOutpatient surgery30% after deductibleMental health visit$40
INPATIENT HOSPITAL CARE
This one is a bronze plan--I can't even FIND a plan that has a 12,700 OOP max:
Kaiser Permanente
Deductible Bronze
KP CA Bronze 5000/60
MONTHLY PREMIUM
$205.21
ANNUAL DEDUCTIBLE
$5,000
MAX OUT-OF-POCKET
$6,350
ANTICIPATED PREMIUM COSTS
See if you qualify for federal financial assistance
Number of people in your household:
Your total expected taxable household income for 2014:
$
get an estimate
PREMIUM
Family breakdown
Self: $205.21
Monthly Premium:$205.21
Your cost:$205.21
OUT PATIENT SERVICES (Per visit or procedure)
Primary care office visitFirst 3 office visits $60. 1 Additional visits $60 after deductible.Specialty care office visit$70 after deductibleMost X-rays30% after deductibleMost lab tests30% after deductibleMRI, CT, PET30% after deductibleOutpatient surgery30% after deductibleMental health visitFirst 3 office visits $60.1 Additional visits $60 after deductible.
So, do you want to tell me again that you are finding no plans that have low copays and out of pocket costs? Again, these are without subsidies...since you said you qualify for one, your costs will be even lower...
The silver plan is actually not a bad plan. However, it costs $274/month. So if you make $30K, you get no subsidy. Your take home just went from $1950 to $1,676, that's quite a chunk.
The silver plan is actually not a bad plan. However, it costs $274/month. So if you make $30K, you get no subsidy. Your take home just went from $1950 to $1,676, that's quite a chunk.
Actually I put in 40K for a 25 year old and that qualified for a subsidy. I just didn't want to do an application so this is a quote from the Kaiser website without subsidies.....
Actually most of the plans on the various exchanges are not bad plans--problem is people assume they are bad because people have been bad mouthing them without really looking into them.
There was a story in the newspaper in our area not long ago about a woman that we clamoring about how awful these plans are and how much more they were going to cost her. She even went as far as contacting her Congresspeople and newspapers....it's since come to light that she never really priced out plans and is saving $171/month on premiums and her out of pocket costs are going down. I don't believe anyone's claim of how expensive these plans are without hard numbers to back it up and proof of those numbers. We have people here saying they have deductibles of $25,000 but when I call them out on that number I get a lot of negative comments----knowing full well that the max out of pocket under the ACA is $12,700. If people would do 10 minutes worth of research vs believing every Tea Partier or Fox news story, they would see that things just are not as bad as these people are making them out to be.
Kate--you are one of them that has gone out of her way to extol the negatives of these plans....and then it comes to life that the plan for your partner just isn't that bad and the real problem is you don't want to have to pay extra for her...and you have a very good plan at your company--why not just add her to that plan???
Actually I put in 40K for a 25 year old and that qualified for a subsidy. I just didn't want to do an application so this is a quote from the Kaiser website without subsidies.....
Actually most of the plans on the various exchanges are not bad plans--problem is people assume they are bad because people have been bad mouthing them without really looking into them.
There was a story in the newspaper in our area not long ago about a woman that we clamoring about how awful these plans are and how much more they were going to cost her. She even went as far as contacting her Congresspeople and newspapers....it's since come to light that she never really priced out plans and is saving $171/month on premiums and her out of pocket costs are going down. I don't believe anyone's claim of how expensive these plans are without hard numbers to back it up and proof of those numbers. We have people here saying they have deductibles of $25,000 but when I call them out on that number I get a lot of negative comments----knowing full well that the max out of pocket under the ACA is $12,700. If people would do 10 minutes worth of research vs believing every Tea Partier or Fox news story, they would see that things just are not as bad as these people are making them out to be.
Kate--you are one of them that has gone out of her way to extol the negatives of these plans....and then it comes to life that the plan for your partner just isn't that bad and the real problem is you don't want to have to pay extra for her...and you have a very good plan at your company--why not just add her to that plan???
I'm all for ACA, I just didn't realize how much money it would cost and how high the deductibles would be. In Florida with her making $30K she would qualify for a small subsidy, however, if she keeps her second job, she will be more around $35K and no subsidy at that level. She will make around that in 2013. All I'm saying is that the good plans with lower deductibles and out of pocket costs are in the range of $280 for her here in Florida. You have to understand that that is a sizable ding to our budget and I wouldn't exactly call it affordable. I don't want to get her a Bronze plan for $200 or so and have no coverage until she hits the $6350 deductible, I feel that is just a waste of money. Mostly when I started this thread, I was referring to the Bronze plans and their high deductibles and how unreasonable they are. I can see paying $100 a month for that plan, but $200 is steep IMO.
We are at the point now that it is better for her to stay home with the baby and work part time at the restaurant. Her income would hover around $1000 a month which would qualify her for almost free insurance with the ACA (her share would be $20/mos), food stamps (which we won't take) and no daycare costs. I understand now why people just don't work. And she wants to work, but when you do the numbers and they come out the same and still with no health benefits, then it doesn't make sense.
The wonderful state we live in will not allow us to get married, so I can't add her to my insurance.
You know we live on a budget, killed a major load of debt this year, we save etc. yet when we try to do it right we're penalized by this tax or that tax or whatever. Another option is for her to adopt the child and go on medicare. Problem is, we don't want to do that. We don't want to leech off of the system, but I'm sick and tired of getting screwed because I make middle-class income. Ideally we both have jobs, with reasonable pay and some benefits, but for one reason or another it just doesn't work out that way. We have our 4 year plan now and see what happens after, probably a move out of Florida is in short order anyway.
Mass Civil Disobedience regarding Obamacare combined with everyone in the country simply stopping their payments to ANY insurance company is the only way to go.
I know so many people who won't be participating in the new system that I do have hope that it will collapse.
Unless the law is changed, the IRS has the legal authority to withhold the no-insurance penalty from your tax refund. They do not have the legal authority to open collections against you, nor place a lien for unpaid taxes, because the penalty has not been interpreted to be a tax due. And you certainly can't be charged in a court of law for tax evasion.
If you are careful with your withholding and end up with no, or a small tax due, then there's nothing to deduct the penalty from, and that's that.
If you want more information about how the IRS will be handling all this, there's a wealth of information on their website. I've been checking every so often to see how they're going to handle the reporting aspect.
Also, regarding the screen shots from Kaiser--I'm wondering if you don't understand the word "deductible"? It means that you have to pay that much before the insurance kicks in. That means you pay cash out of pocket until you've reached the amount of the deductible. In addition to the monthly premium.
If you don't have major medical issues, it wouldn't really matter how low the co-pay is, since you wouldn't even hit the deductible threshhold for it to kick in.
what I want to know is what happens to people who dont qualify for medicaid and who cant afford obamacare or their employers insurance plan ? This is the case of my cousin and her husband . She hurt her back and she is waiting for her dissability to come through and he works his azz off and still cannot afford his employers insurance plan and they cannot afford obamacare either .She can get medicaid but she would have to pay around 300 dollars a month for it because the husband works . Does that make any freakin sense ? We are all worried about them and they are biting their fingernails off .
Mass Civil Disobedience regarding Obamacare combined with everyone in the country simply stopping their payments to ANY insurance company is the only way to go.
I know so many people who won't be participating in the new system that I do have hope that it will collapse.
Join us, everyone! Just don't participate!
That's just fine for those who don't have any assets for a hospital to come after when they don't pay the bill, don't care if their credit is trashed.
I keep wondering what exactly most people think insurance actually IS?
It is NOT free money which everyone automatically gets and which is more than or equal to the amount of the cost of the health services each person uses.
How then would the insurance companies make money?
Insurance companies make money when people actually have medical costs which are LOWER than the insurance fees they pay in.
Take a look at the stock market. The insurance megaliths are very, very profitable. They are profitable because most people actually pay more in premiums than they get in benefits.
The new health system is quite open about this. The government wants healthy young people to pay in, so that the costs of unhealthy people are covered.
Yes, durr, I completely understand the argument that the costs of those unhealthy people (or people on "dissability" per the above) who are currently uninsured are being paid out of our taxes. I'm actually fine with that. That's why I've been a Democrat. That's why I pay my taxes.
Getting insurance is very much like going to a casino. You can either bet against the house, which is sucker's bet, or . . . there's a faint possiblity that you might actually win some money, or . . . you can just not go to the casino at all.
Save your money, invest it wisely, and pay for the cost of the ACTUAL health care services that you need when you need them. That's all each of us needs to do.
Most insurance companies started out as burial societies!
Save your money, invest it wisely, and pay for the cost of the ACTUAL health care services that you need when you need them. That's all each of us needs to do.
Won't work so well if you have a serious medical problem. Pretty tough to save up a hundred thousand that you might need to pay for it.
Also, regarding the screen shots from Kaiser--I'm wondering if you don't understand the word "deductible"? It means that you have to pay that much before the insurance kicks in. That means you pay cash out of pocket until you've reached the amount of the deductible. In addition to the monthly premium.
I've been lurking on the sidelines reading through all these posts, and I have also questioned her knowledge on this as well. Simply put, if your deductible is $5000 (just for the sake of argument), your insurance plan does not contribute a single dime until you've met this amount. So if your monthly premium is $500 (again, just using an arbitrary dollar amount), you will be forking over $6000/year in premiums, IN ADDITION TO your $5000 deductible, for a total out of pocket expense of $11,000 before insurance kicks in.
I am a medical professional, so I deal with this on a daily basis in my practice.
The only exception to this is if there is some language specifically stating otherwise.
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