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I have a high deductible plan with $2K out of pocket before insurance kicks in.
That is better than Obamacare plans which are for people who can't afford insurance.
You continue to distort the ACA plan provisions. There is no "deductible" that has to be met before the insurance kicks in. ACA is first dollar for covered expenses including hospital admission. What you are calling a deductible is, ONCE AGAIN, co-insurance. It is the fraction of the medical bill that is paid by the insured and varies from 10-40% depending on the plan chosen. Unlike your policy, an ACA insured individual would get coverage right away. Their covered expenses would have to add up to $6667 before they would pay the 2 grand you pay right off the top.
I don't know if you are just ignorant of the ACA provisions or if you delight in passing out misinformation to people. In either case, you sure do a lot of misleading and inaccurate posts about it. People would be well-advised to ignore what you (or I for that matter) post on it and get their info from a credible source like healthcare.gov. Enrollment starts tomorrow - regardless of what Congress does.
I have a high deductible PPO plan with a $2K out of pocket expense before insurance kicks in.
Obamacare was supposed to be for people that could not afford insurance.
If people cannot afford monthly premiums how in the heck are they going to afford the out of pocket expenses which are now not capped until 2015 ?
I have always figured it was a little like carrying liability insurance and then getting in a wreck and totaling your car. Although in the case of health insurance you have to spend your deductible which could be $5,000 that's not like buying a junker. The biggest issue is people who fall out side the FPL and still cant afford the Bronze plans. There will have to be changes and the way the money for the support is spread out.
You continue to distort the ACA plan provisions. There is no "deductible" that has to be met before the insurance kicks in. ACA is first dollar for covered expenses including hospital admission. What you are calling a deductible is, ONCE AGAIN, co-insurance. It is the fraction of the medical bill that is paid by the insured and varies from 10-40% depending on the plan chosen. Unlike your policy, an ACA insured individual would get coverage right away. Their covered expenses would have to add up to $6667 before they would pay the 2 grand you pay right off the top.
I don't know if you are just ignorant of the ACA provisions or if you delight in passing out misinformation to people. In either case, you sure do a lot of misleading and inaccurate posts about it. People would be well-advised to ignore what you (or I for that matter) post on it and get their info from a credible source like healthcare.gov. Enrollment starts tomorrow - regardless of what Congress does.
I'm not ignorant. I understand the terms premium, out of pocket, deductible, co-insurance.
There is an out of pocket expense that people must meet BEFORE the insurance kicks in.
ACA does not call it co-insurance. They explain it as out of pocket expenses BEFORE insurance kicks in.
Once insurance kicks in then you have co-insurance which is your part of what's not covered.
A deductible is the amount you have to pay for covered services before your insurance starts to pay.
A co-payment (sometimes called “co-pay”) is a fixed dollar amount that you pay for certain health care services.
Your share of the costs of a health care service is called coinsurance. Typically, this is figured as a fixed percentage of the total charge for a service, such as 15% or 30%. Coinsurance kicks in after you’ve met your deductible.
I know. These are the people that can't afford premiums each month and have to get subsidized yet have an extra $5-12K sitting in the bank for out of pocket expenses BEFORE insurance kicks in. Family deductibles go past $10K.
I lol'd when I saw that.
Easier just to pay the $95 fine and continue to just show up at the ER when you get sick.
Just so long as you pay the bills yourself, you would not want to be considered another user of the system would ya. Better hope no one in your family gets a major illness, otherwise bankruptcy court is in your future.
I'm not ignorant. I understand the terms premium, out of pocket, deductible, co-insurance.
There is an out of pocket expense that people must meet BEFORE the insurance kicks in.
ACA does not call it co-insurance. They explain it as out of pocket expenses BEFORE insurance kicks in.
Once insurance kicks in then you have co-insurance which is your part of what's not covered.
A deductible is the amount you have to pay for covered services before your insurance starts to pay.
A co-payment (sometimes called “co-pay”) is a fixed dollar amount that you pay for certain health care services.
Your share of the costs of a health care service is called coinsurance. Typically, this is figured as a fixed percentage of the total charge for a service, such as 15% or 30%. Coinsurance kicks in after you’ve met your deductible.
You have the definitions right but how they are applied is what matters. I just finished an over the fence discussion with my neighborhood liberal who is also a "navigator" for the ACA. It seems neither of us is completely correct though, sadly I must admit, you may be a little closer than I am. As I now understand it, the 10-40% coverage is an actuarial number that a plan must meet. There are a lot of ways to consume health care and, therefore, a lot of ways to devise a plan at each actuarial level. In fact, there are well over 100 variants of the 4 metal plans in most states. In other words, there are a lot of different bronze plans, silver ones etc. While they all seek to cover the actuarial costs required for that level, they do it in very different ways. For example, one bronze plan may have a high deductible and high copays for primary care visits for lower rates, while another has a very low deductible and low payments for doctor visits at higher premiums. One has to think about how they will consume health services and choose which variant gives them the most for the least. One thing they do share in common is the the maximum out of pocket is the same for each level. It is how you get there that matters from one plan to the next within a given metal group. Frankly, it is a little confusing at this point because no rates or plans are out there to look at - just some general stuff for the press - and the offerings may vary depending on where one lives. You may not get what I get. I guess we will all find out in the morning!
Just so long as you pay the bills yourself, you would not want to be considered another user of the system would ya. Better hope no one in your family gets a major illness, otherwise bankruptcy court is in your future.
That's is the entire reason that Obamacare got passed to begin with because that was happening.
People with insurance couldn't afford to pay what they owed.
Yeah, that's how insurance works..car, home, health.
The more you are willing to pay out of pocket the less your monthly premiums are.
I have high deductibles for all my insurance policies.
In the long run you actually save money.
I was in my previous home for 12 years and only needed insurance once during that time.
I had 12 years of low premiums though which more than made up for the one time I had to pay my out of pocket to get the roof replaced (storm damage ripped off half the shingles).
That may work for you, but not necessarily for someone who goes to the doctor a lot (such as myself).
The deductible amount of Obamacare ranges from $1500 to $5000. That is the amount that the individual will have to pay out of their own pocket. Why isn't anyone talking about that? Only the premiums are being mentioned. How will anyone be able to pay for that?
Ok, so there is different terminology for the type of payments. What it comes down to is: What is the maximum out of pocket expenses that is associated with the different premium payment levels?
If a person has trouble paying premiums of $350 a month what will happen if they have routine procedures? For example: I am an asthmatic. I have been intubated and stayed in the emergency room for up to 12 hours without being admitted. What would the out of pocket cost be to me? Does anyone really know?
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