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Old 01-15-2014, 06:53 PM
 
3,599 posts, read 6,781,640 times
Reputation: 1461

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Quote:
Originally Posted by cxr89 View Post
Lol, those rates you are putting up are teaser rates. Any issue discovered on their health application (which could be 10-30 pages) would dramatically increase rates. Plus, there was no guarantee of insurers paying a claim or there was the possibility of an insurer rescinding the policy after the person got sick due to a discovered pre existing condition that was not disclosed (opps, I forgot to mention I had acne one, so too bad for me, now im stuck with a huge medical bill ) . A young individual in my area can get a PLATINUM plan for as low as 142 (with out subsidies) , with NO deductible, $20 copay's for office visits and $40 copays for specialists, plus, in the worse case scenario, the OOP max is 4000.00 Sound like you live an area where you only have one insurer. Im sorry to hear that. Where I live we have 8 insurers, and thus, a huge variety of choices and has probably caused prices to drop. I also live in one of the most expensive counties in the country as well
Lol at you. I said "the vast majority". Isn't that the democratic mojo these days anyways. Aren't they all saying the ACA is working well for the vast majority of Americans?

They aren't teaser rates in 2013. I stand by my statement. The vast majority of ages 18-40 pre ACA had affordable health care on the individual market.

I live in Florida. Tons of choices.

And it's very misleading when you state "no deductible".


I want to you what my "Max" out of pocket expenses are in network and out of networks. So those "teaser" no deductible platinum plans still come with "max" $2000 out of pocket expenses? Am I right or wrong?

Or what's your max out of network expenses? Oops. Under the ACA there are in max out of network expenses. But pre ACA the usual max out of network expenses were usually twice the in network expenses. They still haven't figured out under the ACA what to do with out of network costs. And most states allow balanced billing as well. Way to go ACA. You guys support the ACA which us to offer financial protection. Yet deductibles are higher for the vast majority of the population compared to pre ACA. And you don't address out of network expenses. After all emergencies can happen anytime? Right?
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Old 01-15-2014, 08:06 PM
 
6,790 posts, read 8,195,863 times
Reputation: 6998
Quote:
Originally Posted by aneftp View Post
Lol at you. I said "the vast majority". Isn't that the democratic mojo these days anyways. Aren't they all saying the ACA is working well for the vast majority of Americans?

They aren't teaser rates in 2013. I stand by my statement. The vast majority of ages 18-40 pre ACA had affordable health care on the individual market.

I live in Florida. Tons of choices.

And it's very misleading when you state "no deductible".


I want to you what my "Max" out of pocket expenses are in network and out of networks. So those "teaser" no deductible platinum plans still come with "max" $2000 out of pocket expenses? Am I right or wrong?

Or what's your max out of network expenses? Oops. Under the ACA there are in max out of network expenses. But pre ACA the usual max out of network expenses were usually twice the in network expenses. They still haven't figured out under the ACA what to do with out of network costs. And most states allow balanced billing as well. Way to go ACA. You guys support the ACA which us to offer financial protection. Yet deductibles are higher for the vast majority of the population compared to pre ACA. And you don't address out of network expenses. After all emergencies can happen anytime? Right?
The ACA requires plans to charge you the same co-pay or deductible for emergency care at in-network and out-of-network hospitals. The deductibles are not higher for anyone who takes a few minutes to shop instead of automatically choosing a bronze. In most states there are many plans available with similar pre ACA deductibles. Deductibles and OOP maxes always existed, these aren't new to the ACA. My current state prohibits balance billing, other state residents can take this up with legislators.

Only the "vast majority" of perfectly healthy 18-40 year olds had access to affordable health insurance, the rest which included millions did not, with many having ZERO access, they either faced exorbitant rates, or complete denial, and many were cancelled if they actually needed to use the insurance within the previous year.

No one loves the ACA, many think it goes too far, many think it doesn't go far enough. It was absolutely time for insurance reform. Where is the alternative? I keep asking what will replace it if it were repealed, I keep hearing crickets...

Until I hear about the amazing new plan that will solve all these issues, my independent vote will not go to anyone supporting repeal which seems to included every single republican. They have some actual work to do that includes real ready to go alternatives, not just obstructionism if they want votes from people other than the die hards.

Last edited by detshen; 01-15-2014 at 08:19 PM..
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Old 01-15-2014, 08:34 PM
 
29,939 posts, read 39,453,111 times
Reputation: 4799
Quote:
Originally Posted by detshen View Post
The ACA requires plans to charge you the same co-pay or deductible for emergency care at in-network and out-of-network hospitals. The deductibles are not higher for anyone who takes a few minutes to shop instead of automatically choosing a bronze. In most states there are many plans available with similar pre ACA deductibles. Deductibles and OOP maxes always existed, these aren't new to the ACA. My current state prohibits balance billing, other state residents can take this up with legislators.

Only the "vast majority" of perfectly healthy 18-40 year olds had access to affordable health insurance, the rest which included millions did not, with many having ZERO access, they either faced exorbitant rates, or complete denial, and many were cancelled if they actually needed to use the insurance within the previous year.

No one loves the ACA, many think it goes too far, many think it doesn't go far enough. It was absolutely time for insurance reform. Where is the alternative? I keep asking what will replace it if it were repealed, I keep hearing crickets...

Until I hear about the amazing new plan that will solve all these issues, my independent vote will not go to anyone supporting repeal which seems to included every single republican. They have some actual work to do that includes real ready to go alternatives, not just obstructionism if they want votes from people other than the die hards.
Are you looking for band-aid reform or are you interested in stopping the harm to your body that requires you to use band-aids.

Market reforms have repeatedly been given yet the people stuck on stupid continue to complain about insurance (band-aids) instead of looking at how to actually lower the cost of healthcare (doing harm to yourself).

Until you learn cause and effect you will never get healthcare for all because you'll never be able to afford it.
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Old 01-15-2014, 08:40 PM
 
29,939 posts, read 39,453,111 times
Reputation: 4799
Quote:
Originally Posted by aneftp View Post
So explain this:

In 2013 pre ACA, the vast majority of young (ages 18-40) could get high quality max in network deductible of around $2000-3000 for around $100-200/month. No out of pocket expenses, even drugs are covered at 100%.

In 2014, the all young adults could get high quality max in network deductibles of close to $6000 for around $100-200/month.

That's right. A "bronze" plan with a $6000 deductible for many young people. Yet a "junk" major comprehensive plan in 2013 that also offered preventive services PLUS is tax deductible with HSA accounts has half the deductible.

You would have to get near silver or even platinum level to get down to the $2000 max out of pocket expense that most young adults could have gotten with no subsidy in 2013.

What crack are you smoking. The vast majority of adults ages 18-40 are getting screwed with the ACA.
That's why only 24% between the ages of 18-34 have signed up. The majority of people signing up are the most expensive. As time goes on the cost to sign up for those younger folks will increase which will discourage younger healthier people even more.

Can you say bailout. Bail outs are popular aren't they?

No doubt liberals will claim that it's some sort of republican conspiracy only to be solved by more government intervention and more redistribution of wealth.
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Old 01-15-2014, 08:44 PM
 
1,199 posts, read 734,263 times
Reputation: 609
Quote:
Originally Posted by aneftp View Post
Lol at you. I said "the vast majority". Isn't that the democratic mojo these days anyways. Aren't they all saying the ACA is working well for the vast majority of Americans?

They aren't teaser rates in 2013. I stand by my statement. The vast majority of ages 18-40 pre ACA had affordable health care on the individual market.

I live in Florida. Tons of choices.

And it's very misleading when you state "no deductible".


I want to you what my "Max" out of pocket expenses are in network and out of networks. So those "teaser" no deductible platinum plans still come with "max" $2000 out of pocket expenses? Am I right or wrong?

Or what's your max out of network expenses? Oops. Under the ACA there are in max out of network expenses. But pre ACA the usual max out of network expenses were usually twice the in network expenses. They still haven't figured out under the ACA what to do with out of network costs. And most states allow balanced billing as well. Way to go ACA. You guys support the ACA which us to offer financial protection. Yet deductibles are higher for the vast majority of the population compared to pre ACA. And you don't address out of network expenses. After all emergencies can happen anytime? Right?
Vast majority my behind. If you go through medical underwriting, any pre exisitng condition may not be ground for flat out denial, but you will be charged an exorbitant amount, making it unaffordable. History of acne, rates get jacked up. History of depression, rates get jacked up. Ever strained your back, rates get jacked up. You'd have to be extremely health to receive those rates. I have a friend, who is smart and is now in medical school. He took a year off and had to get health insurance on his own. He was quoted from multiple places at around 500 a month for a 6k deductible with a 10k oop for, get this: an extra bone in his hand. Guy was and is still in great shape and doesn't abuse his body. But he was getting jipped for a stupid reason.

And there is no deductible with the new health plans I mentioned. ER visits are 150 and inpatient/oupatient services are 150 a day. RX is covered at $5 for generic or $15 for brand name. The PPO choice were I live goes for 170, still much better and cheaper than what you were talking about. No worries about in network, out of network with the PPO, and the MAX is 4k. If you have to go to a specialist 100 times a year at $40 dollars, the 101st visit doesn't cost you since you met the OOP max. Oh and ER treatment is treated as in network, at least according to the regulations of my state. It sounds like the reason why your area is doing bad is because
A. Your state legislatiors are doing all it can to obstruct the ACA
B. The insurance companies said, "forget this, were out" which happened all the time before the ACA.

Like I said sorry to hear your area is doing bad, but where I live, where the ACA is being embraced, man oh man its looking good
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Old 01-15-2014, 08:54 PM
 
29,939 posts, read 39,453,111 times
Reputation: 4799
Quote:
Originally Posted by cxr89 View Post
Vast majority my behind. If you go through medical underwriting, any pre exisitng condition may not be ground for flat out denial, but you will be charged an exorbitant amount, making it unaffordable. History of acne, rates get jacked up. History of depression, rates get jacked up. Ever strained your back, rates get jacked up. You'd have to be extremely health to receive those rates. I have a friend, who is smart and is now in medical school. He took a year off and had to get health insurance on his own. He was quoted from multiple places at around 500 a month for a 6k deductible with a 10k oop for, get this: an extra bone in his hand. Guy was and is still in great shape and doesn't abuse his body. But he was getting jipped for a stupid reason.

And there is no deductible with the new health plans I mentioned. ER visits are 150 and inpatient/oupatient services are 150 a day. RX is covered at $5 for generic or $15 for brand name. The PPO choice were I live goes for 170, still much better and cheaper than what you were talking about. No worries about in network, out of network with the PPO, and the MAX is 4k. If you have to go to a specialist 100 times a year at $40 dollars, the 101st visit doesn't cost you since you met the OOP max. Oh and ER treatment is treated as in network, at least according to the regulations of my state. It sounds like the reason why your area is doing bad is because
A. Your state legislatiors are doing all it can to obstruct the ACA
B. The insurance companies said, "forget this, were out" which happened all the time before the ACA.

Like I said sorry to hear your area is doing bad, but where I live, where the ACA is being embraced, man oh man its looking good
Oh but the 101st visit does cost someone and it will ultimately cost your country. You exemplify everything wrong with not having to pay yourself for healthcare.

In the end the people like yourself will be the downfall of the country because people like you actually think that it's free (at best) or the so long as it doesn't come out of your pocket (at worst) no harm is done (to you).

Denied for acne... You people kill me. That must be the new Stankprogress talking point seeing as how it keeps getting repeated.
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Old 01-15-2014, 09:09 PM
 
8,483 posts, read 6,929,147 times
Reputation: 1119
Quote:
Originally Posted by detshen View Post
Everyone does have access to health insurance, but obviously if someone is so poor that they should qualify for medicaid they likely can't afford the premiums. Those people have to take it up with their republican governors who refused to expand. My state has a R governor, he went against the party and decided to expand.

I belong to a countrywide, large group of self employed individuals and almost no one is paying significantly more for 2014. Some pay a little more, some a little less, but not one person has complained of any dramatic unaffordable increase. These are people who have been buying their own insurance for years, they are used to these ups and downs. Many are thrilled because they can finally get insurance. I have heard that there are a few states where the rates are very high. I don't know anyone in those states, so I can't really say anything about that, but I would take it up with the insurance companies. I heard of a few companies reducing the rates when they were posted online, and people called them out on it. I recently moved to a state where legally one company had to accept everyone, but would put a 6 month wait on PE conditions. The rates here at that company were less than in my last state that denied millions, and the rates were competitive with other companies, so clearly it can be done if the insurance companies are forced to do it. People need to question the insurance companies putting massive profit over people's health, not changing the law.

Many of the complainers are comparing their cancelled plans to the ones their insurance company tried to put them on, and not the actual exchange plans. I have a lot of issues with the ACA, no one loves this, but repeal is not okay until a real alternative is ready to implement. So far I haven't heard anything but repeal. I will always be independent, but I won't vote for a republican until there is a reasonable replacement. The old system is 100% unacceptable. If the Rep would put some of their repeal effort into a new plan, I might vote for one.
Why was it passed without working this out, if it was about making it available to everyone? 25 states not expanding is a large number. The expansion would be needed for many to qualify. It is very easy to not qualify for Medicaid. Can go to states sites and check with their wizards and requirements. Many have this false idea that it is so easy to be approved for Medicaid. Just saying your claim of it being accessible to everyone isn't based in reality. The cost I have seen were from exchange and most were paying more for less. However, accurate data seems to be less than available at this time.
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Old 01-15-2014, 09:30 PM
 
6,790 posts, read 8,195,863 times
Reputation: 6998
Quote:
Originally Posted by CDusr View Post
Why was it passed without working this out, if it was about making it available to everyone? 25 states not expanding is a large number. The expansion would be needed for many to qualify. It is very easy to not qualify for Medicaid. Can go to states sites and check with their wizards and requirements. Many have this false idea that it is so easy to be approved for Medicaid. Just saying your claim of it being accessible to everyone isn't based in reality. The cost I have seen were from exchange and most were paying more for less. However, accurate data seems to be less than available at this time.
I said everyone has access to health INSURANCE, which is true. I never said they have access to medicaid. I also stated that I understood for poorer people the premiums would likely be impossible. That's truly sad, and I oppose the governors who are doing this, but that has to be taken up with them. It was their choice to refuse to expand.

It was worked out that all states would expand medicaid, that was the intent of the ACA, but Republicans challenged it with the Supreme court. The supreme court ruled that states could not be forced to expand medicaid, so many Republican governors refused to expand it. That was their choice.
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Old 01-16-2014, 12:40 AM
 
1,199 posts, read 734,263 times
Reputation: 609
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Originally Posted by BigJon3475 View Post
Oh but the 101st visit does cost someone and it will ultimately cost your country. You exemplify everything wrong with not having to pay yourself for healthcare.

In the end the people like yourself will be the downfall of the country because people like you actually think that it's free (at best) or the so long as it doesn't come out of your pocket (at worst) no harm is done (to you).

Denied for acne... You people kill me. That must be the new Stankprogress talking point seeing as how it keeps getting repeated.
Lol i guess countries like Australia, Canada, Sweden, switzerland and Scandanavian countries (where the everyday person is happier and these economies are doing better than ours) will implode on themselve for their socialistic way, with their single payer or universal coverage. But no, we should continue with people dying because they can't get insured and later finding out they have cancer. Because we know hospitals will treat uninsured cancer patients. I guess well just have to agree to disagree
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Old 01-16-2014, 08:52 AM
 
3,599 posts, read 6,781,640 times
Reputation: 1461
Quote:
Originally Posted by cxr89 View Post
Vast majority my behind. If you go through medical underwriting, any pre exisitng condition may not be ground for flat out denial, but you will be charged an exorbitant amount, making it unaffordable. History of acne, rates get jacked up. History of depression, rates get jacked up. Ever strained your back, rates get jacked up. You'd have to be extremely health to receive those rates. I have a friend, who is smart and is now in medical school. He took a year off and had to get health insurance on his own. He was quoted from multiple places at around 500 a month for a 6k deductible with a 10k oop for, get this: an extra bone in his hand. Guy was and is still in great shape and doesn't abuse his body. But he was getting jipped for a stupid reason.

And there is no deductible with the new health plans I mentioned. ER visits are 150 and inpatient/oupatient services are 150 a day. RX is covered at $5 for generic or $15 for brand name. The PPO choice were I live goes for 170, still much better and cheaper than what you were talking about. No worries about in network, out of network with the PPO, and the MAX is 4k. If you have to go to a specialist 100 times a year at $40 dollars, the 101st visit doesn't cost you since you met the OOP max. Oh and ER treatment is treated as in network, at least according to the regulations of my state. It sounds like the reason why your area is doing bad is because
A. Your state legislatiors are doing all it can to obstruct the ACA
B. The insurance companies said, "forget this, were out" which happened all the time before the ACA.

Like I said sorry to hear your area is doing bad, but where I live, where the ACA is being embraced, man oh man its looking good
85% of Americans have absolutely zero pre existing conditions. According to Democrats/Obama propoganda. They claim the word term "vast majority" as being 80%? We've hear it again and again. The ACA is working great for the "vast majority" of Americans. Agree or disagree?

I stated, pre ACA the "vast majority" of those 18-40 had access to more affordable healthcare pre ACA than now.

I still stand by my statements.

As for your "pre existing conditions". Depression is a red flag. It's not a minor medical condition. Acne could require very expensive medicines as well. Back pain could signify potential for referral to pain docs, potentially costly back surgery.

I'm not sure what the whole story with the extra bone and higher premiums. My cousin age 38 (who is also a physician) and gets individual insurance was paying only $175/month with a $2500 max out of pocket in network through carefirst blue cross of Maryland. She's got an extra toe with extra bones.
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