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U do realize oBama and HHS DETERMINE WHATS BARE ESSENTIALS. It's all a game. They didn't even finalize the bare essentials until 2012 right before his re election.
Bare essentials specifics were never hammered out in the ACA. Rather it was arbitrary. And especially those "free" stuff like colon screenings and free birth control weren't added until 2012 that did not apply to the deductible. IF person has $5000 deductible. It matters if their birth control is "free". And Obama and HHS determine it. Obama and HHS determined men can have "free vasectomies" but women can have "free tubal ligations" outside of their deductible.
Insurance isn't exactly my area of expertise. And unlike people on here, I don't like to pretend like I'm some kind of know-it-all buff regarding insurance.
I just went through some treatments for a health issue I developed. I paid a couple hundred dollars in deductible while my insurance paid thousands. I looked at my policy and it says deductible is $1k. Puzzled, I called and asked my agent why my policy says $1k deductible but I only paid a couple hundred bucks? He said deductible doesn't mean I absolutely have to pay that amount. Usually the insurance can negotiate with the hospital and come up with a number. And then he went on speaking in some weird version of English.
I do not have a plan from the exchange. I bought my own plan and bill my company my monthly premiums. Are the plans from the exchange the same way where the $5k deductible or whatever else amount isn't written in stone and the person actually get charged less?
Insurance isn't exactly my area of expertise. And unlike people on here, I don't like to pretend like I'm some kind of know-it-all buff regarding insurance.
I just went through some treatments for a health issue I developed. I paid a couple hundred dollars in deductible while my insurance paid thousands. I looked at my policy and it says deductible is $1k. Puzzled, I called and asked my agent why my policy says $1k deductible but I only paid a couple hundred bucks? He said deductible doesn't mean I absolutely have to pay that amount. Usually the insurance can negotiate with the hospital and come up with a number. And then he went on speaking in some weird version of English.
I do not have a plan from the exchange. I bought my own plan and bill my company my monthly premiums. Are the plans from the exchange the same way where the $5k deductible or whatever else amount isn't written in stone and the person actually get charged less?
Sorry. But the "free stuff works differently"
Say you have a IUD for birth control. Normally it costs $400-1000.
If you have insurance and have $1000 deductible. The doctor charges $900. Insirance negotiates rate as $500. You would only be responsible for $500 instead of doctor charge of $900 if doctor is in network.
That's how insirance works. But Obama and HHS have so much power to write their own laws. They can determine whether and IUD is "essential coverage" that does not even require a deductible. So that $500 bill the patient normally would be responsible for is "free for the patient". The insurance will pay $500 to doctor and the patient isn't respsonsible for it.
That sounds good? Right. Except Obama and HHS DECIDE FOR YOU. Men get screwed. Cause they don't get a vasectomy for "free" like women. So vasectomies cost between $400-2000 usually depending on where it's done. If patient has $1000 deductible. Charge is $900. Negotiated rate is $500. Men would be responsible for $500 out pf pocket. Cause Obama and HHS HAVE DETERMINED it's not part of the essential health care.
Get it? HHS and Obama have been given too much power to cherry pick what's free and what's not free. Remember they finalized this right before his 2012 re election campaign. It's not secret he was buying the women's vote.
Insurance isn't exactly my area of expertise. And unlike people on here, I don't like to pretend like I'm some kind of know-it-all buff regarding insurance.
I just went through some treatments for a health issue I developed. I paid a couple hundred dollars in deductible while my insurance paid thousands.
...I do not have a plan from the exchange.
Ah, that's why you don't understand the problem. The policies sold on the Obamacare exchanges have very high deductibles. And those who need the subsidies to be able to afford to buy insurance have to buy them on the exchanges.
Quote:
HealthPocket found that the average deductible for an individual enrolled in a bronze plan in 2015 will be $5,181, or $100 more than 2014 limits. For families in bronze plans, the deductible next year will be $10,545, or $159 more than this year.
Sure, those 86% are getting subsidies to buy insurance, which maybe they weren't able to afford before, but how in the hell are they ever going to be able to afford those $5,000 or $10,000 deductibles?
I have to disagree here, for a couple of reasons. Many EU countries are close behind us in obesity. Secondly, most EU countries have far higher rates of alcohol consumption and alcohol related problems, so this "taking personal responsibility" is incorrect. Smoking rates tend to be higher in the EU, too. Our health care costs are high here for many reasons; too much admin being one of them.
According to WHO 39% of adults in the world are overweight/ obese. 74.1 % of US adults are overweight. 33% are obese. 26% of children are obese. Here's the order:
US
China
India
Russia
Brazil
Mexico
Egypt
Germany
Pakistan
Indonesia
US is in 51st place for cigarette consumption. Russia and most of the former USSR states have consumption rates 2-3 X higher than the US rate.
The US tops the list with the most and highest paid non medical hospital administrators, a significant contributer to overhead. In the US, hospitals compete for business on factors unrelated to cost. It's brand management, acquisition or destruction of the competition and medical practices to ensure a pipeline of steady business. It's massive lobbying by the American Hospital Association, Big Pharma and medical device manufacturers to protect their interests.
Last edited by middle-aged mom; 03-17-2015 at 07:57 AM..
U do realize oBama and HHS DETERMINE WHATS BARE ESSENTIALS. It's all a game. They didn't even finalize the bare essentials until 2012 right before his re election.
Bare essentials specifics were never hammered out in the ACA. Rather it was arbitrary. And especially those "free" stuff like colon screenings and free birth control weren't added until 2012 that did not apply to the deductible. IF person has $5000 deductible. It matters if their birth control is "free". And Obama and HHS determine it. Obama and HHS determined men can have "free vasectomies" but women can have "free tubal ligations" outside of their deductible.
" Bare essentials" were negotiated.
I believe a vasectomy is not considered an essential service while a tubal litigation is and that's whacked.
Speculation on my part that perhaps it's easier and cheaper to reverse a tubal litigation than a vasectomy.
I have also read that there are some anti Obamacare internet contingencies that inform readers that Obamacare forces women to use BC or have a tubal litigation. There remains a vast amout of intentional misinformation out there.
In March of 2014, President Barack Obama decided to give states the option of allowing people on noncompliant health plans to be grandfathered in by renewing their old plans early, while problems with insurance exchanges were ironed out.
Colorado insurance commissioner Marguerite Salazar opted to do that for 2015, but told 9NEWS on Friday that the exception is no longer needed for plans in 2016, even though Colorado could have continued them an additional year
Seems to me the Colorado's decision caused the problem, not Obamacare.
In March of 2014, President Barack Obama decided to give states the option of allowing people on noncompliant health plans to be grandfathered in by renewing their old plans early, while problems with insurance exchanges were ironed out.
Colorado insurance commissioner Marguerite Salazar opted to do that for 2015, but told 9NEWS on Friday that the exception is no longer needed for plans in 2016, even though Colorado could have continued them an additional year
Seems to me the Colorado's decision caused the problem, not Obamacare.
Reading comp. 101.
True but if it wasn't for obamacare, these plans would still be compliant and there would not have been any need to grandfather them in, temporarily.
Insurance isn't exactly my area of expertise. And unlike people on here, I don't like to pretend like I'm some kind of know-it-all buff regarding insurance.
I just went through some treatments for a health issue I developed. I paid a couple hundred dollars in deductible while my insurance paid thousands. I looked at my policy and it says deductible is $1k. Puzzled, I called and asked my agent why my policy says $1k deductible but I only paid a couple hundred bucks? He said deductible doesn't mean I absolutely have to pay that amount. Usually the insurance can negotiate with the hospital and come up with a number. And then he went on speaking in some weird version of English.
I do not have a plan from the exchange. I bought my own plan and bill my company my monthly premiums. Are the plans from the exchange the same way where the $5k deductible or whatever else amount isn't written in stone and the person actually get charged less?
I know more than the average bear about insurance, begining with no two individual plans are alike. You raise a good and often overlooked point.
Insurers negotiate their rates with providers and the insured pay a discounted rate when you use in network providers. Unlike say auto insurance where your deductible is fixed, many healthcare plans provide some benefits before you meet the deductible. Many plans cover some benefits even when you have not met your deductible.
Those in the individual healthcare plan market often don't understand what their insurer covers without meeting the deductible. There is a strong tendency to perceive all healthcare insurance is alike.
Unless a plan has been temporarily grandfathered by the state ( the topic of this thread) all plans are ACA/ Obamacare compliant, regardless if purchased on the exchange or elsewhere.
More than 70% of marketplace plans have deductibles of less than $3,000.
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