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Said like someone who has never faced a life-altering illness or the stresses that go with it.
I am an adult. I also had severe cognitive impacts from chemotherapy and was trying to balance multiple weekly appointments, handfuls of medication, taking care of myself, and working full time. Add in keeping track of hundreds of checks a month, reconciling those with both what I was expecting and my medical bills, and negotiating with my medical providers would have been yet ANOTHER full time job. Insurance does all of that for me.
If you are saying you've never been on the phone on hold for hours disputing this or that charge from your hospital or traditiona insurance company, you aren't being truthful. We've had to do that in former years, and we haven't had that many claims. They fight you at every turn. It's not that way with Samaritan at all.
HHS--Government agency filled with leftwing bureaucrats whose goal is to expand government healthcare. But I think the majority of adult 'ailments' have to do with past booze and cigarette use. Plus, if you're a 300-pound hippo, you're going to have some issues, even though they were very preventable.
So the plan doesn't cover overweight people either? And churchgoers don't drink alcohol or smoke?
In my state Medicaid has criteria regarding income, assets and other things.
No mention of being in a healthcare sharing group.
Many people facing uninsured medical costs of $50,000 or more will become medicaid eligible rather quickly, very few people have the money to pay medical bills like that. Medicaid has criteria for income but MAGI eligible applicants have no asset limits. States with expanded medicaid usually set the income level at 138% of the poverty level. If the family member who is ill is the sole wage earner many families who would become eligible as soon as the first paycheck is missed.
So the plan doesn't cover overweight people either? And churchgoers don't drink alcohol or smoke?
Did I list that as one of the exclusions? No. But Samaritan asks people to treat their bodies as the temples they are, and take care of them. The government doesn't do that. They want people to be chubby victims.
I'm just saying the leftwing-run HHS wants as many people to be classified as 'sick' as possible, so that they get to keep increasing their funding and power. So they are happy to label people as 'sick' who are simply obese.
I think one of the great feelings I get with Samaritan is that I'm part of a very efficient self-sustaining plan. Wouldn't it be super if government could be like that? Unfortunately, human nature dictates there will always be a few who want to keep people dependent to enhance their own power and wealth. aka socialists.
HHS--Government agency filled with leftwing bureaucrats whose goal is to expand government healthcare. But I think the majority of adult 'ailments' have to do with past booze and cigarette use. Plus, if you're a 300-pound hippo, you're going to have some issues, even though they were very preventable.
How Christian is it for Samaritan to refuse coverage for adopted children because they consider them to have "preexisting conditions" ?
And since when did smoking and drinking become prohibited by the Catholic church?
The savings are just premium savings from having a plan that covers less. Ideally marketplace plans would be more affordable, particularly for the unsubsidized. That fault is due to ACA law.
Marketplace plan demographics is skewed old and sick, hence the premiums being so high. Little was done to encourage healthy people to enroll: the penalty for not having insurance was a pittance, and companies were not encouraged to get out of covering their employees and give them vouchers to by from the marketplace.
Then we get to the marketplace plans themselves. High premiums with huge deductibles that no one who had a decent employer provided plan would want to touch. Last year my unsubsidized family plan was $1500 a month with a 14K deductible. That is why the association plans look more attractive despite their substantial limitations.
Make marketplace plans more affordable with more realistic deductions, force more employers to place their employees onto marketplace plans to make the applicant pool younger and healthier and the association plans will go the way of the dodo bird as they will no longer be able to compete against good plans.
By law, your plan has a Out of Pocket Cap of $7900 per individual. That includes your deductible, co-pays and coinsurance. Once the individual reaches their cap, the plan pays 100% of qualified claims. Qualified typically means using your insurer’s network providers. Going out of network for non emergency care, subjects the enrollee to Balance Billing.
Group, especially large group plans offered by employers may have substantially lower out of pocket caps.
The Family Cap comes into play only when there are 3 or more enrolled in a family plan and 2 individuals have hit the individual cap.
The monthly medical co- op “ share” ( premium) is cheaper because of exclusions, limitations and caps.
If/ when a co-op enrollee hits a exclusion, limitation and / or cap, they are able to enroll in real insurance, that will cover future expenses. In other words, these faith- based medical payment co- ops reduce the number of healthy enrollees in traditional plans and then pushes the sickest into traditional plans due to the exclusions, limitations and caps of the co-op. In other words, the co-ops are a part of the problem, not solution.
I have no issue with charging lower premiums to those enrollees who demonstrate healthy lifestyle choices.
But Obamacare did not accomplish that. Not enough folks bought into marketplace plans to lower the premiums enough. It basically functioned as a high risk pool and for the unsubsidized, it became unaffordable so plans like Samaritan Care became an option.
True, but that could have been solved by extending medicare to 55 year olds. Older people drive the cost of health care and as you said you need a large pool of younger healthy people to offset it. That is why Switzerland has a penalty of two years premiums if you receive medical care and aren't insured. IMO Samaritan is not an option except for the very lucky few who will never have anything worse than a broken arm or tonsillitis.
How Christian is it for Samaritan to refuse coverage for adopted children because they consider them to have "preexisting conditions" ?
I don't know if this anecdote is even true, but I don't know what is so hard to understand about a self-sustaining charity not being able to be a welfare distributor.
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