Health insurance

[MrsCobraBubbles]

Right now all insurance plans are required to cover pre-existing conditions - that's a provision of the ACA for all insurance, not just ACA policies. However, IF the ACA act is ever repealed/gutted/whatever you want to call it, watch for this provision to be discontinued by insurance companies. And if it is, NOT having insurance until you need it is becomes a huge issue.... because if you don't insure and find out you have a health problem, insurance will NEVER cover it. It becomes a pre-existing condition. So it will be a HUGE RISK to not insure if pre-existing conditions are not covered down the road. Just something to keep in mind....

My husband and I had a terrible time trying to find affordable coverage before ACA. Both of us were considered risky by the insurance companies and we paid a bundle of money for our private policies. My husband's preexisting condition is sleep apnea, mine is/was the high blood pressure that I've had with my pregnancies. Between pregnancies my blood pressure is a healthy 110/70. We paid $750/month for just the two of us at one point, and our combined deductibles were over $10,000. Bear in mind that we were in our 30s at that time.

Then, when I had gallbladder surgery a few years ago (before ACA) my insurance company audited my medical records trying to prove it was a preexisting condition. I was insured, paid my premiums, and yet they were going to stick me with a $20,000 hospital bill because they didn't want to pay for my emergency surgery. I am so grateful for the ACA, it has helped my family so much. Now our insurance costs--including copays and deductibles--are affordable, and thanks to the exclusion of preexisting conditions we don't have to be afraid to go to the doctor anymore.

I wish our country would make the change to government subsidized healthcare, but if we can't have that, the ACA is a good substitute. I've been very happy with the coverage my family has purchased from the exchange the last couple years.

 

[manning]

All I'm going to say is there are unpleasant surprises coming when the entire act kicks in. You'll have to judge for yourselves. I hear the deductibles are high.

 

[tvguy]

And these are the people that greatly contribute to rising healthcare costs. If they file bankruptcy because of medical bills, who do you think gets left hding the bag for the bills? The hospital who passes the costs onto the other patients/insurance companies.

And hospitals only have to cover your emergency care. So you break your leg, they will cast it but follow up is on you. Same with cancer. Diabetes etc etc. they get you stable and ship you out.

Yes, and those are also the people ACA needs to pay premiums to keep the system solvent, people who are not using the insurance.

 

[PlutoPony]

Yes, and those are also the people ACA needs to pay premiums to keep the system solvent, people who are not using the insurance.

ALL insurance plans need healthy people participating in the plan to keep premiums down, not just ACA plans. Insurance companies are for profit entities for the most part, it's the nature of the beast - at least today.

 

[tvguy]

ALL insurance plans need healthy people participating in the plan to keep premiums down, not just ACA plans. Insurance companies are for profit entities for the most part, it's the nature of the beast - at least today.

DW and I work for large corporations. Our health insurance really isn't insurance. Corporations pay a health insurer to administer payments, but the corporations self insure. Basically they just write a check to cover expenses of their employees and their dependents. Cheaper than buying insurance, but they have 20-30,000 people paying into the plan.

 

[J.Casto79]

Let's all agree on the ground rules here. The OP is looking at 400 per month for insurance for her kid. So if she doesn't have insurance and has a $5,000 health care bill during the year she is in the same financial position with or without insurance. The only benefit having insurance would give her is if her family has a major issue that costs more than $5000 in a year.

Now to the point of the person above. Yes you must enroll during open enrollment UNLESS you have a life change. So if you don't get insurance and you come down with a serious illness where you will go bankrupt if you have to pay out of pocket just change jobs and then apply for Obamacare. Problem solved. Remember the ground rules: you're committed to 5k per year with or without insurance. So a major medical issue by definition has to be signifcantly above $5k per year. If you have a 30k medical problem it's well worth your trouble to switch jobs to get on Obamacare and save that 30k.

Only a sucker pays $5k per year for insurance. Over 10 years you'd spend $50k!!! Sure it's possible you COULD have a serious issue and end up hospitalized., but what is probability you will end up with a bill more than $5000? Not very likely. You also could get struck by lightning or win the lottery. Those are all about equally likely outcomes with having a major medical issue (>10,000 in cost) in any one year.

I'm 40, my wife is 40. Outside of her pregnancy and giving birth we've never spent more than a few hundred dollars in any one year on medical care in our entire life.

Insurance company stock prices are up 500% since Obamacare was enacted because Obamacare is a good deal for the insurance companies, not the consumer. Follow the money to find out who the winners and losers are.

I'm sorry, but that is very ignorant. Just last year I broke my leg and had hospital bills totaling over $22,000. Insurance is to cover the unexpected.

 

[DVCcurious]

All I'm going to say is there are unpleasant surprises coming when the entire act kicks in. You'll have to judge for yourselves. I hear the deductibles are high.

The entire act will NEVER kick in. If the PPACA was enacted the way it was written it would fail immediately. It is a terribly written law. That's why so much of it has been repealed already (class act, 1099 rules, and a few others). The administration has decided to ignore the parts that don't work and just enforce the parts that do work. That's the benefit of being President, you can choose which laws to enforce and which to ignore.

Lots of people think the GOP needs a filibuster-proof majority to repeal the ACA. In reality they just need a President. Then that president can choose to ignore the pre-existing conditions, the individual mandate, the subsidies, etc. This is what Obama did with the DOMA, what he did with the DREAMERS, and what they are currently doing with a lot of the ACA.

I'm sorry, but that is very ignorant. Just last year I broke my leg and had hospital bills totaling over $22,000. Insurance is to cover the unexpected.

Why is what I wrote ignorant? Last year I didn't break my leg. I spent $0 on my healthcare. So what's your point about your story? You are a much rarer example than I am. As a mathematical fact your premiums in each year are expected to be more than what you spend on healthcare. If that wasn't the case then how would insurance companies by their overhead or make their exorbitant profits?

 

[SparklePixie]

The entire act will NEVER kick in. If the PPACA was enacted the way it was written it would fail immediately. It is a terribly written law. That's why so much of it has been repealed already (class act, 1099 rules, and a few others). The administration has decided to ignore the parts that don't work and just enforce the parts that do work. That's the benefit of being President, you can choose which laws to enforce and which to ignore.

Lots of people think the GOP needs a filibuster-proof majority to repeal the ACA. In reality they just need a President. Then that president can choose to ignore the pre-existing conditions, the individual mandate, the subsidies, etc. This is what Obama did with the DOMA, what he did with the DREAMERS, and what they are currently doing with a lot of the ACA.



Why is what I wrote ignorant? Last year I didn't break my leg. I spent $0 on my healthcare. So what's your point about your story? You are a much rarer example than I am. As a mathematical fact your premiums in each year are expected to be more than what you spend on healthcare. If that wasn't the case then how would insurance companies by their overhead or make their exorbitant profits?

Waiting to purchase insurance until you need it is neither practical nor wise.

 

[Gracie09]

The entire act will NEVER kick in. If the PPACA was enacted the way it was written it would fail immediately. It is a terribly written law. That's why so much of it has been repealed already (class act, 1099 rules, and a few others). The administration has decided to ignore the parts that don't work and just enforce the parts that do work. That's the benefit of being President, you can choose which laws to enforce and which to ignore.

Lots of people think the GOP needs a filibuster-proof majority to repeal the ACA. In reality they just need a President. Then that president can choose to ignore the pre-existing conditions, the individual mandate, the subsidies, etc. This is what Obama did with the DOMA, what he did with the DREAMERS, and what they are currently doing with a lot of the ACA.



Why is what I wrote ignorant? Last year I didn't break my leg. I spent $0 on my healthcare. So what's your point about your story? You are a much rarer example than I am. As a mathematical fact your premiums in each year are expected to be more than what you spend on healthcare. If that wasn't the case then how would insurance companies by their overhead or make their exorbitant profits?

At some point you will not be able to spend 0 on your healthcare. And if your truly spent 0 I assume you have done no preventative check ups or other test that can detect illness like cancer that have few physical symptoms but can be detected early and treated with a high success rate if you know what to look for. Some tests are simple and inexpensive blood tests. Spending 0 now can bankrupt you next year. And then who will bail you out? Why the suckers who have insurance. Maybe we should enact a law that if you choose not to have insurance your bills will not be done away with in bankruptcy court. Or by charity care. Like what they do with student loans.
I have never files a homeowners insurance claim yet still have insurance on my home and even an umbrella policy. So it a tree falls on my house I'm covered. Even if I see my doctor once a year if I get cancer in five years, I'm covered.

 

[vratiana]

This is similar to our situation. My husband's insurance is a decent deal for just him, but very expensive for the rest of us. I would go to ehealthinsurance now (it is currently open enrollment) and compare private plans. Children are much cheaper than adults. I found I could get a very low deductible kids plan for $200. Much better than $500. And the copay's are only like $20 and $30 I think. Open enrollment only goes until the end of the year, so she needs to look into it now. Good luck!

 

[DawnM]

Can the ex claim the child on his insurance? Seems she could go to court over it.

 

[J.Casto79]

The entire act will NEVER kick in. If the PPACA was enacted the way it was written it would fail immediately. It is a terribly written law. That's why so much of it has been repealed already (class act, 1099 rules, and a few others). The administration has decided to ignore the parts that don't work and just enforce the parts that do work. That's the benefit of being President, you can choose which laws to enforce and which to ignore.

Lots of people think the GOP needs a filibuster-proof majority to repeal the ACA. In reality they just need a President. Then that president can choose to ignore the pre-existing conditions, the individual mandate, the subsidies, etc. This is what Obama did with the DOMA, what he did with the DREAMERS, and what they are currently doing with a lot of the ACA.



Why is what I wrote ignorant? Last year I didn't break my leg. I spent $0 on my healthcare. So what's your point about your story? You are a much rarer example than I am. As a mathematical fact your premiums in each year are expected to be more than what you spend on healthcare. If that wasn't the case then how would insurance companies by their overhead or make their exorbitant profits?

It's ignorant because I assume you are intelligent enough to realize that there exists the possibility that you can get injured or sick to where you would require timely/immediate treatment that could cost potentially into the multiple tens of thousands of dollars. I went 34 years without breaking my leg, that doesn't negate the fact that it happened to me and could happen to someone else. There are 6.8 million fractured bone injuries in the U.S. each year.

The minimum someone should have is a high deductible plan (i.e. Catastrophic coverage). Not knowing the risks and not doing something is being uneducated, but knowing and ignoring is ignorance.

 

[Accident]

As a single parent (with custody), there is times you need to adjust the child support to be different and there is legal guidelines for what is fair in every state. My recommendation is your friend first needs to look if it's possible to adjust. Keep in mind the courts can help you find a pro bono attorney if needed. Health care was always part of the custody order for my daughter and it sounds like in the heat of the moment when she was going through custody it might have been overlooked and time to adjust and get included.