ObamaCare Info

[pantherlj]

For tax purposes neither of my adult daughters are considered dependents. Why should they be considered dependent for the AHCA?

The more I learn about this so called "Affordable Health Care" the less it makes sense. I am all for getting coverage for all Americans but those who can not afford it now still won't be able to afford it.

Ah - j messed

 

[pantherlj]

For tax purposes neither of my adult daughters are considered dependents. Why should they be considered dependent for the AHCA?

The more I learn about this so called "Affordable Health Care" the less it makes sense. I am all for getting coverage for all Americans but those who can not afford it now still won't be able to afford it.

Ah - i missed that part. If not in your taxes they can go to the market place and check to see if they can get a subsidy.

And I agree lots of people still won't be able to afford it. If you are below 100% FPL you can't get a subsidy and depending on the state you live in you might not qualify for Medicaid either!

 

[Colleen27]

So if he can exist quite well like that, then why can't we blow up the current system and start over with something more reasonable, where there is a single price for service from the same dr? Not a medicare rate, medicaid rate, bcbs rate, cigna rate, cash rate, uninsured patient rate, etc, etc. There's so much wasted resources dealing with all the nonsense bookkeeping that you could probably cut healthcare costs in america by 10% tomorrow if you blew up the payment system and made it like any normal service.

That would be the logical answer, but BCBS, Cigna, and all the other health insurance companies spend a lot of money buying Congressional influence to ensure that doesn't happen.

Ah - i missed that part. If not in your taxes they can go to the market place and check to see if they can get a subsidy.

And I agree lots of people still won't be able to afford it. If you are below 100% FPL you can't get a subsidy and depending on the state you live in you might not qualify for Medicaid either!

That's not the fault of the ACA, though. That lies squarely on the heads of the state governors and representatives who are more interested in currying favor with their party than looking out for the people of their states.

 

[Eastern]

So if he can exist quite well like that, then why can't we blow up the current system and start over with something more reasonable, where there is a single price for service from the same dr? Not a medicare rate, medicaid rate, bcbs rate, cigna rate, cash rate, uninsured patient rate, etc, etc. There's so much wasted resources dealing with all the nonsense bookkeeping that you could probably cut healthcare costs in america by 10% tomorrow if you blew up the payment system and made it like any normal service.

I know several dermatologists in NJ that don't take insurance.

It's different with urgent care, though. When someone comes into a hospital in serious condition, you don't ask them for the cash up front. That is where a lot of the expensive, and subsidized care, comes from.

 

[lauradis]

I know several dermatologists in NJ that don't take insurance.

It's different with urgent care, though. When someone comes into a hospital in serious condition, you don't ask them for the cash up front. That is where a lot of the expensive, and subsidized care, comes from.

You forgot will continue, not lowering the cost as much as being claimed.

Until you can keep them out of the er for non emergency issues and tell them to go to doctors office, this practice of going to the er will continue. The only difference is if they are over their deductible then you will be able to recoup some of the cost.

 

[mikek]

I know several dermatologists in NJ that don't take insurance.

It's different with urgent care, though. When someone comes into a hospital in serious condition, you don't ask them for the cash up front. That is where a lot of the expensive, and subsidized care, comes from.

Sorry i ramble so probably wasn't clear. my point wasn't about WHEN you pay but that there is just one price and it's clear and must importantly reasonable becasue there are not so much resources wasted arguing with payors (private AND government)

Also- the dermatologist doesn't demand payment before service- he does what he needs to then his bookeeper asks for a bill. On the flip side I've been to the hospital to take someone for radiation treatment and they demanded cash before letting us get so far as the elevator. So besides the ER hostpitals are not bastions of doign the right thing.

And most surprisingly- in my insomia the other waiting to get on the exchange website i went poking around reading the government projections on healthcare spending- and one thing that schocked me was that hospital spending next year is expected to go up- AND it is projected to go up 1-2% MORE becasue of obamacare. I would have thought with less people in the ER for primary care it would go down somethiung. again zilch nada nothing in the act to control costs in any meaningful way.

I have No Problem at all subsidizing those not as fortunate as myself. But healthcare is getting less and less affordable as a whole.

The act is almost insidious as it is hiding that fact from ~half the population who will be getting tax credits or other subsidies DIRECTLY to the insurance company to pay it. So it's going to be like paycheck witholding- people dont notice it so much becasue it was never there. If people had to pay the 1,000 a month and then got a check back from the government for 900 or 1,000 then they would think there is a problem. Instead they get a bill from the insurance company for 100 and have no idea what people who pay their own insurance costs.

 

[mikek]

That would be the logical answer, but BCBS, Cigna, and all the other health insurance companies spend a lot of money buying Congressional influence to ensure that doesn't happen.
...

the insurance companies share blame for sure.
But made up medicare and medicare pricing that isn't based on reality isn't right either.
The paperwork burden is silly- imagine that all the people, resources, and time spend with billing systems instead got send tomorrow to research centers to figure out cancer? There's a huge bunch or brain power being wasted on stupid stuff.

Also theres no reason that the providers have all sorts of pricing.

You go to the dr, they charge you $400 for fun. You call and say you dont have insurance and they tell you "oh sorry, it's really only $150". Why dont they charge everyone $150 up front and get paid that (including from medicare and medicaid)?

 

[gymjen]

Okay I am totally clueless about all of this. I don't even fully understand what term means what so if someone could help me understand all this that would be great

I am a single mom with one child, so for current insurance purposes I have one dependent. I currently pay roughly $200 per month for insurance for us (medical/dental/vision) through my employer. I don't pay anything for annual medical check ups, pay $25 for office visits ( medical/dental/vision), $75 for urgent care/ER if nor admitted to hosp and pay either 20% or 10% for charges that are billed to me in addition to the $25 co-pays.

So here is my question - what is my deductible? is that my $200 per month or $25 and 80/20 90/10 amount. and my insurance always pays/covers a percentage so what is this out of pocket expense people are quoting. I know once I pay $500 per year for each of us then the coverage percentage goes up so is that my out of pocket expense? $1000?

Base on the numbers listed on the first page I do qualify (barely) based on income for family of two so I want to know what to be comparing when I look online.

Also, current contract has locked in the policies and cost for until 2016 so employer is not dropping insurance or changing it.

 

[njcarita]

have some free time to waste.......... going to try and see if i can get thru the nj website today...........

 

[lauradis]

Okay I am totally clueless about all of this. I don't even fully understand what term means what so if someone could help me understand all this that would be great

I am a single mom with one child, so for current insurance purposes I have one dependent. I currently pay roughly $200 per month for insurance for us (medical/dental/vision) through my employer. I don't pay anything for annual medical check ups, pay $25 for office visits ( medical/dental/vision), $75 for urgent care/ER if nor admitted to hosp and pay either 20% or 10% for charges that are billed to me in addition to the $25 co-pays.

So here is my question - what is my deductible? is that my $200 per month or $25 and 80/20 90/10 amount. and my insurance always pays/covers a percentage so what is this out of pocket expense people are quoting. I know once I pay $500 per year for each of us then the coverage percentage goes up so is that my out of pocket expense? $1000?

Base on the numbers listed on the first page I do qualify (barely) based on income for family of two so I want to know what to be comparing when I look online.

Also, current contract has locked in the policies and cost for until 2016 so employer is not dropping insurance or changing it.

If your employer offers insurance basically you have to take that policy.

The $200 month that is more then likely taken out of your paycheck is called the premium.

The cost to walk in to doctors office 25.00 is called a copay

The deductible is what you must pay per person or family before the insurance will pay for any thing.

That's the basics.

80/20 part looks like the amt for major medical but I could be wrong

 

[mommy4]

So, I'm confused. If my husband's employer offers insurance for our family, we have to take it? We cannot try to get it through this healthcare.gov? We pay a very high premium right now and I honestly think we may be better off if his employer didn't offer it to us. I know there are people at his office that are opting out of the employer insurance, but I'm not sure how they are being covered.

Thanks!

 

[pilferk]

So, I'm confused. If my husband's employer offers insurance for our family, we have to take it? We cannot try to get it through this healthcare.gov? We pay a very high premium right now and I honestly think we may be better off if his employer didn't offer it to us. I know there are people at his office that are opting out of the employer insurance, but I'm not sure how they are being covered.

Thanks!

IF the plan offered meets the standards of the law in terms of care provisions AND affordability....while you CAN go get insurance through the marketplace, instead, you will NOT get a tax subsidy to buy it. You'll be paying full sticker price.

 

[mommy4]

IF the plan offered meets the standards of the law in terms of care provisions AND affordability....while you CAN go get insurance through the marketplace, instead, you will NOT get a tax subsidy to buy it. You'll be paying full sticker price.

Ok, thanks. It really stinks that I think we would be better off if they just didn't offer it.

 

[barkley]

IF the plan offered meets the standards of the law in terms of care provisions AND affordability....while you CAN go get insurance through the marketplace, instead, you will NOT get a tax subsidy to buy it. You'll be paying full sticker price.

HOWEVER, if it qualifies as a grandfathered plan it is exempted from many of the law's provisions.

 

[pilferk]

HOWEVER, if it qualifies as a grandfathered plan it is exempted from many of the law's provisions.

Correct.

So you have to do a bit of detective work.

Your plan, if it grandfathers in, might NOT meet the provisions of the law either in terms of care or affordability.

BUT, if it doesn't meet the provisions (even if the employer continues to offer it under the grandfather clause)...you ARE eligible for subsidy.

AND your employer won't be subject to the penalties of not offering you a plan.

In addition, if you stay with the grandfathered plan, even if it doesn't meet the terms of the law, you will still be considered to have coverage, and not be subject to penalty.

If you find yourself in that situation, you have some math and assessment to do, looking at employer contribution to your premium vs the subsidy, difference in deductibles and services offered (and of what value they are to you), etc to try to determine which way to go.

 

[njcarita]

have some free time to waste.......... going to try and see if i can get thru the nj website today...........

no luck................... today i have work............ so wont be trying again till tonight.... unreal......

 

[4forMe]

have some free time to waste.......... going to try and see if i can get thru the nj website today...........

I had read that they were shutting down the site over the weekend to work out the bugs. As I reported previously, I was unsuccessful in accessing any information and tried 3 consecutive days last week.

Anyone that is actually able to get on the site and receive quotes, please post and let us know.

 

[Megkel]

https://www.youtube.com/watch?feature=player_embedded&v=IsVqOe07cdY

Just curious if anyone had seen this. I'm not posting to start anything just curious if this is a realistic view of the Affordable Health Care Act. I have heard a lot about Dave Ramsey and it's mostly been good.

 

[DawnM]

I have just read that our major hospital network here in my area will not accept any patients with the word "value plan" on their health insurance card.

 

[j's m]

Dawn, this is the part that worries me the most: you don't know what the networks really are. I still can't get on the gov website and when I checked the insurance company plans directly some of the coverage says Tier 1, Tier 2 but no info on who is included.

At least by posting and reading here, we will hopefully be informed on what to look for (thanks for your post so we know to examine further on networks) but how many other people that don't check will be stuck with a plan for a year that doesn't cover their local hospital? So the insurance will be "affordable" but unusable.