How can I get Obamacare?

[ThatsMyBarack]

My current health plan, Blue Cross ICHIP, is costing more and covering less every year. What do I have to do to make sure I don't end up dealing with medical debt and body attachments? For example, I recently ended up paying $800 out of a $1000 for an annual checkup. I tried calling my doctor's office about this, hoping for an explanation why this bill was so high to begin with, but only got an automated runaround ("For billing questions call such-and-such a number). Too many medical middlepersons are cowards who don't want it to be their problem, know what I mean?

[gateley]

1. I'd like to find out, too. Kick. nt

[rurallib]

2. me three

2years 8 months til Medicare (if it is still there) and I have a $10,000 deductible.
So now I am having severe pains in my shoulders, but not $10,000 worth.

I need some decent health care, now.

[Cameron27]

3. You can't...

the only coverage available until 2014 is either Medicaid or PCIP.

PCIP varies depending on your current state of residence. GEHA is administering PCIP benefits in more than 20 states for HHS, while other states will run their own Pre-Existing Condition Insurance Plan

http://www.pciplan.com/index.html

After 2014, PCIP coverage will stop, and everyone will be transferred to regular Obamacare.

[frazzled]

4. First, it's not called Obamacare

It's the Affordable Care Act. The exchanges that will offer various individual insurance plans, and the subsidies that will help cover the costs if you meet various income levels, will become effective in 2014.

I think everybody who actually looked at the law knows that this is the case. I'd suggest you google it to see the provisions so you'll be prepared when the law takes effect.

[Coyote_Bandit]

6. In the meantime

I have a friend who was recently diagnosed with stage 3 breast cancer.

Waiting until 2014 to have meaningful access to healthcare won't do shit for her.

Without access to care now she'll be dead.

Unfortunately there are a lot of other people like her.

[frazzled]

7. Don't look at me

I'm very sorry for your friend. I assume you're saying she has no insurance. But she is in no less a bad spot (in fact, she's in a better spot, because she can currently get on a PCIP, which she couldn't before) than she would be had there been no ACA.

You should be happy for all the women who will not be in your friend's position in two years because something, finally, after 50 years of talking about it, has been passed.

[Coyote_Bandit]

17. Ummmm......

My friend would already have health insurance if she had the ability to pay the fucking premiums. She wasn't denied coverage because she had cancer. She had no insurance because she could not afford it and while she was without insurance coverage she was diagnosed with cancer.

If you happen to be 50 something and unemployed with stage 3 breast cancer then you're best bet to get care is to spend yourself into deep poverty so that you have no assets and can qualify for government assistance. Of course, if you have stage 3 cancer odds are that you'll be terminal before the paperwork is processed.

PCIP is for people who have the abiliy to pay the premiums.

[TheWraith]

9. If she has a condition right now, she can get PCIP.

Preexisting Condition Insurance Plan. It's basically government insurance that guarantees you healthcare even if you have a preexisting condition.

[Coyote_Bandit]

18. You have to be able to pay those premiums to get PCIP n/t

[TheWraith]

21. Then look at Medicaid.

Or state emergency care programs, or other options. Throwing one's hands up in the air and declaring hopelessness because everything isn't solved is not an option.

[Coyote_Bandit]

22. My friend will have to spend

down assets to qualify for Medicaid - and will have to suffer through normal bureaucraic delay to actual obtain assistance.

She's long-term unemployed so that will also qualify her for other forms of assistance. Assuming the stress doesn't kill her first.

[Cameron27]

11. It's brutal...

last year I was lucky enough to be so financially "broke" that I quallified for Medicaid. I say lucky, because I was diagnosed with a very early Stage 1 breast cancer and with Medicaid coverage was able to get the necessary surgery & radiation treatments.

Now that I'm off Medicaid, I'm forced to wait 6 months with no insurance at all to qualify for PCIP. So, next month I'll be paying for my own 6-month mammogram screening & hoping to god that nothing turns up that requires treatment because I won't be qualified for PCIP until June 1st.

Nothing like treating cancer on a wing and a prayer.

[Coyote_Bandit]

19. Sending good thoughts and warm wishes your way

You deserve better care and treatment than what is available here in the US - or what will be in the orseeable future.

[Cameron27]

20. TY

Sending good thoughts to you & your friend too.

(Somehow we're supposed to be grateful to even get this much "healthcare reform." Ask my kids how they feel about it.)

[TransitJohn]

14. Turned on the TeeVee lately, or even listened to NPR? It's Obamacare. eom

n/t

[Hugabear]

24. Think even Obama has embraced that term

Don't have a link - I saw someone else here on DU mention it several days ago - but apparently Obama embraces the term "Obamacare" - after all, he sees it as a positive thing, why not have his name attached to it.

[Coyote_Bandit]

5. Add me to that list of folks who need healthcare NOW

I haven't seen a doctor in nearly 15 years.

Not everyone has the luxury of waiting for several years for Obamacare to take effect (if, in fact, it is not repealed in whole or in part before taking effect).


As for those "medical middlepersons" well they are just doing their job. I know somebody who took one of those jobs hadling medical accounts and payments because she could not find any other employment. She quit just a few weeks into the job because she was afraid she was going to have either a breakdown or a heart attack. It was personal for her and she was stressed out and miserable. She was required to try to collect money from people who needed the care and simply did not have the ability to pay. Her ability to negoltiate fees was extremely limited - as were the resources available for referral for outside assistance. In most cases these folks are just trying to earn a livlihood. They don't set the policies or make the rules.

[alc]

8. wait until 2014

For now, only a few parts have kicked in (kids/adults up to age 26, people with pre-existing conditions).

Everyone will have to have Obamacare in 2014. But that doesn't mean you will be better off. If you were in good health (i.e. low risk insurance pool) your premiums will likely go up. You will probably have fewer out-of-pocket expenses (you just paid $800 for a checkup) but that will be added to premiums. It's now to the insurance companies advantage to pay for as much as possible. Their profit will depend on medical costs. 80-85% of premiums must go to medical costs. They will turn that around and say they are allowed make premiums around 15% more than medical costs. Profits come from that 15% and the best way to increase profit it is to increase medical payments and premium.

Co-pays, deductibles and other things are still being worked on. They may be low or may not. Your annual checkup and a few other things must have no co-pay, but other co-pays may or may not be good.

LOTS of work is still being done by dozens of agencies to set regulations and standards. This work will determine many things like your co-pays, coverage, premiums, doctor access - some doctors already charging a yearly fee and not taking insurance for certain appointments and I'd guess they're preparing for Obamacare and many providers like the Mayo Clinic said they would not accept one of the insurance packages proposed last spring.

You can bet that insurers, doctors, pharma, and other health care providers are working to get regulations they like (the Mayo Clinic said no to a proposal). It seems like everyone is satisfied that Obamacare passed and aren't still working to make sure it's good. But that work is VERY MUCH needed or it won't be good except for a small % of people who can't get insurance without it.

[SammyWinstonJack]

16. Sure sounds like Medicare E(veryone) would have been easier to implement since it's already in

existence. Guess that wouldn't have benefitted the Health Insurance parasites as much, though.

[Puzzledtraveller]

10. As a medicaire caseworker

I can tell you in my state, there has been no talk or discussion at all about implementation. Any new and existing programs would require a lot of preparations and changes and new training. As of yet, not a single word. It isn't even part of our dialogue here, amongst staff and management and definitely not with clients.

[Motown_Johnny]

23. Do you have any idea what is in the bill?

It is called "Health Care Reform" but it is really just health care insurance reform.


I don't think this will affect you very much, if at all. Medicaid will be expanded to include more people at the lower end of the income scale, but other than that I can't think of anything you will need to deal with and since you work with medicare I doubt even this will have anything to do with you.

http://www.healthcare.gov/law/timeline/



P.S. Medicare, not medicaire

[kestrel91316]

12. This should answer ALL your questions.....

.....except, perhaps, how the hell you can afford paying for healthcare after you are done paying premiums.

http://www.healthcare.gov/

[Egalitariat]

13. I'm pretty sure most bigtime first-term legislation

doesn't take effect until after the next election. You don't want to be held accountable if something goes wrong.

After the election, you'll start seeing the benefits and costs dribble in.

And then they'll really ramp up after the politicians that passed it have left office.

[PA Democrat]

15. You are a hostage of your current plan until 2014.

I've got a similar problem. With a preexisting condition I can't change plans, and I've seen double digit rate increases for the past 2 years.

On top of that, it looks like my insurer and the owner of more than half of the hospitals in the area will not be renewing their contract. So they will be considered "out of network." Some of the best specialists are affiliated with those hospitals.

[Motown_Johnny]

26. Don't you wish you could fire people like Mitt Romney?

I am very sorry to hear that you have a health condition and don't mean to exploit that just to make my point..... But......




The whole "I like to fire people" quote that is being turned into a bumper sticker was him saying that people should be able to "fire" their insurance provider if they don't like the service they are receiving.


This struck me as being ass backwards since HCR will actually help people "fire" their insurance companies while Mitt was trying to promote repealing the law with his argument.


I hope the argument is revisited at some point and that the quote is not all that remains. We need provisions in the law like this one and the arguments against them are just plain wrong.


Good luck to you

[Romulox]

25. Just buy private insurance at market prices (before they MAKE you.) Problem solved.

Er?

[TheKentuckian]

27. It depends on what you mean. If you're talking access to your state exchange

then the answer may be never. The ramping is non-existent and so you will have to either qualify for Medicaid at 133% FPL, you'll have to quit and be in the individual market, or your employer will have to drop coverage (which is possible considering their fine would just be $750/year which is cheaper than any policy).

Now, you can get subsidies if your premiums are more than 10% of your income and you meet the income guidelines so that might be some help.

The bill isn't designed to be a game changer if you have employer based coverage, in fact the whole deal is built on the assumption that employer based coverage is largely fine, dandy, and wonderful. The idea is to address the individual market to get it more in line with the employer based system, if the employer based system isn't what you were looking for then, you will largely have to keep on looking though there are some nice pay for play features and they will have to take our money.