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Walk away

(9,494 posts)
Mon Mar 10, 2014, 04:54 PM Mar 2014

This message was self-deleted by its author

This message was self-deleted by its author (Walk away) on Sun Jan 17, 2016, 07:46 AM. When the original post in a discussion thread is self-deleted, the entire discussion thread is automatically locked so new replies cannot be posted.

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This message was self-deleted by its author (Original Post) Walk away Mar 2014 OP
so what is the deductible on your plan? Schema Thing Mar 2014 #1
It's pretty well implied she's got a $6k plan. jeff47 Mar 2014 #2
Thanks wryter2000 Mar 2014 #3
Actually, my deductible is $2500 and my premium is $222 per month. Walk away Mar 2014 #4
Lucky you Demsrule86 Mar 2014 #27
Except most people who get subsidies on their premiums also get credits on their deductibles. n/t pnwmom Mar 2014 #8
We have a new $4000 deductible this year and it's really hurting us LiberalEsto Mar 2014 #5
ACA is a subsidized 70/30 actuarial payout Yo_Mama Mar 2014 #7
Ours is through my husband's employer LiberalEsto Mar 2014 #12
Well, it wouldn't be any better on an ACA plan Yo_Mama Mar 2014 #14
That isn't the whole story. If you are eligible for subsidies.... Walk away Mar 2014 #13
Yes, that's true and I just gave an example in my reply Yo_Mama Mar 2014 #15
Group policies have been getting worse and worse every year without the excuse of the ACA. pnwmom Mar 2014 #9
Colonoscopy Demsrule86 Mar 2014 #29
Everybody doesn't have the same choice of policies Yo_Mama Mar 2014 #6
But that's how it works on the ACA, except for the young people pnwmom Mar 2014 #10
Your workplace health insurance costs $1,200 more woo me with science Mar 2014 #11
I wish we could get ACA Demsrule86 Mar 2014 #28
Funny that you forgot to mention Le Taz Hot Mar 2014 #16
I have a Silver plan.. Walk away Mar 2014 #17
I don't care how "covered" "most" prescription medications are. Le Taz Hot Mar 2014 #22
I don't think you are an idiot but... Walk away Mar 2014 #26
If you are low income aren't you eligible for subsidies? Walk away Mar 2014 #18
So, you're saying the ACA is not Le Taz Hot Mar 2014 #20
I guess I just don't get how no insurance is better than $300 a month... Walk away Mar 2014 #23
If you are eligible for subsidies, Ms. Toad Mar 2014 #19
The Bronze Plan Le Taz Hot Mar 2014 #21
It wasn't a lecture. The vast majority of people are not aware Ms. Toad Mar 2014 #25
K! Cha Mar 2014 #24

Schema Thing

(10,283 posts)
1. so what is the deductible on your plan?
Mon Mar 10, 2014, 05:07 PM
Mar 2014


jeff47

(26,549 posts)
2. It's pretty well implied she's got a $6k plan.
Mon Mar 10, 2014, 05:25 PM
Mar 2014

Which would also comply with the results she's seeing - there's a host of preventive and diagnostic care that is covered with a copay instead of a deductible.

Now, if she broke an arm, she'd probably have to pay $6k (or the remainder of the deductible).

wryter2000

(46,690 posts)
3. Thanks
Mon Mar 10, 2014, 05:44 PM
Mar 2014

That's been confusing my coworker, and I didn't know how to explain it to her.

Walk away

(9,494 posts)
4. Actually, my deductible is $2500 and my premium is $222 per month.
Mon Mar 10, 2014, 06:50 PM
Mar 2014

My old premium was $750 a month without a deductible. However, I had all kinds of limits on my old coverage. I only had $500 per year of testing coverage. That was $500 to cover all blood tests, xrays, sonograms and MRIs. Now, they are all covered 100% if they are performed in hospital or in one of the many facilities that have a contract with BCBS. I also had a total of $500 coverage on prescriptions and then I was shit out of luck. Now I pay between 10% and 20% for meds and my out of pocket gets applied to my deductible.

As far as the broken arm theory goes, my out of pocket for a hospital stay is $500. The people at BCBS told me that I would probably never meet my deductible and I am senior with health issues in one of the most expensive counties in the country for health care.

So far this is just terrific.

Demsrule86

(69,487 posts)
27. Lucky you
Tue Mar 11, 2014, 02:12 PM
Mar 2014

I have a 3500 deductible and my private insurer (employer based) pays nothing until I meet the entire deductible...most years we don't meet it so I pay big money for the plan and all my medical expenses as well...I have one of those medical spending accounts which helps.

pnwmom

(109,196 posts)
8. Except most people who get subsidies on their premiums also get credits on their deductibles. n/t
Mon Mar 10, 2014, 06:57 PM
Mar 2014
 

LiberalEsto

(22,845 posts)
5. We have a new $4000 deductible this year and it's really hurting us
Mon Mar 10, 2014, 06:51 PM
Mar 2014

The coverage is from my husband's company. Last year there were reasonable co-pays.
Now we have to pay full price for every doctor visit and prescription. I have to postpone a colonoscopy because we don't have the money for it up front. We have to save up for it.

I think these high deductible policies were created purposely by the employers and the insurance companies to punish people for the ACA's existence.

Yo_Mama

(8,303 posts)
7. ACA is a subsidized 70/30 actuarial payout
Mon Mar 10, 2014, 06:55 PM
Mar 2014

That's written into the law. If you can afford it, you can buy higher levels of coverage.

But the "Silver" plans are supposed to leave the insured person paying 30% of their total costs, so it's by law, not a revenge thing.

The "Bronze" plans are 60/40. And that's the level of coverage the PPACA mandates for employment insurance, so by that standard you are getting better than the minimum required. But I understand, it still sucks for you.

 

LiberalEsto

(22,845 posts)
12. Ours is through my husband's employer
Mon Mar 10, 2014, 07:08 PM
Mar 2014

It's not an ACA plan.

My problem is that it seems like employers who do provide coverage are now offering these high-deductible plans that totally screw people.

And I think this is being done to push people off company policies so they'll go to ACA plans.

Yo_Mama

(8,303 posts)
14. Well, it wouldn't be any better on an ACA plan
Mon Mar 10, 2014, 07:25 PM
Mar 2014

70/30 actuarial coverage is always going to have a high copay or high deductible.

The reason the employer plans are being changed so much is cost, the extended benefits required, plus the "Cadillac tax" provision.

For families with low incomes (200% of FPL or less), you get significant cost-sharing so an exchange plan might be better, but in any case you don't qualify for the subsidies unless the employer doesn't offer qualifying coverage.

So, for example, in my home county in GA, a couple aged 48 and 50 with an income of $42,000 can get a Silver plan for $302 (that's the second-lowest on which the subsidy is figured). But except for the three free visits, free mammogram, etc., your deductible is $5,000, and your out of pocket maximum is $12,700. So once you meet your deductible (everything that isn't free goes toward your deductible), then you get into the copays and coinsurance until you hit the OOP Max. So primary care is $40 + 10%, hospital is $500 + 10%, and so forth.

It's not particularly attractive for moderate income people, because if they get sick they are faced with a difficult situation. As you say, you have to save up to actually get treated.

I've noticed that some people in metro options have better choices, but in ruralish areas it seems to be very similar, and most of the complaints seem to be coming from the rural areas. But there's no way to cut costs by limiting the network as there is in metro areas, so I think that's why.

Now if that same couple had an income of $31,000, their premium would only be $162 a month, plus the deductible would be $1,500, the OOP Max would be $3,000, and it goes on from there. Their primary care copay would be $25 +10%, etc. So a couple like that would do better on the exchange, but the way the rules are written many can't get the subsidies.

Walk away

(9,494 posts)
13. That isn't the whole story. If you are eligible for subsidies....
Mon Mar 10, 2014, 07:15 PM
Mar 2014

Your co-pay, out of pocket %, deductible and yearly out of pocket is reduced. My "Silver"plan costs 20% of total costs and my co-pays are also reduced to $10 doctors visits.
Someone earning less than I do and paying for a "Silver" plan could be paying 10% or less.

Yo_Mama

(8,303 posts)
15. Yes, that's true and I just gave an example in my reply
Mon Mar 10, 2014, 07:26 PM
Mar 2014

It does help a lot.

pnwmom

(109,196 posts)
9. Group policies have been getting worse and worse every year without the excuse of the ACA.
Mon Mar 10, 2014, 06:58 PM
Mar 2014

But if there's enough of an uproar about that, eventually we'll all move to single payer.

Demsrule86

(69,487 posts)
29. Colonoscopy
Mon Mar 31, 2014, 07:51 AM
Mar 2014

Colonoscopy and mammograms are well care and are covered under hubs job and I think in your case to under the ACA.

Yo_Mama

(8,303 posts)
6. Everybody doesn't have the same choice of policies
Mon Mar 10, 2014, 06:53 PM
Mar 2014

That does seem quite good to me, and I'm happy for you, but many don't have that kind of coverage, nor access to it.

pnwmom

(109,196 posts)
10. But that's how it works on the ACA, except for the young people
Mon Mar 10, 2014, 06:59 PM
Mar 2014

who are allowed to get catastrophic policies.

woo me with science

(32,139 posts)
11. Your workplace health insurance costs $1,200 more
Mon Mar 10, 2014, 07:05 PM
Mar 2014
http://www.democraticunderground.com/10024623144
Posted by Javaman

http://economy.money.cnn.com/2014/03/06/workplace-health-insurance/?iid=HP_LN

Employees are shelling out 28% more for workplace health benefits than just three years ago.

Most probably realize their monthly premiums are going up because they see more taken out of their paychecks. Workers are seeing their premiums rise year after year, going up by 19% on average since 2011, according to a report issued Thursday by Towers Watson/National Business Group on Health.

This is happening though the overall growth in health care spending has slowed in recent years.

Companies, meanwhile, are paying 14% more for their share of the premiums than they did in 2011, as they seek to shift more of the expense to their employees. Premiums cost an average of $9,560 per worker in 2014, up from $8,364 three years ago.

more at link...

Demsrule86

(69,487 posts)
28. I wish we could get ACA
Tue Mar 11, 2014, 02:15 PM
Mar 2014

Our workplace insurance is very expensive but we would receive no subsidy because we have it...of course if it goes much higher ...might as well.

Le Taz Hot

(22,271 posts)
16. Funny that you forgot to mention
Mon Mar 10, 2014, 07:34 PM
Mar 2014

which plan you bought. There are four of them. The Bronze and Silver plans have the $6,000.00 deductible per PERSON per YEAR. That's the one I have which means I can't actually use the insurance. To top it off, I USED to be able to get free Advair because we're low income and was able to sign up for the Bridges to Access plan which provides low-cost or free medications to people who qualify. Now that we're "insured" and I get to pay 100% of the cost, that is, if I could afford it, which I can't. That means that I'll be doing without meds. Again.

I'm happy that you're happy you got forced insurance as opposed to health care but pardon the rest of us who aren't real thrilled at having to purchase insurance that we won't actually be able to use.

Btw, I have the Bronze plan and I DO have a $6,000.00 deductible. Don't take my word for it, check it out here:

www.coveredca.com

Walk away

(9,494 posts)
17. I have a Silver plan..
Mon Mar 10, 2014, 07:55 PM
Mar 2014

have you checked with your insurance company. As I said, Dr visits, testing, all preventative care and most prescription medicine is covered before you pay a penny in deductibles.

I don't understand why you can't use those things.

Le Taz Hot

(22,271 posts)
22. I don't care how "covered" "most" prescription medications are.
Mon Mar 10, 2014, 08:56 PM
Mar 2014

FREE was affordable. Whatever the hell they're going to charge me now will be untenable for us. YOU try gasping for breath, not knowing if you're going to be able to take in enough air to continue to survive. Now, go ahead and minimize my concerns and address me like I'm an idiot again.

Walk away

(9,494 posts)
26. I don't think you are an idiot but...
Tue Mar 11, 2014, 09:53 AM
Mar 2014

If you are actually low income then, possibly, you haven't researched your options completely. Maybe you should check with an insurance counselor.

Walk away

(9,494 posts)
18. If you are low income aren't you eligible for subsidies?
Mon Mar 10, 2014, 08:05 PM
Mar 2014

The top silver plan in CA costs even less than here in NJ. I checked it out on your link.

By the way. I don't have forced health insurance. I have always had health insurance but now I have better coverage.

Le Taz Hot

(22,271 posts)
20. So, you're saying the ACA is not
Mon Mar 10, 2014, 08:49 PM
Mar 2014

mandatory? Seriously?

Yes, I get subsidies. My premiums are $300.00 a month which is a tremendous hardship on us.

Walk away

(9,494 posts)
23. I guess I just don't get how no insurance is better than $300 a month...
Mon Mar 10, 2014, 09:49 PM
Mar 2014

premiums for really good insurance. I always expected to have to pay into health care either directly, through taxes or through an insurance company. The care I have been getting since January would retail for many times $300 per month.

I was under the impression that low income people would pay a dramatically reduced yearly fine. I must be wrong. How much will you have to pay if you don't insure yourself?
I am not being forced to insure myself. I am sorry if you are.

Ms. Toad

(34,743 posts)
19. If you are eligible for subsidies,
Mon Mar 10, 2014, 08:07 PM
Mar 2014

You would probably have been better off with the silver plan. In addition to the premium subsidy, the coinsurance, copays and out of pocket caps are also subsidized. Meaning that the silver plan would have had a nominal $6000 deductible - but the amount you were required to pay would likely have been lower because of the additional cost sharing on the silver plan.

Le Taz Hot

(22,271 posts)
21. The Bronze Plan
Mon Mar 10, 2014, 08:51 PM
Mar 2014

was almost $200.00 more a month. The $300.00 a month for the Bronze Plan is almost more than we can afford now. There's NO WAY we could up that. I know $200.00 a month is pocket change for many people but for those of us living on the edge it's a difference between living in a house and not. But thanks for the lecture!

Ms. Toad

(34,743 posts)
25. It wasn't a lecture. The vast majority of people are not aware
Tue Mar 11, 2014, 04:03 AM
Mar 2014

that not only is the Silver premium subsidized, but so are all of the rest of the costs under the silver plan for many people who are eligible for subsidies.



Cha

(300,535 posts)
24. K!
Mon Mar 10, 2014, 09:52 PM
Mar 2014
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