General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsAnd now will the insurance companies start playing games
with the coverage and payments?
I am betting they will.
Hassin Bin Sober
(26,308 posts)Glimmer of Hope
(5,823 posts)rurallib
(62,373 posts)I hadn't thought about my OP from that perspective
What I meant and expressed poorly is that now that the glare is off the sign up period I think we can expect the insurance companies to screw people right and left with some small print details.
I have already taken one in the shorts on some insurance jargon. My provider told me they were "in network" with my new insurance company. Found out they are not, they merely take their insurance. The provider was misinformed, but I am still screwed.
Apparently most of my "in network" providers are @ 50 miles away. Only 5 months to Medicare.
elleng
(130,712 posts)and many know what they're NOT allowed to do. > REGULATION!
cprise
(8,445 posts)...can still create whatever novel "financial products" it wants to game the system, without regulation.
Do not expect the long-term fruits of a corporate-owned system to come out much better than the mortgage crisis.
Arugula Latte
(50,566 posts)rurallib
(62,373 posts)Kip Humphrey
(4,753 posts)1st dr. appointment Feb 3; 1st diagnosis: Mar 31.
1st prescription: denied.
Platinum Plan - Humana silo-ed ACA into its own HMO (HMOx - the x stands for eXchange) and stripped the plan of specialists resulting in long waits for dr. visits and tests.
Our premium (2 adults): $1,461/month
alc
(1,151 posts)For this year's elections, the Democrat candidates REALLY need insurers to come through with reasonable premiums costs for next year. They can't overplay their cards, but they are in control.
What's going to stop them?
* Regulators? Look at BP and the financial regulators and tell me why ACA regulators will be better in general, much less this year.
* Medical loss ratio? They approve more procedures and increase the medical cost, then request higher premiums (and thus higher profit - in fact the only way to get higher profits once everyone has signed on) They haven't seemed to start yet, but it's a tool they've got. And if regulators push back they get called "death panels".
Obama has 'risk corridors' and other options to play with to keep premiums down for 3 years if the administration and insurers agree to play nice. (e.g. they don't approve more under $45k but do approve more over $45k to set up medical loss ratio for 2017 then only consider < $45k changes for premium calculations) But the more tricks they play the worse 2017 will be (when > $45k will go into medical loss ratio). And the less tricks they play this year, the worse it will be in 2015. Unless you think the insurers are not in it for a profit in which case there's nothing to worry about.
kelliekat44
(7,759 posts)1000words
(7,051 posts)Now, let's see just what kind of care they get.