Thu Sep 26, 2013, 03:21 PM

mrmpa (4,033 posts)

What no one is truly talking about in regard to the Health Care Law........

What I understand will be available in the Health Care Exchanges are Bronze, Silver & one higher plan. The Bronze will cover 60%% of health care costs, Bronze 70%(?) and the last I assume will cover 80% of health care costs.

What I'm not hearing is how someone is supposed to come up with the 40, 30 or 20% of health care costs. One catastrophic injury or illness can send someone into bankruptcy. Even having to pay 40% of prescription costs can be unrealistic for some people.

I'm not working, so my projected income for 2014 is $0. I've tried applying for Medicaid, but since my 83 year old mother lives with me, they include her income as "family" income, and I own my home, I've been denied coverage. My state is not expanding Medicaid, I still wouldn't be eligible. So I will have to go to the exchange. I've done the projections and my Bronze plan on the exchange would be $1156 per year, which I don't have. Even if I could pay for it, I would be stuck with paying 40% of health care costs, which is unthinkable.

I want what my 83 year old mother has, Medicare. She actually has a Medicare Advantage Plan. The highest out of pocket expense she could have on this plan is $250, which is for a hospital stay.

The Insurance Companies still have control, people will still be in Bankruptcy Court and will not seek out medical care.

I want what my 83 year old mother has MEDICARE.

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13 replies	Author	Time	Post
What no one is truly talking about in regard to the Health Care Law........ (Original post)	mrmpa	Sep 2013	OP
I think the way it works is like this:	Turbineguy	Sep 2013	#1
There's no doubt that I will vote for every Democrat...........	mrmpa	Sep 2013	#2
There are out-of-pocket maximums on the plans	synapticwave	Sep 2013	#3
Right, this ends the "$200K of medical debt for pneumonia" problem	Recursion	Sep 2013	#5
True that on the deductible. Mine was $12,500 last month. Now I'm on Medicare!!!!!	Scuba	Sep 2013	#11
Did somebody put out this talking point today? This is the fifth thread that ignores...	Recursion	Sep 2013	#4
i think it is more that it is not clear	questionseverything	Sep 2013	#6
Here's a link	synapticwave	Sep 2013	#10
There is no mandate to provide you care. Only a mandate for you to pay. nt	Romulox	Sep 2013	#7
I'll be getting Medicare in a few months. Prior to that I was self pay uninsured	NightWatcher	Sep 2013	#8
Your mother does not have Medicare. She signed her Medicare rights	Cleita	Sep 2013	#9
Well, some of us have been talking about it.	bvar22	Sep 2013	#12
Is there an asset maximum with Medicaid?	forthemiddle	Sep 2013	#13

Response to mrmpa (Original post)

Thu Sep 26, 2013, 03:35 PM

Turbineguy (35,833 posts)

1. I think the way it works is like this:

Take it the way it is now. Elect Democrats in 2014 and 2016 who will fix all the screwed up shit put into the program for the republicans.

Remember, the first choice of republicans is that you die. The second choice is that you have health care, but that you go bankrupt. And the third choice is that you have Obamacare and that you hate it and put them in office to repeal it and kill you.

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Response to Turbineguy (Reply #1)

Thu Sep 26, 2013, 03:38 PM

mrmpa (4,033 posts)

2. There's no doubt that I will vote for every Democrat...........

I am eligible to vote for, then I will write, call, appear in person, whatever needs to be done until the system is fixed.

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 03:39 PM

synapticwave (52 posts)

3. There are out-of-pocket maximums on the plans

You pay your percentage up to your maximum, then you pay zero! For many plans the maximum will be around $6,000 annually. Which is obviously still a lot when you're income is very low, but should help the vast majority of people stay out of bankruptcy.

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Response to synapticwave (Reply #3)

Thu Sep 26, 2013, 03:44 PM

Recursion (56,552 posts)

5. Right, this ends the "$200K of medical debt for pneumonia" problem

Also I'm wondering where people have been getting their insurance that they think a $2K deductible is outrageous.

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Response to Recursion (Reply #5)

Thu Sep 26, 2013, 04:51 PM

Scuba (53,475 posts)

11. True that on the deductible. Mine was $12,500 last month. Now I'm on Medicare!!!!!

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 03:43 PM

Recursion (56,552 posts)

4. Did somebody put out this talking point today? This is the fifth thread that ignores...

... out of pocket maximums.

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Response to Recursion (Reply #4)

Thu Sep 26, 2013, 04:07 PM

questionseverything (9,155 posts)

6. i think it is more that it is not clear

what yearly out of pocket caps are gonna be

with the 60/40 plan it sounds like if you have a 100,000 bill you owe 40 grand..that is not practical at all

if you have a link that explains something different i would love to see it

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Response to questionseverything (Reply #6)

Thu Sep 26, 2013, 04:36 PM

synapticwave (52 posts)

10. Here's a link

http://www.thelundreport.org/resource/despite_lower_than_expected_premiums_exchange_consumers_will_face_high_cost_sharing_before_

second paragraph says the ceiling on out of pocket costs is $6,350.

Here's another with the same figure:

http://www.mbaileygroup.com/blog/health-care-reform/limits-on-out-of-pocket-maximums-delayed-for-some-health-plans/

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 04:09 PM

Romulox (25,960 posts)

7. There is no mandate to provide you care. Only a mandate for you to pay. nt

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 04:13 PM

NightWatcher (39,343 posts)

8. I'll be getting Medicare in a few months. Prior to that I was self pay uninsured

In the past two years I've had 10 days in the hospital, countless specialists and prescripts out the ying yang. I'm looking forward to the stability of Medicare.

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 04:15 PM

Cleita (75,480 posts)

9. Your mother does not have Medicare. She signed her Medicare rights

away with a Medicare advantage program. I found this out the hard way when my husband and I were in a wilderness area and he had a stroke. I had to use the medical services available and found out that because we hadn't used the services my husband's plan outlined, they wouldn't pay. When I asked Medicare about this, they said he had signed off on his Medicare. So we had to pay almost $10,000 out of pocket.

I have traditional Medicare which pays 80% and the balance is insured by a private plan. It isn't free but at least I'm assured of being covered no matter where I'm in the country and by whom I get medical services from. Please look into it. I believe that Medicaid will pick up the 20% of traditional Medicare if your mother qualifies.

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 04:58 PM

bvar22 (39,909 posts)

12. Well, some of us have been talking about it.

That is going to be a problem when those mandated into the Exchanges
try to convert their "Bronze" (formerly called "junk"

Insurance
into actual Health CARE.

"Medical Bankruptcy" is a term virtually UNKNOWN in civilized countries,
but will still be Big Business in the USA with our "Uniquely American Solution".
Once again, those hardest hit will be the struggling Working Class
who can least afford more hardship.

USA!....USA!....USA!!!

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Response to mrmpa (Original post)

Thu Sep 26, 2013, 05:00 PM

forthemiddle (1,292 posts)

13. Is there an asset maximum with Medicaid?

My State isn't expanding it's Medicaid program, but for States that are is there still an asset maximum?

My parents are going through the paper work now for Medicaid for long term care for Mom, and I know that because there is a surviving spouse they do not count their home as an asset, but it is my understanding that Medicaid has a maximum cash asset of $50,000 to be eligible.
That means that for a single person who owns a home, they would not be eligible for Medical Assistance because they were "worth too much". Does that law apply for the expanded Medicaid for people in states that are participating?

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