General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region Forumsuppityperson
(115,773 posts)was the only thing able to be passed with the congress we have. Thanks Party of No!
But it is better than it was and yes, I have.
DesertFlower
(11,649 posts)i had such hope for ACA.
i'm 72 and have medicare and the supplemental plans are costly.
uppityperson
(115,773 posts)I have to cover the whole costs of every visit as co-pays don't kick in until I've paid $10K. Except for the wellness check which is the one part of ACA that kicked in for us already.
I had such hope for insurance reform. What we got was very watered down because of compromising with those who wanted nothing. Which is amusing since what we got is Romneycare.
bhikkhu
(10,754 posts)when the maximum out-of-pocket rule kicks in.
I'm not an expert, but lots of plans use co-pays to encourage people to go to doctors that are on their network. So if you went to an approved doctor you would have just a co-pay, but to a non-approved doctor and you would pay the full cost up to the deductible?
uppityperson
(115,773 posts)Once I reached 10K, then could go to co-pays. It was catastrophic insurance, in many ways. The premiums were 1/3 of our income last year also. I figure a yr on Obamacare, I should be able to pay off the debt I incurred with the premiums.
Next yr, it will be much better.
bhikkhu
(10,754 posts)My old plan was to try very hard to avoid sickness or accident, as I was liable for everything, without any limits - no insurance. Our family was lucky enough to avoid problems, and in January we'll have much less to worry about. Oregon is a good progressive state, and the premiums, co-pays and deductibles should all be very manageable (with the subsidies at our low income level).
LWolf
(46,179 posts)No matter what doctor I see, in or out of network.
While I haven't met the deductible, I'm paying 100%. Once I've paid the whole deductible, if I still need to see a doctor that year, THEN I pay the copay.
So I pay a premium for the privilege of paying a deductible, and if I still need care, a copay.
I pay 3 times.
The idea that having insurance makes care affordable? Sure, for catastrophic situations.
Paying a few hundred, or more, a month for insurance is "affordable?"
It might be, if there were no copays or deductibles.
My current premium is $885 a month. My youngest son's mortgage, with taxes and insurance, is less than that.
I can get a premium for less on the exchange, but it shoots my deductible up to 10,000 from 2500, and my copay to 40% from 20%.
pangaia
(24,324 posts)and a supplemental plan that has varied between ZERO and $40/ month-- from a not-for profit company. $4500 max out of pocket, no-deductible. Generally $15/PCP $25-35 specialists, etc..
It saved me last year when I had lymphoma.
What kind of rates are you getting?
DesertFlower
(11,649 posts)he worked for IBM for almost 43 years. because of his years of service i was eligible for their supplemental plans. i took one for $28 a month. it has a $4,000 deductible but also a $4,000 max out of pocket which is important to me. i was able to keep our drug plan which paid 65% of generic drugs.
starting in 2014 that plan is no longer available. i was shocked when i saw the new plans. i have an appointment with an advisor this week. it's a $124 for a plan with $4800 deductible and $4800 max out of pocket. i can get a drug plan for $12.40 with a $312 deductible. the other day i got a letter from IBM saying they'll be contributing $1,187 that i can use toward insurance, co-pays, etc. that makes a big difference.
i didn't take the high cost plans because i don't have large medical bills. when i see my primary it costs me $12.50 -- the pain doc runs around the same -- some times a few bucks more. i saw my dermatologist once and it cost $12.50.
so when you do the math it works for me. if i had to spend $4,000 if i got really sick i do have the money (thank goodness).
my friend is 68. her husband is 65. they both have pre-existing condtions. she had coverage from her employer which cost her $710 a month. she couldn't wait for hubby to be 65 so she could get him covered under medicare thinking it would cost less. well now they're paying $260 each for a supplemental policy plus the $105 for medicare. that comes to $730 a month -- more than she paid through her employer and some of her docs don't take medicare. her therapist is one of them. so now instead of seeing her once a month she can only see her every 3 months. the therapist charges a $120.
everyone thinks medicare is the answer, but it's not. if you don't take a supplemental policy you could be screwed and lose everything you have.
pangaia
(24,324 posts)I just am really lucky with my supplemental company--
I live near Rochester, NY-- 2 'very good' non- profit insurance companies - MVP and BC/BS plus a 1st class teaching hospital- Univ of Roch Medical Center- Strong Memorial Hospital and Highland Hospital. Strong has a very good cancer center. Whew.. saved my life.
I wish you had something as good... Nobody should have to go through that.
LiberalArkie
(16,257 posts)moving from Blue Cross to Humana
DesertFlower
(11,649 posts)but the new plans IBM is offering are mostly through humana.
Warpy
(113,054 posts)but had it kicked in after it was passed, say four years ago, I'd have been damned glad to have it.
It was better than nothing, which has been my health insurance for nearly three decades.
bhikkhu
(10,754 posts)Making 30K a year, family of 4 in Oregon, we'll be fully covered for the next two years. If the kids have to age out after that (and I haven't looked at the rules there) the worst case is $100 or $200 a month. The co-pays and deductibles are very reasonable.
If I wind up making more money in the future and having to pay more that would be just fine too. At 49, I know enough people who have lost everything to medical emergencies, its a huge relief to know that won't happen to my family. Much thanks to the president, to everyone in congress who worked hard for this, and to my state government that stayed on top of things and got it all ready well beforehand!
cbayer
(146,218 posts)DesertFlower
(11,649 posts)cbayer
(146,218 posts)I can not express what a relief it is to be able to get a plan.
grantcart
(53,061 posts)Living every day wondering if you are going to get a catastrophic illness that is going to wipe out your family.
Having outlived my father and all of my grand parents life span I thought I was on borrowed time, and if I got cancer or something big, just give up. Now maximum exposure is $ 10,000, its like living on another planet.
Even so everyone else I have talked with who has insurance and checked found better deals through the marketplace, some big savings, some at the same cost but better benefits.
cbayer
(146,218 posts)And the policies are much better.
I've got 6 years until Medicare and it will be 6 years during which so much of my anxiety about this will be relieved.
Glad to know you are covered and love your new avatar, grantcart.
You remain, as ever, a DU treasure.
elleng
(135,477 posts)don't recall who, at the moment.
grantcart
(53,061 posts)I have talked to about 6 other self employed (all Republicans) folks who have been stunned with how much they are going to save and how much better the plans are.
Based on talking with a couple of small business owners I know they are going to give their employees raises and eliminate their coverage so that they increase their take home pay and get better plans.
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3777148
Callmecrazy
(3,066 posts)I can barely afford the shitty bronze plan for myself. Luckily, I don't have any kids. I suppose I can give up something. It has to get better than this for me or I'm going to become discouraged
Zorra
(27,670 posts)and "Sorry the system is shutdown" messages so far.
It's so bizarre it has made me wonder if I am the victim of some remote hacker from ALEC.