General Discussion

Ms. Toad

(38,793 posts)

18. This is absolutely false.

Tue Feb 25, 2014, 01:14 AM

Feb 2014

For all covered charges incurred in 2014, the maximum you can ever be charged is $6350. Period. They cannot carry the charges over to another year and charge you an additional $6350 toward your 2014 expenses.

Once you hit your out of pocket maximum for the year, the insurance company is responsible for satisfying the rest of all charges for that year. You fundamentally misunderstand insurance (generally) and the ACA, specifically.

In addition for you (as I pointed out in another thread), your out of pocket maximum will be closer to $2350 a year. The ACA not only subsidizes premiums, it also subsidizes cost sharing. Most people eligible for subsidized premiums will also be eligible for reduced cost sharing. Here is a way to check what your out of pocket maximum will be.

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ACA insurance. what you need to know about forced shit insurance [View all] frwrfpos Feb 2014 OP

Since we're cursing, are you really somehow bitching about the Affordable Healthcare Act???? NYC_SKP Feb 2014 #1

I think the problem is beer, not beef. DURHAM D Feb 2014 #2

Good Cha Feb 2014 #43

the links and stats are in the ACA language frwrfpos Feb 2014 #4

You would do well to be specific in your Original Post (OP) rather than expect us to do the research NYC_SKP Feb 2014 #6

Nonsense. Ms. Toad Feb 2014 #25

Exactly, that is the way it always has been with insurance lostincalifornia Feb 2014 #54

Expenses are recorded in the year incurred joeglow3 Feb 2014 #34

COBRA is for unemployed people frwrfpos Feb 2014 #17

Have you even looked into an ACA plan? If you take home $1088/month your plan will be almost free. NYC_SKP Feb 2014 #22

I did look itno in very extensively. I take home around 1200 a month frwrfpos Feb 2014 #29

So, about 1.5 days of work to pay that expense? Super! What did you pay before? NYC_SKP Feb 2014 #33

If you take home 1200 a month you qualify for the subsidy, heck, you might qualify for the Medicaid lostincalifornia Feb 2014 #57

about the same as my daughter OKNancy Feb 2014 #80

I'm sorry, truly I am. We have tried to point out how this legislation effects the poorest sabrina 1 Feb 2014 #27

+1 Unkind remarks aren't helpful. NYC_SKP Feb 2014 #37

People who had no coverage because they could not afford it, and no, we were not, as sabrina 1 Feb 2014 #44

do you live in a state that didn't expand Medicaid? VanillaRhapsody Feb 2014 #69

My fight is to pay the most important bills which are increasing each and every day. sabrina 1 Feb 2014 #72

YOUR fight is with YOUR governor.... VanillaRhapsody Feb 2014 #92

Thanks for your understanding of the poor who actually don't need sabrina 1 Feb 2014 #100

... progressoid Feb 2014 #104

What you NEED to do is focus on what CAN help you....not just complaining about OBAMA! VanillaRhapsody Feb 2014 #114

NY has accepted expanded Medicaid, so anyone with income that low should be benefiting greatly. n/t pnwmom Feb 2014 #111

Exactly...some on DU just like pissing and moaning about Obama though... VanillaRhapsody Feb 2014 #115

Aaaand the pony rears its ugly head. WorseBeforeBetter Feb 2014 #113

thats not my reply....that is HERS! VanillaRhapsody Feb 2014 #116

Here's how your messages come across... WorseBeforeBetter Feb 2014 #118

Yes in fact she IS.....She is Anti-Obama AND anti-ACA.... VanillaRhapsody Feb 2014 #119

1x... WorseBeforeBetter Feb 2014 #127

Yes in fact she IS.....She is Anti-Obama AND anti-ACA.... VanillaRhapsody Feb 2014 #119

2x... WorseBeforeBetter Feb 2014 #128

Yes in fact she IS.....She is Anti-Obama AND anti-ACA.... VanillaRhapsody Feb 2014 #119

I can typing 3x! WorseBeforeBetter Feb 2014 #124

then what is your major malfunction....that is what I SAID! VanillaRhapsody Feb 2014 #126

ROFL! SammyWinstonJack Feb 2014 #123

Careful... you'll be accused of "not fooling anyone." WorseBeforeBetter Feb 2014 #125

Yes that would be the Hate Obama and everything he does Club... VanillaRhapsody Feb 2014 #129

Congratulations on having always been healthy. You are deluding yourself if you think pnwmom Feb 2014 #110

She will forgo it if it means she can complain about Pres. Obama causing her problems... VanillaRhapsody Feb 2014 #117

I'm afraid you just don't understand. Let me put it this way, the working poor sabrina 1 Feb 2014 #130

I helped a young woman who is a member of the "working poor" sign up for Medicaid. pnwmom Feb 2014 #132

There are people who are worse off Ms. Toad Feb 2014 #45

Young and healthy people who "never need care" are, indeed, not better off. NYC_SKP Feb 2014 #46

Agreed. n/t Ms. Toad Feb 2014 #59

young means poor, but screw them right? Older affluent folks need their money. nt Demo_Chris Feb 2014 #91

How do you figure? I mean that's the model for social security. NYC_SKP Feb 2014 #93

The ACA specifically says you will not be fined if the premium of the bronze plan exceeds 8% of your lostincalifornia Feb 2014 #58

There is no actual penalty to not getting insurance unless you get a tax refund, JaneyVee Feb 2014 #99

Well, that doesn't help someone who earns $15, 000 or more. Their tax return, if they sabrina 1 Feb 2014 #101

This person isn't giving the facts. It is not mean to correct mistakes that could hurt this person. pnwmom Feb 2014 #108

I'm envisioning a place where when someone is sick, they go to the doctor/hospital sabrina 1 Feb 2014 #131

The ACA is making it possible for Vermont to expand clinics pnwmom Feb 2014 #133

Post removed Post removed Feb 2014 #3

This simply isn't true. missingthebigdog Feb 2014 #5

yes, it is true. frwrfpos Feb 2014 #7

I don't have time to educate you on this. missingthebigdog Feb 2014 #9

You are correct. In addition, the yearly physical is NOT subject to the deductible, and based on lostincalifornia Feb 2014 #60

Calm the heck down!! bravenak Feb 2014 #8

Im not buying the shit insurance and Im not paying to be poor frwrfpos Feb 2014 #10

OK, good, so don't. Lex Feb 2014 #11

yes I do make enough to be fined frwrfpos Feb 2014 #13

If one makes enough to qualify for Medicaid, then the penalty is waived. Lex Feb 2014 #14

10 dollars an hour does not qualify me for medicaid frwrfpos Feb 2014 #15

So how much is your monthly premium? Lex Feb 2014 #16

it would have been 90 a month frwrfpos Feb 2014 #20

There are lots of exemptions at this link Lex Feb 2014 #23

Then tell what state are you from. I would like to plug in the figures myself to verify lostincalifornia Feb 2014 #65

Nope. jeff47 Feb 2014 #28

wrong frwrfpos Feb 2014 #32

Reading. You should try it. jeff47 Feb 2014 #36

It's really nice, and I mean that, that you are in a position where your every thought sabrina 1 Feb 2014 #70

If you don't recognize this as a progressive democratic forum anymore, TexasTowelie Feb 2014 #76

I feel much the same way and I'm still here Fumesucker Feb 2014 #78

I feel very welcome here but thanks for your concern. Sorry, we haven't met before sabrina 1 Feb 2014 #94

First, let me introduce myself to you. TexasTowelie Feb 2014 #96

I believe you suggested that I should leave DU suggesting that I did not 'feel welcome' here. sabrina 1 Feb 2014 #97

And I apologize for making the suggestion that you leave DU, but it seems that you were discontent TexasTowelie Feb 2014 #103

No problem. I understand trying to make the best of what we got. sabrina 1 Feb 2014 #109

That's why they set up the navigator program jeff47 Feb 2014 #84

No, anyone that would've qualified for Medicaid, but can't because of their state, is exempt. phleshdef Feb 2014 #49

Don't pay the fine. bravenak Feb 2014 #12

Even with 18k a year income the bronze plans are fully paid by the gov. Sunlei Feb 2014 #53

I put your numbers into the calculator and in California you qualify for Medicaid, so I do not know lostincalifornia Feb 2014 #61

What's your State? Here in Oregon, you would qualify for the Oregon Health Plan Bluenorthwest Feb 2014 #87

You are wrong. I DARE YOU to speak to an ACA navigator and get the actual numbers in your case. pnwmom Feb 2014 #106

This is absolutely false. Ms. Toad Feb 2014 #18

That is incorrect frwrfpos Feb 2014 #24

No, she's right. jeff47 Feb 2014 #30

I think you need to spend some time reading how the plans work joeglow3 Feb 2014 #31

I happen to be an attorney, well versed in this particular law - Ms. Toad Feb 2014 #40

I believe that a couple of corrections might be in order. TexasTowelie Feb 2014 #74

I was crunching numbers too late at night Ms. Toad Feb 2014 #77

the reason to choose the bronze plan Ms. Toad Feb 2014 #79

It's very simple: you have no idea what you're talking about alcibiades_mystery Feb 2014 #41

You couldn't be more wrong. Its insurance, not a friggin credit line. phleshdef Feb 2014 #51

What state are you in? In California you qualify for Medicaid. Provide the link to your state's lostincalifornia Feb 2014 #62

She is correct and you're wrong. Call the ACA, speak to a navigator there, pnwmom Feb 2014 #112

The key word is "incurred". TexasTowelie Feb 2014 #26

The OP seems to be missing experience with insurance, Ms. Toad Feb 2014 #42

I also knew the OP was wrong immediately, TexasTowelie Feb 2014 #47

That's why it has been so easy to lie about it Ms. Toad Feb 2014 #52

Yes, I agree. TexasTowelie Feb 2014 #75

Tick tock tick tock Pretzel_Warrior Feb 2014 #19

You're confused about several things, both what 60/40 means and what OOP/deductibles are Recursion Feb 2014 #21

Unfortunately, many of the marketplace plans are odd Ms. Toad Feb 2014 #48

Weird, though I guess that's like the old "catastrophic plan" idea Recursion Feb 2014 #50

Basically, Ms. Toad Feb 2014 #56

Ms Toad... I must say.... MysticHuman Feb 2014 #73

I hope it helps others - Ms. Toad Feb 2014 #85

That certainly would explain things... MysticHuman Feb 2014 #102

I am hoping that once people get used to have better access to health care Ms. Toad Feb 2014 #122

However, there is a minimum requirement lostincalifornia Feb 2014 #67

I'm not following you. Ms. Toad Feb 2014 #68

Didn't word it right. A minimum basic standard of coverage. For example all the policies under lostincalifornia Feb 2014 #71

Got it! Thanks for the clarification. n/t Ms. Toad Feb 2014 #86

So your claim is the Hospital/Nursing home will break federal law? jeff47 Feb 2014 #35

Too Bad for You davekriss Feb 2014 #38

Then get a silver or a gold plan bluestateguy Feb 2014 #39

I do not know if you're a troll or just dumb, but you are 100% wrong krawhitham Feb 2014 #55

It could be just pure flame bait, because the numbers do not make sense, and it a most states lostincalifornia Feb 2014 #63

Meh...I don't think the OP understands insurance and I think folks keep conflating TheKentuckian Feb 2014 #81

Actually it is Modified adjusted Gross. A subtle, but sometimes, significant point. I do not think lostincalifornia Feb 2014 #82

It's a dead ender who is in denial Pretzel_Warrior Feb 2014 #66

The poster attacked LGBT people for boycotting the Olympics, called it 'red baiting' Bluenorthwest Feb 2014 #89

Your negative publicity flops. Millions including young, healthy Pretzel_Warrior Feb 2014 #64

Not right. Insurance can be difficult to understand. Let me try. uppityperson Feb 2014 #83

I don't know if you are making this up Dorian Gray Feb 2014 #88

Lalo describes this perfectly: FSogol Feb 2014 #90

I can certainly understand your concern postatomic Feb 2014 #95

Our current health insurance situation sucks. NCTraveler Feb 2014 #98

Ms. Toad had a great post about this yesterday that included info you left out. pnwmom Feb 2014 #105

Simply not true for the same incident of care. Now if you get readmitted to a hospital every year, Hoyt Feb 2014 #107