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questionseverything

(11,990 posts)

76. about the 80% thing

Sat Mar 22, 2014, 04:36 PM

Mar 2014

I see the sudden rise in the cost of prescription drugs as a"gaming " of the 80% rule......I think the same 1%ers that own stock in the ins companies also probably own the bulk of the stock in the drug companies

so increase actual costs of the drugs makes the 80% number higher and while the ins does pay more for that part they also have to refund less while they are moving money from one pocket to the other

only antidotal evidence but recently my grown daughter came to me very upset, a script that she has used sporadically for years went from 150/ tiny tube to over 400/tiny tube....the generic is no longer available here in US

one of the needs my spouse has is chiropractic adjustments,,,,,we found out recently that no ins in Illinois covers it now

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Even with Platinum coverage, you still get narrow networks [View all] eridani Mar 2014 OP

there is only ONE provider who accepts Covered California plans in my area.... mike_c Mar 2014 #1

"There is no place for private for-profit insurance in health care. They add zero value, and are... CurtEastPoint Mar 2014 #2

I got slammed when i pointed that out awhile back. dixiegrrrrl Mar 2014 #3

Yikes. What happens if you move to another county? suffragette Mar 2014 #27

I have no idea. dixiegrrrrl Mar 2014 #33

Well, I think you raised an excellent point and one that could be a hard suffragette Mar 2014 #35

Or spend a lot of time on the road from one state to another? Lars39 Mar 2014 #34

Great point suffragette Mar 2014 #36

This is my issue. I am always travelling, it's my job... Demo_Chris Mar 2014 #44

bull. emergency care is covered wherever you are in the US. elehhhhna Mar 2014 #46

At higher rates perhaps. Lars39 Mar 2014 #49

Yep, in my area very few doctors accept any exchange plans at all. Nye Bevan Mar 2014 #4

The fact is..... cynzke Mar 2014 #22

Beginnings of a two tier system Kilgore Mar 2014 #25

It leads to an interesting question: should you force doctors to accept a plan? theboss Mar 2014 #26

3-tier: those in red states w no expansion Lars39 Mar 2014 #37

that's what you have in single payer countries treestar Mar 2014 #40

My hubs employer is a Fortune 100 company and we have narrow networks too elehhhhna Mar 2014 #47

That's what we had before too, and a lot of those folks couldn't get insurance if they Hoyt Mar 2014 #58

This message was self-deleted by its author questionseverything Mar 2014 #72

if you want more, go outside the exchanges. crimeariver1225 Mar 2014 #5

Then fight with exchanges Aerows Mar 2014 #7

Regardless of "how it works" forthemiddle Mar 2014 #42

as of today, you can keep your insurance that you previously had. Promise kept. crimeariver1225 Mar 2014 #83

Should we repeal the ACA? JoePhilly Mar 2014 #6

The ACA needs serious adjustments Aerows Mar 2014 #8

So that's a "no", correct? JoePhilly Mar 2014 #9

JoePhilly, do me a favor Aerows Mar 2014 #12

I asked a simple question, why not answer it? JoePhilly Mar 2014 #13

it should not be repealed, but it does need some fixes noiretextatique Mar 2014 #14

Thank you, I agree, Aerows Mar 2014 #19

Well I will give you the answer you want...NO. zeemike Mar 2014 #16

Agreed. Aerows Mar 2014 #21

And the only argument against it that can be made is zeemike Mar 2014 #23

Sure, I'd support that. JoePhilly Mar 2014 #24

No it is not step one...it is not even step 0 zeemike Mar 2014 #30

You see it as complaining while others see it Lars39 Mar 2014 #38

I see lots of "pointing out what needs fixing", very little HOW to do it. JoePhilly Mar 2014 #41

It's a hard problem to solve, but we'll get there. Lars39 Mar 2014 #52

ACA made my choices dramatically worse, policy-wise... Thank goodness for the 2-year extension! ReverendDeuce Mar 2014 #43

So what made your pre-ACA plan, non-ACA compliant? eom 1StrongBlackMan Mar 2014 #56

Lack of maternity care for one... ReverendDeuce Mar 2014 #82

Good luck against big pharma ramapo Mar 2014 #18

I know. Aerows Mar 2014 #20

no just amend it for now Rosa Luxemburg Mar 2014 #31

Unless you think handing big insurance a hundred billion a year weakens them... Demo_Chris Mar 2014 #45

We are going to be stuck with these vultures between us and Health CARE for a LONG time. bvar22 Mar 2014 #10

They are the obstacle between us and health care..... cynzke Mar 2014 #32

Without a deductible, your premium would be hundreds of dollars more every month. Hoyt Mar 2014 #60

i wonder when we will see the numbers questionseverything Mar 2014 #73

I am too. bvar22 Mar 2014 #75

about the 80% thing questionseverything Mar 2014 #76

Duh. Igel Mar 2014 #11

Limited choice of doctors is a part auntsue Mar 2014 #15

Hell, it's a part of TRICARE, too! And if you go "out of network" you're paying for the privilege. MADem Mar 2014 #77

NJ networks are more limited than pre-ACA ramapo Mar 2014 #17

I have had a BCBS PPO plan years before Obamacare through my doc03 Mar 2014 #28

This is my experience as well BrotherIvan Mar 2014 #29

+1 area51 Mar 2014 #53

That stood out for me as well. SammyWinstonJack Mar 2014 #69

i am questioning this statement questionseverything Mar 2014 #74

One thing that people need to remember about ACA eridani Mar 2014 #39

I'm on Medicare, but when my wife signed up on Minnesota's MineralMan Mar 2014 #48

While I'm not against single payer, I think there is a seriously false premise here OmahaBlueDog Mar 2014 #50

I agree with a lot of that. Personally, I'm fine with letting insurance companies take on risk and Hoyt Mar 2014 #55

Jesus Christ, the AEI again? that's two AEI and one OP citing The Blaze. PeaceNikki Mar 2014 #51

I'm behind on my sources background, Lars39 Mar 2014 #54

OK... PeaceNikki Mar 2014 #57

Thank you! Lars39 Mar 2014 #59

The OP also cites another RW organization PeaceNikki Mar 2014 #61

Hard to keep up sometimes! Lars39 Mar 2014 #63

Not really. It's all a simple Google search away. PeaceNikki Mar 2014 #64

Thanks for the reminder to check sources. Lars39 Mar 2014 #65

The premise of the spin is absurd. ProSense Mar 2014 #68

This crap is being spread all over the Internet. ProSense Mar 2014 #66

If the AEI were the only source for the OP, you'd have a legitimate gripe eridani Mar 2014 #78

You want more links? Here-- eridani Mar 2014 #80

I posted an analysis that supports what you're saying about a month ago: TexasTowelie Mar 2014 #62

I have also gotten the advice to go with the highest deductible plan BrotherIvan Mar 2014 #67

It's actually the mix of the deductibles and the percentage reimbursement levels. TexasTowelie Mar 2014 #70

Thanks, that makes a lot of sense BrotherIvan Mar 2014 #71

The bronze plan is obviously the best--unless you get expensively sick eridani Mar 2014 #79

Thanks BrotherIvan Mar 2014 #81