General Discussion

jeff47

(26,549 posts)

21. The thing is "best" is not necessarily easy to find.

Mon Nov 17, 2014, 04:24 PM

Nov 2014

My work-based insurance offers 2 plans - a PPO and a "high deductible/HSA" plan.

It looks like the PPO would be better, since it doesn't have a giant multi-thousand deductible to meet before coverage starts on anything not routine. Especially since I'm going through some "not routine" problems right now.

Until you add up the premium difference. Which is almost double that giant multi-thousand deductible. I happen to have enough credit to smooth out hitting that giant deductible early in the year. If I didn't, I'd have to go with the PPO to essentially finance the deductible.

"Best" ends up depending on your finances and your guess about what medical care you'll need over the next year. So it isn't trivial to pick a good plan, and a navigator can be extremely helpful in spotting differences you don't realize are critical.

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Instead of saying "Screw the ACA", why don't people ask for help to find their best plans? [View all] moriah Nov 2014 OP

When a law serves the needs of the insurance industry as opposed to the needs of the people Wella Nov 2014 #1

If you can think of a way to progress sharp_stick Nov 2014 #3

A public option would be a stepping stone, I think Art_from_Ark Nov 2014 #76

MIllions of People are covered for Free thanks to Obamacare and there's No Denying Insurance for Cha Nov 2014 #94

The ACA is a stop-gap measure, but it's helping people, too. moriah Nov 2014 #5

Do you consider limiting profits of the Insurance industry, "the needs of the Insurance industry"? tridim Nov 2014 #11

You say "limiting the profits of the Insurance industry." NCTraveler Nov 2014 #100

The ACA, if nothing else, is a step forward groundloop Nov 2014 #53

Single payer would be awesome - but we need some kind of insurance TODAY csziggy Nov 2014 #75

Too much effort Prophet 451 Nov 2014 #2

Do you know if you are considered a smoker Curmudgeoness Nov 2014 #42

Really? That's weird Prophet 451 Nov 2014 #43

You would have to look at the Sgent Nov 2014 #47

Thankfully, I'm British Prophet 451 Nov 2014 #50

Friends are trying to too. Any particular info. that helped? appalachiablue Nov 2014 #59

Not really Prophet 451 Nov 2014 #66

Appreciate info. & suggestions much, will pass along. appalachiablue Nov 2014 #71

Yes. Doctors, the New England Journal of Medicine, says they are an acceptable route jtuck004 Nov 2014 #73

Great info. Glad you had success, will give to friends. They'll make it for sure. appalachiablue Nov 2014 #78

The NHS is looking into them Prophet 451 Nov 2014 #93

We have a HUGE industry making money from over the counter crap that doesn't work for millions jtuck004 Nov 2014 #95

Insurance requests a blood test for nicotine I believe. herding cats Nov 2014 #55

That seems insane to me Prophet 451 Nov 2014 #67

I always thought it was foolish. herding cats Nov 2014 #99

They didn't request a blood test for me. subterranean Nov 2014 #81

I imagine, if this is even still done, it's up to the individual insurance company to choose. herding cats Nov 2014 #98

Medicare doesn't HockeyMom Nov 2014 #101

I wonder if any Medicare supplement policies do? herding cats Nov 2014 #102

Medicare Advantage are private Insurance Companies HockeyMom Nov 2014 #104

I'm cloudy on why they didn't make it a mandatory federal law? Rex Nov 2014 #4

Wasn't it supposed to be federal but the Supremes went with each state making the decision? LawDeeDah Nov 2014 #8

Yep, it would have gone to the Supreme Court and lost if it had... Spazito Nov 2014 #13

you are correct Rstrstx Nov 2014 #17

Because health care is a right, not a privilege Matrosov Nov 2014 #6

So you're saying I should have been denied help now, until we could have gotten single-payer? moriah Nov 2014 #7

I think you will find that every country that does have single payer LawDeeDah Nov 2014 #9

If I am correct Canada got theirs one state at a time. It took them a while. Unfortunately we do not jwirr Nov 2014 #14

Vermont is Sgent Nov 2014 #48

One step allows another step. Thank you. jwirr Nov 2014 #52

Canada never made for profit insurers part of the federal government Doctor_J Nov 2014 #63

Did not say they did we were talking about programs taking time to get in place. jwirr Nov 2014 #69

'we're basically saying that your worth as a person is defined by your income.' Rex Nov 2014 #16

Exactly. n/t truedelphi Nov 2014 #56

May I ask how you know what is affordable to other people? Unless they post their Autumn Nov 2014 #10

Hence why I suggested going through a navigator, either in person or through the Helpline. moriah Nov 2014 #12

The navagators are awesome here. And the site allow you to compare every insurance plan Autumn Nov 2014 #15

The thing is "best" is not necessarily easy to find. jeff47 Nov 2014 #21

The way the one here was set up everything could be compared. Autumn Nov 2014 #24

Anyone who thinks that will help a lot of folks is living in a dream world. Daemonaquila Nov 2014 #37

That's why they need to look for PPO plans. I didn't have to touch my deductible at all last year. moriah Nov 2014 #40

It will help millions. I personally know two who got good deals last year. One is now eligible pnwmom Nov 2014 #44

The ACA says that for the wealthiest customers 9.4% of income is affordable. lumberjack_jeff Nov 2014 #45

The insurance premiums themselves might be affordable, but how does an truedelphi Nov 2014 #57

That's where the annual cap on out-of-pocket cost come in. Hoyt Nov 2014 #62

All policies Sgent Nov 2014 #65

I find it interesting that "wealthy" is like 29k now but people that made 250k were in the poorhouse TheKentuckian Nov 2014 #84

Did Costco have a coupon for hyperbole this week? lumberjack_jeff Nov 2014 #90

Opps...I missed that 2nd bracket went from a little over 8% to 9.5 so wealthy starts at about 35k TheKentuckian Nov 2014 #91

I'm sure we've all lost friends. lumberjack_jeff Nov 2014 #92

How do you find a navigator? Curmudgeoness Nov 2014 #74

Call them at 1-800-318-2596 csziggy Nov 2014 #79

Thanks. I will try that. Curmudgeoness Nov 2014 #83

One thing about ACA - at least we get to compare plans on the same terms csziggy Nov 2014 #87

I feel for you. That is a lot of hassle you have had for years. Curmudgeoness Nov 2014 #89

I just called the number as soon as I got a bit confused. They called me back Autumn Nov 2014 #86

Post removed Post removed Nov 2014 #18

wow. where have I heard *that* talking point before? nt m-lekktor Nov 2014 #22

Post removed Post removed Nov 2014 #29

You are simplifying the problem. Curmudgeoness Nov 2014 #77

Because spittle-flecked outrage gets more hits and a higher rec count... SidDithers Nov 2014 #19

Are we forgetting how many states did not opt in to Medicaid expansion? Atman Nov 2014 #20

State governors opting out is not Obama's fault, however, & too many here at DU are .... Hekate Nov 2014 #32

Believe me, we know who screwed us over. Brigid Nov 2014 #33

You don't have the right to say so if you are wrong. Atman Nov 2014 #35

That would be IN. And Pence the Dense. Brigid Nov 2014 #36

So then, how is the OBAMA's FAULT that Pence refused to opt in? Atman Nov 2014 #38

It's not Obama's fault. Brigid Nov 2014 #41

Rub the salt into Mike Pence. Atman Nov 2014 #61

It isn't. Brigid Nov 2014 #64

Sorry about your gov Pence who cares nothing for people who can't afford health insurance, Brigid. Cha Nov 2014 #96

This message was self-deleted by its author Corruption Inc Nov 2014 #23

Agreed. I spend some twenty years inside the medical system truedelphi Nov 2014 #28

Which Red State do you live in? Atman Nov 2014 #34

California is a Blue state. truedelphi Nov 2014 #39

Then go to a California non-profit insurer. Blue Shield, for example. n/t pnwmom Nov 2014 #46

If you' re on the Calif. exchange, due to low income,you can't. truedelphi Nov 2014 #54

In many places there are NO good plans. truedelphi Nov 2014 #25

I've heard horrible things about Kaiser. progressoid Nov 2014 #31

I know people who think Kaiser is great -- personal anecdotes mean very little. pnwmom Nov 2014 #49

non-profit. progressoid Nov 2014 #58

I have Kaiser and it's OK. No frills though. The dislike for HMOs Hoyt Nov 2014 #68

Because how else are you going to get over 600 responses & the chance to flame those who ask basic Q Hekate Nov 2014 #26

Thank you for this. MannyGoldstein Nov 2014 #27

Too many make conclusions based on selective and incomplete information gmb92 Nov 2014 #30

because that's just prolonging the inevitable Doctor_J Nov 2014 #51

I think you've really distilled the essence of the absurdity. We are a rich enough KingCharlemagne Nov 2014 #60

Good post. bigwillq Nov 2014 #82

k&r for asking for help when you need it. uppityperson Nov 2014 #70

I stopped asking why tabasco Nov 2014 #72

OP Content: A but OP Title: F-- Why are SOME people so accusing towards a generalised other? carolinayellowdog Nov 2014 #80

Why would folks want to "shop" for new plans each year TBF Nov 2014 #85

I'm 63, self employed and my income varies from year to year. JEB Nov 2014 #88

Aloha moriah.. good question.. thank you. Sen Sanders on ACA/Obamacare today.. Cha Nov 2014 #97

I found a plan that is rather high, but the lowest that I could get. Jamastiene Nov 2014 #103