General Discussion

Ms. Toad

(38,525 posts)

59. There is an option available now -

Fri Jun 29, 2012, 08:06 AM

Jun 2012

but you have to be willing to be without insurance for 6 months.

There are PCIP plans for people with pre-existing conditions who cannot obtain health insurance. The premiums range from around $90 to around $600 a month (depending on age and geography). Most have a substantial deductible. But that premium is dirt cheap for anyone with pre-existing conditions.

If I had overpriced insurance (because it was the only thing I could get) I would consider getting 3 months worth of drugs, and any medical care I could predict, the day before I terminated my policy. Live off the drugs for 3 months, purchase the next 3 months worth out of pocket, then buy into the PCIP plan for my state. (And hope I didn't have a medical disaster during those 6 months.)

My daughter's out of pocket drug costs for 3 months come to around $2500 - so as long as I could save that much in premiums in a reasonable period of time under the new plan it would be a pretty easy decision. (With our current plan, if we were paying the premiums rather than work, it would take about 2 months to recover the out of cost drug costs in premium savings. Pretty much a no brainer.)

Edit history

Please sign in to view edit histories.

Recommendations

0 members have recommended this reply (displayed in chronological order):

119 replies

= new reply since forum marked as read

Highlight:

Did you notice you didn't have to pay a copay for your annual exams the last 2 years? [View all] Honeycombe8 Jun 2012 OP

Then to whom do I apply for a refund? (NT) Zavulon Jun 2012 #1

The benevolent insurance companies. (n/t) WorseBeforeBetter Jun 2012 #6

Good. Maybe after 6-8 months of paperwork I will Zavulon Jun 2012 #17

Hmm. cliffordu Jun 2012 #45

The IRS is hiring 16,000 new enforcement agents specifically to collect fines for ACA. Sirveri Jun 2012 #46

Fuck Ron Paul! NNN0LHI Jun 2012 #54

YEP- FUCK RON PAUL. cliffordu Jun 2012 #73

I saw it posted by another poster here. Sirveri Jun 2012 #80

Because it's cheaper to pay the fine. Zavulon Jun 2012 #84

You don't provide data about your situation to back up your post. LiberalFighter Jun 2012 #103

Do you have any proof that employers have to pay a fine?? cliffordu Jun 2012 #109

Who is your ins. company? In what state? Let's check this out and get this taken care of. Honeycombe8 Jun 2012 #51

Kaiser, Virginia (although both co-pays were collected in DC). Zavulon Jun 2012 #86

Our benefit reps advise our retirees LiberalFighter Jun 2012 #104

Here's an article that explains how it works, when it applies & doesn't. Honeycombe8 Jun 2012 #111

Your doctor. Ms. Toad Jun 2012 #35

Yes, I think it's the DOCTOR who incorrectly charges the copay. Remember, it's free for PREVENTIVE Honeycombe8 Jun 2012 #52

Thanks. Zavulon Jun 2012 #87

No need to apply. mzmolly Jun 2012 #43

I thinfk if I had any refund coming for those visits Zavulon Jun 2012 #85

The refunds haven't been sent mzmolly Jun 2012 #110

Duplicate mzmolly Jul 2012 #118

IIRC the refund is issued to the client who holds the policy -- elehhhhna Jul 2012 #116

On edit, I've read differing mzmolly Jul 2012 #117

I've paid a copay every single time I went to every one of my doctors this year. Electro Jun 2012 #2

Hello bigwillq Jun 2012 #5

Thanks and Electro Jun 2012 #7

You can do it now. Welcome to DU! gkhouston Jun 2012 #25

It applies to your annual physical, and certain other exams Ms. Toad Jun 2012 #36

I was charged a co-pay for my annual physical exam- back in March of 2012. nt Dr Fate Jun 2012 #101

Call your insurance company and tell them they BROKE THE LAW. tridim Jun 2012 #107

It is now the law of the land that PREVENTIVE well exams do not have copay amounts. Honeycombe8 Jun 2012 #56

What are annual exams? n/t EFerrari Jun 2012 #3

+1 Le Taz Hot Jun 2012 #23

Hey, sweetie. EFerrari Jun 2012 #28

I went through that myself until recently. xmas74 Jun 2012 #92

I hope it goes well for you. :) EFerrari Jun 2012 #94

thank you. xmas74 Jun 2012 #96

Not silly at all! EFerrari Jun 2012 #98

It's the one you get the same year a truck runs you over. Then they tell you to go away... freshwest Jun 2012 #42

Unless, I believe, your doctor diagnoses a new condition. n/t Ian David Jun 2012 #4

What are you talking about. I always pay a co-pay. But I am not complaining. I have southernyankeebelle Jun 2012 #8

$400/mo for a family of 4 is FABULOUSLY cheap insurance. kestrel91316 Jun 2012 #16

I guess the prospect you come from. My son is a cook. Over $400 a month for terrible southernyankeebelle Jun 2012 #24

I know someone who was laid off GObamaGO Jun 2012 #93

Wow, what the heck the guy suppose to do? Give them a damn leg for payment? LOL awful southernyankeebelle Jun 2012 #95

Apparently they were supposed to stop paying their mortgage GObamaGO Jun 2012 #97

$400/mo. is cheap for an entire family. That doesn't mean it's easy for anyone to afford, but it's Honeycombe8 Jun 2012 #57

I pay $225/mo, but that's thanks to the Teamster's Union NickB79 Jul 2012 #114

You are entitled to a general check up once a year without charge, Ms. Toad Jun 2012 #37

I live at the at doctors office unfortunately. I thought he/she was talking in general. I misunder southernyankeebelle Jun 2012 #77

A specialist is not a well exam. A well exam is where you go to the dr once a year... Honeycombe8 Jun 2012 #58

I'm on Tricare sammytko Jun 2012 #60

I am not talking about tests. I didn't either. How do you like Tricare Primary? I love it. southernyankeebelle Jun 2012 #75

The company I was with sold it as something they did for us SoutherDem Jun 2012 #9

So who has an annual exam? DURHAM D Jun 2012 #10

ha... i was sayin. but, if i dont have to pay, i may have one, lol. nt seabeyond Jun 2012 #12

I'm booking an appointment with an ob/gyn as we speak. xmas74 Jun 2012 #81

remember the day when that use to be a given. preventative covered. nt seabeyond Jun 2012 #82

I'm glad to see that it's covered again. xmas74 Jun 2012 #90

yup. nt seabeyond Jun 2012 #106

what about eye doctor. my son has his yearly on monday. $160 for me. seabeyond Jun 2012 #83

Yep. intheflow Jun 2012 #88

oh geez... i never had eye issue, no one in our family did. everyone in hubbies family seabeyond Jun 2012 #105

I don't know about the eye. xmas74 Jun 2012 #91

sigh... lol, ya. nt seabeyond Jun 2012 #108

sheeeit, i just pay thru hsa cause i have a piece of shit insurance. seabeyond Jun 2012 #11

I've never had to pay a co-pay for preventive visits n/t SickOfTheOnePct Jun 2012 #13

No one told the insurance companies! CALL CONGRESS RIGHT FRACKING NOW!1!1! Zorra Jun 2012 #14

Your once a year check-up with your primary doc Ms. Toad Jun 2012 #38

Thanks! Zorra Jun 2012 #99

IIRC this only applies to NEW policies. If you have an old pre-ObamaCares policy kestrel91316 Jun 2012 #15

Yes, or ProSense Jun 2012 #18

Problem is, if you have ever seen a doctor for squat, you have a pre-existing condition kestrel91316 Jun 2012 #19

Really? Electro Jun 2012 #20

No, that part goes into effect Jan 2014. kestrel91316 Jun 2012 #22

Website is not really that easy to understand. intheflow Jul 2012 #113

Somebody found an estimator online from some university I think kestrel91316 Jul 2012 #115

There is an option available now - Ms. Toad Jun 2012 #59

I checked out PCIP on the advice of a friend. It would cost me $500/mo. If I had that kind of money kestrel91316 Jun 2012 #74

Not true: we had the same old policy and didn't have to co-pay for the physical frazzled Jun 2012 #31

Interesting. I read that differently at the time it was written - Ms. Toad Jun 2012 #40

Not sure about that. I have a new employer and new plan, but it was no copay under old plan.... Honeycombe8 Jun 2012 #61

my annual exams are free...medicare! madrchsod Jun 2012 #21

Um, no. Matariki Jun 2012 #26

Um, yes. The ins. co. CAN put some restrictions, I guess, but I'm not sure it can, regarding copay Honeycombe8 Jun 2012 #63

YES. And for my kids too, even though I have a high-deductible plan. Nye Bevan Jun 2012 #27

Yes frazzled Jun 2012 #29

I paid full price for all medical services last year because I wasn't going to pull anything out of RB TexLa Jun 2012 #30

No. I still have to pay every time I go to the doctor. proud2BlibKansan Jun 2012 #32

My insurance already covered annual exams before ACA as passed with no copay. n/t tammywammy Jun 2012 #33

The problem is copays and deductibles apply to any follow up care those annual exams may indicate dflprincess Jun 2012 #34

Still paying co-pays.. Some companies are ahead of the curve. other's waiting for 2014. glowing Jun 2012 #39

It is required for some plans. Ms. Toad Jun 2012 #41

Perhaps its a Florida thing, but we are still paying co-pays... My son's physical yesterday was glowing Jun 2012 #48

There's a quirk I wasn't aware of - Ms. Toad Jun 2012 #49

That is against the law. That provision went into effect a year or so ago. It is the drs. who charge Honeycombe8 Jun 2012 #64

I've never paid a copay for preventative stuff Skittles Jun 2012 #44

I hadn't been to the doctor for a long time and was having some issues maryellen99 Jun 2012 #47

We ran into that quirk, as well... Ms. Toad Jun 2012 #53

I knew I was going to have to pay a part of it going in maryellen99 Jun 2012 #62

Yes. Before patients had to pay for colonoscopies. NOW they only don't have to pay IF nothing is Honeycombe8 Jun 2012 #66

WHAT?! I just paid co-pay to get my BP taken! WinkyDink Jun 2012 #50

You can take your bp yourself. Why would you go to a dr. for that? nt Honeycombe8 Jun 2012 #68

Because it was taken earlier by a dentist, and it was sky-high. I needed meds for the first time. WinkyDink Jun 2012 #78

Oh.....that's not a "well exam." That's a diagnostic exam for a problem. Copays apply. Honeycombe8 Jun 2012 #112

I've had to pay. AngryOldDem Jun 2012 #55

It is against the law to be charged a copay for a preventive well exam Honeycombe8 Jun 2012 #65

Do you know the exact date this started? flamingdem Jun 2012 #76

I cannot imagine such a luxury as an annual exam. JNelson6563 Jun 2012 #67

Not a very good deal MadrasT Jun 2012 #69

We still need to pay for labwork Proud Liberal Dem Jun 2012 #70

I paid a co-pay, plus $100 for labwork for my physical exam. Dr Fate Jun 2012 #102

I noticed I haven't had insurance for more than 2 years, so NO. undeterred Jun 2012 #71

I don't get annual exams but my wife just got a colonoscopy without copay cbdo2007 Jun 2012 #72

Actually Xyzse Jun 2012 #79

I notice that you've been living a privileged existence where you had health insurance intheflow Jun 2012 #89

No. I paid a co-pay 3 times this year alone. Who do I write to to get my money back? nt Dr Fate Jun 2012 #100

Nothing has changed for me... always have to pay copays budkin Jul 2012 #119