General Discussion

Roselma

(540 posts)

80. Annual max out of pocket is tiered. One way to

Reply to cherokeeprogressive (Reply #66)

Sun Jul 1, 2012, 09:21 PM

Jul 2012

determine it per tier is to use the KFF subsidy calculator and see the premiums (sometimes with subsidies) and then look on that very same page (in lighter print) and read the verbiage explaining the annual maximum out of pocket for the income that was placed in the calculator:

http://healthreform.kff.org/SubsidyCalculator.aspx

Also, additional explanation is here (it is a pdf):

http://cs.infospace.com/ClickHandler.ashx?du=http%3a%2f%2fwww.kff.org%2fhealthreform%2fupload%2f8177.pdf&ru=http%3a%2f%2fwww.kff.org%2fhealthreform%2fupload%2f8177.pdf&ld=20120702&ap=1&app=1&c=info.metac&s=metacrawler&coi=239138&cop=main-title&euip=74.103.126.73&npp=1&p=0&pp=0&pvaid=8aebd2ae68214295a1a9f12c66458600&sid=1108563648.3177602116641.1341191251&vid=1108563648.3177602116641.1321655616.1801&fcoi=417&fcop=topnav&fpid=27&ep=1&mid=9&hash=6916ACBC81DBDC623DFB3D1A4A474972

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OK, the Affordable Care Act makes me feel 100% better about losing my job..... [View all] Logical Jun 2012 OP

sounds about right Schema Thing Jun 2012 #1

The KFF site shows a 'Government Tax Credit'. Does that mean I pay that also? Logical Jun 2012 #3

The tax-credit is how the government subsidizes the plans. You receive the credit... PoliticAverse Jun 2012 #26

Fat chance quinnox Jun 2012 #2

But for that $100 a month they get insurance...... Logical Jun 2012 #4

yes, exactly quinnox Jun 2012 #6

I understand your point..... Logical Jun 2012 #8

unpaid ER visits end up on credit rating reports Motown_Johnny Jun 2012 #17

You are wrong, Grasshopper. How do we know that? Massachusetts Mandate. Almost 100% coverage. Honeycombe8 Jun 2012 #45

Most of the increased coverage was achieved through expanding medicaid. dkf Jul 2012 #52

Most of the states will keep the increased Medicaid. A few won't. Wait and see. Honeycombe8 Jul 2012 #77

I wonder if they can keep it til the Fed contribution goes down dkf Jul 2012 #115

And remember that the ACA's terms are even more favorable than in MA. TheWraith Jul 2012 #78

The MA program has its flaws. Marrah_G Jul 2012 #85

That is poor people logic RegieRocker Jul 2012 #51

Yes, poor people don't have enough money to go around. Fumesucker Jul 2012 #81

I lived RegieRocker Jul 2012 #84

You've already stated that all poor people have "poor people ways".. Fumesucker Jul 2012 #88

If everyone were just like you there wouldn't be a problem. rrneck Jul 2012 #89

Your reply is arrogant RegieRocker Jul 2012 #98

Measuring others against your own experience rrneck Jul 2012 #113

I guess I just need a 3rd part time job! Marrah_G Jul 2012 #92

Really RegieRocker Jul 2012 #99

I am an admin asst at job number one. Marrah_G Jul 2012 #103

So you work almost 13 hours a day, 7 days a week? bluedigger Jul 2012 #114

This poor person finds your comments offensive Marrah_G Jul 2012 #82

Not all poor people ways RegieRocker Jul 2012 #86

And what's that honey? I force my employer to pay me shit? Starry Messenger Jul 2012 #83

Over the top RegieRocker Jul 2012 #87

Your original comment is the one that's over the top.. Fumesucker Jul 2012 #90

Nope RegieRocker Jul 2012 #91

The ones who stay poor obviously just aren't trying hard enough Marrah_G Jul 2012 #94

You could do the work I do but you won't RegieRocker Jul 2012 #106

I've spent a lifetime sacrificing Marrah_G Jul 2012 #108

The poor people that don't remain poor start making more money.. Fumesucker Jul 2012 #100

Not at all RegieRocker Jul 2012 #102

Medical bills aren't due to sheer random chance? Fumesucker Jul 2012 #110

That worldview is very common and has a name. 2ndAmForComputers Jul 2012 #123

another factor is timing Skittles Jul 2012 #107

Nope Marrah_G Jul 2012 #93

Can't refute it, I see. Starry Messenger Jul 2012 #95

Ok RegieRocker Jul 2012 #104

LOL Marrah_G Jul 2012 #105

I watched the Grapes of Wrath RegieRocker Jul 2012 #109

You should consider yourself fortunate Marrah_G Jul 2012 #111

i understand RegieRocker Jul 2012 #116

Thank you Marrah_G Jul 2012 #117

Should I rob them? Starry Messenger Jul 2012 #112

You make no sense RegieRocker Jul 2012 #118

LOL. Starry Messenger Jul 2012 #119

Not all. lumberjack_jeff Jul 2012 #121

"ER for free" SoCalDem Jun 2012 #42

It's not free- it's just another bill that you can't pay Marrah_G Jul 2012 #96

A lot of ProSense Jun 2012 #5

Hmmmm...depends on your definition of "forced" Haha ScruffyTheJanitor Jun 2012 #12

then every tax is forcing people to do something Motown_Johnny Jun 2012 #13

The basis of all governmental entities is power derived from force and threats of violence. ScruffyTheJanitor Jun 2012 #18

And if you don't pay your rent or mortgage goverment may be employed with LEOs to force you... freshwest Jun 2012 #23

There are Mutual insurance companies which are owned by the policy holders... PoliticAverse Jun 2012 #31

Yes, my auto insurance is that way. They used to give us a rebate. We generally have a few of these freshwest Jun 2012 #39

Did I mention that I also hate the mandate? Motown_Johnny Jun 2012 #43

I suppose it never occurred to you Spitfire of ATJ Jul 2012 #58

But why cheer such a hugely regressive tax? girl gone mad Jun 2012 #22

Or ProSense Jun 2012 #14

"...remain a freeloader" ScruffyTheJanitor Jun 2012 #21

What an ugly post, Prosense. girl gone mad Jun 2012 #24

Why? ProSense Jun 2012 #25

You are adopting industry approved hate language. girl gone mad Jun 2012 #27

Take it up with Nancy Pelosi SickOfTheOnePct Jun 2012 #49

Yes, they are forced to contribute to their medical care costs, just like they are forced to Honeycombe8 Jun 2012 #46

Is paying $$ to a private corporation always bad? treestar Jul 2012 #57

Imagine making minimum wage and being sick/injured without any insurance Motown_Johnny Jun 2012 #11

Note that for such a person buying insurance would cost less than the $695 penalty PoliticAverse Jun 2012 #28

you will be proven wrong, thankfully. dionysus Jun 2012 #16

You of course realize that if you are at the lowest threshold of poverty nadinbrzezinski Jun 2012 #37

This might help Live and Learn Jul 2012 #53

Very good point, many Americans cannot afford any additional out of pocket expenses Puzzledtraveller Jul 2012 #72

more pissed when they find out what they actually GET for it Skittles Jul 2012 #101

From the title, I thought you were blaming the ACA for job loss, but... freshwest Jun 2012 #7

I fully agree the media has created massive confusion about this by flamingdem Jun 2012 #9

It's been a load off my soul to know that so many others will get help now. freshwest Jul 2012 #73

My guess is the catch is going to be the healthcare we can receive. I pay 500 a robinlynne Jun 2012 #10

This is still a free market system Motown_Johnny Jun 2012 #15

Let me fix that sentence for you: Schema Thing Jun 2012 #19

Insurance companies don't 'provide healthcare'. n/t PoliticAverse Jun 2012 #29

great point. robinlynne Jun 2012 #33

Talk about life being better with FACTS lol. Why do people insist on mingling those two terms? cherokeeprogressive Jul 2012 #64

No they will not. they are going to raise current rates 9.9% this year and robinlynne Jun 2012 #30

"Probably at that price, you will only get to see interns, student doctors. " dionysus Jun 2012 #20

I ahve been shipping for ehalth insuracne for my Mom, 78 yeras old. Experienced doctors will robinlynne Jun 2012 #32

that is how it is right now. Unless you have insurance through an employer, or an HMO. robinlynne Jun 2012 #34

The insurance could go to any provider, except for closed systems like Kaiser. pnwmom Jun 2012 #35

and you think the insurance company is going to give great health care for less profit? good luck. robinlynne Jul 2012 #50

Insurance companies don't give care; doctors do. pnwmom Jul 2012 #54

Yes, from a cost standpoint, but not from a likelyhood one. Ruby the Liberal Jul 2012 #59

Again, health insurers don't have to make a profit. The best tend to be non-profit. pnwmom Jul 2012 #70

I have Kaiser, aged 57, $418 a month, have no problem seeing my doctor. Ikonoklast Jul 2012 #61

same boat different story The Jungle 1 Jun 2012 #36

Congrats! I love hearing stories like yours! n-t Logical Jun 2012 #38

I just checked and I will be able to retire before i am eligible for Medicare likesmountains 52 Jun 2012 #40

Great news! Congrats! Logical Jun 2012 #41

This is quite a heartwarming thread. Being able to retire with a good conscious... joshcryer Jun 2012 #44

You are lucky you live in a state that will have exchanges. TX won't, I think (where I am). Honeycombe8 Jun 2012 #47

Wait, woah. 15% copay? My heart, my failing heart. Zalatix Jun 2012 #48

There will be an annual maximum out-of-pocket. Roselma Jul 2012 #55

So what is the maximum out-of-pocket? Hasn't the bill been written and passed already? cherokeeprogressive Jul 2012 #66

Annual max out of pocket is tiered. One way to Roselma Jul 2012 #80

According to the OP the maximum out of pocket is 15% of total cost. former9thward Jul 2012 #74

It will help a lot of people when we can finally break this employer-provided custom treestar Jul 2012 #56

The catch... RAlgarJr Jul 2012 #60

Medicare seems to work... cyberswede Jul 2012 #62

Here's two: SCHIP and NFIP. n/t Chan790 Jul 2012 #63

Sort of true..... physioex Jul 2012 #65

Seems to me that Social Security is a real success. NRaleighLiberal Jul 2012 #67

Dude... you stepped in it now. And on your first post even. cherokeeprogressive Jul 2012 #69

As a recipient of both Soc Sec and Medicare, I'd say "the catch" is they both work really well... pinto Jul 2012 #71

Enjoy your PPR.... NYC_SKP Jul 2012 #79

The difference for me would be $4000 under ACA in 2014 vs $16,800 today. Kablooie Jul 2012 #68

I used this tool for my situation... rbnyc Jul 2012 #75

Check out also the Patient Protection part of the Patient Protection & Affordable Care Act too patrice Jul 2012 #76

If You Can Afford An iPhone or iPad or Netflix or Video Game Consoles.... Yavin4 Jul 2012 #97

How much extra in taxes would you have to pay in a country with single payer?? cbdo2007 Jul 2012 #120

Precisely. Most Nations with Single Payer Have National Sales Taxes Yavin4 Jul 2012 #122