Nazgul Girl
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Post by Nazgul Girl on Oct 14, 2013 20:00:50 GMT -5
Well, hell, I'm still trying to be verified to finish my application to see if I like any of the plans and/or rates in case I want to retire soon, and don't take COBRA. I tried 3x to do the online verification questions, and one was asking about a credit card which I've NEVER opened. That answer was "none of the above", and the system locked me out after three tries. Then, I was supposed to call an 800# for Experian, but the Healthcare.gov website never has given me a 17-digit reference# due to a "glitch", as it's being called by the customer service.
I have fille an app out over the phone, but nothing has arrived. I have talked to Experian 3x, I have called the customer service help line at least 20 times, and have uploaded a "document." Not much happening at this time. Tomorrow, I call my Congressman's office. I have been lied to, given bad information, put on hold for 20-30 minutes, been hung up on after waiting for 20 mins, etc. My Congressman, who I am not fond of, is a Tea Party man to the core, and I will give him my tale of woe and anger about the ineptly programmed and inept, under- trained customer service reps that I've had the misery of doing business with. I still have not seen any prices on any of the plans.
I am pro ACA ( Obamacare ), but I am displeased and in this case, I agree with my Congressman. What an effing mess.
On a good note, probably due to market forces ( unlike TSkeeter's experience ), my premium at work has dropped by $70 for my Blue Cross Community Blue PPO plan. It used to cost my employer and myself $ 658 per month for 2013 for my gold-level plan. Next year, the montly premium will be $ 570. I do not want to work forever, so I do need to find out what my nice Obamacare options are.
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Deleted
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Post by Deleted on Oct 14, 2013 20:04:25 GMT -5
I will simply say this: when they passed the legislation that allowed for 401ks, all of the corporations didn't exit pensions the next day. But over the next two decades, most of them managed to shed that obligation in favor of workers having to fund retirement themselves. Many of them did matching, but that has also disappeared because of the recession. Many of those companies who shed the matching have yet to reinstate it.
Companies will see this as a way to shed expensive insurance coverage. They have started by eliminating family coverage. They will shift more and more to individuals through High Deductible plans with some $$$ put into HSA plans. Eventually, "times will get tough" and they will quit depositing.
In 20 years few people will get employer paid health insurance. It will go the way of pensions.
I know it is too soon to say that absolutely, but don't be surprised.
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Nazgul Girl
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Post by Nazgul Girl on Oct 14, 2013 20:16:08 GMT -5
You could very well be right about that trend, Southernsusana. I wouldn't be surprised if that happened.
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tallguy
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Post by tallguy on Oct 14, 2013 20:56:55 GMT -5
It should happen. Employers should not be involved, and health care should not be tied to employment.
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Sum Dum Gai
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Post by Sum Dum Gai on Oct 15, 2013 1:26:10 GMT -5
In a way it would be nice if companies axed health insurance and offered a straight annual amount towards coverage. Would make it easier to compare compensation packages when selecting jobs. Right now you don't know what the insurance will cost until after you're hired and go through enrollment. Last time I switched companies I got a $7,200 a year raise and made slightly less money after paying health insurance.
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Formerly SK
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Post by Formerly SK on Oct 15, 2013 8:48:44 GMT -5
It should happen. Employers should not be involved, and health care should not be tied to employment. I don't understand why anyone would want health insurance tied to employment. They have nothing to do with each other, and since not everyone has a job (or a job that offers insurance) the concept doesn't make any sense. I think the ACA largely missed the point when it was designed in that it focused on insurance coverage rather than the outrageous cost of medical care. That said, getting people to be responsible for their own coverage (like auto or life or homeowners insurance) will drive down prices a bit just because people will shop around once the true financial impact hits them. It's a step in the right direction.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 8:53:04 GMT -5
It should happen. Employers should not be involved, and health care should not be tied to employment. I don't understand why anyone would want health insurance tied to employment. They have nothing to do with each other, and since not everyone has a job (or a job that offers insurance) the concept doesn't make any sense. I think the ACA largely missed the point when it was designed in that it focused on insurance coverage rather than the outrageous cost of medical care. That said, getting people to be responsible for their own coverage (like auto or life or homeowners insurance) will drive down prices a bit just because people will shop around once the true financial impact hits them. It's a step in the right direction. I think a shift toward HDHP's in general may accomplish this. I know that I consider more carefully my doctor visits and treatment options since moving to an HDHP, knowing that I will be footing much more of the bill than in the past. I certainly don't avoid the doctor, but I do consider whether I'm just on-the-fence about a symptom actually being a problem. Y'know what I mean? I don't know I'm helping drive down prices, but I'd like to hope so!
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Formerly SK
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Post by Formerly SK on Oct 15, 2013 10:00:18 GMT -5
I don't understand why anyone would want health insurance tied to employment. They have nothing to do with each other, and since not everyone has a job (or a job that offers insurance) the concept doesn't make any sense. I think the ACA largely missed the point when it was designed in that it focused on insurance coverage rather than the outrageous cost of medical care. That said, getting people to be responsible for their own coverage (like auto or life or homeowners insurance) will drive down prices a bit just because people will shop around once the true financial impact hits them. It's a step in the right direction. I think a shift toward HDHP's in general may accomplish this. I know that I consider more carefully my doctor visits and treatment options since moving to an HDHP, knowing that I will be footing much more of the bill than in the past. I certainly don't avoid the doctor, but I do consider whether I'm just on-the-fence about a symptom actually being a problem. Y'know what I mean? I don't know I'm helping drive down prices, but I'd like to hope so! I agree with this. I also think if we can get some govt reform requiring facilities to publish their rates for say, MRIs, people can then begin to price shop between facility A vs facility B.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 10:06:49 GMT -5
That would be awesome!
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Deleted
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Post by Deleted on Oct 15, 2013 11:24:12 GMT -5
It would be fine with me if health care wasn't tied to employment, but you don't really think employers are going to give us the $8000 a year mine costs them as a raise, do you? They are going to shed the cost along with the health care. We the tax payers will pick it up for the poor, and the middle class will be left to fend for themselves.
It will be gradual just as shedding responsibility for employees retirement was. Many people are 100% responsible for their retirement even with extremely low wages. We the taxpayers actually assume that responsibility.
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Post by The Walk of the Penguin Mich on Oct 15, 2013 12:01:43 GMT -5
I agree with this. I also think if we can get some govt reform requiring facilities to publish their rates for say, MRIs, people can then begin to price shop between facility A vs facility B.
I am going to come at this with my experience last year. When you have a life altering illness, you do NOT price shop. You search for the best that you can find, regardless of the cost, because the personal cost can be so much worse.
When I got sick, I got the hell out of dodge. I knew that if I had continued treatment where I was at, I would AT BEST wind up permanently disabled. At worse, dead. But the treatment was cheap.....9 days in the hospital only cost my insurance $25,000 vs $105,000 bill I received for the second 9 days. Granted, the second 9 days my treatment was a hell of a lot better.
Once you are in the system, being treated, you tend not to say 'no' to tests to determine whether your infection has stuck in your kidneys (no), heart (no), spine (no) or lungs (unfortunately, yes). You don't care if your antibiotic costs $700+/week for 26 weeks, all you know is that it is determined that this is the best one to handle your infection and you deal with the cost later.
I belong to some hip groups and have seen what a less than good surgeon can do. I'm not going to shop cost for a $20,000 hip replacement if there is a good chance I'll wind up disabled, I'm going to shop for the doctor that has the best results, regardless of cost.
I don't think that I am that different from any one of you. And I seriously doubt that if anyone is in a situation where their life is in the balance, they are going to shop for the cheapest MRI.
JMHO
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justme
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Post by justme on Oct 15, 2013 12:10:51 GMT -5
Nazgul Girl, have you tried looking outside the exchange? I have no idea whether the price is similar or not as I didn't bother filling out an application for the exchange. ehealthinsurance.com had info to a lot of plans offered in my state and most said whether they were bronze/gold/silver/platinum. I'm assuming the prices would be similar in the exchange, but not sure since I'm in one of the states that chose to have the feds run it all.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 12:21:16 GMT -5
While I agree with you, Mich, that we tend not to (or shouldn't) comparison-shop in life-altering situations, there are a lot of times when it would be very appropriate to do so if we had more info.
We already do this to some extent with prescriptions. I was prescribed a birth-control pill that began costing me $70 monthly on a HDHP, so I asked for a cheaper option so I would only be paying $10 monthly. I comparison-shopped solely because I could get the same benefit from a cheaper option. When the cost had been completely covered by insurance, I didn't care how much it cost.
Now, if that were heart medicine or brain medicine or something, that would be different and I probably wouldn't be comparison-shopping. But there are a lot of non-lifethreatening or routine things we COULD make more cost-effective decisions on if we had the ability.
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justme
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Post by justme on Oct 15, 2013 12:30:34 GMT -5
I'm with Mich. I've had some bad doctors, though thankfully my situation wasn't anywhere near as dire as hers, and don't give a rat's ass if they're cheaper. My foot is permanently screwed up and I have some bad scars from a surgery from incompetent doctors. I no longer wait to see if things get better and have seen several doctors only once because they were that bad. I'd possibly shop for things like labs for bloodwork or urgent care places, maybe MRI and that sort of thing too but those tests include the facilities lab determining the results.
HDHP helps to a point...mostly with those that don't have chronic health problems or a lot of small little things. I thought MORE about whether something deserved a trip to urgent care or a doctor when I was on a copay system. Now, I'm going to meet my OOP max every year regardless so it doesn't matter. I thought a lot more when it was $60 for urgent care vs $0 since I already met my OOP. I calculated it and the year I was on a traditional copay plan I spent a few thousand more including premiums than if I had selected the HDHP. The question is - how many will that situation be possible for? I don't know.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 12:38:00 GMT -5
I think the difference, justme, is that I consistently spend just about exactly what my high deductible is, so I don't often hit that magical point when the insurance starts picking up the majority of costs. Hence, for me, the HDHP is more of a cost issue and never (so far) have expenses become significantly free to me. Well... perhaps sometimes for about that 12th month, and yes I do think about what I can get done before it resets!
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justme
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Post by justme on Oct 15, 2013 12:48:35 GMT -5
Yeah, I know I'm not "normal" with my health issues. I've just always wondered what the percent is. And it makes a lot of difference what the deductible/OOP max is. Mine is quite low from what I hear about on here, but it'd also have to be decently high for me not to hit it. And I know some with other, worse, chronic conditions. Just wonder how many of the population would be something like that plus how many who could hit it as a fluke one year but then go do everything since it's the year they hit it. As long as it's the minority it shouldn't cause to big of a problem.
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tskeeter
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Post by tskeeter on Oct 15, 2013 12:49:35 GMT -5
skeeter, in the op did you mean that when you retire you will have income levels which will put you outside the subsidies level? Yup. I really didn't expect that we'd qualify for subsidies. But, hope springs eternal. I don't consider us rich. We both get up in the morning and go to work, just like we have for the last 35 years. I mow my own lawn. And I spent last weekend doing car repairs to try to save a few bucks and to nurse the car along to close to 200K miles. And we don't have a boat, quads, a cabin, or the like. I was just a bit surprised that the rates on the state insurance exchange were quite a bit higher than even COBRA rates, which have a reputation for being unaffordably expensive. I thought I'd been more than appropriately conservative in my projections. Turns out I was probably way too optimistic about the medical insurance rates we are likely to see in the future.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 12:51:52 GMT -5
Yeah, I know I'm not "normal" with my health issues. I've just always wondered what the percent is. And it makes a lot of difference what the deductible/OOP max is. Mine is quite low from what I hear about on here, but it'd also have to be decently high for me not to hit it. And I know some with other, worse, chronic conditions. Just wonder how many of the population would be something like that plus how many who could hit it as a fluke one year but then go do everything since it's the year they hit it. As long as it's the minority it shouldn't cause to big of a problem. FWIW, my HDHP has one of the lowest deductible amounts allowed, around $1500. But I'm still fairly healthy. Less healthy than I used to be, now that I'm 40, but certainly not a bad situation at all. If I lose this insurance, I would have to switch to an exchange-offered HDHP plan with a higher deductible, probably $3000, to make it work.
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justme
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Post by justme on Oct 15, 2013 12:58:53 GMT -5
My deductible/OOP max are both $1500. Hit that beginning Feb in 2012 and the beginning of Mar this year. That's a long time not to pay out of pocket for anything medical besides rx copays. Granted every time I went to urgent care it was something since I've become more attuned to when things are wrong due to my problems, but I also went a lot sooner than I would have if I hadn't hit it. Actually, even before I hit it I went because I was like well I'm going to hit it anyways.
I don't want to look at how much a similar plan will cost me on the exchange. Just from the numbers I've heard it will be a LOT more. I'm half dreading when this years open enrollment starts for work.
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Post by The Walk of the Penguin Mich on Oct 15, 2013 13:04:39 GMT -5
Yeah, I know I'm not "normal" with my health issues. I've just always wondered what the percent is. And it makes a lot of difference what the deductible/OOP max is. Mine is quite low from what I hear about on here, but it'd also have to be decently high for me not to hit it. And I know some with other, worse, chronic conditions. Just wonder how many of the population would be something like that plus how many who could hit it as a fluke one year but then go do everything since it's the year they hit it. As long as it's the minority it shouldn't cause to big of a problem.
Neither am I.....BUT.....
I met my OOP max for 2010 (hip replacement and gall bladder), 2011 (2 excisions, one revision) and 2012 (breast biopsy and last revision). I've not met it for 2013 and not likely to (other than I've maxed out my PT benefits). This fiscal year, I have had 4 doctor appointments (gyn, primary care, 2 orthopod) and other than the orthopod and PT benefits, which is where I normally am at.
My OOP max is $1500/4500 each year so I'm maxed out at $6000 between in/out of network. My orthopod is out of network and I will gladly pay his deductible each year.
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Post by The Walk of the Penguin Mich on Oct 15, 2013 13:09:22 GMT -5
I was just a bit surprised that the rates on the state insurance exchange were quite a bit higher than even COBRA rates, which have a reputation for being unaffordably expensive. I thought I'd been more than appropriately conservative in my projections. Turns out I was probably way too optimistic about the medical insurance rates we are likely to see in the future.
Why? They are allowed to take your age into consideration. COBRA benefit has an average of all employees, including those who are young and healthy. As you reach retirement, your costs increase and the health exchanges are allowed to adjust for this - just like if you put your age at 25, you'd probably get a premium in the health exchange way lower than COBRA.
I'm 54 and the local exchanges are just a little higher than my COBRA, which is what I expected.
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Angel!
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Post by Angel! on Oct 15, 2013 14:08:29 GMT -5
The point I was trying to make is that it shouldn't matter whether you are buying insurance through the exchange or not, for the same plan, the rates should be the same. Rocky Mtn Saver's comment seemed to me to imply that because I had access to insurance outside the exchange, I would be able to buy insurance for less than the rates quoted on the exchange. I can't see that happening. but - it's never been that way. I learned the hard way when I took a job without insurance. I took cobra for the 18 months while I figured out what to do, I was paying ~850 for the policy. When I called up to get a private policy at the end of the 18 month - the same policy, exactly the same - was only 250 month. I was stunned. Then I remembered all the old, overweight workers at the old job. If you get a private policy (pre ACA) they calculate your risk on gender, age, weight, smoker or not, etc. When you get a group policy, they calculate based on what that group cost the previous year. It has always been this way - it is not like buying a car. Yeah, I didn't realize when reading the OP that we were comparing employer plan rates to the exchange (Cobra should have been a giveaway on that, but my brain didn't register that at that time). This is basically comparing apples to oranges simply due to how the pricing is calculated. On the flip side a 30 year old that was looking to switch from your company to the exchange would likely find massive savings. This is because right now you both pay the same price and the 30 year old paying more to subsidize you for your age. In the exchange you have to pay for your age and pricing will be higher.
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workpublic
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Post by workpublic on Oct 15, 2013 15:37:18 GMT -5
just went on ehealthinsurance.com
there are no plans available for me in 2014. i'm in westchester ny so looks like i have to use the exchange
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tskeeter
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Post by tskeeter on Oct 15, 2013 15:43:21 GMT -5
but - it's never been that way. I learned the hard way when I took a job without insurance. I took cobra for the 18 months while I figured out what to do, I was paying ~850 for the policy. When I called up to get a private policy at the end of the 18 month - the same policy, exactly the same - was only 250 month. I was stunned. Then I remembered all the old, overweight workers at the old job. If you get a private policy (pre ACA) they calculate your risk on gender, age, weight, smoker or not, etc. When you get a group policy, they calculate based on what that group cost the previous year. It has always been this way - it is not like buying a car. Yeah, I didn't realize when reading the OP that we were comparing employer plan rates to the exchange (Cobra should have been a giveaway on that, but my brain didn't register that at that time). This is basically comparing apples to oranges simply due to how the pricing is calculated. On the flip side a 30 year old that was looking to switch from your company to the exchange would likely find massive savings. This is because right now you both pay the same price and the 30 year old paying more to subsidize you for your age. In the exchange you have to pay for your age and pricing will be higher. The above statements are correct, historically seniors consume about five times the medical care services than are consumed by the young. And insurance companies charged seniors accordingly. However, viewed in the context of people complaining about how unaffordable COBRA coverage has been (to cover all those old, fat employees coasting toward retirement), it was my hope that the ACA limits on premiums charged to seniors (capped at three times the rates charged younger citizens) would result in premium rates that were less than the premiums typcially available for COBRA coverage. Especially since COBRA rates would often include coverage for maternity care for young mothers and their children, fertility treatments for middle aged couples, family coverage for single income families, and a variety of other services that late middle aged males do not normally require. It simply was not to be.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 15:52:28 GMT -5
So, to recap. Older, less-healthy people are expensive to cover either through a group plan or individually. I'm shocked.
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justme
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Post by justme on Oct 15, 2013 15:58:21 GMT -5
The Affordable in the ACA is a misnomer. It wasn't designed to make insurance overall cheaper, or to necessarily be cheaper than employer plans. It's whole design is to bring individual health insurance into the same range of costs as employer health insurance because employer pooled costs over everyone while individual plans were priced on you and your health (and ultimately your cost).
I was looking around and found one similar to my current insurance for a bit less (probably because I'm 27). Though, question to those who may know. It says $1900 deductible, 0% coinsurance (pay nothing after deductible), but $6,350 OOP max. If I pay nothing after my deductible shouldn't OOP equal the deductible? The only thing I can see is it says that non-preferred brand prescriptions is 50% after deductible - so that's the only thing counting between $1900 and $6350?
ETA: For curiosities sake I looked up a few of my doctors, only one accepted that plan though.
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Formerly SK
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Post by Formerly SK on Oct 15, 2013 15:59:52 GMT -5
I agree with this. I also think if we can get some govt reform requiring facilities to publish their rates for say, MRIs, people can then begin to price shop between facility A vs facility B. I am going to come at this with my experience last year. When you have a life altering illness, you do NOT price shop. You search for the best that you can find, regardless of the cost, because the personal cost can be so much worse. When I got sick, I got the hell out of dodge. I knew that if I had continued treatment where I was at, I would AT BEST wind up permanently disabled. At worse, dead. But the treatment was cheap.....9 days in the hospital only cost my insurance $25,000 vs $105,000 bill I received for the second 9 days. Granted, the second 9 days my treatment was a hell of a lot better. Once you are in the system, being treated, you tend not to say 'no' to tests to determine whether your infection has stuck in your kidneys (no), heart (no), spine (no) or lungs (unfortunately, yes). You don't care if your antibiotic costs $700+/week for 26 weeks, all you know is that it is determined that this is the best one to handle your infection and you deal with the cost later. I belong to some hip groups and have seen what a less than good surgeon can do. I'm not going to shop cost for a $20,000 hip replacement if there is a good chance I'll wind up disabled, I'm going to shop for the doctor that has the best results, regardless of cost. I don't think that I am that different from any one of you. And I seriously doubt that if anyone is in a situation where their life is in the balance, they are going to shop for the cheapest MRI. JMHO I agree with you completely that there are times when you want the best regardless of cost. But I don't even think that is the case all of the time. I don't even think it is the case most of the time. MRIs are routine, so are xrays, CT scans, labs, surgeries for appendicitis or hernias, etc. DS (autism) has had a boatload of therapy that we've paid for out of pocket and believe me we factored price in considering who we took him to. DD has had nine sedated MRIs in the past few years at three different local hospitals. If I could figure out in advance which hospital was cheaper, I would totally go there as we've received excellent service at each one. Certainly pregnant people price compare delivery costs before choosing hospital vs birthing centers. Heck, people price compare plastic surgeons and Lasik. It doesn't mean you automatically go with the cheapest option, it just means you KNOW IN ADVANCE what a procedure will cost so you can make an informed decision.
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on Oct 15, 2013 16:05:12 GMT -5
I was looking around and found one similar to my current insurance for a bit less (probably because I'm 27). Though, question to those who may know. It says $1900 deductible, 0% coinsurance (pay nothing after deductible), but $6,350 OOP max. If I pay nothing after my deductible shouldn't OOP equal the deductible? The only thing I can see is it says that non-preferred brand prescriptions is 50% after deductible - so that's the only thing counting between $1900 and $6350? ETA: For curiosities sake I looked up a few of my doctors, only one accepted that plan though. Does the OOP include out-of-network providers' expenses?
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justme
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Post by justme on Oct 15, 2013 16:06:33 GMT -5
I was looking around and found one similar to my current insurance for a bit less (probably because I'm 27). Though, question to those who may know. It says $1900 deductible, 0% coinsurance (pay nothing after deductible), but $6,350 OOP max. If I pay nothing after my deductible shouldn't OOP equal the deductible? The only thing I can see is it says that non-preferred brand prescriptions is 50% after deductible - so that's the only thing counting between $1900 and $6350? ETA: For curiosities sake I looked up a few of my doctors, only one accepted that plan though. Does the OOP include out-of-network providers' expenses? There was a separate out-of-network deductible and OOP max. It specifically said in-network $6350 OOP max.
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tskeeter
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Post by tskeeter on Oct 15, 2013 16:56:03 GMT -5
The Affordable in the ACA is a misnomer. It wasn't designed to make insurance overall cheaper, or to necessarily be cheaper than employer plans. It's whole design is to bring individual health insurance into the same range of costs as employer health insurance because employer pooled costs over everyone while individual plans were priced on you and your health (and ultimately your cost). I was looking around and found one similar to my current insurance for a bit less (probably because I'm 27). Though, question to those who may know. It says $1900 deductible, 0% coinsurance (pay nothing after deductible), but $6,350 OOP max. If I pay nothing after my deductible shouldn't OOP equal the deductible? The only thing I can see is it says that non-preferred brand prescriptions is 50% after deductible - so that's the only thing counting between $1900 and $6350? ETA: For curiosities sake I looked up a few of my doctors, only one accepted that plan though. Justme, even after you have met your deductible, you will have to pay whatever co-pays your plan specifies. Such as the 50% co-pay on prescriptions or $25 per Dr. visit, etc. After you've spent $6,350, even the co-pay goes away. By the way, I agree that affordable is a bit of a misnomer. We like to interpret affordable as cheaper. Or, at least, hope that is true. But, for many, the affordable part of ACA doesn't translate into cheaper. Or even the same cost. By the time many peope get done subsidizing medical care for others, the ACA turns out to be more expensive. And it looks like I'm one of those for whom the ACA would be more expensive. Jiggers!
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