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Old 10-31-13, 05:49 PM   #51
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I think if we bottom line things it is clear that healthcare is the United States is frighteningly expensive, that a good part of this expense is driven by insurers and the medical establishment, and that the ACA legislation and implementation is a mess.

Many other countries do a much better job of providing healthcare at lower costs and see much better outcomes.
The US is 37th in outcomes on the WHO list and #1 in costs. We spend more on medical care than other countries spend on everything.
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Old 11-01-13, 04:58 AM   #52
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The US is 37th in outcomes on the WHO list and #1 in costs. We spend more on medical care than other countries spend on everything.
Another way to look at it, is that we subsidize the healthcare for the rest of the world to maintain the profitability of the healthcare industry.
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Old 11-01-13, 06:53 AM   #53
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I was asking about the disability because if she can get a doctor to say she is temp disabled but still able to work with medication she might be eligible for MAWD (medical for worker's with a disability), that's what it's called in PA. Where they pay a small premium a month. I would have her apply through the state welfare system first to see if she's eligible for any of those programs first.
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Old 11-01-13, 07:16 AM   #54
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Something else to take into consideration, that hasn't been mentioned yet. Since Texas declined to expand Medicaid she may not qualify for subsidies at all and will have to pay full price. Everyone between the medicaid level and the federal poverty level is out of luck.
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Old 11-01-13, 08:51 AM   #55
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ACA exposes people to the cost of retail market for healthcare insurance, many of whom have been dumb and happy in highly subsidized corporate plans for years and have no idea what's been going on in the bubble of the healthcare industry - or have been uninsured. As a self-employed family, our plan has been over $20K a year since forever; welcome to the reality of an industry gone wild. ACA won't change much, doctors expect to make at least $350K a year, good nurses makes $80K with union benefits, insurance brokers live in million dollar homes, the pharm and medical device industries are fat, fat, fat. It's like the real estate bubble at its height, x2, and no one on the inside wants it to change.

The best thing about ACA is more people will see what real costs of health insurance are.
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Old 11-01-13, 10:28 AM   #56
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So you are retiring before you are eligible for medicare? That is one thing that keeps me employed at the moment, knowing that I would lose medical coverage if I retired. The mortgage is another... but that is a different situation. I can sell and move into something smaller to take care of the housing situation, I don't know of a good solution to the medical needs.
Yes. I'm retiring from one job but I'll keep working. I don't have enough quarters for social security or Medicare.
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Old 11-07-13, 09:55 AM   #57
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On Oct 15th I tried to access healthcare.gov - to no avail. But, I had previously reviewed the supposed plans to be offered in WV through the exchange, and for a single person I would have had to pay $479 per month for a plan with a $5000 deductible. So, anyway, I googled "cheap health insurance", and some of those "e-insurance" things came up. Clicked on one, answered about 10 questions, and was called by a person about 10 minutes later. She took a bit more info, and transferred me to an insurance agent. The agent screened plans for my local hospitals, doctors, etc., and, given a monthly range of $300 - 500 that I gave him, came up with a plan for my husband (age 62 with COPD and excessively high triglyceride) - $432 per month buys him a plan with NO deductible, pays for all diagnostics & tests, 7 dr visits per year (and 50% of each visit thereafter), all ER care, has co-pays on drugs of $10 - $30 with a $300/month payout cap, includes a pretty good vision & dental plan. Because his conditions were diagnosed more than 12 months ago, there is no issue with "pre-existing" conditions - he's covered. The agent enrolled him in some sort of group plan., which is not expected to change on 1-2014, and locks his rate in until he turns 65.

So, why are health insurance companies which offer individuals the opportunity to join group plans NOT ADVERTISING this???

I'll post the insurance company's name/contact info later this evening - just in case anyone's interested.
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Old 11-07-13, 10:11 AM   #58
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On Oct 15th I tried to access healthcare.gov - to no avail. But, I had previously reviewed the supposed plans to be offered in WV through the exchange, and for a single person I would have had to pay $479 per month for a plan with a $5000 deductible. So, anyway, I googled "cheap health insurance", and some of those "e-insurance" things came up. Clicked on one, answered about 10 questions, and was called by a person about 10 minutes later. She took a bit more info, and transferred me to an insurance agent. The agent screened plans for my local hospitals, doctors, etc., and, given a monthly range of $300 - 500 that I gave him, came up with a plan for my husband (age 62 with COPD and excessively high triglyceride) - $432 per month buys him a plan with NO deductible, pays for all diagnostics & tests, 7 dr visits per year (and 50% of each visit thereafter), all ER care, has co-pays on drugs of $10 - $30 with a $300/month payout cap, includes a pretty good vision & dental plan. Because his conditions were diagnosed more than 12 months ago, there is no issue with "pre-existing" conditions - he's covered. The agent enrolled him in some sort of group plan., which is not expected to change on 1-2014, and locks his rate in until he turns 65.

So, why are health insurance companies which offer individuals the opportunity to join group plans NOT ADVERTISING this???

I'll post the insurance company's name/contact info later this evening - just in case anyone's interested.
Because we're all in for a nasty surprise next year.
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Old 11-08-13, 07:54 PM   #59
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The agent I spoke to was Colby at the George Steele agency, 817-763-9088.
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Old 11-20-13, 12:16 PM   #60
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*UPDATE* My wife sat down with my daughter yesterday to start to explore ACA alternatives. The first suggestion my wife made was that they make a trip to the local "navigator" to help her through the process. She was extremely hesitant to do this because she feels she knows NOTHING about the topic and that she would feel "stupid" (her anxiety/depression kicked in pretty hard here) once engaged with the navigator. So it was up to my incredibly patient wife to try to at least get her grounded on the topic. They spent more than an hour on the Healthcare.gov website, looking through the plans and working with the calculator.

They ultimately reached a point in the website where they couldn't continue ("Error - Please re-submit). Up until that point, they learned:
* The "silver" policy would cost her about $260/month (about 1/4 of her take home pay)
* She's eligible for a stipend to help defray the cost...but the stipend comes in the form of a tax credit when she files 2014 taxes

I'll update again as they continue to explore.
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Old 11-20-13, 12:20 PM   #61
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*UPDATE* My wife sat down with my daughter yesterday to start to explore ACA alternatives. The first suggestion my wife made was that they make a trip to the local "navigator" to help her through the process. She was extremely hesitant to do this because she feels she knows NOTHING about the topic and that she would feel "stupid" (her anxiety/depression kicked in pretty hard here) once engaged with the navigator. So it was up to my incredibly patient wife to try to at least get her grounded on the topic. They spent more than an hour on the Healthcare.gov website, looking through the plans and working with the calculator.

They ultimately reached a point in the website where they couldn't continue ("Error - Please re-submit). Up until that point, they learned:
* The "silver" policy would cost her about $260/month (about 1/4 of her take home pay)
* She's eligible for a stipend to help defray the cost...but the stipend comes in the form of a tax credit when she files 2014 taxes

I'll update again as they continue to explore.
I think a lot of people are going to be hurt by this "law"...that credit when they file their taxes is a year+ away, and in the meantime, they will be having to pay a large portion of their take home for insurance. Many simply can't afford the added monthly outflow, even if the annual total is less.
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Old 11-20-13, 12:43 PM   #62
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Per apclassic9's post above, I googled cheap healthcare texas and ended up clicking a link for ehealthinsurance (or something like that). After plugging in a few numbers, it told me that she'd be elegible for $181 monthly in subsidies. It then showed me the monthly plan prices minus the subsidy, which made everything look very affordable...until I reminded myself that her subsidy would show up a year later. The website is extremely easy to navigate and showed me a HUGE range of options, allowed me to look up participating doctors, etc.
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Old 11-21-13, 08:46 AM   #63
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Just to add a note for folks with expensive prescriptions that insurance might not completely cover, or do not have insurance - my insurance plan directed me to www.planetdrugdirect.com for WAY cheaper drug prices.
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Old 11-21-13, 08:59 AM   #64
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*UPDATE* My wife sat down with my daughter yesterday to start to explore ACA alternatives. The first suggestion my wife made was that they make a trip to the local "navigator" to help her through the process. She was extremely hesitant to do this because she feels she knows NOTHING about the topic and that she would feel "stupid" (her anxiety/depression kicked in pretty hard here) once engaged with the navigator. So it was up to my incredibly patient wife to try to at least get her grounded on the topic. They spent more than an hour on the Healthcare.gov website, looking through the plans and working with the calculator.

They ultimately reached a point in the website where they couldn't continue ("Error - Please re-submit). Up until that point, they learned:
* The "silver" policy would cost her about $260/month (about 1/4 of her take home pay)
* She's eligible for a stipend to help defray the cost...but the stipend comes in the form of a tax credit when she files 2014 taxes

I'll update again as they continue to explore.
My son signed up through the California exchange. Simple. He works for a decent comany but it turns out he can get a better plan for him for similar money on the exchange than the plan offered his employer with his required contribution. Nothing but whoop, whoops here.

Last edited by FrenchFit; 11-21-13 at 09:04 AM.
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Old 11-21-13, 09:05 AM   #65
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My son signed up through the California exchange. Simple. He works for a decent comany but it turns out he can get a better plan for him for similar money on the exchange than the plan offered his employer with his required contribution. Nothing but whoop, whoops here.
That's pretty awesome.
So he qualified for a cheaper plan even without subsidies?

I ended up going with my employer offered plan.I'm paying about 250 a month for family coverage, but I have a hefty deductible.
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Old 11-21-13, 09:14 AM   #66
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As he reports it, not cheaper but in the ballpark and a better plan for his needs. Best thing is he gets to use local services/doctors vs driving 20 miles to get care.

It's interesting to think about in the context of ACA being a free market catayst, unbalancer: If he tell his buddies to forget joining the employer plan, they can do better on the exchange, then these 20 somethings drop out of the employer plan which actuarially messes with the profit expectation for the insurance company offering the employer plan, which means that they raise premiums to the employer, and we can assume the employer is eventually going to pass those premium increases to employees. That causes more employees, and perhaps the more profitable insureds, to leave the employer plan and go retail. Downward spiral yo.


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Old 11-21-13, 10:26 AM   #67
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I deleted some recent posts that started to get political. Please take any political discussion to the healthcare threads in P&R. Thank you.
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Old 11-21-13, 10:39 AM   #68
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I deleted some recent posts that started to get political. Please take any political discussion to the healthcare threads in P&R. Thank you.
Obesity is a political issue?
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Old 11-21-13, 10:42 AM   #69
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Obesity is a political issue?
No, the comment about the Democrats that started the thread in that direction was.
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Old 11-21-13, 10:44 AM   #70
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No, the comment about the Democrats that started the thread in that direction was.
okay....I'll shut up about it and go back to mentally undressing your avatar.
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Old 11-21-13, 11:46 AM   #71
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Who is that in the avatar anyway? Is it someone famous, or is it a stock photograph showing too large of a frame for the rider?
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Old 11-21-13, 12:19 PM   #72
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I think its Barbara Eden.
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Old 11-21-13, 12:19 PM   #73
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The ACA is simple-
It is good for folks with preexisting conditions and on the lower end income wise.
Not good for somewhat affluent folks and young folks who are affluent and healthy.
The young healthy affluent will subsidize the less affluent and the less healthy.
Of course you could just let folks with preexisting conditions who are not affluent-die- or get so sick it becomes an emergency-then treat for "free"
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Old 11-21-13, 02:36 PM   #74
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I think its Barbara Eden.
Bingo!



Now back to the healthcare discussion...
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Old 11-23-13, 09:00 AM   #75
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The ACA is simple-
It is good for folks with preexisting conditions and on the lower end income wise.
Not good for somewhat affluent folks and young folks who are affluent and healthy.
The young healthy affluent will subsidize the less affluent and the less healthy.
Of course you could just let folks with preexisting conditions who are not affluent-die- or get so sick it becomes an emergency-then treat for "free"
I experienced that "talking point" about emergency rooms being tax payer subsidized healthcare first hand. My young daughter cut her finger badly on a Sunday, my emergency attendant pediatric group advised me to take her a local hospital. This hospital is in a very affluent neighborhood, but when you drove in there are a dozen people waiting for what we could consider routine medical - "I have the flu" type emergencies. These were all 20-40 year olds. Took us 3 hours to get out of there - and I think it was partly because we weren't as profitable business as there other "patients", my insurance would cap their payment for service rendered.

The current system is very broken. Time to shake things up.

I think that Barbara Eden picture would look sweet on the front page of healthcare.gov. Damn! Too bad it's only available in a 8x10 glossy, it would be a natural hanging over the fireplace.

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