obama care question

[sawyerloggingon]

So it looks like we will get obama care and I spent some time yesterday trying to figure out how it will work for me but came up empty, maybe somebody in here has some facts that will help. My income is fairly low as I am semi retired but I have approximately 750K in assets and own my home. Apparently I will be required to purchase full coverage insurance instead of the catastrophic I currently have. This will be very expensive but not to worry, the gov will help me pay the difference, or will they? Even though my income is low will I qualify for gov reimbursement with all my assets or will I be required to dip into my retirement fund to buy this very expensive gov approved insurance?

My next question is if I opt to pay the fine instead of buy insurance and end up in the hospital from a car wreck or sudden illness do I get on the phone and buy insurance with my "preexisting condition" and get immediate coverage or does it take so long I end up with a hospital bill that breaks me? Obama care is 3000 pages so these questions are surly addressed somewhere but I sure can't find the answerers.

 

[tessaesque]

Can't help you, but how's this for a cluster??

I get my birth control "free". (It isn't ACTUALLY free, since my premiums, deductible, and copays all went up well beyond the $15/month savings).

I got a letter from my insurance provider yesterday saying that the generic I receive (Gianvi, generic form of YAZ) is being moved to the Tier 3 level (full-cost, no coverage). YAZ, however, stays in Tier 2 (name brand, $35 copay). I called the company to ask them how the move would affect the price, since they have it currently set at $0. The lady couldn't tell me. Had NO IDEA how the move would affect my prescription copay, and also had no idea why the generic form of YAZ was now being classified as "Premium" medication.

Not that it will matter too much longer....My company's running the numbers right now to determine if it would be cheaper to pay the fines than to supply us with insurance. The new program requirements coupled with our small size means our premiums are about to sky rocket. The company currently pays a fixed price, but wouldn't meet the contribution standards laid out by the bill.

Two years ago, individual insurance for just me would have been about $200/month for crappy deductibles and copays without maternity coverage (probably the biggest must have for me at this point in my life). Finding insurance that offered maternity coverage was near impossible....and assuming they add that coverage into new plans at the behest of the ACA law I'd imagine those premiums will jump even higher.

So I'm still questioning how this bill makes me better off. Or ANYBODY, really. 'Cause even seniors are going to get shafted, regardless of what they've been spoon fed.

 

[ttwtt78640]

So it looks like we will get obama care and I spent some time yesterday trying to figure out how it will work for me but came up empty, maybe somebody in here has some facts that will help. My income is fairly low as I am semi retired but I have approximately 750K in assets and own my home. Apparently I will be required to purchase full coverage insurance instead of the catastrophic I currently have. This will be very expensive but not to worry, the gov will help me pay the difference, or will they? Even though my income is low will I qualify for gov reimbursement with all my assets or will I be required to dip into my retirement fund to buy this very expensive gov approved insurance?

My next question is if I opt to pay the fine instead of buy insurance and end up in the hospital from a car wreck or sudden illness do I get on the phone and buy insurance with my "preexisting condition" and get immediate coverage or does it take so long I end up with a hospital bill that breaks me? Obama care is 3000 pages so these questions are surly addressed somewhere but I sure can't find the answerers.

As I understand the PPACA deal the fine (for an individual) is essentially the same % of income as the "maximum" premium requirement for an "exchange" plan. The bad news is that your non-PPACA catastrophic plan is now likely considered "uninsured" so that you are fined for having "substandard" insurance. If you make up to 133% of the "poverty" income (as I do) then you only have to pay 2% of your AGI as either an exchange policy premium or an "uninsured" fine. Welcome to the wonderful world of gov't "help" that is now controlling your medical care "options". Yes they did!

 

[MaggieD]

Can't help you, but how's this for a cluster??

I get my birth control "free". (It isn't ACTUALLY free, since my premiums, deductible, and copays all went up well beyond the $15/month savings).

I got a letter from my insurance provider yesterday saying that the generic I receive (Gianvi, generic form of YAZ) is being moved to the Tier 3 level (full-cost, no coverage). YAZ, however, stays in Tier 2 (name brand, $35 copay). I called the company to ask them how the move would affect the price, since they have it currently set at $0. The lady couldn't tell me. Had NO IDEA how the move would affect my prescription copay, and also had no idea why the generic form of YAZ was now being classified as "Premium" medication.

Not that it will matter too much longer....My company's running the numbers right now to determine if it would be cheaper to pay the fines than to supply us with insurance. The new program requirements coupled with our small size means our premiums are about to sky rocket. The company currently pays a fixed price, but wouldn't meet the contribution standards laid out by the bill.

Two years ago, individual insurance for just me would have been about $200/month for crappy deductibles and copays without maternity coverage (probably the biggest must have for me at this point in my life). Finding insurance that offered maternity coverage was near impossible....and assuming they add that coverage into new plans at the behest of the ACA law I'd imagine those premiums will jump even higher.

So I'm still questioning how this bill makes me better off. Or ANYBODY, really. 'Cause even seniors are going to get shafted, regardless of what they've been spoon fed.

The questions you raise, and those in the OP, show that nobody really KNOWS what's going to happen with Obamacare. What an absolutely dismal job the administration has done getting the word out. Perhaps, though, that was by design.

Just one comment: those seniors on Medicare will be unaffected, at least cost-wise.

 

[tessaesque]

The questions you raise, and those in the OP, show that nobody really KNOWS what's going to happen with Obamacare. What an absolutely dismal job the administration has done getting the word out. Perhaps, though, that was by design.

Just one comment: those seniors on Medicare will be unaffected, at least cost-wise.

I know several in the medical field who will discontinue service to medicare patients because they have not received increases in payouts in years, and will now be receiving a DECREASE because of the restructuring as relates to Obamacare, so yeah...they'll be affected. Maybe not in cost, but in accessibility.

My grandmother's doctor told her to start looking for a new PCP, because he'll be cutting Medicare provision in half in the next 6-8 months. She lives in a town of 6k in southern Oklahoma, essentially in the boonies.

 

[sawyerloggingon]

As I understand the PPACA deal the fine (for an individual) is essentially the same % of income as the "maximum" premium requirement for an "exchange" plan. The bad news is that your non-PPACA catastrophic plan is now likely considered "uninsured" so that you are fined for having "substandard" insurance. If you make up to 133% of the "poverty" income (as I do) then you only have to pay 2% of your AGI as either an exchange policy premium or an "uninsured" fine. Welcome to the wonderful world of gov't "help" that is now controlling your medical care "options". Yes they did!

I could be wrong but the way I understand it insurance comps won't even be able to offer catastrophic coverage after obama care kicks in.

 

[MaggieD]

I could be wrong but the way I understand it insurance comps won't even be able to offer catastrophic coverage after obama care kicks in.

You're correct:

For example, the law bans deductibles over $2,000 for single coverage. As a result, 14 percent of all workers — and 27 percent of those in small firms — will end up paying more for coverage after they’re forced into a government-approved plan.

Another Broken Obama Promise: The Healthcare Cost Monster Emerges - Forbes

 

[sawyerloggingon]

You're correct:



Another Broken Obama Promise: The Healthcare Cost Monster Emerges - Forbes

Thanks Maggie, I am really trying to educate myself on obama care because it is now going to happen and the more I find out the more I think I'm going to end up paying more than I do now. I truly thought Romney would win and this would go away but reality is reality and I need to make some plans and decisions on this issue, I hope I don't end up needing to go to some obama care attorney to find out my best options in this 3000 page mess. Maybe some lib in here that was rooting for this all along has done some research on the subject and can help me know where I stand in this brave new world.

 

[MaggieD]

Thanks Maggie, I am really trying to educate myself on obama care because it is now going to happen and the more I find out the more I think I'm going to end up paying more than I do now. I truly thought Romney would win and this would go away but reality is reality and I need to make some plans and decisions on this issue, I hope I don't end up needing to go to some obama care attorney to find out my best options in this 3000 page mess. My hope is some lib in here that was rooting for this all along has done some research on the subject and can help me know where I stand in this brave new world.

Well, honestly, I was for some form of universal healthcare. Not necessarily Obamacare, because we don't even know what the hell's in it.

Romney would have never been able to keep his promise to get it repealed. That was a pipe dream.

 

[ttwtt78640]

I could be wrong but the way I understand it insurance comps won't even be able to offer catastrophic coverage after obama care kicks in.

That seems to be true for those over 30 years of age. As you noted the PPACA is a huge and complicated mess made even worse by Obama's assertions that you may ALWAYS keep your current plan. It seems that the law is "evolving" as details are filled in. I can still find many catastrophic (high deductable) plans available here in TX but it is unclear if they will still be around after 2014.

http://www.kff.org/healthreform/upload/7908-02.pdf

http://www.ifebp.org/inforequest/0160537.pdf

With Obamacare, it's the economic costs that matter | WashingtonExaminer.com

 

[Diogenes]

The questions you raise, and those in the OP, show that nobody really KNOWS what's going to happen with Obamacare. What an absolutely dismal job the administration has done getting the word out. Perhaps, though, that was by design.

Just one comment: those seniors on Medicare will be unaffected, at least cost-wise.

The administration can't get the word out because they don't know what's in the plan. The big problem is that Congress punted, and left the regulations to implement the law up to HHS and sub-agencies. The devil is in the details, and the details haven't been written yet.

ObamaCare is one big cluster, and really needs to be scrapped entirely. Health care is a huge problem, and getting bigger as people live longer and our aging population grows. It was simply not possible to come up with a comprehensive acceptable solution conceived by one political party, behind closed doors, in consultation with who-knows-how-many private interest groups.

 

[Diogenes]

My grandmother's doctor told her to start looking for a new PCP, because he'll be cutting Medicare provision in half in the next 6-8 months. She lives in a town of 6k in southern Oklahoma, essentially in the boonies.

I sympathize with your grandmother because she is facing a real problem. My daughter is a doctor, and would like to get out. She has a lot of Medicaid patients and is fed up with the routine of 3 minutes with the patient, 17 minutes on the paperwork.

 

[sawyerloggingon]

Well this sucks. All day and not a single lib who supported obama and obama care can give me any information on the program. I would think if you supported this obama care thing so much you would be a fountain of facts and figures but apparently you guys don't have a freakin clue how this is going to work either.

 

[Monserrat]

Well this sucks. All day and not a single lib who supported obama and obama care can give me any information on the program. I would think if you supported this obama care thing so much you would be a fountain of facts and figures but apparently you guys don't have a freakin clue how this is going to work either.

They probably just looked into how it would affect them...

 

[specklebang]

That doesn't seem to be the case for this old guy. Medicare seems to be sharply increased.

Next year, my monthly fee (in addition to the $100 medicare deduction from my SS) will go from $0 to $69 - the cheapest one I could find. My co-pay goes from $35 to $50. My out-of-pocket goes from $0 to $6000.00.

Definitely has had an effect as far as I can tell. I'm not complaining, I'm thrilled to get any insurance at my age. However, prices seem to be very increased.

The questions you raise, and those in the OP, show that nobody really KNOWS what's going to happen with Obamacare. What an absolutely dismal job the administration has done getting the word out. Perhaps, though, that was by design.

Just one comment: those seniors on Medicare will be unaffected, at least cost-wise.

 

[MaggieD]

That doesn't seem to be the case for this old guy. Medicare seems to be sharply increased.

Next year, my monthly fee (in addition to the $100 medicare deduction from my SS) will go from $0 to $69 - the cheapest one I could find. My co-pay goes from $35 to $50. My out-of-pocket goes from $0 to $6000.00.

Definitely has had an effect as far as I can tell. I'm not complaining, I'm thrilled to get any insurance at my age. However, prices seem to be very increased.

I'd be interested where you got that information, Speckle. I Googled part of the quote and it didn't come up.

(Glad to see you on board!)

 

[Ikari]

So it looks like we will get obama care and I spent some time yesterday trying to figure out how it will work for me but came up empty, maybe somebody in here has some facts that will help. My income is fairly low as I am semi retired but I have approximately 750K in assets and own my home. Apparently I will be required to purchase full coverage insurance instead of the catastrophic I currently have. This will be very expensive but not to worry, the gov will help me pay the difference, or will they? Even though my income is low will I qualify for gov reimbursement with all my assets or will I be required to dip into my retirement fund to buy this very expensive gov approved insurance?

My next question is if I opt to pay the fine instead of buy insurance and end up in the hospital from a car wreck or sudden illness do I get on the phone and buy insurance with my "preexisting condition" and get immediate coverage or does it take so long I end up with a hospital bill that breaks me? Obama care is 3000 pages so these questions are surly addressed somewhere but I sure can't find the answerers.

Obamacare is nothing more than a giveaway to the insurance companies. And if you take the fine and become catastrophically ill, you just do what other people without insurance do now. Wait till you're just about dead, go to the emergency room, and use up a ton of money that could have otherwise been saved had they the insurance for regular doctor visits.

 

[specklebang]

This isn't something I read. It's exactly what is actually happening. I've been reviewing my options because my current insurer is closing shop on 12/31.

This affected a few of my friends as well so we'v all been doing R&D for weeks now. There are only 3 PPOs remaining, down from 8 last year. The cheapest is Aetna at $69 and the highest is Humana at $129 (monthly additional premium). All of them want $50 co-pays but Humana offers out-of-pocket limits of $3K instead of Aenta's $6K.

You can still get into HMOs for $0 but you get incredibly poor care. Long waits, no competent Doctors. Probably better off with Original Medicare but then you have no part D. Try to buy part D alone and they want $100 so the PPO at $69 is quite the bargain relatively speaking. They'll probably deny any expensive meds but thats nothing new. I've paid cash for meds for the last 2 years because they only let you have a 30 day supply one time basis on most of them. I take 2 uncovered meds and spend about $200 a month on them.

I'd be interested where you got that information, Speckle. I Googled part of the quote and it didn't come up.

(Glad to see you on board!)

 

[MaggieD]

This isn't something I read. It's exactly what is actually happening. I've been reviewing my options because my current insurer is closing shop on 12/31.

This affected a few of my friends as well so we'v all been doing R&D for weeks now. There are only 3 PPOs remaining, down from 8 last year. The cheapest is Aetna at $69 and the highest is Humana at $129 (monthly additional premium). All of them want $50 co-pays but Humana offers out-of-pocket limits of $3K instead of Aenta's $6K.

You can still get into HMOs for $0 but you get incredibly poor care. Long waits, no competent Doctors. Probably better off with Original Medicare but then you have no part D. Try to buy part D alone and they want $100 so the PPO at $69 is quite the bargain relatively speaking. They'll probably deny any expensive meds but thats nothing new. I've paid cash for meds for the last 2 years because they only let you have a 30 day supply one time basis on most of them. I take 2 uncovered meds and spend about $200 a month on them.

I see. My mom has a Blue Cross Blue Shield Medicare Supplement. Her out-of-pocket cost is zero -- for doctor visits/hospital stays/whatever. She's 85 years old, so her monthly is, I think, around $250 for that -- plus $39 for Part D. She pays $4 a refill for all her meds. She goes to Loyola University Medical Center doctors and their hospital in Maywood, IL. One of the best in the country. Hers isn't a PPO or HMO -- she goes to whatever doctor she wants without a referral. There's no doubt it's the Cadillac, but compared to what I pay for a $5,200 annual deductible? It's a steal. My insurance costs $670/month.

I do wonder if Obamacare is actually responsible for your current plight. Everything I've read says that Medicare is unaffected. Oh!!! Wait!!! Unless one has Medicare Advantage--I think those rules have changed. But I'm not sure it has anything to do with Obamacare legislation...?

I may know nothing here, but perhaps your friends/you should look into opting out of Medicare Advantage, if that's what you have? I understand many people are doing that.

 

[specklebang]

There are some pretty good supplement plans but because I had 2 surgeries in 2011 I can't get in them, although my health is pretty good. Even if I could, I would definitely be paying more than the curent $69 PPO fee and I don't know what I would get out of the deal. All doctors look alike to me so I just take my chances with whomever is in the PPO. I don't have to have a referral (unlike the HMO) and as long as I'm not going out of town for medical help, it really won't matter much. I could afford better insurance but my inner cheapskate cries out for bargains.

I have no idea about the Obamacare relationship. I do think Medicare pays less and less so fewer and fewer doctors will take it but heck, I only need one doctor at a time. I traveled so much when I was younger that I have no interest in traveling now so I'm in Las Vegas 99% of the time anyway.

It is inevitable that medical care will rise and we'll all be paying more, Obama or no Obama. Health care has always increased more than anything else so I assume that it's no big deal and we'll all adjust.

I see. My mom has a Blue Cross Blue Shield Medicare Supplement. Her out-of-pocket cost is zero -- for doctor visits/hospital stays/whatever. She's 85 years old, so her monthly is, I think, around $250 for that -- plus $39 for Part D. She pays $4 a refill for all her meds. She goes to Loyola University Medical Center doctors and their hospital in Maywood, IL. One of the best in the country. Hers isn't a PPO or HMO -- she goes to whatever doctor she wants without a referral. There's no doubt it's the Cadillac, but compared to what I pay for a $5,200 annual deductible? It's a steal. My insurance costs $670/month.

I do wonder if Obamacare is actually responsible for your current plight. Everything I've read says that Medicare is unaffected. Oh!!! Wait!!! Unless one has Medicare Advantage--I think those rules have changed. But I'm not sure it has anything to do with Obamacare legislation...?

I may know nothing here, but perhaps your friends/you should look into opting out of Medicare Advantage, if that's what you have? I understand many people are doing that.

 

[Deuce]

Well, honestly, I was for some form of universal healthcare. Not necessarily Obamacare, because we don't even know what the hell's in it.

Romney would have never been able to keep his promise to get it repealed. That was a pipe dream.

Well, it was written by the insurance industry so you should be able to ask them for information on it, right?

 

[sawyerloggingon]

They probably just looked into how it would affect them...

I am not looking for a fight here, just some info. I spent more time today trying to get some specifics on how this is going to work and there just aren't any. Every site says basically the same thing, you will be able to join group plans and your cost are projected to go down. There are absolutely no charts, graphs, or tables to let you figure out how it will effect you in your specific situation.They better figure out how this is going to work, a year from now we will be supposed to follow this new law and everyone seems confused on how it will be implemented.

 

[melons]

The questions you raise, and those in the OP, show that nobody really KNOWS what's going to happen with Obamacare. What an absolutely dismal job the administration has done getting the word out. Perhaps, though, that was by design.

Just one comment: those seniors on Medicare will be unaffected, at least cost-wise.

That isn't true for my Mom on medicare. She just got a letter yesterday stating that hers would increase almost 25 percent.

 

[azgreg]

Stop it!!! I'm 48 years old and you guys are scaring the **** out of me.

 

[Diogenes]

Stop it!!! I'm 48 years old and you guys are scaring the **** out of me.

Wait until you see the next chapter... :shock: