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Health insurance, Medicaid and permanent residents?

Health insurance, Medicaid and permanent residents?

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Old Mar 25th 2014, 2:57 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
I tried to find an article online I read in yesterdays Denver Post. DP is a Obama friendly source.

It was examining the actual costs people were finding for their plans, particularly with regards to drug costs. seems many drugs have been shall we say re allocated.

One of the things they mentioned was the co pays, the amount you pay once you have maxed out your deductibles etc. So that $12,170 is not a max cost.
Some basic arithmetic on Michael's post would tell you it is.

Originally Posted by Boiler
ACA premium comparison with a Mobile or TV package, $1,000 a month, who pays that.
Who makes that comparison? Given that 16% of GDP is spent on healthcare it can't possibly, on average, be true.

Some info on how out of pocket maximums are calculated:

http://healthinsurance.about.com/od/...imum-Works.htm

Last edited by Giantaxe; Mar 25th 2014 at 3:04 am.
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Old Mar 25th 2014, 3:07 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Giantaxe
Some basic arithmetic on Michael's post would tell you it is.
just pointed out that it was not a max as implied.

Who makes that comparison? Given that 16% of GDP is spent on healthcare it can't possibly, on average, be true.
Obama

http://dailycaller.com/2014/03/12/ob...ellphone-bill/
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Old Mar 25th 2014, 3:11 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
just pointed out that it was not a max as implied.
Yes it is. Read the explanation I provided.

Originally Posted by Boiler
The premium cost for young Americans after subsidies probably is about the same. Odd the the article you link doesn't mention subsidies. Oh wait, it's the Daily Caller.

Last edited by Giantaxe; Mar 25th 2014 at 3:15 am.
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Old Mar 25th 2014, 3:14 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Giantaxe
Yes it is. Read the explanation I provided.



The premium cost for young Americans after subsidies probably is about the same. Odd the the article you link doesn't mention subsidies. Oh wat, it's the Daily Caller.
They compared the most expensive cell plans they could find with the cheapest Obamacare cover.

And there was still a minimum 70% difference.

My 3G plan costs $25 a month. 4G would be $40.

So you are saying that once you have maxed out your Deductible that is it?
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Old Mar 25th 2014, 3:19 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
They compared the most expensive cell plans they could find with the cheapest Obamacare cover.

And there was still a minimum 70% difference.

My 3G plan costs $25 a month. 4G would be $40.
Even the Daily Caller acknowledges that the average cell phone bill is around $80. And, as I pointed out, absent factoring in premium subsidies the Daily Caller's "comparison" is pointless.

Originally Posted by Boiler
So you are saying that once you have maxed out your Deductible that is it?
Read the link I provided as to how out of pocket maximums work. Then go back to Michael's post and do the arithmetic. You'll then see that the figure he quotes - $12,170 - is the yearly out of pocket maximum. Here's a clue for you - use this info from Michael's post:

Checking Covered California ACA for a Bronze PPO Plan with Anthem Blue Cross, the cost for someone 57 is $485 per month with a $5,000 deductible and $6,350 maximum out of pocket expenses for a maximum annual cost of $12,170 including premiums. So it would have been a no brainer if Blue Cross would have offered me that policy 13 years ago.

Last edited by Giantaxe; Mar 25th 2014 at 3:36 am.
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Old Mar 25th 2014, 3:43 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by penguinbar
That's terrible what happened to you but I think part of the problem with Obamacare is that it can really vary not only state to state but county to county. You could be the same age and have the same conditions as I have but if you love in California and I live in New York we would be offered totally different plans. I still hate to pay nearly $800 a month. My husband hopes to change jobs partially because the next step up would be his bosses position which won't happen anytime too soon and the other is that his insurance options with his company. I think everyone has to do what's right for them. I also have a feeling that like everything else the Obamacare premiums will continue to increase as well.
I remember before 9/11 I worked for a restaurant that offered a great insurance plan The owner owned three restaurants so we were under a group plan. I was paying $128 for a great low deductible Blue Cross plan. A few months after 9/11 when the renewal came up it went to $266 because New York was a dangerous place to live. I couldn't believe that it more than doubled.I wish they could just come up with a happy medium.
Even though my lab tests were normal and there wasn't any indication of any serious problem, I suspect Blue Cross/Blue Shield didn't want to take the risk (risk analysis) just in case I had a serious problem. Five years after the fatigue started, it disappeared.

There seems to be more horror stories than good stories. Brat1's policy was cancelled when she got sick even though she told them about a previous pre-existing condition that appeared to have been cured. The insurance company claimed that her current illness was caused by her old illness and cancelled her policy. Fortunately Brat1 was trying to save money by purchasing open market insurance instead of being on her husbands employer provided insurance policy so due to the cancellation, she was immediately eligible for the employer provided insurance.

California where I live and Connecticut where Brat1 lives had some of the toughest pre-ACA health insurance regulations in the US so I can only imagine what insurance companies could do prior to ACA in some of the red states. The "right" wants to sell insurance across state lines to reduce costs but wants the regulations of the state where the companies are headquartered to govern regulations for all states. Probably premiums would drop for probably better coverage but that won't do any good if there are so many loopholes in the policies that policy holders can be cancelled or co-pays and deductibles can rise for any reason that the insurance company desires.

For most people, the US health care system appeared to work very well but it is only when someone got caught up with a bad situation with an insurance company do they realize that it may only work very well when they are relatively healthy.

Personally I'm not a great fan of ACA since it could have been done better but for many people, it is a lifesaver.
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Old Mar 25th 2014, 3:50 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Giantaxe
Even the Daily Caller acknowledges that the average cell phone bill is around $80. And, as I pointed out, absent factoring in premium subsidies the Daily Caller's "comparison" is pointless.



Read the link I provided as to how out of pocket maximums work. Then go back to Michael's post and do the arithmetic. You'll then see that the figure he quotes - $12,170 - is the yearly out of pocket maximum. Here's a clue for you - use this info from Michael's post:
He doesn't like anything about ACA since he pays a few dollars per month for a plan that doesn't cover 100%. For him, it's only good if he gets a Platinum plan for a few dollars a month.
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Old Mar 25th 2014, 3:54 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Giantaxe
Even the Daily Caller acknowledges that the average cell phone bill is around $80. And, as I pointed out, absent factoring in premium subsidies the Daily Caller's "comparison" is pointless.



Read the link I provided as to how out of pocket maximums work. Then go back to Michael's post and do the arithmetic. You'll then see that the figure he quotes - $12,170 - is the yearly out of pocket maximum. Here's a clue for you - use this info from Michael's post:
You are confusing maximum out of pocket with maximum annual cost.

Out of pocket does not include everything.
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Old Mar 25th 2014, 4:05 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Michael
He doesn't like anything about ACA since he pays a few dollars per month for a plan that doesn't cover 100%. For him, it's only good if he gets a Platinum plan for a few dollars a month.
From a selfish bastard perspective I do OK out of it.

If I had Platinum for 'free'. I would still think the scheme itself is illogical, unfortunately I can add up.

There was an article in the local rag about the Ambulance service. They receive 70% of their income from Property Taxes. Before my time but I have been told by many many people that the understanding was that Property taxes would pay for locals and everybody else would be charged.

Somehow that got lost and everybody gets charged. Now Property taxes have gone down and they are bitching about not having enough funding. They want increased property tax which of course is not going to happen.

They charge apparently $80 a mile... (with the property tax subsidy)
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Old Mar 25th 2014, 4:05 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
You are confusing maximum out of pocket with maximum annual cost.

Out of pocket does not include everything.
$485 premium * 12 months + $6,3250 maximum of pocket expense = $12,170 maximum annual cost. Drugs are not included in the plan I quoted except when prescribed when in the hospital. If you have to have the best specialist and go out of network, the costs could be more.

Last edited by Michael; Mar 25th 2014 at 4:11 am.
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Old Mar 25th 2014, 4:07 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
You are confusing maximum out of pocket with maximum annual cost.

Out of pocket does not include everything.
There is no confusion on my part. In Michael's example, the maximum you will pay (including premiums, deductibles and copayments ) in a year is $12,170. Your claim that "One of the things they mentioned was the co pays, the amount you pay once you have maxed out your deductibles etc. So that $12,170 is not a max cost." is false. Once again, do the math. I'ts not difficult.

Last edited by Giantaxe; Mar 25th 2014 at 4:36 am.
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Old Mar 25th 2014, 4:19 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Michael
He doesn't like anything about ACA since he pays a few dollars per month for a plan that doesn't cover 100%. For him, it's only good if he gets a Platinum plan for a few dollars a month.
I have to lol at the amount of inaccurate info he posts on the ACA - all of which makes the ACA seem worse than it is. Strange, that.
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Old Mar 25th 2014, 4:41 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
From a selfish bastard perspective I do OK out of it.

If I had Platinum for 'free'. I would still think the scheme itself is illogical, unfortunately I can add up.
You could always get a policy outside of an exchange so you wouldn't have to sully yourself with the ACA.
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Old Mar 25th 2014, 4:59 am
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Default Re: Health insurance, Medicaid and permanent residents?

Originally Posted by Boiler
From a selfish bastard perspective I do OK out of it.

If I had Platinum for 'free'. I would still think the scheme itself is illogical, unfortunately I can add up.
ACA could be better but since you usually side with people that democrats tried to please by putting all those "potholes" in the bill that the opponents wanted, don't complain if the opponents take it away from you. By continuing to support them, you may loose what you got from ACA but if you really want ACA to work correctly, you should look at it as if the glass if half full and see if it can be made completely full instead of trying to make it empty.

Because of constant opposition from the right, every health care program had to be done piecemeal (Medicare, Medicaid, VA, CHIPS, and ACA) instead of one program that covers all. Since the "right" doesn't like any of them and would like to destroy then all, none is perfect. Fixing them is not an option for the "right" since they are opposed to any form of government provided health care. Although many on the right believe in "no pay, no treatment", few have the courage to admit that to the public except Bachmann who thinks trading "chickens" for "health care" is a solution. It even took 9 years to pay for medical costs for 9/11 first responders due to opposition from the right and then they only agreed to pay for about 1/2 the estimated costs and certain illnesses weren't covered.

Last edited by Michael; Mar 25th 2014 at 5:58 am.
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Old Mar 25th 2014, 9:04 am
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Default Re: Health insurance, Medicaid and permanent residents?

Another thing that I think is good about ACA is that if you end up in the hospital and can't pay the deductible and co-pays because income is low, generally the hospital will just write it off. But if you don't have health insurance, the hospital will likely hound you to try to get at least a small percentage of the bill paid.

The reason I believe that is that my uncle had surgery to remove a clot and it caused a stroke and he was in a coma for about 6 months and then died. My aunt received bills for the deductible and co-pay (quite a large amount) but she just ignored them since she had little income and an old house. The hospital never again sent her a bill. I guess they figured that they got most of the bill paid so why hound someone who couldn't afford the rest.
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