Personal Impact of the ACA for VJ Users

[Boiler 46,188]

It does, exactly my point.

It does, exactly my point.

It does, exactly my point.

[Harpa Timsah 13,258]

Monthly cost going up nearly 100% and deductible increasing. I am pretty upset. Employer is offering a new high deductible crappy plan which is only like 20% more than the old because the plans are changing so much, but I don't think we should do that.

Company cites "rising costs, increased MRIs, and new healthcare fees" as the reasons for the increase.

I even feel some anger that the poor can have babies for free and I am prevented from having a baby because I feel like I can never afford it and I don't qualify for aid. I could afford $2k for delivery, sure, but not $6k.

[Boiler 46,188]

I am not that familiar with Employer provided cover, but looking at Medicaid/Exchanges it could just be a question of timing

The parameters are horribly complicated and vary so much between individual.

But let us say you are Exchange subsidy area, with a child your income would be quite possibly going down so you might qualify for enhanced Medicaid, Even if you do not and you normally would be carrying Bronze cover but need Platinum cover for the latter stages, seems to me that you could see a lot of pregnancies commencing mid summer.

[agrabs 246]

All of the plans being discontinued by blue care KC have at least one factor that is not longer allowed under the ACA. Looking at the plans, they have things like exclusion periods on preexisting conditions, maximum lifetime limits, and specific limits on certain coverages (ie. maximum daily room allowance for hospital admission, maximum coverage for ambulance transport).

No matter how good the rest of the coverage is, plans with any one of those factors are no longer available. Those are the issues that make them substandard. You guys would have found that out eventually when you needed the coverage for something more than preventative care.

Actually, I just looked through the plan details to make sure I was correct before I stated this again. It offers the same coverage with the same deductable as my Humana plan offered by my employer - except my Humana plan has maternaty coverage( which I am unable to decline even though I will never use it and resent I have to pay for it) It has no daily limits on hospitalization unless you are using a non-provider located in a service area where there is a participating provider located. The difference is and what makes it NON- ACA compliant is that it clearly states " Applications are subject to medical underwriting where rates are based on age, gender, and health conditions".

So, my point is, the assumption here is that the rate was so affordable because it was a substandard plan - no - the rate was affordable because we are young and healthy and can live with a $5000.00 deductable. - I understand why it is non-compliant - but it is an example of who is NOT going to benefit from the changes - those of us who are healthy and take care of ourselves and who are not a drain on the system. we didn't purchase the insurance for preventative care, we purchased it for the unexpected and yes - it does provide that, and so will the new plan - only we will no longer be getting a discount for being healthy. Don't interpret that to mean something it doesn't. EVERYONE deserves access to affordable health care.

What most people don't seem to understand is preventive care isn't why they get insured! Insurance is to protect you from what you're not expecting. You can save and plan for the things you expect. But for the things you don't expect? That's why you pay your premium!

So when people tell me they pay money to an insurance company every month and the policy doesn't cover hospitalization, it boggles my mind. Why would you pay for such a thing

[Dakine10 5,452]

Actually, I just looked through the plan details to make sure I was correct before I stated this again. It offers the same coverage with the same deductable as my Humana plan offered by my employer - except my Humana plan has maternaty coverage( which I am unable to decline even though I will never use it and resent I have to pay for it) It has no daily limits on hospitalization unless you are using a non-provider located in a service area where there is a participating provider located. The difference is and what makes it NON- ACA compliant is that it clearly states " Applications are subject to medical underwriting where rates are based on age, gender, and health conditions".

So, my point is, the assumption here is that the rate was so affordable because it was a substandard plan - no - the rate was affordable because we are young and healthy and can live with a $5000.00 deductable. - I understand why it is non-compliant - but it is an example of who is NOT going to benefit from the changes - those of us who are healthy and take care of ourselves and who are not a drain on the system. we didn't purchase the insurance for preventative care, we purchased it for the unexpected and yes - it does provide that, and so will the new plan - only we will no longer be getting a discount for being healthy. Don't interpret that to mean something it doesn't. EVERYONE deserves access to affordable health care.

All l of the plans are substandard for (as I said previously) at least one of the reasons I listed. The examples I gave weren't specific to your plan, although I have looked at the Bluecare KC plans. They do have lifetime maximum benefits, the prexisting condition exclusion period, and there are individual limits (for example the ambulance reimbursement).

You can't just say it has the same coverage as your plan because it has the same deductable and co-insurance when it limits those other things. That's what substandard means. It's the same thing as non ACA compliant. Yes they are cheap and give you a discount for being young. They accomplish that by not covering things and/or limiting things. They can't give you a plan that actually covers everything for the same price.

[Mr. Big Dog 10,747]

... it is an example of who is NOT going to benefit from the changes - those of us who are healthy and take care of ourselves and who are not a drain on the system. we didn't purchase the insurance for preventative care, we purchased it for the unexpected and yes - it does provide that, and so will the new plan - only we will no longer be getting a discount for being healthy. Don't interpret that to mean something it doesn't. EVERYONE deserves access to affordable health care.

Even the young and healthy benefit - in the long run once they're no longer young or healthy or neither. You seem to think that only those that don't take care of themselves get sick, that those that have serious ailments are themselves responsible for that. That's not necessarily so. There are scores of people that have lived healthy lifestyles but still came down with cancer or other serious conditions and then there are those that live very unhealthy lifestyles and they're doing great. Yes, a healthy lifestyle certainly improves your odds of staying healthy but it ain't no guarantee.

[agrabs 246]

Even the young and healthy benefit - in the long run once they're no longer young or healthy or neither. You seem to think that only those that don't take care of themselves get sick, that those that have serious ailments are themselves responsible for that. That's not necessarily so. There are scores of people that have lived healthy lifestyles but still came down with cancer or other serious conditions and then there are those that live very unhealthy lifestyles and they're doing great. Yes, a healthy lifestyle certainly improves your odds of staying healthy but it ain't no guarantee.

Hmmm.... nowhere did I say that only those who don't take care of themselves get sick and never did I say that those that have serious ailments are responsible themselves for that....wow!

[Mr. Big Dog 10,747]

Hmmm.... nowhere did I say that only those who don't take care of themselves get sick and never did I say that those that have serious ailments are responsible themselves for that....wow!

So what exactly does this mean?

"...those of us who are healthy and take care of ourselves and who are not a drain on the system. ... we will no longer be getting a discount for being healthy."

Or asked differently, why do you think one should be getting a discount for being healthy? You appear to agree that that discount isn't earned but granted because you just happen to be young and healthy and is granted only as long as you are young and healthy.

[Boiler 46,188]

It is supposed to be Insurance, the premium you pay is dependent on your risk profile.

Under Obamacare the older you are the more you pay, you could have a very healthy 60 year old and a very sick 20 year old. The 60 year old pays a much much higher premium.

[Mr. Big Dog 10,747]

It is supposed to be Insurance, the premium you pay is dependent on your risk profile.

Yes, at the group level. Because adding insult to injury is what the private health insurance market has done to those Americans that became sick for decades. They were priced out of the health insurance market or outright denied coverage that they needed when they needed it. That's how we left tens of thousands of our fellow Americans for dead each and every year. Is that really a model worth preserving?

[Protocol417 161]

I received a letter from my insurance provider United HealthCare. They are replacing my plan, more information pending.

So no idea how I'm being affected right now.

The thing that really p*sses me off about this is that these insurance companies have had 3+ years to get all this information sorted and out to their customers, yet they're all waiting until the 11th hour to do so, leaving us very little time to explore new or alternative options if we end up needing or wanting to.

[mota bhai 2,675]

I received a letter from my insurance provider United HealthCare. They are replacing my plan, more information pending.

So no idea how I'm being affected right now.

The thing that really p*sses me off about this is that these insurance companies have had 3+ years to get all this information sorted and out to their customers, yet they're all waiting until the 11th hour to do so, leaving us very little time to explore new or alternative options if we end up needing or wanting to.

Insurers know the best way to retain you.

[Harpa Timsah 13,258]

I received a letter from my insurance provider United HealthCare. They are replacing my plan, more information pending.

So no idea how I'm being affected right now.

The thing that really p*sses me off about this is that these insurance companies have had 3+ years to get all this information sorted and out to their customers, yet they're all waiting until the 11th hour to do so, leaving us very little time to explore new or alternative options if we end up needing or wanting to.

I have United and my plan is going up nearly 100%.

I really thought nothing would change, because I hadn't heard anything, and last year or so there was a note sent out that the plan was already compliant so they would not give us a refund (I think some plans that became illegal had to do a one-time reimbursement or something). So I was just relaxing until this letter came. I am still very upset about it.

[Teddy B 17,252]

I have United and my plan is going up nearly 100%.

I really thought nothing would change, because I hadn't heard anything, and last year or so there was a note sent out that the plan was already compliant so they would not give us a refund (I think some plans that became illegal had to do a one-time reimbursement or something). So I was just relaxing until this letter came. I am still very upset about it.

100% is a hard pill to swallow. Have they given you the reasoning behind the increase?

How much are you paying before the increase?

Edited November 13, 2013 by Teddy B

[Harpa Timsah 13,258]

100% is a hard pill to swallow. Have they given you the reasoning behind the increase?

They say rising cost of healthcare, increased MRIs, and new healthcare fees. I am also pissed because we have not used our insurance hardly at all, so I feel like I paid into the system for a while without using it and now I am being screwed over.

We are paying $302/month. The plan for a single person is about $100, so I thought adding $200 for just a spouse was high already. Now the plan will be $570.

I hesitate to say the amount because if someone comes and says it was cheap then I will be mad. We have a lot of expenses with a high cost of living, student loans, international family, etc. I feel like we live modestly. We don't have a car, or cable, and we have a pay-as-you-go cell phone.

Edited November 13, 2013 by Harpa Timsah