# [ACA] Premium Increase



## bogey21 (Nov 16, 2014)

Last year I bought a (el cheapo) Bronze Plan for my 43 year old Son.  It carries a $6,000 deductible which is fine with me at all I want is catastrophic coverage.  Premium is $157.84 without a subsidy.  The ACA website prices the exact same plan (same provider) for 2015 at $220.  If my math is correct, this is a 40%increase.

Before you ask, yes he is eligible for a subsidy.  Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford.

George


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## myoakley (Nov 16, 2014)

Thank heavens there are still a few people like you with integrity left!


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## cissy (Nov 16, 2014)

Ditto.


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## Roger830 (Nov 16, 2014)

The subsidy is a big part of the program that is necessary to make it successful, otherwise there wouldn't be enough members. 

With a half billion dollar deficit, 17 trillon total debt, the taxpayers will never pay for it.


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## Sugarcubesea (Nov 16, 2014)

bogey21 said:


> Last year I bought a (el cheapo) Bronze Plan for my 43 year old Son.  It carries a $6,000 deductible which is fine with me at all I want is catastrophic coverage.  Premium is $157.84 without a subsidy.  The ACA website prices the exact same plan (same provider) for 2015 at $220.  If my math is correct, this is a 40%increase.
> 
> Before you ask, yes he is eligible for a subsidy.  Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford.
> 
> George



My company will be charging me $950 a month for family coverage with a $10,000 deductible before our 80/20 kicks in…I can not afford to work at this company any longer and have started my job search… Our new benefit package came out on Friday for 2015 and we are seeing a 38% increase across the board yet the company only gave me a 2% raise (the bulk of the company got a 1% raise, so I guess I'm in the lucky group who received more)


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## ondeadlin (Nov 16, 2014)

bogey21 said:


> Before you ask, yes he is eligible for a subsidy.  Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford.



So I assume you've never taken the mortgage deduction, either?  After all, you've already paid the mortgage, so clearly you could afford it, so why would you ask your fellow taxpayers to pay for it?


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## ace2000 (Nov 16, 2014)

The rates are going up but you may have to shop around and switch to keep the increase to a minimum.



> Initial analyses showed that many current enrollees will be better off switching coverage to avoid a premium increase. The Obama administration is encouraging current participants in the exchange to window shop to avoid paying more every month.



http://thehill.com/policy/healthcare/224254-o-care-costs-to-rise-for-many


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## VacationForever (Nov 16, 2014)

Sugarcubesea said:


> My company will be charging me $950 a month for family coverage with a $10,000 deductible before our 80/20 kicks in…I can not afford to work at this company any longer and have started my job search… Our new benefit package came out on Friday for 2015 and we are seeing a 38% increase across the board yet the company only gave me a 2% raise (the bulk of the company got a 1% raise, so I guess I'm in the lucky group who received more)



Don't blame it on the company. ACA should have reformed carriers and the premium that they charge but it didn't.  Unless the business is in a high margin type of industry, it won't be able to keep absorbing the increases without closing shop.  ACA has put a huge burden on small and medium size businesses.  The so called subsidies are coming from the businesses.


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## Sugarcubesea (Nov 16, 2014)

sptung said:


> Don't blame it on the company. ACA should have reformed carriers and the premium that they charge but it didn't.  Unless the business is in a high margin type of industry, it won't be able to keep absorbing the increases without closing shop.  ACA has put a huge burden on small and medium size businesses.  The so called subsidies are coming from the businesses.



I agree, I do not blame the company at all, but this increase will not allow me to stay within my budget without cutting out many necessary expenses such as dental, eye care and home and car repairs. I will need to move to a larger company.

My deductible used to be $4K and then the 80/20 kicked in, but to have the deducible and the monthly premium go up so drastically, leaves me no choice but to move on. My company does not offer a pension, so there is really nothing keeping me there.


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## staceyeileen (Nov 16, 2014)

I have a marketplace plan for my 4yo son.  Believe it or not, it was cheaper to put him on his own marketplace plan than to add him onto either my husbands or my plan at work.  So our family of 3 has 3 different insurance plans!  Kind of crazy, but worked out to be the cheapest.  For anyone complaining about the pries of "family" plans at your work you may want to consider this.  We do not qualify for any subsidies.

Anyway, it's a platinum plan with a $750 deductible and very low co-pays, and we have been paying $157/mo.  It also included full dental coverage for him at 100%, which was a nice perk.  New plan has an $800 deductible and no dental coverage, and the rate is $172/mo.  Look like all other benefits are the same.  The rate increase is not bad, but I'm not happy about the loss of dental coverage because now we'll need to get a separate policy or add him onto mine at work.  I guess I'll be shopping.


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## bogey21 (Nov 16, 2014)

ondeadlin said:


> So I assume you've never taken the mortgage deduction, either?  After all, you've already paid the mortgage, so clearly you could afford it, so why would you ask your fellow taxpayers to pay for it?



Maybe you don't see the difference that I do.  To each his/her own.

George


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## DeniseM (Nov 16, 2014)

A gentle request - let's try to avoid the political angle and focus on the insurance itself.


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## mtm65 (Nov 16, 2014)

bogey21 said:


> Maybe you don't see the difference that I do.  To each his/her own.
> 
> George



Two very different programs with the home mortgage deduction designed as an incentive to home ownership.  Thanks for your choice George.


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## Ron98GT (Nov 16, 2014)

bogey21 said:


> Last year I bought a (el cheapo) Bronze Plan for my 43 year old Son.  It carries a $6,000 deductible which is fine with me at all I want is catastrophic coverage.  Premium is $157.84 without a subsidy.  The ACA website prices the exact same plan (same provider) for 2015 at $220.  If my math is correct, this is a 40%increase.
> 
> Before you ask, yes he is eligible for a subsidy.  Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford.
> 
> George


 Your paying for your 43 year old sons insurance policy, obviously due to lack of income.  

 Your son, not you, is entitled to a subsidy due to a lack of income.

 Your complaining about a premium increase, because you won't use the subsidy

  It's your son's policy, not yours, let "him" take the subsidy that he is entitled to


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## Ron98GT (Nov 16, 2014)

ondeadlin said:


> So I assume you've never taken the mortgage deduction, either?  After all, you've already paid the mortgage, so clearly you could afford it, so why would you ask your fellow taxpayers to pay for it?



If you want to help out your fellow taxpayers, what about:

Mortgage interest deduction 
Property tax deduction 
State sales tax deduction (for states without incomes taxes)
Charitable deductions
Business deductions 
etc..

As long as someone can afford it, I guess they shouldn't take any of the above deductions, to help out their fellow taxpayers.

If you shop on-line, make sure that you send Texas a check at the end of each year for all of the sales taxes that you didn't pay, but can afford.

And while we're at it, people shouldn't take Social Security either, as long as they can afford not to.  And oh yeah, don't forget skipping Medicare after retirement also.


It's not a matter of stupidity, it's being pig headed (facts confusing reality):

http://www.merriam-webster.com/dictionary/pigheaded


Based upon your post, I need to start paying more in taxes, NOT.


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## Ron98GT (Nov 16, 2014)

Ron98GT said:


> If you want to help out your fellow taxpayers, what about:
> 
> Mortgage interest deduction
> Property tax deduction
> ...




BTW, it's the Affordable Care Act (ACA) and maybe if your state (Texas) had it's own web-site/exchange you'd get better prices.


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## Timeshare Von (Nov 16, 2014)

My personal plan went up from $663 to $801 effective 1/1/15, about a 20% increase.  This is with a private, non-exchange type plan.


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## Beaglemom3 (Nov 16, 2014)

For the first time in my life, I have to buy my own healthcare insurance until Medicare eligible (2.5 years). My Ex paid my health insurance costs for the last three years until the Cobra status was exhausted, so here I am.

I am grateful that Massachusetts' Romneycare  (with its own website ) is (and has been) available for the past several years. Not perfect, but getting better with time.
 I have been going over all my options and although the premiums are high for the coverage and insurers that I want, it's still a bargain. So many options that analysis-paralysis has set in. ! 

I am not eligible for any subsidy and that's fine. I am more than happy to pay my premium withourt having to worry about a catastrophic event taking everything I own.

 When I had my meningioma and then a fractured leg, I never felt so blessed, in an odd way, knowing that I had good medical insurance and was covered. As I age, I am grateful to have it on my own going forward. 




0


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## Kal (Nov 16, 2014)

You should have seen what your premiums would have been pre-ACA.  In the pre Medicare age bracket (for an individual policy), the insurance companies were GOUGING with huge annual increases.


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## Beaglemom3 (Nov 16, 2014)

Kal said:


> You should have seen what your premiums would have been pre-ACA.  In the pre Medicare age bracket (for an individual policy), the insurance companies were GOUGING with huge annual increases.



Amen to that, so I heard others say. So glad that I was protected from that due to age, ex's coverage and Massachusetts' covering its citizens.

It could have been a lot worse for someone in another state and circumstance.



-


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## Ken555 (Nov 16, 2014)

I have the only PPO plan offered in Los Angeles via the ACA, and my premiums will be increasing about 10% in January. I'll look at other options, but I suspect it's still the best choice for me. It's still a much better plan than my previous company group plan, which was exorbitant for what we received.


Sent from my iPad


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## momeason (Nov 16, 2014)

Beaglemom3 said:


> For the first time in my life, I have to buy my own healthcare insurance until Medicare eligible (2.5 years). My Ex paid my health insurance costs for the last three years until the Cobra status was exhausted, so here I am.
> 
> I am grateful that Massachusetts' Romneycare  (with its own website ) is (and has been) available for the past several years. Not perfect, but getting better with time.
> I have been going over all my options and although the premiums are high for the coverage and insurers that I want, it's still a bargain. So many options that analysis-paralysis has set in. !
> ...



Can I hit a like button? Great sane response. I also am grateful that insurance is available to me and all my pre-existing conditions. It is expensive but necessary to get good care. We also do not qualify for a subsidy but I know that is because we have been blessed with a good income. I studied for over a month to choose the best alternative last year for me and my husband and then for my married daughter and her husband and then for my 30 yr old son, who would be on Medicaid if our state had Medicaid Expansion.


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## ondeadlin (Nov 16, 2014)

mtm65 said:


> Two very different programs with the home mortgage deduction designed as an incentive to home ownership.  Thanks for your choice George.



Actually, they're very similar.

Our government has made a policy decision that it wants to support home ownership, hence it subsidizes mortgages.

Our government has also made a policy decision that it wants to support full coverage for health insurance.  There's a good reason for that - when people aren't covered, they go to the ER, don't pay, and we all end up paying for their coverage in the form of higher prices for medical services.

So … yeah … same thing, really.


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## Ken555 (Nov 16, 2014)

ondeadlin said:


> Actually, they're very similar.
> 
> 
> 
> ...




Well said. 


Sent from my iPad


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## Beaglemom3 (Nov 16, 2014)

momeason said:


> Can I hit a like button? Great sane response. I also am grateful that insurance is available to me and all my pre-existing conditions. It is expensive but necessary to get good care. We also do not qualify for a subsidy but I know that is because we have been blessed with a good income. I studied for over a month to choose the best alternative last year for me and my husband and then for my married daughter and her husband and then for my 30 yr old son, who would be on Medicaid if our state had Medicaid Expansion.



Thank you. I knew there was something that I liked about you when we met at the Custom House. 

For the most part, back in the _dark ages_, you were toast with respect to pre-existing conditions. My heart used to ache for parents trying to cover their child who had a recurrent, life-threatening condition. Often times there would be neighborhood fund-raising benefit fairs, raffles, drawings or similar to raise money . Romneycare made a big difference here. 


B


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## Ron98GT (Nov 16, 2014)

Ken555 said:


> Well said.
> 
> 
> Sent from my iPad




Yeah, I agree.



Sent from my iPhone using Tapatalk


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## am1 (Nov 16, 2014)

I may not agree with bogey21 in what he is doing.  As I think everyone entitled to a subsidy, tax deduction etc should take it as that is what it is there for and using it shows support for it.  But if someone wants to spend their money how they see fit I have not issues with that as long as they do not come asking for more.  In this situation it seems like they will not.  But one should not be criticized for passing on one subsidy but possibly taking another (deduction, rebate).   

I do not even think he was complaining in his post.  Just stating the situation.  

Hopefully no one thinks this is the best solution to a serous problem.


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## Ken555 (Nov 16, 2014)

am1 said:


> [...]if someone wants to spend their money how they see fit I have not issues with that as long as they do not come asking for more.




I think the issue is whether or not to accept a qualified rate. If it were me, and I also had a philosophical or other concern about accepting  a discounted rate, I would likely take the difference and donate it to a charity of choice rather than a health insurance company. I would believe that to be better use of the money (and of course also permit another deduction...).


Sent from my iPad


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## Talent312 (Nov 16, 2014)

I work for a state government which subsidizes my health insurance as a fringe benefit.
The taxpayers foot the bill, so I have no issue with anyone else getting a subsidy, either.


Sent from my KFJWI using Tapatalk 2


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## bogey21 (Nov 16, 2014)

Ron98GT said:


> BTW, it's the Affordable Care Act (ACA) and maybe if your state (Texas) had it's own web-site/exchange you'd get better prices.



I live in Texas.  He lives in Illinois.  The insurance company is in Illinois and the policy is issued in Illinois.

George


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## am1 (Nov 16, 2014)

Ken555 said:


> I think the issue is whether or not to accept a qualified rate. If it were me, and I also had a philosophical or other concern about accepting  a discounted rate, I would likely take the difference and donate it to a charity of choice rather than a health insurance company. I would believe that to be better use of the money (and of course also permit another deduction...).
> 
> 
> Sent from my iPad



I would as well.  Then write off the donation but add that to the amount I donated.  But it is not my money.


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## Kal (Nov 16, 2014)

bogey21 said:


> I live in Texas. He lives in Illinois. The insurance company is in Illinois and the policy is issued in Illinois.
> 
> George



 Policy premiums are based on a number of criteria, most importantly the local cost of care where the policy holder resides and his/her age.

 The location of the place where the policy is printed is only affected by the cost of paper and ink.


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## VacationForever (Nov 16, 2014)

Ken555 said:


> I think the issue is whether or not to accept a qualified rate. If it were me, and I also had a philosophical or other concern about accepting  a discounted rate, I would likely take the difference and donate it to a charity of choice rather than a health insurance company. I would believe that to be better use of the money (and of course also permit another deduction...).
> 
> 
> Sent from my iPad



The health insurance company gets the full rate regardless of whether the insured takes a subsidy or not.  I wish more would do what OP did and I  applaud him for that.  In an earlier thread he had disclosed his son's situation.


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## easyrider (Nov 16, 2014)

There are many items the government subsidizes that really do not benefit most of the citizens. Healthcare is important and the subsidies are a way to provide everyone an equal opportunity to gain access to healthcare. People like incentives and the subsidies are incentives to purchase a healthcare plan. People do not like penalties and the tax consequence of not participating in the ACA is a tax penalty. 

I have always had to purchase individual policies for my family so the sticker shock isn't really a shock for us. In fact, we now have a better plan for about the same cost as pre-ACA. 

Bill


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## PStreet1 (Nov 17, 2014)

Just one note of caution:  you don't actually know how good/bad your plan is until you have to use it for a hospital stay.  The routine physicals/strep throat cultures/etc. at your doctor's office don't tell you anything.  Those things I'd assume could simply be paid for, easily, by anyone on this board.  A hospital stay is a totally different thing.  Unfortunately, I have them on a semi-routine basis, and whatever your insurance is, you won't know until you have to use it in a major way whether it is good/bad/indifferent.


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## Kal (Nov 17, 2014)

PStreet1 said:


> Just one note of caution: you don't actually know how good/bad your plan is until you have to use it for a hospital stay. The routine physicals/strep throat cultures/etc. at your doctor's office don't tell you anything. Those things I'd assume could simply be paid for, easily, by anyone on this board. A hospital stay is a totally different thing. Unfortunately, I have them on a semi-routine basis, and whatever your insurance is, you won't know until you have to use it in a major way whether it is good/bad/indifferent.



Given the current trends in diagnosis, I would include MRI into a common category of services.  The "retail" price is about $1,100.  A good measurement of insurance is to see what they will pay.  Of course take into account deductibles to get your bottom line cost.  My wife got lucky with her shoulder MRI.  Her out of pocket cost was $21.95


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## Brett (Nov 17, 2014)

Ron98GT said:


> Your paying for your 43 year old sons insurance policy, obviously due to lack of income.
> 
> Your son, not you, is entitled to a subsidy due to a lack of income.
> 
> ...




right, the health care "subsidy" is for poor people

(let the wealthy have their own subsidies)


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## VacationForever (Nov 17, 2014)

My response to the posts criticizing OP in not getting his son to take a subsidy is that it is that mentality which USA has become.  Why should the government/other taxpayers be paying for your family's bills?  What happened to the traditional society where we take care of our own family?   I met this guy from India on a plane, who was an engineer working at Tata, the India car maker.  He said only he and another family member are working and they are supporting 20+ people which include grand parents, cousins, uncles and aunts.


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## SueDonJ (Nov 17, 2014)

I don't get the willingness to forego subsidies, especially when the items for which they're available are criticized as being too expensive a proposition for the people who benefit most by them.  It's not as if there's a boatload of money floating around out there and if it's your lucky day, you'll get some of it!  If you satisfy the requirements for a certain something, there's no "Good On You!" award for not accepting it.

I also don't share the perception that Americans are no longer "traditional" good citizens simply because aid programs are available to those who qualify for them.  If not for the federal/state aid that my parents accepted forty years ago when my dad was hospitalized for a year with TB and my mom was home with 11 children under age 16, we would have in all probability been split up and lived completely different lives.  It irks me to no end to see criticisms directed toward people in unfortunate situations, and in my opinion adopting a martyrdom veil for not accepting what's rightfully due is a backhanded criticism of those who don't do the same.

There, my rant for the day.

And for the record, my husband is working in India for two years.  The guy on the plane who is taking care of a large extended family is, by far, the exception to the rule.  They definitely have a different ethic when it comes to feeling a sense of responsibility for their own families, but it's a VERY small minority of the population who are fortunately able to do so financially.  In that respect their numbers pale in comparison to the number of Americans who are financially stable.  Plus, I highly doubt that Americans want to adopt the squalid living conditions that the majority of Indians face, not even if it results in a better financial situation all around.


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## PamMo (Nov 17, 2014)

Kal said:


> Given the current trends in diagnosis, I would include MRI into a common category of services.  The "retail" price is about $1,100.  A good measurement of insurance is to see what they will pay.  Of course take into account deductibles to get your bottom line cost.  My wife got lucky with her shoulder MRI.  Her out of pocket cost was $21.95



Lucky you! DH just had an MRI and out of pocket cost was $700.


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## vacationhopeful (Nov 17, 2014)

Yes, I had surgery and my out of pocket cost was $5000. And then under that NEW plan this year, my doctor's office visits should be $15 except my GYN's office codes his services as from a surgical office and I am expected to pay the $365 in full as I have NOT met my yearly $5000 deductible ... a 5 minute office visit I am supposed to go to 4 times a year. Along with my $1100 monthly health insurance premium ....


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## SMHarman (Nov 17, 2014)

bogey21 said:


> Before you ask, yes he is eligible for a subsidy.  Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford.
> 
> George


Ah but can your 43 year old son afford it on his AGI without assistance from you or the government. That's who the subsidy is meant for.


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## SMHarman (Nov 17, 2014)

Sugarcubesea said:


> My company will be charging me $950 a month for family coverage with a $10,000 deductible before our 80/20 kicks in…I can not afford to work at this company any longer and have started my job search… Our new benefit package came out on Friday for 2015 and we are seeing a 38% increase across the board yet the company only gave me a 2% raise (the bulk of the company got a 1% raise, so I guess I'm in the lucky group who received more)


My employee rates went up 72% this year also and that is a big self insured group plan.


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## SueDonJ (Nov 17, 2014)

vacationhopeful said:


> Yes, I had surgery and my out of pocket cost was $5000. And then under that NEW plan this year, my doctor's office visits should be $15 except my GYN's office codes his services as from a surgical office and I am expected to pay the $365 in full as I have NOT met my yearly $5000 deductible ... a 5 minute office visit I am supposed to go to 4 times a year. Along with my $1100 monthly health insurance premium ....



Have you been given a good reason for why your surgeon's office can't correct the coding so that the services provided to you are categorized, and more importantly covered, the way they should be?  Incorrect coding is an issue which has been a component of health insurance for years; as a claims adjustor at John Hancock years ago it was practically routine to deal with it.


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## Ken555 (Nov 17, 2014)

sptung said:


> Why should the government/other taxpayers be paying for your family's bills?  What happened to the traditional society where we take care of our own family?




As a society, we have agreed to pay for certain items. This now includes health care. 

I don't see how different this is to other subsidies that local and federal governments have offered for decades. Somehow it is construed that health care is a personal or familial responsibility in America...but that hasn't always been the case, and certainly isn't now. There are many aspects to American society and I think it difficult to conclude that "traditional society" always meant what you think it did. 

I could posit the same question in regards to other benefits our society has determined should be subsidized. Similarly, I could ask why we offer any subsidies or deductions at all, on anything? Many make sense to me, since I want to live in a society where all may benefit from basic support and have an opportunity to thrive, as in other industrialized countries. Health care is a critical component which has long been neglected in this regard, and it appears that after just less than a year of the ACA, that we are making progress toward a better solution. Still not perfect, but progress.


Sent from my iPad


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## VacationForever (Nov 17, 2014)

Ken555 said:


> As a society, we have agreed to pay for certain items. This now includes health care.
> 
> I don't see how different this is to other subsidies that local and federal governments have offered for decades. Somehow it is construed that health care is a personal or familial responsibility in America...but that hasn't always been the case, and certainly isn't now. There are many aspects to American society and I think it difficult to conclude that "traditional society" always meant what you think it did.
> 
> ...



My rant is not about health insurance subsidies. It is about all subsidies.  I am all for safety nets.  But safety net should be a safety net, not something that people take for granted.  If you should get health insurance subsidy because you cannot afford, then of course take it.  In a traditional society, I live with my parents till I get married and then I move out if we can afford to.  In the US, most kids all want to move out when they turn 18 or whatever young age and parents expect the same.  Housing cost is one of the biggest ticket items when you live on your own.  Many of these folks who move out realize quickly that they really cannot afford to live on their own.  We have housing subsidy for the low income, food stamps etc.  They are all great programs for those in need.  However, many of the folks who move out do NOT need to move out, unless there are good reasons like safety issues.  As a society, many folks become reliant on subsidies, and their kids do the same and it perpetuates.  If there is a real need and as a last resort, i.e. they cannot afford it and family cannot afford to help pay for it, then yes, the society / government / taxpayers should pay for the need.


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## Patri (Nov 17, 2014)

SueDonJ said:


> It irks me to no end to see criticisms directed toward people in unfortunate situations, and in my opinion adopting a martyrdom veil for not accepting what's rightfully due is a backhanded criticism of those who don't do the same.



Methinks you are a bit too sensitive. George's post in no way slammed those who take subsidies. Your thought process needs an adjustment. He did not assume a martyrdom veil. It is simply a choice he made. 
My school district gives a particular small tax break to senior citizens. All you have to do is sign up for it. One man who complains regularly about taxes at school board meetings, when asked if he took the rebate, said no. We were all shocked, but he rose in my esteem. He complains to keep the school board on task, not to get something for nothing.


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## Kal (Nov 17, 2014)

sptung said:


> ...What happened to the traditional society where we take care of our own family? ...


 
 The bills for medical care are outrageously high.  Passing the hat to family members isn't like a donation to the girl scouts.  How do you think any family member will react to a request for $4-5,000 for THIS current health issue?  Then what happens when you and your family can't pay the bills?  Just declare bankruptcy and bingo, it's all good. Somebody else pays the bills. 

 The costs have been incurred so those costs are then covered by the "extended family" of all US citizens thru the increased cost of their medical care.  So, yes, the _traditional society_ is still in place.  It's just that the "family" is 317 million in size.


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## DeniseM (Nov 17, 2014)

Folks - if this becomes a debate over social services - it's going to get closed.  Please stick to the topic.


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## Beaglemom3 (Nov 17, 2014)

SueDonJ said:


> Have you been given a good reason for why your surgeon's office can't correct the coding so that the services provided to you are categorized, and more importantly covered, the way they should be?  Incorrect coding is an issue which has been a component of health insurance for years; as a claims adjustor at John Hancock years ago it was practically routine to deal with it.





  Sue could be onto something. 

  I used to do ICD-9 coding at the doctor's office that I worked at and still keep up with it (out of morbid curiosity). This doesn't sound right.

 This could be an error in coding. I'd either call or make an appt. at your GYN's business office to discuss.


  -


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## Ron98GT (Nov 17, 2014)

DeniseM said:


> Folks - if this becomes a debate over social services - it's going to get closed.  Please stick to the topic.


First, I have to say that everybody has done a great job of not making this discussion political 

Second, and this is just a question so don't get offended I'm still learning the rules, but in the OP's original post, #1, George specifically stated "Before you ask, yes he is eligible for a subsidy. Color me stupid if you want but I won't accept one as I am not comfortable asking my fellow taxpayers to help pay for something I can afford. QUESTION: Isn't that part of the topic & can it not be discussed? Discussed but no debate? Again just asking, and at this point just following the discussion which is interesting, hopefully you wont close it.


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## DeniseM (Nov 17, 2014)

This thread has veered far from that topic - now there have been posts about the "ethics" of social services in general - so thanks for asking, but no, we don't want to go there….


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## vacationhopeful (Nov 17, 2014)

Beaglemom3 said:


> Sue could be onto something.
> 
> I used to do ICD-9 coding at the doctor's office that I worked at and still keep up with it (out of morbid curiosity). This doesn't sound right.
> 
> ...



I agree with both of your suggestions (Beaglemom3 & SueDonJ) .. it is a coding issue. But the medical office when I talked to the insurance company -- the office the doctor works out of, is the surgery doctors group associated with the hospital. They reside in a hospital branch (property) ... XYZ Hospital Surgery Center. Says so on the building. They all get MORE insurance (not just government) money from the insurance companies or the individuals as they are located in the wealthier area (hospital is located in Camden, NJ; surgery is performed in Camden, NJ; the doctors' office is located in upper income Voorhees). 

So the initial consult and all follow up appointments are done at the labeled "Surgery Center in Voorhees" office. And I will bet, after being there 6 times in the past 18 months --- blood is not spilled in that building. Staple  removal there was the closest they come to doing any procedures (and billing).


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## Ron98GT (Nov 17, 2014)

DeniseM said:


> This thread has veered far from that topic - now there have been posts about the "ethics" of social services in general - so thanks for asking, but no….


OK, thank you for the response and specific explanation.


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## SueDonJ (Nov 17, 2014)

Patri said:


> Methinks you are a bit too sensitive. George's post in no way slammed those who take subsidies. Your thought process needs an adjustment. He did not assume a martyrdom veil. It is simply a choice he made.
> My school district gives a particular small tax break to senior citizens. All you have to do is sign up for it. One man who complains regularly about taxes at school board meetings, when asked if he took the rebate, said no. We were all shocked, but he rose in my esteem. He complains to keep the school board on task, not to get something for nothing.



Of course I'm sensitive, that's a natural reaction to experience.  My thought process is appropriate based on what Ive lived through as well as what I'm reading here.

Do you realize that your post implies the same martyrdom that I mentioned?  Why should a person who is entitled to a subsidy have to refuse it in order to "rise in your esteem?"  And why do you categorize acceptance of aid to which a person is entitled as, "getting something for nothing?"

I don't expect you to answer, don't mean for you to be put on the spot and made to share the personal details that have contributed to your thought process.  But I'm commenting because in my experience, people aren't always aware that they're projecting a certain process until it's pointed out to them.


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## vacationhopeful (Nov 17, 2014)

*US HealthCre.gov email -- December 15th deadline to change plans*

I just went surfing thru my NEWEST emails ... Ugh! There is an email from the US HealthCare.gov site .....

Those of us who have the whatever you want to call the Marketplace health insurance ... we only have until Dec 15th pick a new plan if we are changing for the 2015 year.

UGH! The agony, the pain, the confusing, the hair pulling uncertainty ... it has only been 7 months .... and to go thru it AGAIN.


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## Kal (Nov 17, 2014)

vacationhopeful said:


> I just went surfing thru my NEWEST emails ... Ugh! There is an email UGH! The agony, the pain, the confusing, the hair pulling uncertainty ... it has only been 7 months .... and to go thru it AGAIN.



Actually it's easy.  Just figure out what your health will be for next year then it's all downhill from there!!


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## am1 (Nov 17, 2014)

What would be the cost to provide basic health care to all?  What is the cost in not providing it?


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## staceyeileen (Nov 17, 2014)

vacationhopeful said:


> I just went surfing thru my NEWEST emails ... Ugh! There is an email from the US HealthCare.gov site .....
> 
> Those of us who have the whatever you want to call the Marketplace health insurance ... we only have until Dec 15th pick a new plan if we are changing for the 2015 year.
> 
> UGH! The agony, the pain, the confusing, the hair pulling uncertainty ... it has only been 7 months .... and to go thru it AGAIN.



We've had a few job changes recently, so this is actually the 3rd time I am insurance shopping in the past 6 months.  Ugh.


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## ondeadlin (Nov 17, 2014)

sptung said:


> My rant is not about health insurance subsidies. It is about all subsidies.  I am all for safety nets.  But safety net should be a safety net, not something that people take for granted.  If you should get health insurance subsidy because you cannot afford, then of course take it.  In a traditional society, I live with my parents till I get married and then I move out if we can afford to.  In the US, most kids all want to move out when they turn 18 or whatever young age and parents expect the same.  Housing cost is one of the biggest ticket items when you live on your own.  Many of these folks who move out realize quickly that they really cannot afford to live on their own.  We have housing subsidy for the low income, food stamps etc.  They are all great programs for those in need.  However, many of the folks who move out do NOT need to move out, unless there are good reasons like safety issues.  As a society, many folks become reliant on subsidies, and their kids do the same and it perpetuates.  If there is a real need and as a last resort, i.e. they cannot afford it and family cannot afford to help pay for it, then yes, the society / government / taxpayers should pay for the need.



If I understand you correctly, and your position is that government should generally limit all subsidies - healthcare, mortgage, food assistance - to people below the poverty line or even people at an even lower income, then I agree with you in theory.  That would be a true safety net.

But we don't.

And I don't understand how anyone can view healthcare subsidies as something questionable (or take pride in not taking them) when, for example, our government subsidizes second and third mortgages for millionaires.  That's not an exaggeration, of course.  That's what we do.  If you are a millionaire, and you take out a second mortgage, we subsidizes it with the mortgage deduction.  Again, there's a good (in theory) reason behind that - as a society we want to encourage home ownership.  Even - apparently - second home ownership.  

So … yeah.  It's real hard to for me to view the healthcare subsidy - which overwhelmingly goes to either poor families or singles with incomes under $35k - as a problem when we are all subsidizing those mortgages.


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## Ken555 (Nov 17, 2014)

Kal said:


> Actually it's easy.  Just figure out what your health will be for next year then it's all downhill from there!!




From what I read earlier today, if you like your current plan you don't need to make any changes...you'll automatically be renewed at the current rate. At least, that's what I read about coveredca.com. Seems like I don't need do anything to renew, so easy as can be.


Sent from my iPad


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## VacationForever (Nov 17, 2014)

ondeadlin said:


> If I understand you correctly, and your position is that government should generally limit all subsidies - healthcare, mortgage, food assistance - to people below the poverty line or even people at an even lower income, then I agree with you in theory.  That would be a true safety net.
> 
> But we don't.
> 
> ...



I am not talking about changing subsidy levels.  I am talking about our mindset that everyone as an individual which the society, i.e. state/federal is responsible for first as opposed to last resort/safety net.  Children should help their parents and parents help their children prior to getting others to help foot their bills.


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## ondeadlin (Nov 17, 2014)

Under your theory, whether one gets healthcare depends no whether one's parents (or children) can afford it, i.e. can take care of them, help them out, whatever.  I'd rather live in an America where we help everyone below a certain income level, rather than depend on folks' parents to help them out.

Why?  Because your policy means that we just accept that people without well-off parents (or kids) will - in many cases - be left without health insurance.

Which ultimately means I'm paying for their healthcare when they go to the ER, which is just another form of subsidy, albeit a less efficient one.


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## VacationForever (Nov 17, 2014)

ondeadlin said:


> Under your theory, whether one gets healthcare depends no whether one's parents (or children) can afford it, i.e. can take care of them, help them out, whatever.  I'd rather live in an America where we help everyone below a certain income level, rather than depend on folks' parents to help them out.
> 
> Why?  Because your policy means that we just accept that people without well-off parents (or kids) will - in many cases - be left without health insurance.
> 
> Which ultimately means I'm paying for their healthcare when they go to the ER, which is just another form of subsidy, albeit a less efficient one.



That is not what I said.  When there is no family to help, then the subsidy / safety net applies.


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## staceyeileen (Nov 17, 2014)

One could argue that the ACA is actually promoting the "family as a safety net" theory for young adults given that the law now allows them to remain on their parent's insurance plans to age 26.


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## ondeadlin (Nov 17, 2014)

sptung said:


> That is not what I said.  When there is no family to help, then the subsidy / safety net applies.



That wasn't clear from your posts.  If that's your position - and if I understand you correctly - you're basically saying that those who can afford to go without government subsidies should do so, and the subsidies should exist for those who can't afford to go without.

Again, as I said at the beginning, I can respect that position if one is choosing to voluntarily forgo all subsidies.  I don't see the need for that, but I can respect the position.


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## Patri (Nov 17, 2014)

Of course I'm sensitive, that's a natural reaction to experience.  My thought process is appropriate based on what Ive lived through as well as what I'm reading here.

And everyone else's opinion is based on their experience.

Do you realize that your post implies the same martyrdom that I mentioned?
No, it does not. 

 Why should a person who is entitled to a subsidy have to refuse it in order to "rise in your esteem?"  And why do you categorize acceptance of aid to which a person is entitled as, "getting something for nothing?"
In the school case I am referring to, it is a program that has veered from its original intent. In the past the seniors had to do something to get the rebate. Now all they have to do is sign up, but not actually serve volunteer hours. The rebate is available, but whether it is an entitlement is up for debate. The school board would lose goodwill by taking it away. 

  But I'm commenting because in my experience, people aren't always aware that they're projecting a certain process until it's pointed out to them. Touche'


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## laurac260 (Nov 18, 2014)

[political]


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## geekette (Nov 18, 2014)

sptung said:


> My response to the posts criticizing OP in not getting his son to take a subsidy is that it is that mentality which USA has become.  Why should the government/other taxpayers be paying for your family's bills?  What happened to the traditional society where we take care of our own family?   I met this guy from India on a plane, who was an engineer working at Tata, the India car maker.  He said only he and another family member are working and they are supporting 20+ people which include grand parents, cousins, uncles and aunts.



If you look at dollars vs rupies you'll see how it's possible.  

Not sure what is to become of orphans and those kept in foster care until shown the door at age 18, or maybe parents were deported.  Everything is groovy for those with families, looking after their own people, but that is not the reality for everyone.  

I resent the notion that a person's character is measured by their salary, and tough crap to those who can't seem to pull up on their bootstraps high enough to exit cycle of poverty.


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## Passepartout (Nov 18, 2014)

laurac260 said:


> Imagine how far 6 million dollars could go toward insuring the uninsured, rather than spending it on salary and "payments", to one guy in particular that was involved in designing this.



Laura, while $6mil is a lot of money to me and you, in the overall scheme of getting affordable care to millions of people who didn't have it a year ago, it's pretty small potatoes. About $.02 each for the 300 million of us. 

Jim


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## ondeadlin (Nov 18, 2014)

Some really great information here, especially the two charts:

http://dish.andrewsullivan.com/2014/11/18/next-years-obamacare-premiums-ctd/

Hard to see that and not think something's working.


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## rapmarks (Nov 18, 2014)

ondeadlin said:


> Some really great information here, especially the two charts:
> 
> http://dish.andrewsullivan.com/2014/11/18/next-years-obamacare-premiums-ctd/
> 
> Hard to see that and not think something's working.



thanks for your post.


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## DeniseM (Nov 18, 2014)

We are done here…


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