Health Care Insurance

[Panina]

Don't really understand the purpose of this discussion....people are just complaining about their individual issues but can't propose a solution because that would cross the line into politics?

Sharing, that's what some of us are doing. It's kind of a support network, sometimes speaking to others that are experiencing the same hardship is comforting, knowing others understand.

 

[bogey21]

Don't really understand the purpose of this discussion....

My purpose in starting this discussion was to point out that my Son was insured with an alternative to the ACA which as of now will not be available when my Son's current policy expires in December. IMO it was a viable alternative. Others are free to not agree.

George

 

[Tia]

It's a gamble as you never know when your going to have something come up like a gall bladder or accidental fracture missing a step. I didn't know about those policies Bogey21 talks about until now.

You could roll the dice and go with no insurance, then just pay the ACA penalty if it survives the reform efforts.


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[PamMo]

Don't really understand the purpose of this discussion....people are just complaining about their individual issues but can't propose a solution because that would cross the line into politics?

Hmmmmmm.......to inform others that a healthcare option is no longer available, or maybe it's a case of misery loves company?

In the TUG community, a timeshare scam is nothing compared to not having access to healthcare when someone in your family needs it.

 

[VacationForever]

He lives in Illinois. I checked Medicaid a couple of years ago. I don't think he qualified then but may have to take another look at it.

George

If not, look into a silver plan, he may qualify for both premium subsidy and cost sharing subsidy. If he does, you may be surprised with how little out of pocket cost to him/you.

 

[Timeshare Von]

Timeshare von, what is badger care? Hear the term a lot


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I believe it is basically the state medicare program. Even when I was unemployed and collecting unemployment, I/we were not eligible for it. That was a few years ago.

 

[Patri]

I am in the same boat as some of you. I was laid off from my job over a year ago and am paying Cobra. It runs out Dec. 1. DH goes on Medicare Oct. 1. I can't find a job with health benefits. I think they think I am over-qualified or too old. The best I can find under ACA for me alone is $993 a month. We only have two providers to choose from.
The insurance broker suggested looking into Christian Healthcare Ministries. I tooled around on the website last night. It is a strong possibility for me. My medications are not expensive. They also offer a prescription card that seemed to drop the price significantly. There are three plans, and you pay for routine services out of pocket. But you get good coverage for major incidents. Another search now shows there are a number of religion based organizations that work off the same concept, the group helping the individual with large medical expenses. And I'd rather be the person paying in, but never needing the funds.
Never thought I would find myself in this situation.

 

[Panina]

I am in the same boat as some of you. I was laid off from my job over a year ago and am paying Cobra. It runs out Dec. 1. DH goes on Medicare Oct. 1. I can't find a job with health benefits. I think they think I am over-qualified or too old. The best I can find under ACA for me alone is $993 a month. We only have two providers to choose from.
The insurance broker suggested looking into Christian Healthcare Ministries. I tooled around on the website last night. It is a strong possibility for me. My medications are not expensive. They also offer a prescription card that seemed to drop the price significantly. There are three plans, and you pay for routine services out of pocket. But you get good coverage for major incidents. Another search now shows there are a number of religion based organizations that work off the same concept, the group helping the individual with large medical expenses. And I'd rather be the person paying in, but never needing the funds.
Never thought I would find myself in this situation.

I didn't quote numbers but about the same here for our individual coverage. Mind boggling that almost $12,000 a year and that doesn't include the very high deductible and copayments that have to be paid too.

This is not political as I am saying everyone regardless of their political opinions......What if ALL federal employees, elected and not elected had to use ACA? .... they would understand our situation

 

[rapmarks]

I didn't quote numbers but about the same here for our individual coverage. Mind boggling that almost $12,000 a year and that doesn't include the very high deductible and copayments that have to be paid too.

This is not political as I am saying everyone regardless of their political opinions......What if ALL federal employees, elected and not elected had to use ACA? .... they would understand our situation

I think congress has to use aca, they get the cost subsidized 75 per cent and get a silver plan.


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[VacationForever]

I think congress has to use aca, they get the cost subsidized 75 per cent and get a silver plan.


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Where did you read that they use ACA? I thought it was long debated years back but their Federal health care plan was sacred.

 

[ace2000]

Where did you read that they use ACA? I thought it was long debated years back but their Federal health care plan was sacred.

I think this answers it pretty well:

http://www.snopes.com/members-congress-health-care/

 

[Panina]

I think this answers it pretty well:

http://www.snopes.com/members-congress-health-care/

Says it all, more choices, subsidies regardless of income, not what the rest of us are offered. If they had one choice and no subsidies then they would understand.

 

[VacationForever]

The issue remains regardless of ACA or AHCA is that individual plan health care costs are extremely high for older people.

 

[Tia]

Someone at work the other day told me she used www.goodrx.com/ when she didn't have insurance and it saved her $ for prescriptions

 

[Timeshare Von]

Someone at work the other day told me she used www.goodrx.com/ when she didn't have insurance and it saved her $ for prescriptions

I have insurance through the exchange and with pretty fair copays on Rxs. We buy ALL OF OUR MEDS through bidrx.com . . . and they are all less than our insurance copays.

Last year UHC had both my husband & me go in for a "health screening follow-up" at no charge to us. Once there we learned it was because we had been flagged due to the number of appointments and medical expenses we had incurred for chronic issues . . . and yet had ZERO prescription expense for them. They were fishing around to see if there had been insurance fraud.

They could have just called and asked a few questions, rather than incurring over $500 of useless additional doctors' appoints.

 

[Tia]

Just got notice my employer subsidized insurance is going up $1000+/yr starting Jan 1st OUCH, benefits getting trimmed at the same time.

 

[VacationForever]

I forgot about this thread. So here is my update for what is happening now with my state and county. Anthem BCBS is leaving end of the year and the exchange now has 2 choices for next year, both HMO. I walked through the process online - none of my doctors is in their network and my "lifeline" drug is not covered at all. Fortunately there is one player that sells in the individual market where all my doctors, except for the OBGYN (which is easy to replace), accept the plan. It also covers that one drug that I am on (autoimmune issue). I am 55 and my premium will be $896 per month, with $3K deductible and $7.35K max out of pocket. The same plan costs $1,205 at age 64. My husband said I need to get old quickly so that I can start on Medicare.

 

[vacationhopeful]

Reminds me to pay my next 3 months (quarterly bill) for my Medicare of $402 soon. What a difference from the $1000/monthly of 6+ months ago. My blood pressure came down ... as the older we become our insurance coverage expenses SOARED while benefits SANK like a lead balloon. Our doctors closed up their offices (retiring or joining hospital's WALK IN clinics at ER rates) ... medical records seem to NEVER get transferred ... your doctor (actually, your NP) gets a better job ...etc. I have for the last several years, just ask the guy who works with me "so, who is our current MD or MP AND where are they located?" ... as his wife is retired and keeps track of these almost monthly changes).

As for pharmacies ... I got reamed out on yesterday from the NEW pharmacy yesterday ... about my attitude ... which I had to change due to my new script plan. The pharmacist seems to think I had an attitude that I had to WAIT several days for them to get in the meds to fill my scripts ... but common blood pressure & collestaral meds not in stock? Expect all those hundreds of drug stores to start cutting back locations and hours.... seems the insurance companies have titled the balance to "Mail Order" prescription filling.

I wonder HOW 'mail order' is going to annoy me .... I have no street delivery address on any records, just a PO Box .... including my driver's license, car registration, voting records or medical cards. Domestic Violence victims and residents of crime areas do NOT receive any mail or deliveries at their home.

And the USPS actually does have a procedure for mail delivery .... PM me if you need to know how MY post office handles it in some cases where the "POWERS to BE" demand sending something to a STREET ADDRESS (works ONLY for USPS delivered packages ... not UPS or other commercial delivery services).

 

[WinniWoman]

I forgot about this thread. So here is my update for what is happening now with my state and county. Anthem BCBS is leaving end of the year and the exchange now has 2 choices for next year, both HMO. I walked through the process online - none of my doctors is in their network and my "lifeline" drug is not covered at all. Fortunately there is one player that sells in the individual market where all my doctors, except for the OBGYN (which is easy to replace), accept the plan. It also covers that one drug that I am on (autoimmune issue). I am 55 and my premium will be $896 per month, with $3K deductible and $7.35K max out of pocket. The same plan costs $1,205 at age 64. My husband said I need to get old quickly so that I can start on Medicare.

Wow. One of the big issues as to why I can't retire until at least 65. Even then, who knows how much the supplements will cost.

 

[VacationForever]

Wow. One of the big issues as to why I can't retire until at least 65. Even then, who knows how much the supplements will cost.

I keep threatening my husband that I will need to go back to work for a company that has a medical insurance which my doctors accept. The issue is that I have to find out what kind of insurance that they offer. Many companies cut medical insurance costs by going with bare bones minimal or cheapest plan. My PCP who knew that I was stressing over Anthem BCBS withdrawal and needing to find an insurance that would cover my doctors for next years told me MGM had good insurance and one of his patients worked at their florist just to get on their medical insurance. But every company reviews their medical plans each year and they can go from a good plan to an inferior plan the following year.

 

[WinniWoman]

I keep threatening my husband that I will need to go back to work for a company that has a medical insurance which my doctors accept. The issue is that I have to find out what kind of insurance that they offer. Many companies cut medical insurance costs by going with bare bones minimal or cheapest plan. My PCP who knew that I was stressing over Anthem BCBS withdrawal and needing to find an insurance that would cover my doctors for next years told me MGM had good insurance and one of his patients worked at their florist just to get on their medical insurance. But every company reviews their medical plans each year and they can go from a good plan to an inferior plan the following year.

But then again a lot of companies have gone to high deductible plans with decent networks or PPO's, with good prescription drug coverage through mail order. So you could luck out. My husband has no premium in such a plan and my premium is $200 per month with the plan. But- big deductible= $6000/$12,000. Have an HSA and we put over $700 per month into it to cover our out of pocket expenses. You can't win to lose as they say.

 

[VacationForever]

But then again a lot of companies have gone to high deductible plans with decent networks or PPO's, with good prescription drug coverage through mail order. So you could luck out. My husband has no premium in such a plan and my premium is $200 per month with the plan. But- big deductible= $6000/$12,000. Have an HSA and we put over $700 per month into it to cover our out of pocket expenses. You can't win to lose as they say.

The key is have an insurance that is PPO or EPO (new term that I learned - an extended/enhanced network). In the healthcare market, the employers and consumers are the losers. Health insurance companies and Pharmaceuticals, Medical Equipment Manufacturers are the huge winners.

 

[icydog]

I am in the same boat as some of you. I was laid off from my job over a year ago and am paying Cobra. It runs out Dec. 1. DH goes on Medicare Oct. 1. I can't find a job with health benefits. I think they think I am over-qualified or too old. The best I can find under ACA for me alone is $993 a month. We only have two providers to choose from.
The insurance broker suggested looking into Christian Healthcare Ministries. I tooled around on the website last night. It is a strong possibility for me. My medications are not expensive. They also offer a prescription card that seemed to drop the price significantly. There are three plans, and you pay for routine services out of pocket. But you get good coverage for major incidents. Another search now shows there are a number of religion based organizations that work off the same concept, the group helping the individual with large medical expenses. And I'd rather be the person paying in, but never needing the funds.
Never thought I would find myself in this situation.

Can you please share some of these religious based organizations. My searches proved fruitless. Thanks

 

[icydog]

I have insurance through the exchange and with pretty fair copays on Rxs. We buy ALL OF OUR MEDS through bidrx.com . . . and they are all less than our insurance copays.

Last year UHC had both my husband & me go in for a "health screening follow-up" at no charge to us. Once there we learned it was because we had been flagged due to the number of appointments and medical expenses we had incurred for chronic issues . . . and yet had ZERO prescription expense for them. They were fishing around to see if there had been insurance fraud.

They could have just called and asked a few questions, rather than incurring over $500 of useless additional doctors' appoints.

I get calls from UHC routinely asking me to allow a nurse to do a home visit. I always decline. Now, Last week I get a call from my PC doc asking me to come in for a physical After reading your post I will be canceling that appointment. If it seems to good to be true it probably isn't! I was suspicious before-- but now I am certain. Thanks posting this!

 

[vacationhopeful]

.....asked a few questions, rather than incurring over $500 of useless additional doctors' appoints.

Is that over $500 pf appointments YOU PAID out of your pocket for? For them to do a hunt for fraud on your part BUT you paid for the costs for them to try and 'get you' into being charged for fraud?

If you paid the $500 .. I would write them a letter (if you found another medical insurance company by now) to request REIMBURSEMENT as no fraud was charged legal against you ... (don't stay found ... that is an opinion on your part and they might then file a minor fraud claim against you).

I am NOT A LAWYER .. I am NOT GIVING YOU LEGAL ADVICE. YOU MIGHT WANT TO CONSULT A LAWYER IN YOUR STATE.

Or just eat the loss of the $500+ .... and be sure ONLY your enemies ever buy medical insurance from them in the future.