[Health Care Threads merged - please stop creating new threads]

[momeason]

PLEASE do not make this political.

I read and researched and figured out if I closed all my windows and tabs, made sure that my browser was set to accept cookies and deleted all previous cookies, I was able to sign in and complete my application on healthcare.gov.

I now know my current exchange options and the options with my current insurer, but I am still waiting because BCBSNC has stated on their website that they will roll out some lower cost options in the coming week.

Most Tuggers spend lots of time making their timeshare work for them. I hope people will spend time exploring which insurance option works for them. Things are changing and just like we do not take the developer's word on what works best for us in timeshares, it benefits each individual to learn about their new coverage options and not take your insurance company's advice without researching on your own. My husband and I have to get our own individual coverage. We are no longer under group coverage. When we were under group coverage, I spent many hours each year deciding on a plan and how much to put in Flex,etc.

The website is improving, but it is still a work in progress. After you finish applying by phone or the website, you will learn your personal options.
We plan to help our 29 yr old son who is a grad student to apply soon. He has no insurance right now. That really scares me.

 

[StevenTing]

Shouldn't your 29yo be doing this himself? Or by help out, do you mean help him pay?

 

[Patri]

Thankfully my employer is offering the same coverage next year, but part of the rate increase is because of ACA, the letter stated. I have no confidence next year's hours won't be cut etc. so they can get out of coverage for 2015 if it is too burdensome.
I got onto a preliminary healthcare.gov page a few weeks ago just to look at rates (without having to put in personal information). Rates were triple what mine are now, but I couldn't see if I would qualify for any tax credit. Aren't they giving a credit vs. just a better rate? I'd rather not spend the extra money up front.

 

[SMHarman]

Aren't they giving a credit vs. just a better rate? I'd rather not spend the extra money up front.

the credit is computed as an immediate rate discount.



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[glypnirsgirl]

I provide health insurance for 3 employees (others have better coverage through their spouses) --- two employees in their late 50s and one in his late 20s. The two fifty years olds cost me $3,200 per month NOW.

I asked each employee to go to the website to see what they can get. Without qualifying for any credit, the savings are huge.

For the same insurance carrier with a lower deductible, the rate drops to $1100 for BOTH of the 50 year olds - a savings of $2100. I have not been able to give anyone raises for the last 3 years because any raise has been eaten up by health insurance costs. I provide 100% coverage.

It goes up some for the 29 year old. So, I will be increasing everyone's wages by enough to cover the health insurance plus $500 per month as the first raise in a long time.

For us, it has been a win-win-win-win. They get better insurance, it costs me less to subsidize the coverage, they get more money in their pocket, I get more money in my pocket.

I do not understand the anomalies. I am just happy to see the results.

elaine

 

[Patri]

Wow Elaine, you are a NICE employer. Fully-paid insurance is almost unheard of these days. Employees should not have fussed about no raise, as the benefits more than compensated. It's been a tough couple of years for many people.

 

[Ken555]

FYI-I did log onto healthcare.gov

I provide health insurance for 3 employees (others have better coverage through their spouses) --- two employees in their late 50s and one in his late 20s. The two fifty years olds cost me $3,200 per month NOW.

I asked each employee to go to the website to see what they can get. Without qualifying for any credit, the savings are huge.

For the same insurance carrier with a lower deductible, the rate drops to $1100 for BOTH of the 50 year olds - a savings of $2100. I have not been able to give anyone raises for the last 3 years because any raise has been eaten up by health insurance costs. I provide 100% coverage.

It goes up some for the 29 year old. So, I will be increasing everyone's wages by enough to cover the health insurance plus $500 per month as the first raise in a long time.

For us, it has been a win-win-win-win. They get better insurance, it costs me less to subsidize the coverage, they get more money in their pocket, I get more money in my pocket.

I do not understand the anomalies. I am just happy to see the results.

elaine

Fantastic. I'm in a similar position, though not with such savings. I've decided also to cancel our group policy effective 1/1/14...it simply doesn't make any sense to keep it given the alternatives. The company will continue to contribute under Section 125 so it doesn't cost the staff more than needed, saving taxes, etc. (if you're not planning on this, you may want to inquire with your payroll company, as it will be a direct savings to your staff with a little more paperwork for you).


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[momeason]

Shouldn't your 29yo be doing this himself? Or by help out, do you mean help him pay?

I mean encourage him to get insurance and yes, help him pay. He is a Seminary student with very low income. I am concerned about him not having insurance. It is more of a priority for me than for him.

 

[PStreet1]

From what I've seen, the actual number of doctors/hospitals you can use on the plans offered is more important than the cost. Lots of networks are narrowing hugely to achieve cost savings. If there are fewer doctors/hospitals you can use, but the same number (or more) people using them, that will be a problem.

 

[Passepartout]

From what I've seen, the actual number of doctors/hospitals you can use on the plans offered is more important than the cost.

Around here virtually ALL healthcare is provided by one conglomerate hospital group. There are very few outlier docs who are not part of the umbrella organization, so one insurance plan is about the same as another- as far as docs-in-network is concerned.

Jim

 

[geekette]

From what I've seen, the actual number of doctors/hospitals you can use on the plans offered is more important than the cost. Lots of networks are narrowing hugely to achieve cost savings. If there are fewer doctors/hospitals you can use, but the same number (or more) people using them, that will be a problem.

Note that one is free to visit any doctor that will see them, it's just less expensive to use a doctor in-network. If your preferred doc is not on the list for in-network, call them up to see if they would accept your ins anyway or if you can negotiate self-pay rates. Over time my primary has or has not been "in my network" but I never quit seeing him. most specialists he recommends are also not in-network but have always been willing to work with me.

Official lists of providers are more of a guide than an absolute with the big asterisk in place to let you know it may cost more to go off-network.

 

[bogey21]

Why Buy Insurance

I bought one of the new policies for my 42 year old Son primarily so that if something "catastrophic" happened to him, our (self, ex-wife and our other 2 kids) exposure would be limited to his annual "out of pocket". If all 4 of us chip in, we can easily handle that.

The question I have is did I make a mistake? He has no income (please don't ask why) so I guess he wouldn't have a penalty to pay for not having insurance. Couldn't I just wait until something happens to him to buy insurance as he can't be denied coverage for a pre-existing condition?

George

 

[geekette]

I bought one of the new policies for my 42 year old Son primarily so that if something "catastrophic" happened to him, our (self, ex-wife and our other 2 kids) exposure would be limited to his annual "out of pocket". If all 4 of us chip in, we can easily handle that.

The question I have is did I make a mistake? He has no income (please don't ask why) so I guess he wouldn't have a penalty to pay for not having insurance. Couldn't I just wait until something happens to him to buy insurance as he can't be denied coverage for a pre-existing condition?

George

I think the fly in the ointment is Open Enrollment. If Something Happens beyond open enrollment, I don't think he can just sign up right there and then.

So far as I know, no one would be on the hook for his out of pocket but him, depending on family structure. I think a spouse is the only one legally liable as spouses are always responsible for each others' debts.

I think your intention was that the rest of you help foot his bills until he reaches the annual limit and then bennies are in full force, and from that standpoint, it seems like a good way to go.

Good for you for looking after him. I hope his health remains solid so no catastrophic care is ever necessary.

 

[SMHarman]

So far as I know, no one would be on the hook for his out of pocket but him, depending on family structure. I think a spouse is the only one legally liable as spouses are always responsible for each others' debts.

Only if it is a joint debt or maybe in community property states.

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[Passepartout]

The question I have is did I make a mistake? He has no income (please don't ask why) so I guess he wouldn't have a penalty to pay for not having insurance. Couldn't I just wait until something happens to him to buy insurance as he can't be denied coverage for a pre-existing condition?

George

George, with no income, does your son qualify for Medicaid? That is what many people in very low income situations are finding.

Jim

 

[bogey21]

George, with no income, does your son qualify for Medicaid?

I'm sure he does but our concern is not regular medical needs but rather something catastrophic and our thought is that we would rather have Blue Cross and Doctors and Hospitals accepting Blue Cross available. Probably not rational thinking but that is where we are coming from.

George

 

[pjrose]

I provide health insurance for 3 employees . . .

For us, it has been a win-win-win-win. They get better insurance, it costs me less to subsidize the coverage, they get more money in their pocket, I get more money in my pocket.

. . .

elaine

Elaine, without the three employees, will your own insurance go up since you aren't a group? Or maybe there weren't enough of you to be a group anyway?

 

[momeason]

I'm sure he does but our concern is not regular medical needs but rather something catastrophic and our thought is that we would rather have Blue Cross and Doctors and Hospitals accepting Blue Cross available. Probably not rational thinking but that is where we are coming from.

George

If you fill out an application with your son on healthcare.gov and use his income info, he can buy a BCBS plan and you can pay the low cost. You get to choose the plan and what doctors.

 

[momeason]

The majority of working adults are covered under a group health plan and do not need to buy individual health plans. Until 2011, my family had always been covered. When my husband retired early after Wachovia Bank was forced to sell out, we found ourselves shopping for individual plans. We turned down the retiree plan because it was $2000/month.
We had several pre-existing conditions but none are life threatening. We thought we would be able to get coverage. We thought wrong. Both of us were turned down. I was turned down for acid reflux, past physical therapy for a back issue and past use of anti-anxiety meds prescribed during a family crisis with our daughter. My husband was turned down for moderate sleep apnea.
For those of you who have always been under a group plan, you do not understand how difficult it can be to get individual coverage. We did not know either until it happened to us. We went under COBRA for 18 months.
We were able to get individual coverage when COBRA ran out. ( I believe it was because the ACA was about to come into full effect) On June 1, 2013 we started a high deductible plan with BCBS and opened a Health Savings Account. We pay most of our costs because our deductible is $10,000 family. We use pre-tax dollars to pay our medical bills. We are also able to deduct our cost of insurance from our taxes since we pay 100% of the costs. Having insurance we pay at the BCBS negotiated rate. I see the original charges and they are outrageous. A normal income person would never be able to pay their medical bills if they had even a moderately serious illness or injury if they had to pay the un-negotiated rates.

In September, we received a notice that our policy is being cancelled. Of course, the notice blames the ACA..Affordable Care Act, aka Obamacare.
Now I am shopping again for a plan. At least now, we will never be turned down for a pre-existing condition. Now, I do not have to decide whether or not to go to the doctor for a problem based on whether it is worth it to get another diagnosis on my record. For the past 2 years, I considered that when deciding whether to ask my doctor about a problem or potential problem. That is not a good way to manage potential problems, but under the current system I had to weigh that. I needed insurance but I was often afraid to use it. I was paying for the visits with our money, but I still had to decide if I wanted to risk another black mark on my medical history.
In our case, we have funds to cover day to day medical needs with negotiated insurance rates. We also have the funds to buy insurance. People with lesser incomes are not so fortunate. Many have to choose between food and medical care.
I believe many who have never faced shopping for individual plans do not know what it is like. Just wanted to share a little of my personal experience of the reality.

 

[bogey21]

If you fill out an application with your son on healthcare.gov and use his income info, he can buy a BCBS plan and you can pay the low cost. You get to choose the plan and what doctors.

I spent about 45 minutes on healthcare.gov but to no avail. Response times were fine but they want me to call Experian to verify something or other. Couldn't get through to Experian so I went to the Blue Cross Illinois website and found that the Bronze 06 Plan would cost $157.84 per month. That took me 5 minutes. One of these days when I can make contact with Experian I will verify the price of the Bronze 06 Plan using healthcare.gov. I won't know until I get through but my gut tells me that the cost will be the same $157.84 which I am ok with. This is almost as frustrating and time consuming as filing my income taxes!!

George

 

[bogey21]

......Having insurance we pay at the BCBS negotiated rate. I see the original charges and they are outrageous. A normal income person would never be able to pay their medical bills if they had even a moderately serious illness or injury if they had to pay the un-negotiated rates.....

Some may not realize it but one of the benefits of having a BCBS Plan (even one with a high deductible) is getting the benefit of the BCBS negotiated rates even for the charges you pay out of pocket.

George

 

[SMHarman]

Some may not realize it but one of the benefits of having a BCBS Plan (even one with a high deductible) is getting the benefit of the BCBS negotiated rates even for the charges you pay out of pocket.

George

That should be the case for any medical plan. The negotiated rate is what you or the insurer will be paying the bill based on.

Looking at the rack rate on my EOBs is another thing that makes me shake my head about the best medical system in the world. Pretty easy to do an awesome job for $1000 when the procedure costs $10

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[momeason]

My point exactly. If the visit, lab or procedure can be done for that price..then that should be the price. I am glad most people can get insurance now which will level the playing field. Using the insurance company to get there is convoluted but at least care will be more affordable. I am trying hard not to be political. I have run across many people in the last two years who told me that I must have done something wrong if I was being denied coverage. They said I must have let my policy lapse. I have been insured every day of my life but until Jun1,2013, it was through group coverage or COBRA group coverage. A lot of people with group coverage know nothing about the individual market for health insurance. The insurers business is to make money, not to worry about the health of their individual policyholders.

 

[Ken555]

FYI-I did log onto healthcare.gov

Elaine, without the three employees, will your own insurance go up since you aren't a group? Or maybe there weren't enough of you to be a group anyway?

Speaking for myself and my business, our insurance costs with everyone as an individual via the new plans will be significantly less than what it was with a group. We've had group insurance for about six years (for the first bunch of years we were all on individual policies that the company helped pay for, but when I acquired a company about six years ago I convinced myself I needed a group policy for the new staff...I was wrong) and by my rough estimate my company has spend more than $30,000 in order to have group insurance rather than individual. For small businesses, group policies don't always make sense. The biggest advantage was the ability to provide insurance for anyone but now that everyone is able to get individual policies that advantage is no longer true. I wouldn't be surprised to find a major change in small group premiums in the next few years, assuming the insurance companies want to retain those accounts.

FWIW, a group needs two people to qualify.

Sent from my iPad

 

[floridabob]

PLEASE do not make this political.

I read and researched and figured out if I closed all my windows and tabs, made sure that my browser was set to accept cookies and deleted all previous cookies, I was able to sign in and complete my application on healthcare.gov.

I now know my current exchange options and the options with my current insurer, but I am still waiting because BCBSNC has stated on their website that they will roll out some lower cost options in the coming week.

Most Tuggers spend lots of time making their timeshare work for them. I hope people will spend time exploring which insurance option works for them. Things are changing and just like we do not take the developer's word on what works best for us in timeshares, it benefits each individual to learn about their new coverage options and not take your insurance company's advice without researching on your own. My husband and I have to get our own individual coverage. We are no longer under group coverage. When we were under group coverage, I spent many hours each year deciding on a plan and how much to put in Flex,etc.

The website is improving, but it is still a work in progress. After you finish applying by phone or the website, you will learn your personal options.
We plan to help our 29 yr old son who is a grad student to apply soon. He has no insurance right now. That really scares me.

I think posters that are recommending logging into healthcare .gov should add a disclaimer that their information may be hacked including SS numbers.

An expert testified before the Senate today and stated if your info hasn't been hacked it will be in the future. Please be aware. Below is a portion of the story. Please don't make this political.

Kennedy told FoxNews.com he based this on an analysis revealing a large number of SQL injection attacks against the healthcare.gov website, which are indicative of "a large amount" of hacking attempts.

'I would say the website is either hacked already or will be soon.'
- David Kennedy, CEO of information security firm TrustedSEC
"Based on the exposures that I identified, and many that I haven’t published due to the criticality of exposures – if a hacker wanted access to the site or sensitive information – they could get it," he told FoxNews.com.

A spokesman for the Department of Health and Human Services, which runs the nation's new healthcare website, did not immediately respond to a request to for more information.

One key problem facing Healthcare.gov is that security wasn’t built into the site from the very beginning, he said -- an opinion shared by both Kennedy and Fred Chang, the distinguished chair in cyber security at Southern Methodist University.

“There’s not a lot of security built into the site, at least that’s what we can see from a 10,000 foot view,” Kennedy told the committee. And although the site doesn’t house medical records, it integrates deeply with other sites, includes ecommerce information, and houses a vast array of data that presents a very salient target.

“It’s not only social security numbers … it’s one of the largest collections of personal data, social security and everything else, that we’ve ever seen,” Kennedy said.

Some members of the panel expressed surprise at the harsh words, noting that, among other things, people enter social security numbers all over the web. Congresswoman Eddie Johnson, D.-Texas, a member of the committee, noted too the ready availability of medical records in the past.

“Why is there such an outcry in this court when medical records have been so available [in the past],” she asked. “Is the healthcare industry lagging in these security measures?”

That’s exactly the case, said Avi Rubin, technical director of Johns Hopkins University's Information Security Institute. The healthcare industry is indeed woefully behind.

“It’s actually the most far behind in terms of security … there are even things in the operating room that surprise me. I think the healthcare it industry needs to learn a lot from some of the other industries to bring its security up to par,” Rubin said.

Rubin called for a security review of the site, but stopped short of calling for a complete tear down and rebuild of the healthcare.gov site. Others were less cautious.

“You can bolt a metal door on to make a house better, but if the foundation is bad…” Kennedy said.

All four cyber security experts unanimously concurred that, given the security issues, Americans should not use the site at present.
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