Beauty

[AnotherView2]

On 3/27/2015 chi5925 said:

On 3/26/2015 Tinkrbl44 said:

Uh, people ....... This ISN'T about the ACA.

I read the OP's comments twice, and her MD is opting out of ALL PPO insurances, because of the insurance companies' actions and delays. That's not Obamacare.

I also agree with the other poster that said $1600 a MONTH to insure two people is BEYOND STUPID ...... and not being able to opt out? Yikes!

If it were me, I'd call the State Consumer Affair regulators and lodge a complaint!

The OP's husband is in a union and that's what his union charges. The union has to charge them that much so union leaders can maintain their homes on Star Island in Miami.

Never mess with the Teamsters -- only they know what states Jimmy Hoffa's body parts are buried in......

yes. it's a union issue. either the union has lousy negotiating skills when dealing with ins companies or they are getting a kickback. those rates quoted are even higher than a COBRA rate, even including dental and vision.

[LeaLeander]

On 3/27/2015 Icegoddess said:

On 3/27/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 jackthebear said:

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

I don't have a huge issue with the dental coverage being mandatory, as there are kids who don't get to the dentist at all, and good teeth are very important.

And as for dental and optical insurance we have never had any.

I don't have children at home, so I don't see why I need pediatric dental or optical. I also don't need obstetric care but have to have that too.

Because that's how insurance pools work.

If pools were sliced and diced so that, for example, only people your age, s*x and with your particular medical conditions/hereditary risks were in the pool, you would be in for an extremely rude awakening when it came to premiums.

In a pool, young pay for old, old pay for fertile, healthy pay for sick, etc.

I'm not interested in an insurance pool. That's the point. For pediatric care, that is what a Family Plan is for. Plus, the promise was that costs would go down, but instead mine went up, way up even though I had obstetric coverage before. $6000 deductible? I don't use $6000 in medical care a year, so it is actually a deterrent to going to the doctor. I don't want to pay for other people and I don't expect other people to pay for me.

I simply don't know what to say to this kind of ignorance about how the world works. Insurance IS risk pools. You cannot purchase insurance "just for yourself."

Costs did go down for many people. Those whose costs went up are probably in an age range where they are a bigger liability to insurers and now are being charged more fairly for the burden they place on the system.

I don't have high medical costs. I rarely go to the doctor and the 2 prescriptions I have cost a total of about $30/month. I had to qualify for the insurance I have as not being high risk and yet it is still out of this world at $1500/month and a $6000 deductible for just me.

I understand that insurance is a pool, but the pool has changed because of the ACA.

And I don't think there is any reason to call someone ignorant just because they have a different point of view.

yes, the pool is BIGGER due to the ACA. More young and healthy people paying premiums to support care for older people. That was a large part of the point of the law.

[Tinkrbl44]

On 3/31/2015 Cinder63 said:

On 3/27/2015 Icegoddess said:

On 3/27/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 jackthebear said:

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

I don't have a huge issue with the dental coverage being mandatory, as there are kids who don't get to the dentist at all, and good teeth are very important.

And as for dental and optical insurance we have never had any.

I don't have children at home, so I don't see why I need pediatric dental or optical. I also don't need obstetric care but have to have that too.

Because that's how insurance pools work.

If pools were sliced and diced so that, for example, only people your age, s*x and with your particular medical conditions/hereditary risks were in the pool, you would be in for an extremely rude awakening when it came to premiums.

In a pool, young pay for old, old pay for fertile, healthy pay for sick, etc.

I'm not interested in an insurance pool. That's the point. For pediatric care, that is what a Family Plan is for. Plus, the promise was that costs would go down, but instead mine went up, way up even though I had obstetric coverage before. $6000 deductible? I don't use $6000 in medical care a year, so it is actually a deterrent to going to the doctor. I don't want to pay for other people and I don't expect other people to pay for me.

I simply don't know what to say to this kind of ignorance about how the world works. Insurance IS risk pools. You cannot purchase insurance "just for yourself."

Costs did go down for many people. Those whose costs went up are probably in an age range where they are a bigger liability to insurers and now are being charged more fairly for the burden they place on the system.

I don't have high medical costs. I rarely go to the doctor and the 2 prescriptions I have cost a total of about $30/month. I had to qualify for the insurance I have as not being high risk and yet it is still out of this world at $1500/month and a $6000 deductible for just me.

I understand that insurance is a pool, but the pool has changed because of the ACA.

And I don't think there is any reason to call someone ignorant just because they have a different point of view.

yes, the pool is BIGGER due to the ACA. More young and healthy people paying premiums to support care for older people. That was a large part of the point of the law.

Same thing for how Social Security operates .... and I doubt many people want to get rid of SS !!

[Dawn01]

I have tried to figure out what has caused so many of these changes.I know that until this yr, a good friend of mine always had good health ins through her employer.Fast forward to this yr and she still has same amount deducted from her check for health ins,yet her policy pays almost nothing.Not even for labwork to see if her meds are affecting her liver,kidney,etc.Guy at ins co told her they only pay for minimal tests,even though my friend is pre-diabetic.It won't even pay for blood sugar tests,she pays all labs and most of dr visit cost...Plus deductible is high.

Thankfully she can go on Medicare in a few years but she was told they pay for very few lab tests either.But at least deductible is low and cost is too.

I also know someone who draws SS as a widow ,inherited quite a bit of money,yet somehow qualified for a govt assisted rate under the ACA rules.So I guess assets do not have to be listed to get the cheap rates...This picture does not seem fair but I guess that is the way the system works now.

[CalminHeart]

Things like this happen in rural area quite often. I don't understand why but it does. IMO, the fault lies squarely with insurance companies who tell doctors and patients what can and can't be done. This has nothing to do with ACA. Some people will say it's ACA's fault but it isn't. For a doctor to go to cash only tells me he/she doesn't like the constraints an insurance companies put on medical care, which I totally get. It tells me that the doctor wants independence from medical practices. But it also makes me highly suspicious. For any doctor to refuse to do business with insurance companies seems odd at best. I don't think I would go to a doctor like that.

[Icegoddess]

On 3/31/2015 Cinder63 said:

On 3/27/2015 Icegoddess said:

On 3/27/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 jackthebear said:

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

I don't have a huge issue with the dental coverage being mandatory, as there are kids who don't get to the dentist at all, and good teeth are very important.

And as for dental and optical insurance we have never had any.

I don't have children at home, so I don't see why I need pediatric dental or optical. I also don't need obstetric care but have to have that too.

Because that's how insurance pools work.

If pools were sliced and diced so that, for example, only people your age, s*x and with your particular medical conditions/hereditary risks were in the pool, you would be in for an extremely rude awakening when it came to premiums.

In a pool, young pay for old, old pay for fertile, healthy pay for sick, etc.

I'm not interested in an insurance pool. That's the point. For pediatric care, that is what a Family Plan is for. Plus, the promise was that costs would go down, but instead mine went up, way up even though I had obstetric coverage before. $6000 deductible? I don't use $6000 in medical care a year, so it is actually a deterrent to going to the doctor. I don't want to pay for other people and I don't expect other people to pay for me.

I simply don't know what to say to this kind of ignorance about how the world works. Insurance IS risk pools. You cannot purchase insurance "just for yourself."

Costs did go down for many people. Those whose costs went up are probably in an age range where they are a bigger liability to insurers and now are being charged more fairly for the burden they place on the system.

I don't have high medical costs. I rarely go to the doctor and the 2 prescriptions I have cost a total of about $30/month. I had to qualify for the insurance I have as not being high risk and yet it is still out of this world at $1500/month and a $6000 deductible for just me.

I understand that insurance is a pool, but the pool has changed because of the ACA.

And I don't think there is any reason to call someone ignorant just because they have a different point of view.

yes, the pool is BIGGER due to the ACA. More young and healthy people paying premiums to support care for older people. That was a large part of the point of the law.

The older people were already there on Medicare (another system I generally don't hear praises for). So, if that's the case our premiums/deductibles would be going down instead of up. I just think there were plenty of things that could've been done to "fix" the system without having to totally overhaul it along with forcing people to buy coverages they didn't want. Even though the old catastrophic coverages are no longer available, that is what mine has basically become because I have to spend so much out of pocket before insurance will cover anything. And, after all that, there are still millions who fall through the cracks and still get no coverage.

Tinkrbl44 said:Same thing for how Social Security operates .... and I doubt many people want to get rid of SS !!

Social Security is going bankrupt just like a lot of the pension programs people are counting on that may not be there when they need it. I know the company I worked for offered everyone not already drawing a pension cash buyouts.

[LeaLeander]

As the expression goes, "None are so blind as those who refuse to see."

I don't know why I bother, but:

Medicare starts at age 65. Many people begin experiencing costly health problems -- joint damage, diabetes, heart disease, back problems, depression/anxiety, obesity, kidney problems, etc. -- in early middle age -- say 45 to 65.

That is 20 years of coverage before Medicare starts. When we have a situation where younger people who feel invincible aren't paying into the insurance pool, we have sick people trying to cover one another's medical needs.

Just as with auto insurance, those who don't get into accidents are paying for those who do.

If everyone is required to buy insurance and participate in the pool, you will get many more healthy people contributing premium dollars to the pool that covers sicker, older people. Not everyone contributing is a "taker" just as not every driver makes an insurance claim every year or every decade.

Social Security is not going bankrupt. You can easily go online and read the audit report for yourself. A small tweak in the cap could prolong its viability indefinitely. The threat of a bankrupt SS system is a tool used by unscrupulous politicians to manipulate gullible people. Just as the same politicians and biased media outlets use the "evil ACA" to whip up fallacious stories that hoodwink the same people into blaming ACA for completely unrelated phenomena.

[annpete]

On 3/26/2015 adelle38 said:

Several factors are responsible. The doctor shortage has been in the making for decades partly because of our aging population. Until we regulate insurance companies they will continue to control the purse strings of our health care.

Amen to this and you are so right. No one accountable & that means they can do as they will and everyone blames whoever they choose...no controls on anything!

[Anniecamp]

It took a long time for me to finish reading this thread from the point of where I had my last post. I realize this is an "old thread", but I wanted to add my thoughts. It bothers me that uneven coverage exists between those who don't pay a dime on Medicaid, and those who pay high premiums, as well as Medicare people who also pay a lot for "medi-gap" plans. Children on Medicaid get free braces on their teeth and dental care, vision coverage, hearing, etc. The gov't seems to recognize it as necessary care. Again, their parents don't have to contribute a time. I also know a woman who has had weight loss surgery, as well as other expensive surgeries via Medicaid, and she hasn't paid a cent. Dental, Vision, and Hearing is not covered by Medicare. Why are seniors forced to let their teeth rot, etc. when they've been paying all along, and continue to pay for things after retirement? That's not even addressing the lack of coverage and high prices that all of the other people are paying. When the powers that be do look at Medicare, they think of "benefits" to cut, or give low coverage for things, instead of requiring more from the able bodied on Medicaid (not all are). For example, if you have more than one child you couldn't afford to have insurance for in the first place, you're out! Clinton had a good program for welfare to work, but that has since been phased out. That's a setback and a real shame. So many were growing and becoming contributors instead of takers, making welfare a helping hand temporarily, rather than a lifestyle.

[Mustang Shar]

You all must keep in mind the good changes that we all pay for that used to be excluded. Wellness visits, used to be not covered or very limited. Mental health, limited. Pre existing, gone now. Dependent children over 19 had to be full time college students to have coverage. Now they are covered to age 26, married, with or without their own coverage. Multiple dependent pregnancies in that age group. Lots that were excluded expenses that we all pay for. That money has to come from somewhere. Plus tons of billing errors that end up costing you, the patient, because the providers billing office NEVER FILED YOUR CLAIM until 2 years too late! Ugh, what a shame....physicians don't get paid by insurance and guess what, you signed a document that makes you responsible and its on file in their office.