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Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: 2015 Annual Notice of Changes

On 9/21/2014 sylviahomeatlast said: thank you, Pitdakota---I have to ask when i don't know--- Smiley Happy)))

No problem sylvia! Now let's hope that is accurate in terms of what sfnative was referring to. LOL!


* Freedom has a taste the protected will never know *
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Respected Contributor
Posts: 3,958
Registered: ‎09-28-2010

Re: 2015 Annual Notice of Changes

On 9/21/2014 RibbonsRosesRainbows said:

Let me know what you read............it could be

www.ncbi.nlm.nih.PMC/articles/gov./PMC40051201/

there will be an article that you will search for about drug plans changing in 2015.........you will find it if you look correctly............I found it again.

You are visiting the library and it includes articles from a variety of sources, not just government. There are many "opinion" pieces contained in that library.

Trusted Contributor
Posts: 3,697
Registered: ‎03-09-2010

Re: 2015 Annual Notice of Changes

On 9/21/2014 Lucky Charm said:
On 9/21/2014 adelle38 said:
On 9/21/2014 spindlegirl said:
On 9/21/2014 qvcaddition said:

I guess we have to pay for those that have no ins.

We've been paying for the uninsured for years.

We've also been paying for the insured who get employer subsidized insurance.


Many people are so disgruntled because employers offer (group) health insurance. I always thought it was a plus. (I worked several jobs where health insurance was free) I took the jobs because of the importance of having health insurance and the fact it was free was better.

Any ways, it seems the same (disgruntled) people are pro-Union. Do they realize that many, many, many unions offer free or very cheap health insurance to their members? I know someone who just retired in June at 55 years old. His union will pay the Cobra premiums till he reaches Medicare age. Sweeeet deal, huh?

I was referring to the fact that people complain about paying for the uninsured and also about supplementing insurance for the working poor. None to those people seem to understand that insurance through employers is supplemented by tax breaks for the employer and is untaxed income for the employee. As to the Unions, they negotiate those insurance benefits in collective bargaining and yes it is supplemented in the same way.

Meanwhile people with low paying jobs or tempory jobs have had no access to insurance prior to the ACA.

The fairest system would be Universal Health Care or Medicare for all. It would end all these outrageous rises in fees by insurance companies and medical professionals.

It's always a victory for me when I remember why I entered a room.
Honored Contributor
Posts: 13,954
Registered: ‎03-10-2010

Re: 2015 Annual Notice of Changes

On 9/21/2014 Lucky Charm said:

I just heard tonight that O'care is not available to people who have employers that offer health insurance.

Is this true?

(He pays over $900/month for wick*ed coverage and was hoping for 'more affordable' insurance.)

If you work for an employer that offers HI, why would you want to use ACA coverage, where you will probably pay a larger share of the premium? That makes no sense....why pay more when your employer is offering subsidized coverage to it's employees???

Honored Contributor
Posts: 13,858
Registered: ‎03-09-2010

Re: 2015 Annual Notice of Changes

On 9/22/2014 terrier3 said:
On 9/21/2014 Lucky Charm said:

I just heard tonight that O'care is not available to people who have employers that offer health insurance.

Is this true?

(He pays over $900/month for wick*ed coverage and was hoping for 'more affordable' insurance.)

If you work for an employer that offers HI, why would you want to use ACA coverage, where you will probably pay a larger share of the premium? That makes no sense....why pay more when your employer is offering subsidized coverage to it's employees???


The guy works for a Mom and Pop printing company. He told us how much he makes annually (clears about $2k/mo). I thought $950 was steep for a family plan. I believe his wife is epileptic so she has medical needs. (Not sure if ACA offers drug/prescription coverage.) I was just wondering if the ACA could be a cheaper option for them.

Honored Contributor
Posts: 13,954
Registered: ‎03-10-2010

Re: 2015 Annual Notice of Changes

On 9/22/2014 Lucky Charm said:
On 9/22/2014 terrier3 said:
On 9/21/2014 Lucky Charm said:

I just heard tonight that O'care is not available to people who have employers that offer health insurance.

Is this true?

(He pays over $900/month for wick*ed coverage and was hoping for 'more affordable' insurance.)

If you work for an employer that offers HI, why would you want to use ACA coverage, where you will probably pay a larger share of the premium? That makes no sense....why pay more when your employer is offering subsidized coverage to it's employees???


The guy works for a Mom and Pop printing company. He told us how much he makes annually (clears about $2k/mo). I thought $950 was steep for a family plan. I believe his wife is epileptic so she has medical needs. (Not sure if ACA offers drug/prescription coverage.) I was just wondering if the ACA could be a cheaper option for them.

If a small business offers HI, but an employee can get coverage for LESS money on the exchange, they can buy directly from the exchange. Making 24K a year for a family of 2 adults would also entitle your friend to both a tax subsidy and also deductible and co-pay help. ALL HI coverage now includes prescription coverage.

The ACA is set up so that families don't have to pay more than 9% of their income (roughly) in HI premiums, $950 is almost HALF of his take home pay...in general, the ACA will be a better deal.

Your friend should #1 - contact their doctors and find out if they accept exchange policies...and which insurance companies exchange plans (if keeping doctors is important to them). Then they can go to the website for that plan, go to the exchange and look around. Enrollment for 2015 starts on Nov. 15th, so your 2015 plans may not be available to view yet.
In order to receive both the tax subsidy AND the deductible & co-pay assistance, they will have to choose a SILVER exchange plan. Please note that in order to see the specific premiums and assistance, they will need to enter their income information. There are graphs to help them online - plus insurance companies have people to answer questions. This is a money maker for private insurance plans - they all offer help and may be easier to contact than the state exchange (or the federal exchange, if you live in a state with no state program). They can walk someone through the application to see if it would be cost effective.

This is again JUST GENERAL INFORMATION. You can contact your state's exchange for further information...or a local health insurance company that is on the exchange.

I put that in BOLD because every state and every family's situation is different. This is just general info.

Esteemed Contributor
Posts: 5,821
Registered: ‎03-10-2010

Re: 2015 Annual Notice of Changes

I am going to write something that no one proberly wants to hear, but it is the god awful truth. A few years ago about 15, I was an admitting clerk in an hospital at the ER. I had to pass through people from the free clinic. Whole families medical free. This hospital was already in trouble of closing and the town people loved this hospital so much everything was raised to save it and they did for a few years until so many people got free medical, the hospital closed last year.

Well as I'm sitting at my desk, I am getting chest pains, so I told one of the nurses and she advised I get checked out with an EKG. I am now being checked in by my co worker and paying my co pay which at the time was cheap, but I was working there and an American citizen born and raised here and paid my taxes and all the stuff we do, yet I still had to pay my co pay. If you were not born here and not a citizen, you got your medical free.

I can see in an emergency anyone getting free ER, it is to save a life, but people were using it because they had no DR. The druggies were using it to get drugs and selling them down the next corner. The Drs. knew this, but could not refuse anyone. You can't tell when someone has a headache or backache so they would come in with that excuse to get their drugs. Oh, and of course they were allergic to this and that drug, until the Dr. hit their drug of choice. If they didn't get it at our ER, they would travel to other ER's., so we would call all the ER in the vicinity to warn them. H

Honest people don't stand a chance with the system, you have to know how to work the system. I was also a Med I cal, (aid, don't know what they call it today) biller and that system is really overused. The ones that need it had a hard time getting it, and the ones that didn't want to work, knew how to work the system and get it. I bet that holds true today.

You can slam me, but you know that is what is wrong with the system and we as taxpayers are paying for it, while we are struggling with our own medical dilemma.

Super Contributor
Posts: 1,248
Registered: ‎03-09-2010

Re: 2015 Annual Notice of Changes

On 9/22/2014 qvcaddition said:

I am going to write something that no one proberly wants to hear, but it is the god awful truth. A few years ago about 15, I was an admitting clerk in an hospital at the ER. I had to pass through people from the free clinic. Whole families medical free. This hospital was already in trouble of closing and the town people loved this hospital so much everything was raised to save it and they did for a few years until so many people got free medical, the hospital closed last year.

Well as I'm sitting at my desk, I am getting chest pains, so I told one of the nurses and she advised I get checked out with an EKG. I am now being checked in by my co worker and paying my co pay which at the time was cheap, but I was working there and an American citizen born and raised here and paid my taxes and all the stuff we do, yet I still had to pay my co pay. If you were not born here and not a citizen, you got your medical free.

I can see in an emergency anyone getting free ER, it is to save a life, but people were using it because they had no DR. The druggies were using it to get drugs and selling them down the next corner. The Drs. knew this, but could not refuse anyone. You can't tell when someone has a headache or backache so they would come in with that excuse to get their drugs. Oh, and of course they were allergic to this and that drug, until the Dr. hit their drug of choice. If they didn't get it at our ER, they would travel to other ER's., so we would call all the ER in the vicinity to warn them. H

Honest people don't stand a chance with the system, you have to know how to work the system. I was also a Med I cal, (aid, don't know what they call it today) biller and that system is really overused. The ones that need it had a hard time getting it, and the ones that didn't want to work, knew how to work the system and get it. I bet that holds true today.

You can slam me, but you know that is what is wrong with the system and we as taxpayers are paying for it, while we are struggling with our own medical dilemma.

So true. We have had some of our smaller clinics close down. And, we have had to open closed schools to accommodate the influx. I know exactly what you are talking about.

Honored Contributor
Posts: 13,954
Registered: ‎03-10-2010

Re: 2015 Annual Notice of Changes

On 9/22/2014 MaggieToo said:
On 9/22/2014 qvcaddition said:

I am going to write something that no one proberly wants to hear, but it is the god awful truth. A few years ago about 15, I was an admitting clerk in an hospital at the ER. I had to pass through people from the free clinic. Whole families medical free. This hospital was already in trouble of closing and the town people loved this hospital so much everything was raised to save it and they did for a few years until so many people got free medical, the hospital closed last year.

Well as I'm sitting at my desk, I am getting chest pains, so I told one of the nurses and she advised I get checked out with an EKG. I am now being checked in by my co worker and paying my co pay which at the time was cheap, but I was working there and an American citizen born and raised here and paid my taxes and all the stuff we do, yet I still had to pay my co pay. If you were not born here and not a citizen, you got your medical free.

So true. We have had some of our smaller clinics close down. And, we have had to open closed schools to accommodate the influx. I know exactly what you are talking about.

Everyone gets free EMERGENCY room treatment (at hospitals that accept Medicaid patients), thanks to a law signed by Ron R. I doubt that he thought emergency rooms were going to be abused the way they have been - I think it was because he thought it was the right thing to do (US citizens are treated overseas the same way) and because he wanted votes from certain groups, once they became citizens.

You must prove citizenship (or have a VALID green card) to get ACA insurance. You cannot get Medicaid unless you are a citizen or landed immigrant either.

I have a feeling you both live in states that didn't accept expanded Medicaid benefits for people making less than 138% of the poverty level. States that rejected setting up their own exchanges and expanding Medicaid have lost billions in federal assistance. Yes, small hospitals have closed. Your local leaders are to blame and should be held accountable.

Honored Contributor
Posts: 25,929
Registered: ‎03-09-2010

Re: 2015 Annual Notice of Changes

I don't know where you get the idea that you get free care in the ER - my late husband had no insurance - self employed - and after he died in the ER I was very unceremoniously handed a bill for $83,000. Don't tell me you get free care in the ER - they can't turn you away but they absolutely expect to be paid in the end of it all.