Community Chat

[Annabellethecat66]

What is ACA?

[manny2]

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@NYC Susan wrote:

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@pigletsmom wrote:

I think in most places you can go around the marketplace and just buy from the insurer but there wouldn't be any subsidy. It would make no sense otherwise. What if some 50 year old person that had made a couple of million dollars took a year off just because? I best not be payng for them to go on Medicaid because they have no income. Although I suppose they could if they wanted to but Medicaid stinks so that's unlikely to happen. I do remember stories about that in California I think when it first started. If you went on the site and filled out the stuff and say your only income was interest income so it was low, your stuff was sent right to Medicaid and it was an auto signup.

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It's not that simple.  They look at assets too.  Someone who had millions of dollars (or any amount above the allowed limit in their state) would have to spend that money down before qualifying for Medicaid.  Marital status and other factors are also taken into consideration.  It's not just based on income from one year.

When the ACA was new, I had two patients who tried to sign up and were told they qualified for Medicaid and would be automatically signed up. However, when they continued the process, they were both denied because they had assets over the allowable limit.  The ACA just sends the info to Medicaid, and then Medicaid determines if the person actually qualifies.  

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The spend down for medicaid is only if you are in long term care. When you apply for the expanded medicaid they look at income. 

[Anonymous032819]

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@SilleeMee wrote:

All kinds of people cheat their income to get on Medicaid. That upsets me so much because I know some of those people and they appear to be living beyond their means and enjoying every minute of it, partying and gambling, on taxpayer money...on foodstamps, too.

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Yes, yes, the old "Everybody cheats!" mantra.

I'm sure these same people that you are judging are also driving Royal Royces or Teslas too. Taking trips to Monaco.

No system is perfect or will ever be perfect, but what we have now is better than nothing and letting people starve to death, letting children and babies go hungry.

And no, there isn't always enough beds in shelters or food at food banks or soup kitchens to accomodate everyone.

[willdob3]

This is really very old news. It has always been this way. It was never affordable for everyone. 

[Anonymous032819]

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@Annabellethecat66 wrote:

What is ACA?

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Affordable

Care

Act

[SilleeMee]

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@Anonymous032819 wrote:

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@Goldengate8361 wrote:

And, this is bad because........?

Do you really know how little $11,000 is?

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That's LESS than $1,000 PER MONTH.

I'd like to see anybody here try to live off of less than $1,000 per month.

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You would be surprised to know there are people who do live on less than that. They do what they can to make ends meet. 

[Anonymous032819]

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@SilleeMee wrote:

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@Anonymous032819 wrote:

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@Goldengate8361 wrote:

And, this is bad because........?

Do you really know how little $11,000 is?

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That's LESS than $1,000 PER MONTH.

I'd like to see anybody here try to live off of less than $1,000 per month.

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You would be surprised to know there are people who do live on less than that. They do what they can to make ends meet. 

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And trust me, they are NOT living high off of the hog.

They are struggling.

[SilleeMee]

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@Anonymous032819 wrote:

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@SilleeMee wrote:

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@Anonymous032819 wrote:

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@Goldengate8361 wrote:

And, this is bad because........?

Do you really know how little $11,000 is?

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That's LESS than $1,000 PER MONTH.

I'd like to see anybody here try to live off of less than $1,000 per month.

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You would be surprised to know there are people who do live on less than that. They do what they can to make ends meet. 

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And trust me, they are NOT living high off of the hog.

They are struggling.

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No, not high on the hog but comfortable enough to afford to buy cigs, booze and go out to eat in restaurants just about every other night. Point is...it's taxpayer's money they're spending on stuff that is normally not covered with foodstamps or any such programs.

[Jordan2]

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@SilleeMee wrote:

If you buy an affordable plan from the health insurance marketplace, just know that the deductibles are through the roof and it's laughable to say the least. The marketplace offers plans based on your income. Many companies have bailed from the marketplace so what that means is the ones left to choose from really sock. I know too well about the coverage and what the ACA has to offer which is mostly a free one-a-year wellness check with some labs included. All the rest is paid out of pocket until you meet a very high deductible which can be around $8K, some are more, for those affordable plans. Discounts for Rx drugs are almost nonexistent and the ones covered under most of the affordable plans are very limited. It's cheaper to just buy generic from a drugstore without going through the insurance. 

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I live in New York and purchase my health plan through the marketplace. It seems the choices get less and less each year. I started out with a platinum plan, then gold, now a silver, which is getting too expensive for me. I use the plan mostly for what I am covered for, such as a mammogram, sonogram, wellness visit with my gynecologist, and I see my PCP twice a year. My deductibles are sky high, I really can’t afford to use my insurance.

[momtochloe]

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@SilleeMee wrote:

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@Drythe wrote:

@SilleeMee 

So many rules are based on decisions made by your representatives in the state in which you reside.

Example:  I live in a state in which the State Legislature has voted AGAINST expanding ACA coverage, which would make it more affordable and include more people.

Perhaps you might be helped by visiting a certified Insurance Specialist.

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@Drythe 

Several years ago when this ACA stuff all started, it was required to find and use an insurance broker to obtain plans through the marketplace. So I have a broker and he does as little as possible. To say the least, I know more than he does about what's being offered in the marketplace! He's like an appointed public defender...just doing what the system tells him to do and nothing extra. It's such a joke.

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@SilleeMee  I have been on ACA plans since they were first introduced and have never used a broker.  I have always signed up directly with the ACA.  I live in a state that supports the ACA and have always been a BCBS member.  I work with them to figure out the plan that is best for me and then sign up via the ACA.