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Respected Contributor
Posts: 2,158
Registered: β€Ž03-10-2010

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

It's all well and good to complain about the cost of insurance but please remember: not everyone who incurs major medical bills has always been ill or elderly.  My husband had his first heart attack he was 36 and an Athletic Director who looked to be in perfect health.  Thankfully we had (and still have) excellent insurance (not cheap!!).  In the 35 years we have been married our insurance has paid out several million dollars (heart attack, by pass, aortic aneurysm, septsis and my C-section.  We did have one major episode (that involved an air evac, 3 hospitals and six weeks) that was "out of network".  After screaming bloody murder over the $450,000 that wasn't covered, we negotiated our part down to $10,000 (not pleasant but doable).

Honored Contributor
Posts: 9,279
Registered: β€Ž10-25-2010

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

[ Edited ]

@bathina wrote:

@CARMIE wrote:

I figured this would happen.Obama Care is wonderful if you have a low income.

 

if your income is middle class or higher, your premiums are super high, with high deductibles that can't be reached unless you are super ill or in a major accident.

 

i know many people who just paid the penalty because it was cheaper than the insurance.

 

My son had Obama Care with a $7000 deductible per year.  This wonderful coverage cost him about $800 a month.  He paid it for two years and never used it.

 

thank goodness his employer decided to offer him group insurance.  He still has to pay for it, but it is more affordable with a lower deductible.

 

Obama Care insurance was a joke for most people who had a good income.


What's "good" income? Most people with "good" income receive insurance through their employers. Obama care was certainly no joke to people with pre existing conditions or those who had no access to health insurance prior to the law being passed.


Most people with a good income receive insurance from work???? Well, no that is not true.  many people are self employed or work in fields where their income is dependent on the time of year or the amount of work they do. Not all employers offer health insurance to their employees.  If yours does, you are fortunate.

 

My son is single.  He lives in a beautiful large house with 4 bedroom upstairs and one downstairs in an exclusive neighborhood.  He lives there because he lived at home until he was in his 30's and saved every dime he ever made.  He works at least 12 hours a day and is on call on weekends.  He makes a real good income and he works hard for it.

 

He has an income so good that he was not eligible for government help or tax breaks for purchase health insurance.

 

Preexisting conditions have been covered for many years for most people .  There are laws on the books that have been in existence since 1996. Like the Kennedy Kasselbaum Act. This act allowed people to change insurance if they lost theirs and not be subject to preexisting conditions.

 

Most insurance companies covered pre-x conditions after a one year wait if you did not have prior insurance and you paid a higher fee for it.  Medicare does this now.

 

How fair is it for someone to go without insurance for years, then when they get sick to hurry up and purchase it, then drop it again when they are healthy?  It happens.  

 

ACA was only affordable for the low income people.  As always, the upper middle class had to pick up the tab for everyone else.  It would only be fair, if the plans were the same in all 50 states and the premiums were the same too adjusted for the economy of the area.  Everyone should be made to pay a certain percentage of their income and a $7000 deductible per year should be abolished.

 

 

Honored Contributor
Posts: 9,279
Registered: β€Ž10-25-2010

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“


@Patbz wrote:

It's all well and good to complain about the cost of insurance but please remember: not everyone who incurs major medical bills has always been ill or elderly.  My husband had his first heart attack he was 36 and an Athletic Director who looked to be in perfect health.  Thankfully we had (and still have) excellent insurance (not cheap!!).  In the 35 years we have been married our insurance has paid out several million dollars (heart attack, by pass, aortic aneurysm, septsis and my C-section.  We did have one major episode (that involved an air evac, 3 hospitals and six weeks) that was "out of network".  After screaming bloody murder over the $450,000 that wasn't covered, we negotiated our part down to $10,000 (not pleasant but doable).


Because of pre-x conditions, we paid 100% our of,our pocket for my first two pregnancies, one of which was a  C-section.  My first child was conceived while I was working and on my own health insurance.  When I could no longer work, my insurance cancelled and I went on my DH's group policy.  Because I was already pregnant, there was no coverage for me for my pregnancy.  I was in the hospital for seven days.

 

When I was pregnant with my second child, my DH lost his job and his insurance.  He got another job right away with health insurance, but my pregnancy wasn't covered.  I had a C-section with a few complications.   Our medical bills were more than our yearly earnings. it took years, but we paid every penny.  My middle child was expensive.

 

For my third child, insurance paid everything except for $35.

 

There have been laws on the books for years that would have prevented the pregnancies from being excluded for pre-x. Also when my children were young, we had to pay for all of their immunizations and well doctor visits.  There was no preventative care coverage.

 

Health insurance should be affordable for everyone, not just the low income.  There is no reason why the upper middle class has to carry the whole ACA program.

 

BTW, thank goodness you can get out of network charges paid if you did not have a choice in choosing that provider in an emergency.  It comes under guidelines called invisible provider or ghost provider.  You have to appeal to get it paid, it won't happen on it's  own.  I am glad you insurance paid this for you. You were wise to appeal their payment or lack of payment.

Trusted Contributor
Posts: 1,951
Registered: β€Ž03-14-2010

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

[ Edited ]

@CARMIE wrote:

@bathina wrote:

@CARMIE wrote:

I figured this would happen.Obama Care is wonderful if you have a low income.

 

if your income is middle class or higher, your premiums are super high, with high deductibles that can't be reached unless you are super ill or in a major accident.

 

i know many people who just paid the penalty because it was cheaper than the insurance.

 

My son had Obama Care with a $7000 deductible per year.  This wonderful coverage cost him about $800 a month.  He paid it for two years and never used it.

 

thank goodness his employer decided to offer him group insurance.  He still has to pay for it, but it is more affordable with a lower deductible.

 

Obama Care insurance was a joke for most people who had a good income.


What's "good" income? Most people with "good" income receive insurance through their employers. Obama care was certainly no joke to people with pre existing conditions or those who had no access to health insurance prior to the law being passed.


Most people with a good income receive insurance from work???? Well, no that is not true.  many people are self employed or work in fields where their income is dependent on the time of year or the amount of work they do. Not all employers offer health insurance to their employees.  If yours does, you are fortunate.

 

My son is single.  He lives in a beautiful large house with 4 bedroom upstairs and one downstairs in an exclusive neighborhood.  He lives there because he lived at home until he was in his 30's and saved every dime he ever made.  He works at least 12 hours a day and is on call on weekends.  He makes a real good income and he works hard for it.

 

Preexisting conditions have been covered for many years for most people .  There are laws on the books that have been in existence since 1996. Like the Kennedy Kasselbaum Act. This act allowed people to change insurance if they lost theirs and not be subject to preexisting conditions.

 

Most insurance companies covered pre-x conditions after a one year wait if you did not have prior insurance and you paid a higher fee for it.  Medicare does this now.

 

How fair is it for someone to go without insurance for years, then when they get sick to hurry up and purchase it, then drop it again when they are healthy?  It happens.  

 

ACA was only affordable for the low income people.  As always, the upper middle class had to pick up the tab for everyone else.  It would only be fair, if the plans were the same in all 50 states and the premiums were the same too adjusted for the economy of the area.  Everyone should be made to pay a certain percentage of their income and a $7000 deductible per year should be abolished.

 

 


Over 55% of the population receives their health insurance through their employer. Only 14% purchase direct from an insurer. If your son has what you say he has, regardless of how he got it, he can well afford to pay for his own insurance and doesn't need a subsidy, for which he should be grateful. Every tax payer contributes toward the subsidy, not just the "upper middle class". ACA made it illegal to discriminate against people with pre-existing conditions. Many sick people were priced out of the market prior to the law. It is not fair that someone should only purchase when they're sick, but that's why we had the mandate, which was reversed during this administration. Effectively, removing the mandate removes the underpinning which is needed to control costs. You are right, everyone should be made to pay a percentage of their income and then everyone could be covered from cradle to grave, which is what they do in Canada, Great Britain, Australia and other first world countries.

Honored Contributor
Posts: 16,889
Registered: β€Ž05-22-2016

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

I am 63, disabled and not eligible for Medicare for the disabled (long story). So the only way I can afford health insurance is to buy it thru our state marketplace which has become a dire situation with high priced premiums, lousy coverage and high deductibles. For me there's no getting around expensive health insurance.

Valued Contributor
Posts: 933
Registered: β€Ž11-21-2011

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

The problem is that health insurance itsn't insurance anymore. I put a large amount of the blame on the people of this country.

 

Everyone loved to hate on their insurance carrier. No one ever felt they were getting enough, even those getting it through work where they had no idea what the cost was to their employer.

 

Your insurance doesn't pay enough for a mammo? Complain to a politician and they'll get if for you for free. 30 days of inpatient rehab not enough. Again get a politician to mandate it. That's what we did in NY and why our costs were already high. When the ACA was being passed anyone here could see this writing on the wall.

 

Then add in the hospitals have a pretty good upper hand in negotiating what they'll get paid. It's not like any other insurance where you can just get something done and your insurance says "hey that sounds reasonable" and cuts you a reimbursement check.

Highlighted
Respected Contributor
Posts: 3,596
Registered: β€Ž03-10-2010

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

Carmie, We are in CA.  The prices didn't go up much if any from the quote we got last year when we first checked out Covered California plans. 

Esteemed Contributor
Posts: 7,602
Registered: β€Ž06-08-2016

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“


@bathina wrote:

@CARMIE wrote:

I figured this would happen.Obama Care is wonderful if you have a low income.

 

if your income is middle class or higher, your premiums are super high, with high deductibles that can't be reached unless you are super ill or in a major accident.

 

i know many people who just paid the penalty because it was cheaper than the insurance.

 

My son had Obama Care with a $7000 deductible per year.  This wonderful coverage cost him about $800 a month.  He paid it for two years and never used it.

 

thank goodness his employer decided to offer him group insurance.  He still has to pay for it, but it is more affordable with a lower deductible.

 

Obama Care insurance was a joke for most people who had a good income.


What's "good" income? Most people with "good" income receive insurance through their employers. Obama care was certainly no joke to people with pre existing conditions or those who had no access to health insurance prior to the law being passed.


 

 

Not everyone with a "good income" has an employer.

Esteemed Contributor
Posts: 7,602
Registered: β€Ž06-08-2016

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“


@pigletsmom wrote:

The problem is that health insurance itsn't insurance anymore. I put a large amount of the blame on the people of this country.

 

Everyone loved to hate on their insurance carrier. No one ever felt they were getting enough, even those getting it through work where they had no idea what the cost was to their employer.

 

Your insurance doesn't pay enough for a mammo? Complain to a politician and they'll get if for you for free. 30 days of inpatient rehab not enough. Again get a politician to mandate it. That's what we did in NY and why our costs were already high. When the ACA was being passed anyone here could see this writing on the wall.

 

Then add in the hospitals have a pretty good upper hand in negotiating what they'll get paid. It's not like any other insurance where you can just get something done and your insurance says "hey that sounds reasonable" and cuts you a reimbursement check.


 

 

 

I don't blame "people of this country"    I blame

  1. Lawyers
  2. Politicians
  3. Unions
Honored Contributor
Posts: 16,889
Registered: β€Ž05-22-2016

Re: πŸ“ Medical ACA insurance Deadline 12/15/18 πŸ“

I can also blame the food industry and also the FDA for making us a country full of unhealthy people who have unfortunately driven the cost of healthcare in an upward spiral.