Lany Freelove Cassandra Posted November 14, 2014 Share Posted November 14, 2014 Time to enroll in health care plans here in the USA and it is more of a PITA for us this year than ever. Husband's work insurance plan went up in cost and down in coverage. Problem we have is that my son and I take daily medications and have quarterly doctor visits, in addition to any other illnesses or injuries the 3 of us might have, and we truly cannot afford a $1000 deductible (after paying $5000 a year for the coverage) So my experience so far (could update differently over the next few days): Currently, we have spent about 4 hours total, including a 45 minute phone consultation The ugly: Trying to navigate Maryland's health care site The bad: Not clearly defined who can use the exchange (if you have work sponsored insurance, it needs to be deemed "unaffordable" (I think that is at 15% of your pay); sign ups don't start until AFTER the husband's deadline for submitting his insurance (this is our biggest issue, and it still has us a little scared as we have had to make a decision without concrete information); no concrete information until you actually sign up The Good: the phone consultant was amazing! I wish I had her name, I'd call up and report how awesome she was! she told me what the major problem was that I was having with the website (our income was actually too low and once I opted out of medicaid it refused to allow me a subsidy. Problem is, we are only $500 below the medicaid threshold, and 5 days of subbing will kick us out of it, so I had to add that possible money in for the insurance, just enough to pass medicaid, although my son apparently still qualifies); being able to see if your doctor is in a plan before you decide (Yes, we can keep our doctors :P ) If all goes as it looks right now, we will save over $2000 in premiums and the $1000 deductible, definitely a good thing over all. Link to comment Share on other sites More sharing options...
awesome possum Posted November 14, 2014 Share Posted November 14, 2014 My wife and I are covered through my work, but the only reason that sentence includes "My wife" is the ACA. My wife's mother had a rare disorder when she was pregnant with my wife that caused her umbilical cord to stop sending nutrients. My wife was born full term but only weighed 1.2 pounds and spent the first three months of her life in intensive care. That really killed her immune system. She has Type-1 Diabetes (despite living a mostly healthy lifestyle) and in the last two years has had to have her uterus, appendix and gall bladder removed. She spends at least one week of every month sick as a dog, without fail. If someone two houses down sneezes, she gets the flu. That's how much her immune system sucks. Before the ACA it cost me $27 per paycheck to insure me. To add my wife it pushed the price up to $185 every two weeks. After the ACA we're both covered for $58 per paycheck. The ACA is not perfect, but it's far better than what we had before. Link to comment Share on other sites More sharing options...
Nichole Posted November 14, 2014 Share Posted November 14, 2014 The ACA is not perfect, but it's far better than what we had before. I agree with this. I would rather see totally socialized healthcare in our country, but ACA is better than what we had. While I'm lucky to have good insurance through my husband my parents are another story. They have always had their own business and my mom has a heart condition that while being very healthy otherwise, she is considered to have hearth disease and was not insurable before the ACA. My dad had a plan, but it was shitty with high deductibles and now they are both insured under better plans. Also, I went to the doctor very seldom as a kid because my parents couldn't afford it. I'm amazed by often I read on mommy groups that parents will take their kids to the doctor over a small fever, this was not done in my house growing up, you had to be really really sick to go to the doctor. I now worry that I will wait too long to take my kid to the doctor because of how I was raised. Link to comment Share on other sites More sharing options...
TrackerNeil Posted November 14, 2014 Share Posted November 14, 2014 If all goes as it looks right now, we will save over $2000 in premiums and the $1000 deductible, definitely a good thing over all. Great news! Right now I'm on my spouse's policy, but, boy, could I have used this back in 2010! I'm still glad it's there for me -- and for others. Link to comment Share on other sites More sharing options...
Andriy Czarchenko Posted November 14, 2014 Share Posted November 14, 2014 I now worry that I will wait too long to take my kid to the doctor because of how I was raised. People usually take their kids to the doctor way too easily. Link to comment Share on other sites More sharing options...
Fez Posted November 14, 2014 Share Posted November 14, 2014 The bad: Not clearly defined who can use the exchange (if you have work sponsored insurance, it needs to be deemed "unaffordable" (I think that is at 15% of your pay); sign ups don't start until AFTER the husband's deadline for submitting his insurance (this is our biggest issue, and it still has us a little scared as we have had to make a decision without concrete information); no concrete information until you actually sign up I believe (but obviously listen to whatever your consultant or other professionals tell you) that the definition of "unaffordable" is 9.5% of your income. However, that is just for individual insurance. Even if you and your son are on your husband's plan and the cost for all three of you is greater than 9.5%, so long as it would be less than 9.5% if it was just your husband getting the insurance its considered affordable and you don't qualify for the exchange subsidies (anybody can use the exchange, the question is whether you get the subsidies that go along with it). There is going to be an exception though for people who's work insurance doesn't cover hospitalization, they can get subsidies if they would otherwise qualify for them even if their work insurance is considered affordable. And that's to cover a loophole, because the fact is that the feds intended for every plan to be required to cover hospitalization. Link to comment Share on other sites More sharing options...
Lany Freelove Cassandra Posted November 14, 2014 Author Share Posted November 14, 2014 I believe (but obviously listen to whatever your consultant or other professionals tell you) that the definition of "unaffordable" is 9.5% of your income. However, that is just for individual insurance. Even if you and your son are on your husband's plan and the cost for all three of you is greater than 9.5%, so long as it would be less than 9.5% if it was just your husband getting the insurance its considered affordable and you don't qualify for the exchange subsidies (anybody can use the exchange, the question is whether you get the subsidies that go along with it). There is going to be an exception though for people who's work insurance doesn't cover hospitalization, they can get subsidies if they would otherwise qualify for them even if their work insurance is considered affordable. And that's to cover a loophole, because the fact is that the feds intended for every plan to be required to cover hospitalization. She could have said that, I didn't hear her clearly, and our numbers were at 18% so I didn't really care (but it is annoying that it is not listed on the sites) Link to comment Share on other sites More sharing options...
SuitableTrain8 Posted November 17, 2014 Share Posted November 17, 2014 the ACA is a train wreck and was doomed to fail from the start. I hate just about everything about it. Link to comment Share on other sites More sharing options...
SuitableTrain8 Posted November 17, 2014 Share Posted November 17, 2014 I agree with this. I would rather see totally socialized healthcare in our country, but ACA is better than what we had. what? For most countries that have a socialized system it's a nightmare. The ACA is in no way shape or form better then what we had before. If you have something to back that up please feel free to share. Link to comment Share on other sites More sharing options...
Isabel Posted November 17, 2014 Share Posted November 17, 2014 What gives you the idea that countries that have a socialized system it is a nightmare? I pay about 100 euros a month and i dont have to worry about going bankrupt if i get ill. Link to comment Share on other sites More sharing options...
brook Posted November 17, 2014 Share Posted November 17, 2014 Yeah I'm interested in which systems are supposedly a nightmare and who it is that apparently gets to decide that? Link to comment Share on other sites More sharing options...
Alex. Posted November 17, 2014 Share Posted November 17, 2014 what? For most countries that have a socialized system it's a nightmare. The ACA is in no way shape or form better then what we had before. If you have something to back that up please feel free to share. Take it from me, having a health service where you can roll up and the vast, vast majority of stuff is free for anyone whether they're rich or poor is the absolute best. The NHS, and the *idea* of the NHS >>>>>>>>>>>>> Anyone who says different is wrong, sorry. No one should have to die or suffer constant pain because they don't have enough money. That is barbaric. Link to comment Share on other sites More sharing options...
TrackerNeil Posted November 17, 2014 Share Posted November 17, 2014 the ACA is a train wreck and was doomed to fail from the start. I hate just about everything about it. And you have used the exchanges, I assume, and have a personal story to share? Link to comment Share on other sites More sharing options...
aceluby Posted November 17, 2014 Share Posted November 17, 2014 what? For most countries that have a socialized system it's a nightmare. The ACA is in no way shape or form better then what we had before. If you have something to back that up please feel free to share. More people now have insurance than before. The rise in cost is smaller nation wide. Children can stay on their parents plan until they are 26. Can't be denied insurance because of pre-existing conditions. All of those things are better than before. Can you name anything that would be considered 'worse'? Link to comment Share on other sites More sharing options...
TrackerNeil Posted November 17, 2014 Share Posted November 17, 2014 I strongly suggest not debating the ACA here. The law is passed, the debate is over, and the opponents are implacable in their hatred. Nothing anyone here says is going to change any of that. Link to comment Share on other sites More sharing options...
Mudguard Posted November 17, 2014 Share Posted November 17, 2014 I would say the main negatives that I read about now are high deductibles and a smaller network of approved providers. The smaller network of providers probably isn't that problematic for people living in a large metropolitan area, but it might be for people living in rural areas or small towns. This potential issue would be hard to quantify and compare though. The deductible issue should be more easily quantified and compared. Although it sucks on the individual level to have to pay a high deductible, I do think it likely has an effect of reducing health care consumption, and therefore could help reduce aggregate health care expenditures in the US. I'm curious about people's experiences purchasing insurance through the ACA. Were the deductibles really higher than your previous insurance? If so, did it make you less likely to see the doctor than before? Link to comment Share on other sites More sharing options...
Suttree Posted November 17, 2014 Share Posted November 17, 2014 the ACA is a train wreck and was doomed to fail from the start. I hate just about everything about it. 1. How is it doomed to fail? 2. What specifically do you hate about it? Link to comment Share on other sites More sharing options...
aceluby Posted November 17, 2014 Share Posted November 17, 2014 Fiance has an ACA plan. Got it last year, no deductible, $3 Rx coverage, $4 to see a doctor. WAY better than my private plan, though she's unemployed. We don't have anything bad to say about the plans available, the pricing, or the enrollment. Link to comment Share on other sites More sharing options...
MercenaryChef Posted November 17, 2014 Share Posted November 17, 2014 what? For most countries that have a socialized system it's a nightmare. The ACA is in no way shape or form better then what we had before. If you have something to back that up please feel free to share. yep. every single country with socialized healthcare is far worse because of it. you are so so right. we need more people like you who are so well versed in absolute truths to help us lead us into the light. Link to comment Share on other sites More sharing options...
Wee baby Shamus Posted November 17, 2014 Share Posted November 17, 2014 I strongly suggest not debating the ACA here. The law is passed, the debate is over, and the opponents are implacable in their hatred. Nothing anyone here says is going to change any of that. Laws can be changed. The debate isn't over. I guess that means anything stated in the political is pointless too. Link to comment Share on other sites More sharing options...
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