A Post From The Obamacare Website?

[ohiomike]

Man, sometimes you hear things that really bring a smile to your face.....

a longtime friend of mine has been one of those advocates for the 'affordable' health care bill arguing with anyone about it, saying the poor need affordable health care and all that. Welll....he went on one of the exchanges just to prove everyone wrong. Now let me tell you this guy is a very studied individual. Went to college and really understand economics much better than I ever could. The was his statement after doing the 'exchange estimated cost' deal...."I just tried applying for health insurance as a 21 year old non smoking male.
I was shocked at the cost. There was a 6300.00 deductible plan for 170.00 a month. That is freaking ridiculous.
I wonder when the "affordable" kicks in under the affordable health care act.....170.00 with a 6300.00 deductible but there was a 202.00 option with a 4000.00 deductible"

Just like we've been hearing. There are going to more like my friend who continue to believe what they want, but when their time comes to do the exchange estimate deal I'm sure many are going to find the things that many of us have been complaining about isn't really so far fetched as they want to believe.

The people/family groups who are going to actually save money are going to be far smaller a group.

Edited October 7, 2013 by ohiomike

[20thGix]

Man, sometimes you hear things that really bring a smile to your face.....

a longtime friend of mine has been one of those advocates for the 'affordable' health care bill arguing with anyone about it, saying the poor need affordable health care and all that. Welll....he went on one of the exchanges just to prove everyone wrong. Now let me tell you this guy is a very studied individual. Went to college and really understand economics much better than I ever could. The was his statement after doing the 'exchange estimated cost' deal...."I just tried applying for health insurance as a 21 year old non smoking male.

I was shocked at the cost. There was a 6300.00 deductible plan for 170.00 a month. That is freaking ridiculous.

I wonder when the "affordable" kicks in under the affordable health care act.....170.00 with a 6300.00 deductible but there was a 202.00 option with a 4000.00 deductible"

Just like we've been hearing. There are going to more like my friend who continue to believe what they want, but when their time comes to do the exchange estimate deal I'm sure many are going to find the things that many of us have been complaining about isn't really so far fetched as they want to believe.

The people/family groups who are going to actually save money are going to be far smaller a group.

Thats what happens when a single, young and healthy person enrolls in a group plan. They have to pay for the people that use the coverage the most. Tell him to go get a private plan on his own and it will be less than $100 a month.

[magley64]

Thats what happens when a single, young and healthy person enrolls in a group plan. They have to pay for the people that use the coverage the most. Tell him to go get a private plan on his own and it will be less than $100 a month.

 

THIS... The exchanges won't be the best solution for everybody. They are there to fill a need, they aren't the only option.

[Scruit]

I had a $200 copay at OrthoNeuro and $250 at Mt Carmel East earlier this year...It was while I was in between jobs that had insurance so I tagged onto my mom's UHC plan through her employer and still had those copays

OrthoNeuro said my copay was high to cover different possible treatments and if my bill turned out to be lower than expected, they would refund some of it... Ended up getting 160 back (so 40 total copay, but still had to front the 200)...Mt Carmel called me every day twice a day looking for their 250 though, not a penny less

The orthoneuro was a doc visit, yeah? And Mt.Carmel was a hospital visit? 250 is a typical copay for a hospital given they charge 2.5k the moment you set foot in the door.

[magley64]

What's a co-pay?

In the United States, copayment or copay is a payment defined in the insurance policy and paid by the insured person each time a medical service is accessed. It is technically a form of coinsurance, but is defined differently in health insurance where a coinsurance is a percentage payment after the deductible up to a certain limit. It must be paid before any policy benefit is payable by an insurance company. Copayments do not usually contribute towards any policy out-of-pocket maxima whereas coinsurance payments do.^[1]

Insurance companies use copayments to share health care costs to prevent moral hazard. Though the copay is often a small portion of the actual cost of the medical service, it is meant to prevent people from seeking medical care that may not be necessary (e.g.: an infection by the common cold). The underlying philosophy is that with no copay, people will consume much more care than they otherwise would if they were paying for all or some of it. In health systems with prices below the market-clearing level in which waiting lists act as rationing tools,^[2] copayment can serve to reduce the welfare cost of such waiting lists.^[3]

However, a copay may also discourage people from seeking necessary medical care and higher copays may result in non-use of essential medical services and prescriptions, thus rendering someone who is insured effectively uninsured because they are unable to pay higher copays. If the insured cannot afford the copay, they effectively have no insurance (high copays can cause a false sense of security). Thus there is a balance to be achieved: a high enough copay to deter unneeded expenses but low enough to not render the insurance useless.

[ohiomike]

Our 'family' copay is $300, then it switches to 80/20.  The thing that really kills that is its 20% of the 'usual and customary' which is hardly ever what the hospitals or Dr.s really charge, so we end up paying more.  Once I called the insurance company and asked them to tell me where any hospital or office actually charges their 'u&c' rate, and was told its all based on averages, but they still could not tell me what or where they got their figures.

[magley64]

Our 'family' copay is $300, then it switches to 80/20.  The thing that really kills that is its 20% of the 'usual and customary' which is hardly ever what the hospitals or Dr.s really charge, so we end up paying more.  Once I called the insurance company and asked them to tell me where any hospital or office actually charges their 'u&c' rate, and was told its all based on averages, but they still could not tell me what or where they got their figures.

 

 

I think you might be getting the terms "copay", "deductible", and "coinsurance" mixed up...

 

I think what you're saying is that your deductible is $300 (you pay that amount before your insurance kicks in)

Your co-insurance is then 80/20 (you pay 20% of the bills you accrue from that point forward)

 

if this is not correct, please correct me

 

Copay is usually a set amount for basic services (no matter what the doctor charges the company)

$20 for an office visit, $100 for emergency room, $200 for CT/MRI/PET scans etc...

[magley64]

Yeah. I was being facetious. Co-pays are for suckers.

 

so are FSA's or "cafeteria" plans

 

but then on the other hand, if you've got someone who is sick or injured A LOT, the copay is sometimes a better option.

Edited October 8, 2013 by magley64

[ohiomike]

I misspoke myself.  I meant deductable, not copay amounts.  We do have a copay for each Dr. visit.  $30 unless its a specialist, then it goes up to $40 per visit.

[magley64]

I misspoke myself.  I meant deductable, not copay amounts.  We do have a copay for each Dr. visit.  $30 unless its a specialist, then it goes up to $40 per visit.

 

Then what are you complaining about? $30 seems affordable to me...

 

The only legitimate bitch you seem to have is that the insurance companies are raising your premiums.

Surprise, surprise they cite the ACA that they lobbied so hard against as the reason for jacking your rates.

 

The good news is that now there is a limit to how much they can jack your rates and how much of your money they can waste on advertising and executive bonus checks.

[ohiomike]

Surprise. Surprise. Shits gonna fail.

I agree

[magley64]

Another Ted Cruz/Tea party Anti-Obamacare Claim bites the dust...

 

"More workers are being bumped to part time as a function of the new law"

 

http://finance.yahoo.com/news/myth-obamacare-causing-part-time-135441398.html