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I realize this is a 3 yr. old thread, but I'd like to comment on it since we have the benefit of time now. I have no idea how anyone can afford the insurances offered through ACA. My mother's insurance went from $380 a month for BC/BS, $20 copays, $0 deductible for preventative and routine visits, and $1000 deductible for catistrophic prior to Obama and ACA. Also, she had cancer in early 2000s and it remained the same coverage, same price, and she was not dropped. Then Obama was elected and her insurance premiums for the exact same coverage went up several hundred dollars a year. This went on for several years and she had to keep getting different insurance for worse coverage and was paying a lot more than the $380 she had been paying. By the time she was able to get Medicare, her insurance was $1240 a month for $10,000 deductible for catastrophic, $5,000 deductible for routine doctor visits before her insurance would kick in and then she would pay $35 copays. ACA has greatly benefited the insurance companies. Their revenue jumped dramatically and their coverage is now minimal. Hats off to the insurance lobbyists who were able to push this through D.C.
The only way to have truly competitive and the best insurance is to make insurance companies have to compete for people to buy their insurance. Currently they have quassi monopolies divided by states. Policies should be truly free market. The free market works for the benefit of the buyer and government works for itself (politicians) and lobbyists these days anyways.
Chiye5 - I so agree. ACA has impacted Medicare Advantage big time also. You are right - the insurance companies are making out just fine, so are the politicians and certain people who are on a free ride - and many of those are not the people who really need the help (like seniors and veterans). I know several doctors who have retired early because insurance pays them less each year, they are working more and more and still have to struggle with the ACA rules. A few have had to close private practice because complying with all the red tape ACA laws have literally cost them more than they earn. They end up going to large groups and have to practice "herd medicine" according to the "rules". My wonderful family doctor was one of them - she finally gave up and retired 10 years before she planned to. For myself, all I know is that as the ACA kicked in, my Medicare Advantagecare plan premium doubled. My co-pays are double what they were 3 years ago. Coverage no longer includes vision care or dental checkups or cleaning. I now have to pay a huge co-pay for x-rays, MRI and CT and ultrasound are even higher. Urgent care (which was supposed to fill in with the same co-pay when GP practice was not open now is three times as expensive as seeing your doctor in the office. I need physical therapy and had to drop it - who can afford $40 twice a week for a few exercise tips and a hot pack and stim? I wish the congress would get off their self serving high horse and simply let the free market take over - allow insurance to be purchased across state borders. Nothing keeps prices down better than competition. For those who need help, we already have Medicaid - that wouldn't change. And how about investigating those getting things for free when they can really afford it, or do not qualify. That is driving prices up! The only thing the government should be doing is create an unbiased commission to investigate and calculate the REAL (and reasonable cost of medical care and drugs) and punish price gougers. (I had a CT scan in urgent care and the original bill the hospital sent to my insurance company was $5800! Something has to be done about that kind of highway robbery.) Why are they allowed to set prices 10x the actual cost?
Amygrace, I can answer your last question. There are two parts to medical billing - the amount of the charge and the amount insurance allows. Did you get an EOB that showed what your insurance actually paid for that CT scan? Insurance companies negotiate payments with the providers and then pay according to their contracts. I would be surprised if the urgent care got more than half of that charge. Providers cannot charge patients different amounts based on insurance coverage, so everyone is "charged" the same, even though reimbursement depends on insurance allowances. Medicaid is the worst for reimbursements. My husband is sometimes reimbursed less than 20% of charges for Medicaid services. He could "charge" Medicaid 20% for the service, knowing that it is all he would get anyway, but then he would have to charge all patients that figure for that service. He would have gone bankrupt years ago. It is a messed up system. The government does not want to "investigate and calculate the reasonable cost of medical care and drugs" because then they would have to pay those amounts rather than continue to require health care providers to essentially be subsidized by patients who have commercial insurance or are private pay.
meghart13 I agree; my husband (who is an advanced EMT) sees so many people over 80 with lots of things wrong with them, and I see them at the AL facility I visit and the SR building my mom is in, and think people are just being supported to live too long.... If I get cancer; I will not do surgery and chemo or radiation - have seen too many suffer from those - nor go through extensive/expensive surgeries, or take 6 different meds each day - some of which are life threatening, cognitive damaging, and interactive..... and I am only 66.
Before Obamacare i could not get insurance...pre-existing conditions. The only (garbage) policy I could get basically excluded everything and would have cost me $850 per month....just for me. Needless to say I could not afford to pay that much for no next to no coverage.
Now, my premiums are $400 per month....but it covers everything after $3000 annual deductible.
So, you were lucky to have such great coverage. His company could still provide it..they just want an excuse to cut their costs...and gee, its easy to blame Obamacare....
For every story of coverage cost increase...there are just as many like me that final HAVE coverage at all
Agree with Mally & akdaughter. Obamacare is terrible. I have seen so many great physicians retire in the past 3- 4 yrs and more are leaving practices every day. What a loss for us! And why, because reimbursement rates are awful for Medicare & Medicaid. So many providers don't even take Medicare & Medicaid anymore. The entire premise of the individual mandate backfired. People opt not to pay and accept the IRS tax as they are not sick & don't use the system. The mandate was supposed to help pay for those with preexisting conditions but it doesn't. There are only 2 or 3 major insurance companies left, and they are licking their chops making profit hand over foot. Those three are powerful lobbyists that don't want Obamacare to go away. It's almost a monopoly. Agree we need to be able to purchase insurance over state lines and increase competition as yes that's the way to keep cost of premiums down. Sure it's good for those that had preexisting conditions and I don't think that was going to change in the last Republican plan. Even the Dems stated there is plenty wrong with the ACA this past July. But many of those people are train wrecks that never took the least bit care of themselves and it's not fair the middle class has to foot the bill. Sorry but as an RN I have tried to educate many people that know better but they choose to ignore their MD's advice & continue to make the wrong choices over & over again. It will only get worse for all of us if Obamacare isn't repealed or replaced. No blame, just facts. A poorly written law "you had to pass it to know what's in it". Passed without one Republican vote. Ditto this last attempt- no Democrats voted for it this time. Politicians need term limits - they have no clue what we middle class workers go through. We get to pay for everyone. Yes also to cleaning out the ranks of those that are taking entitlement programs like Medicaid and SSDI that can clearly work. It's frustrating for me. But the younger generations will bear the worst of it. I am pretty set with Medicare $ SS when I retire, what about them? There won't be those safety nets.
Katiekate, I had something similar regarding trying to get health insurance with a pre-existing condition which was something minor, allergic to gluten.
Not to make light on this, but I was wondering if the insurance companies were thinking I would OD on a loaf of bread.
I was self-employed at the time, so once a job opened up in the same career path which included benefits, I jumped onto it, and got excellent insurance. Then I was home free once I could get Medicare. And didn't have to worry about looking for a secondary insurance since the ACA allowed for pre-existing conditions.
I think Obamacare has some serious issues, but I also think it's a godsend for people who couldn't get insurance any other way. You saw what happened when Congress tried to repeal and replace it - they couldn't devise anything better that could get the votes needed to pass it. It's a very complex problem, how to offer people at least some minimally decent health care protection without bankrupting the country. I can't claim to have an answer or even any good suggestions.
I had better coverage under COBRA until it ran out. I was shocked to find myself paying more, even with the subsidy, with higher copayments and deductibles under Obamacare. Still, I intend to keep paying for it until I qualify for Medicare, in less than a year now. I too have pre-existing conditions, and my insurance in the private market would have been even less affordable, if I could have qualified at all.
I will agree that the one good thing about the ACA is that it prevents insurance companies from denying coverage to people with pre-existing conditions. That is something that already was in existence in insurance plans through an employer.
It would have been smarter if the law had started out simply "insurance companies may not deny insurance due to a pre-existing condition" and then let the insurance companies figure it out, form risk pools, etc. That would have covered most of those people without insurance (who wanted it) Instead the government created a Frankenstein monster which is totally out of control, failing and costing a fortune, driving our doctors away and draining seniors' savings.
FYI, for the person who mentioned the insurance rates going up because of the employer not wanting to pay for the coverage after ACA .....Mom was self-employed with that great BC/BS coverage that didn't drop her after Cancer either. BC/BS said they had to raise the rates because of ACA.
And that is the point. When politicians raise taxes on industries or businesses to supposedly support some government program (and of course not line their pockets at all) who ends up paying for the tax hike? The consumer. It has always been that way and will always be that way. Big businesses have to keep their profits up to keep shareholders happy to sell and trade shares etc. And small businesses can't afford to take financial hits caused by tax hikes. So all businesses pass the tax hike expense off to the consumer. And in the case of Insurance companies they have the added benefit of having quasi monopolies. So those things added together equalled government sanctioned price gouging. Again I say hats off to the insurance companies and politicians for really screwing the American people over.
And for people who could not get coverage before because of pre-existing conditions; that's where a truly free market would have solved the problem. If insurance companies can compete across state lines or even across oceans their pool of insured would be larger and would off set the cost of higher risk insured. For example, my dad couldn't find house insurance in his state for property in a flood zone that was affordable, so he bought it through a very reputable company in London at a much lower rate. True free market competition saved the day. Of course insurance companies don't want true competition and enjoy the benefits of this quasi monopoly so they will keep buying off politicians to keep things going like this. Health insurance companies need to be called on their greed. And politicians need to be held accountable.
I can't see how any amount of competition could induce insurance companies to insure high risk clients, at least at an affordable price. They're not in business to lose money. I just can't imagine companies competing to insure people my age with pre-existing conditions. Extending Medicare to cover younger retired people on a voluntary basis would have been the best option for folks in my position, but that idea did not get off the ground.
And over and over.... where I live the ambulances haul drunks and druggies to the hospital, where they get "hydrated" to dilute the alcohol and stuff, instead of to the jail, where they - especially the chronic ones - should go. Guess who pays for most of it? Not them....
I've never had to deal with it myself but I knew someone who had complaints about it. I've heard talk about Obama care being repealed and maybe even replace with something better. I can't see how anyone can be penalized for having too good of insurance, that just don't jive, and if it don't jive it's probably not true
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I have no idea how anyone can afford the insurances offered through ACA. My mother's insurance went from $380 a month for BC/BS, $20 copays, $0 deductible for preventative and routine visits, and $1000 deductible for catistrophic prior to Obama and ACA. Also, she had cancer in early 2000s and it remained the same coverage, same price, and she was not dropped. Then Obama was elected and her insurance premiums for the exact same coverage went up several hundred dollars a year. This went on for several years and she had to keep getting different insurance for worse coverage and was paying a lot more than the $380 she had been paying. By the time she was able to get Medicare, her insurance was $1240 a month for $10,000 deductible for catastrophic, $5,000 deductible for routine doctor visits before her insurance would kick in and then she would pay $35 copays.
ACA has greatly benefited the insurance companies. Their revenue jumped dramatically and their coverage is now minimal. Hats off to the insurance lobbyists who were able to push this through D.C.
The only way to have truly competitive and the best insurance is to make insurance companies have to compete for people to buy their insurance. Currently they have quassi monopolies divided by states. Policies should be truly free market. The free market works for the benefit of the buyer and government works for itself (politicians) and lobbyists these days anyways.
For myself, all I know is that as the ACA kicked in, my Medicare Advantagecare plan premium doubled. My co-pays are double what they were 3 years ago. Coverage no longer includes vision care or dental checkups or cleaning. I now have to pay a huge co-pay for x-rays, MRI and CT and ultrasound are even higher. Urgent care (which was supposed to fill in with the same co-pay when GP practice was not open now is three times as expensive as seeing your doctor in the office. I need physical therapy and had to drop it - who can afford $40 twice a week for a few exercise tips and a hot pack and stim?
I wish the congress would get off their self serving high horse and simply let the free market take over - allow insurance to be purchased across state borders. Nothing keeps prices down better than competition. For those who need help, we already have Medicaid - that wouldn't change. And how about investigating those getting things for free when they can really afford it, or do not qualify. That is driving prices up! The only thing the government should be doing is create an unbiased commission to investigate and calculate the REAL (and reasonable cost of medical care and drugs) and punish price gougers. (I had a CT scan in urgent care and the original bill the hospital sent to my insurance company was $5800! Something has to be done about that kind of highway robbery.) Why are they allowed to set prices 10x the actual cost?
Now, my premiums are $400 per month....but it covers everything after $3000 annual deductible.
So, you were lucky to have such great coverage. His company could still provide it..they just want an excuse to cut their costs...and gee, its easy to blame Obamacare....
For every story of coverage cost increase...there are just as many like me that final HAVE coverage at all
There are only 2 or 3 major insurance companies left, and they are licking their chops making profit hand over foot. Those three are powerful lobbyists that don't want Obamacare to go away. It's almost a monopoly.
Agree we need to be able to purchase insurance over state lines and increase competition as yes that's the way to keep cost of premiums down.
Sure it's good for those that had preexisting conditions and I don't think that was going to change in the last Republican plan. Even the Dems stated there is plenty wrong with the ACA this past July. But many of those people are train wrecks that never took the least bit care of themselves and it's not fair the middle class has to foot the bill. Sorry but as an RN I have tried to educate many people that know better but they choose to ignore their MD's advice & continue to make the wrong choices over & over again.
It will only get worse for all of us if Obamacare isn't repealed or replaced. No blame, just facts. A poorly written law "you had to pass it to know what's in it". Passed without one Republican vote. Ditto this last attempt- no Democrats voted for it this time.
Politicians need term limits - they have no clue what we middle class workers go through. We get to pay for everyone.
Yes also to cleaning out the ranks of those that are taking entitlement programs like Medicaid and SSDI that can clearly work.
It's frustrating for me. But the younger generations will bear the worst of it. I am pretty set with Medicare $ SS when I retire, what about them? There won't be those safety nets.
Not to make light on this, but I was wondering if the insurance companies were thinking I would OD on a loaf of bread.
I was self-employed at the time, so once a job opened up in the same career path which included benefits, I jumped onto it, and got excellent insurance. Then I was home free once I could get Medicare. And didn't have to worry about looking for a secondary insurance since the ACA allowed for pre-existing conditions.
I had better coverage under COBRA until it ran out. I was shocked to find myself paying more, even with the subsidy, with higher copayments and deductibles under Obamacare. Still, I intend to keep paying for it until I qualify for Medicare, in less than a year now. I too have pre-existing conditions, and my insurance in the private market would have been even less affordable, if I could have qualified at all.
It would have been smarter if the law had started out simply "insurance companies may not deny insurance due to a pre-existing condition" and then let the insurance companies figure it out, form risk pools, etc. That would have covered most of those people without insurance (who wanted it) Instead the government created a Frankenstein monster which is totally out of control, failing and costing a fortune, driving our doctors away and draining seniors' savings.
And that is the point. When politicians raise taxes on industries or businesses to supposedly support some government program (and of course not line their pockets at all) who ends up paying for the tax hike? The consumer. It has always been that way and will always be that way. Big businesses have to keep their profits up to keep shareholders happy to sell and trade shares etc. And small businesses can't afford to take financial hits caused by tax hikes. So all businesses pass the tax hike expense off to the consumer. And in the case of Insurance companies they have the added benefit of having quasi monopolies. So those things added together equalled government sanctioned price gouging. Again I say hats off to the insurance companies and politicians for really screwing the American people over.
For example, my dad couldn't find house insurance in his state for property in a flood zone that was affordable, so he bought it through a very reputable company in London at a much lower rate. True free market competition saved the day.
Of course insurance companies don't want true competition and enjoy the benefits of this quasi monopoly so they will keep buying off politicians to keep things going like this. Health insurance companies need to be called on their greed. And politicians need to be held accountable.