... dearest Luigi, marking his milestone in Obamacare history ~

Discussion in 'Fred's House of Pancakes' started by asjoseph, Dec 12, 2024.

  1. Prodigyplace

    Prodigyplace 2025 Camry XLE FWD

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    I was looking at the best balance between deductible and total out of pocket because my wife is going through cancer treatment & we expect her to meet total out of pocket quite quickly. Her specialty drug retails at $40K for 30 days. Visits & scans add even more to the costs.
     
  2. Mr.Vanvandenburg

    Mr.Vanvandenburg Senior Member

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    The ACA is still a law, didn’t end. The next admin was a total disaster. They have damage controlled it endlessly with propaganda, but nothing changes the facts of what happened during the worst presidency in US history. Three big ones, Covid fail, public debt fail, and of course Jan 6. For someone to say things got better is bizarre.
     
  3. bisco

    bisco cookie crumbler

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    'government run healthcare'

    'socialized medicine'

    let's skip the preconceived notions and simply apply medicare to all people
     
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  4. Prodigyplace

    Prodigyplace 2025 Camry XLE FWD

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    That is basically what people are requesting, without any competition from other insurance providers. I am just starting down that path next year and am already dreading it. Up until the end of this year, I have a good employer insurance policy.We did aa ACA policy for my wife this next year util she is old enough for medicare.
     
  5. ChapmanF

    ChapmanF Senior Member

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    I'm not sure what sort of circumstance would make ignorance necessary.

    Some states rolled out their own versions of a marketplace. I'm ignorant about those (not necessarily so, I just am).

    I'm in a state that didn't roll out its own, so the healthcare.gov portal is what's used here.

    I remember the initial stories of web tech issues when it first went live a decade ago. I can't see any signs of such issues now. It's a lean, straightforward web site that plays well with my browser and blocking extensions. It needs JavaScript enabled for the site itself, but not for 57 other random domains as so many sites these days require.

    Once you've said where you live, it shows you available plans. You can add filters to focus on those of most interest, as you'll be familiar with from other shopping sites. You know you're not making bogus apples-to-anvils comparisons because all of these plans meet a uniform standard. They do differ in things like their premium, deductible, copay, and max out-of-pocket expenses, and those are clearly shown in a uniform way for all the plans. You can select plans to compare and see that all side by side for those plans. Again, standard shopping-site fare. The full plan docs for each plan are one click away.

    If you have specific doctors, facilities, hospitals, pharmacies you want to make sure will accept the plan, you can look up and enter those by name, and every plan displayed will show with green checks or red Xs who will and won't accept the plan.

    If you have a specific pattern of usage, recurring treatments, office visits, prescriptions, etc., you can enter those details, and the plans will be shown to you with the real-world total cost (premium + out-of-pocket) estimated.

    This makes easy and straightforward for you everything insurance salesmen used to want to be hard and obscure to boost their chances you'd make a pick more to their advantage than yours.

    Once you've settled on one plan, you can enroll and pay your first month's premium right on the site. Your coverage isn't affected by preexisting conditions so you don't eff around with any medical exam or wondering if your application will go through. Your plan documents and ID card arrive shortly in the mail from the insurance company directly. All your subsequent premium payments and other dealings are directly with them, so you won't visit healthcare.gov much anymore unless you want to comparison shop again next year.

    There was a time in my career that I shopped for individual-market health insurance and it was a nightmare, taking untold hours comparing apples-and-anvils policies, meeting with different agents, etc. The current marketplace was clearly designed by seeing everything that sucked about that and making it not suck.

    If you enter an estimate of your AGI for next year, the site computes what subsidy amounts, if any, will apply, and all of the dollar amounts shown you for all of the plans are adjusted accordingly, and the premium you send the insurer every month is just your portion.

    Because this needs you to predict next year's AGI, if it ends up being far from your prediction and the subsidy amounts are wrong (high or low), you square up the difference with next year's tax return. If you know during the year that it's going to be off from your prediction, you can update your prediction on healthcare.gov as soon as you know, so your premiums adjust right away, leaving less to square up.

    If you would much rather have the eventual square-up be a check to you and not a check from you, you have the option to apply just a portion of any available subsidy to your premiums during the year. You pick the portion. So you're making higher premium payments during the year, and getting the difference in next year's refund.

    There ARE "navigators" available, in case you're the kind of person who might be flummoxed by a web site like what I've described here. They'll basically sit with you and step you through what I've just described. But honestly, if you're able to buy a capacitor on Digi-Key's web site, you don't need a navigator for healthcare.gov.
     
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  6. bisco

    bisco cookie crumbler

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    medicare is great, no worries. we've had a ton of injury and disease, and they've covered everything except donut hole pharma which maxes out at 2k next year.
    as far as insurance company competition, that's pretty rare in my experience.
     
  7. Trollbait

    Trollbait It's a D&D thing

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    Remember, half the people that didn't like ACA when it was signed, did so cause it didn't include a public option.

    Even if a public option got rid of private providers, the private gap insurances will still be in around.
     
  8. Prodigyplace

    Prodigyplace 2025 Camry XLE FWD

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    Insurance, pharmacy benefit managers, & pharmacies are all owned by the same company, in ma
    That depends. You do not see advertising on their Medigap policies because the coverage levels are tightly controlled. Medicare Advantage permits them much more leeway, so that is what they push in advertising.
     
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  9. John321

    John321 Senior Member

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  10. Prodigyplace

    Prodigyplace 2025 Camry XLE FWD

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  11. Trollbait

    Trollbait It's a D&D thing

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    And one of the biggest fraudsters was once a governor and now a Senator.

    "A convicted fraudster tells CNBC it’s easy to steal from the health-care programs because there aren’t enough agents to keep up with the various schemes."
    This is also how people get away with tax fraud, and likely is true in other realms.
     
  12. Isaac Zachary

    Isaac Zachary Senior Member

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    I don't know if there is any perfect solution, but I do wonder, if health insurance is considered a necessity, why isn't it a mandated law that all employers have to provide it? Why do some do and some don't? Why are there areas in the USA where very few, if any, employers offer health insurance?

    Why are policies on the ACA also priced according to area, age, etc? My health insurance is 1/3 my full-time income, and everyone wants 2/3 my full-time income for a single room with no kitchen an with a communal bathroom. What's going on here? Obviously I can do things to change my circumstances, or just live with it because of my own reasons. But I don't see there being any solution to all these problems for everyone.

    Speaking of which I did just start a job that offers health care and I can include my wife. I did this after going without work for a whole month. I applied everywhere, turned down a few that got back to me that didn't seem like they had everything I wanted, and just kept looking. Oddly I didn't even apply for the job I have now. The person called me saying they saw my resume at another place that had already filled the position and asked if I'd be interested in work for them instead. It seems kind of weird, and I hope it works out.
     
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  13. ETC(SS)

    ETC(SS) The OTHER One Percenter.....

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    When they were jamming the ACA up our collective backsides, THAT was one of the things that they were going to try to fix - and in fact they mostly did.
    I do not know of very many companies with more than 50 'FTE' employees that do not offer some kind of healthcare benefit even for their part-time employees - which makes sense for the companies if you know how risk pools work.
    The truth is that unless you force people without kids under about 30 to buy health insurance - they're mostly not going to do it - and people WITH kids are either going to be covered by AGI adjusted programmes or they're going to be incentivized to get a full-time job.
     
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  14. Mr.Vanvandenburg

    Mr.Vanvandenburg Senior Member

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    The ACA was on everyone’s desk to read as required, and it wasn’t jammed in. All bogus accusations that never go away. They took a comment and twisted it into a pretzel, lied about what it meant. Lets have some more Benghazi shall we, 13 or whatever investigations wasn’t enough.
     
  15. John321

    John321 Senior Member

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    derlete
     
    #75 John321, Dec 18, 2024
    Last edited: Dec 18, 2024
  16. Mr.Vanvandenburg

    Mr.Vanvandenburg Senior Member

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    It never ends, almost 15 years and counting. . Obama was saying what they knew at the time. When junk plan companies, who prey on the weakest for maximum profit, cancelled plans, the government stepped in and made it right for the relatively few people who made an issue about getting a quality health care plan to replace their junk plans they loved. So was it lying? Absolutely not. But don’t tell the whole story as it destroys the agenda.
    An simple example is telling your spouse eggs are $2 at the store because you saw an ad, and they get there and it’s $3. Then they come home and call you a liar. No you weren’t.
     
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  17. ChapmanF

    ChapmanF Senior Member

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    I had a neighbor who fell for one of those junk plans just a few years pre-ACA (in fact, I think it was in those few years after ACA passage but before full implementation). She was telling me how happy she was that she had finally found a health insurance plan she could afford for her family. I skimmed the policy and prayed for none of them to get sick.
     
  18. John321

    John321 Senior Member

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    I deleted my post - I was getting sucked into politics and arguing - both worthless endeavors.

    What would happen if there were no political parties and people only had to rely on what was best for America and themselves to decide matters like Healthcare.

    For example if there was some idiotic debate on Healthcare - what would happen if the American people decided to band together and rather than argue told their Political Representatives in Washington that the Healthcare Debate had been finally settled and as a joined people they had decided that the Healthcare Plan for America was going to be the same one Senators and Representative in the US Congress and House of Representatives enjoy.

    How long would it take to reform Healthcare in a positive way if all the Representatives and Senators had to participate in the same plan their citizens have?

    Political parties and their loyalty have done irreparable harm to our Country.

    No wonder George Washington was so adamantly opposed to them

    Why Was George Washington Opposed to Political Parties? | American Majority

    Political Parties | George Washington's Mount Vernon
     
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  19. bwilson4web

    bwilson4web BMW i3 and Model 3

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    Not skilled:
    • Keeping the weapon
    • Homemade weapon that was not a reliable revolver
    • Keeping ammunition that should have been 22 hollow point or frangible
    • Keeping same clothes
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    Bob Wilson
     
    #79 bwilson4web, Dec 18, 2024
    Last edited: Dec 18, 2024
  20. bisco

    bisco cookie crumbler

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    it's the same everywhere, unless it's a dictatorship. what choice do we have?