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The Great ObamaCare Debate, Part 237: Back to Court The Great ObamaCare Debate, Part 237: Back to Court

12-16-2017 , 02:11 AM
Quote:
Originally Posted by domer2
alright so what are my options if i decided to not to buy into a healthcare marketplace plan next year? is catastrophic insurance coming back or is that still not a thing?

there's gotta be a huge market that is opening up to insure healthy ppl, but is it legal for companies to offer insurance to these people?
Depends on what state you're in. I pay for a catastrophic policy for my 52 year old brother in California. 5K deductible 2 million cap $360 a month Blue Cross.

Might have been able to do a bit better, but I'm fairly certain BC isn't going to suddenly go out of business.

MM MD
12-22-2017 , 06:30 PM
so when you cancel obamacare because you got a job and are going to get insurance through your employer, thy extend your insurance until the 15th of the next month... are they gonna try and penalize me over on the subsidies they pay to the health insurance company for those two weeks?
12-22-2017 , 06:33 PM
Quote:
Originally Posted by fatboy8
Frankly, I think a whole lot of deplorables are going to have watch their family members die before they're able to connect the dots and figure out that the right doesn't have their best interests in mind.
They will just think it's gods will/they didn't pray hard enough.
12-23-2017 , 07:09 PM
Quote:
Originally Posted by OmgGlutten!
so when you cancel obamacare because you got a job and are going to get insurance through your employer, thy extend your insurance until the 15th of the next month... are they gonna try and penalize me over on the subsidies they pay to the health insurance company for those two weeks?
Depending on how much you make in your job, you may have to pay back past subsidies.
12-29-2017 , 04:04 PM
Quote:
Originally Posted by domer2
alright so what are my options if i decided to not to buy into a healthcare marketplace plan next year? is catastrophic insurance coming back or is that still not a thing?

there's gotta be a huge market that is opening up to insure healthy ppl, but is it legal for companies to offer insurance to these people?
Obama silver plans look a lot like what people used to call catastrophic plans.
12-29-2017 , 04:40 PM
Quote:
Originally Posted by grizy
Obama silver plans look a lot like what people used to call catastrophic plans.
wat
12-29-2017 , 05:00 PM
I have $15 PCP copays on ACA Silver, $2500 deductible. Not sure in what universe that resembles old catastrophic plans.
12-29-2017 , 06:26 PM
Quote:
Originally Posted by maxtower
Depending on how much you make in your job, you may have to pay back past subsidies.
Yep, my wife had an Obamacare plan last year and received subsidies that we as a couple didn't qualify for, so they deducted it from our refund.
12-30-2017 , 02:40 AM
Old catastrophic plans had reasonable copays as well though not as low as 15. 50-75 was typical for PCP and 100-150 for specialists, basically passing the cost of office visit entirely to insured. (Ballpark, I don’t remember clearly but I used to work with the data). Lowering copays to 15 doesn’t change actuarial values much. 2500 deductible was not out of ordinary either. And this was by design organized around qualifying for HSA accounts.

I know these were the cheapest plans you could get because I was in those plans from mid 2000s all the way to Obamacare. They costed me, a non smoker NJ male in his 20s, 50-100 a month.

There were cheaper plans but none that I could find with guaranteed renewal with limited rate increase. There were also some cheaper plans that had no maximum out of pocket spending and or had maximum spending by insurance company. I doubt this is the type of catastrophic insurance people in this thread are talking about since these policies don’t really cover catastrophes.

Last edited by grizy; 12-30-2017 at 02:54 AM.
12-30-2017 , 02:43 AM
Given that the IM repeal passed under the tax bill, we should probably change the title, right?
12-30-2017 , 11:30 AM
They didn’t repeal Obamacare.

They are just trying to destroy it so rubes die.
01-15-2018 , 04:51 PM
Ali Velshi: What is this Kentucky Medicaid work requirement about?

Matt Bevin: It's about giving the people of Kentucky their dignity back!

I mean, that's refreshing. Caretakers and the disabled might have ****ty lives and limited employment opportunities, but at least now they can have their dignity.
01-16-2018 , 06:24 PM
Quote:
Originally Posted by Lawnmower Man
Ali Velshi: What is this Kentucky Medicaid work requirement about?

Matt Bevin: It's about giving the people of Kentucky their dignity back!

I mean, that's refreshing. Caretakers and the disabled might have ****ty lives and limited employment opportunities, but at least now they can have their dignity.
Kind of betrays the dignity idea if the Kentucky Gov is threatening to end the Medicaid expansion in toto if the courts strike down any part of the work requirements.
01-16-2018 , 09:25 PM
Quote:
Originally Posted by maxtower
Depending on how much you make in your job, you may have to pay back past subsidies.
For previous tax years or only the current year?
01-18-2018 , 06:17 AM
Quote:
Originally Posted by OmgGlutten!
For previous tax years or only the current year?
It's year-by-year.
01-22-2018 , 10:47 PM
when i choose my healthcare plan from a list at work, they showed me what they were paying for each option. are they legally required to be telling the truth here or could it be bull****?
01-23-2018 , 02:43 PM
Quote:
Originally Posted by OmgGlutten!
when i choose my healthcare plan from a list at work, they showed me what they were paying for each option. are they legally required to be telling the truth here or could it be bull****?
Probably, but even if not any reasonable company is not going to be lying to you here. Do you also worry that they will stiff you on your paycheck every two weeks?

Wait, do you work for the Trump Organization?
01-29-2018 , 09:41 AM
Looks like we're going to be getting long waits to get diagnosed and treated because if you go to the ER under the US system you're going to get charged an arm and a leg, might as well make it single payer

Quote:
Cloyd has her health insurance coverage through her husband’s job. His company uses Anthem, one of the country’s largest health insurance plans. In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.

The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case.

The policy has so far rolled out in four states: Georgia, Indiana, Missouri, and Kentucky.


“We cannot approve benefits for your recent visit to the emergency room (ER) for pelvic pain,” the letter that Cloyd received from Anthem stated, which she shared with Vox. “Emergency room services can be approved ... when a health problem is recent and severe enough that it needs immediate care.”

The Anthem letter goes on to list “stroke, heart attack, and severe bleeding” as examples of medical conditions for which ER use would be acceptable.

Anthem’s new policy mirrors similar recent developments in state Medicaid programs, which increasingly ask enrollees to pay a higher price for emergency room trips that the state determines to be non-urgent.

Indiana implemented this type of policy in 2015, and the Trump administration recently approved a request from Kentucky to do the same. Beginning in July, Kentucky will charge Medicaid enrollees $20 for their first “inappropriate” emergency room visit, $50 for their second, and $75 for their third.

All of these policies suggest a new and controversial strategy for reining in health care costs: asking patients to play a larger role in assessing their own medical condition — or pay a steep price.
https://www.vox.com/policy-and-polit...-inappropriate
01-29-2018 , 09:58 AM
results-oriented claim approval for ER visits is such unambiguously, abjectly horrible policy on SO MANY LEVELS

#murica
01-29-2018 , 12:13 PM
It's obviously terrible and there are other much better ways to address the problem.

I can at least anecdotally confirm the problem exists though. I've been watching an ER status screen for the past couple months at my PT job and at any given time at least half the patients are there for routine ****, and of those I'd guess 2/3 are medicaid.
01-29-2018 , 01:07 PM
Finding a PCP that accepts Medicaid can be a challenge in many locales.
01-29-2018 , 01:15 PM
Wow. That's so evil that it's unbelievable. I guess a lot of things are though, nowadays under Trump.

So is this correct - if a 65 year old man goes to the ER because he is experiencing all the symptoms of a heart attack, but it turns out not to be a heart attack - the insurer says he is responsible for 100% of the ER bills? (Even though the ER is "covered" under his policy?)
01-29-2018 , 01:55 PM
Quote:
Originally Posted by patron
Wow. That's so evil that it's unbelievable. I guess a lot of things are though, nowadays under Trump.

So is this correct - if a 65 year old man goes to the ER because he is experiencing all the symptoms of a heart attack, but it turns out not to be a heart attack - the insurer says he is responsible for 100% of the ER bills? (Even though the ER is "covered" under his policy?)
You would fall under Medicare and entirely different set of circumstances.

I doubt if you were +55 and complaining of chess pains you would be denied coverage from ER visit, but who knows.
01-29-2018 , 02:55 PM
Quote:
Originally Posted by stinkubus
Finding a PCP that accepts Medicaid can be a challenge in many locales.
I'm about to be an outpatient therapist who doesn't accept Medicaid. I see 25 or 30 people a week, and when 1/3 are Medicaid and Medicaid clients reimburse 30% less and no show / cancel twice as often it really ****s up the bottom line.
01-29-2018 , 03:37 PM
Quote:
Originally Posted by DudeImBetter
I'm about to be an outpatient therapist who doesn't accept Medicaid. I see 25 or 30 people a week, and when 1/3 are Medicaid and Medicaid clients reimburse 30% less and no show / cancel twice as often it really ****s up the bottom line.
lol wow

      
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