Non-profit healthcare org that charges 25% more than other hospitals destroys 10 years of records. We all pay for this with higher insurance.

“I’ve pushed the button … if someone is in need of a box between 3/15/95 & 11/23/05 … I’m running and hiding. … ‘Fingers crossed’ that I haven’t authorized something the FTC will hunt me down for.”

https://www.google.com/amp/
http://www.latimes.com/business/la-f...story,amp.html

Making an extra $10 could cost you $24,000 more for health insurance

Quote:

Consider the situation of a 63-year-old married couple with a projected household income of $70,000 next year. The lowest-cost health plan they can buy in Milwaukee County will cost them $24,034.80.

If that couple’s income falls to $60,000, however, the same health plan would cost them $24.

That’s not a typo. It’s the total premium for the year.
The difference: At $60,000, they’ll qualify for a federal subsidy. At $70,000, they won’t.

“The disparity between the cost of health insurance for people eligible for the subsidy and middle-class people who are not is huge,” said Larry Levitt, a policy expert at the Kaiser Family Foundation.

It stems in large part from the Trump administration’s decision to end certain payments to health insurers and steps that Wisconsin and other states have taken in response.

“The uncertainty by the Trump administration’s action has destabilized the market and led to big premium increases,” Levitt said.

As a result, people who are close to the threshold for receiving the subsidies may want to give thought to steps they can take — there are several — to report less income on their tax returns for 2018.

The subsidies end at 400% of the federal poverty threshold — $48,240 for one person, $64,960 for two and $98,400 for a family of four.

Being eligible for the federal subsidy — whether you’re $10 or $10,000 over the cutoff — can translate into thousands of dollars in savings when buying health insurance. And for some people, talking to a tax accountant could be as important as talking to an insurance agent or broker this year.

In past years, the difference was much smaller. It could be significant for people who are older. But for most people, the subsidy was relatively small if their income was near the cutoff.

“That cliff is now much, much steeper,” Levitt said.

It has always been steep for older folks pre mecicare. A feature not a bug?

It has always been steep for older folks pre mecicare. A feature not a bug?[/QUOTE]

It's the only reason I'm still working - I hit 62 in October, and am going to keep working until 63 1/2 - I can COBRA then until I hit 65 and go on Medicare.

Of course, if the economy tanks I'll be working longer.....

MM MD

It's the only reason I'm still working - I hit 62 in October, and am going to keep working until 63 1/2 - I can COBRA then until I hit 65 and go on Medicare.

Of course, if the economy tanks I'll be working longer.....

MM MD[/QUOTE]Could / would you keep your medical license active? If not, could you re-activate it at a later date?

I'll probably keep it active because it's a ginormous pain in the ass to reactivate it from what I understand. I'm thinking about doing some cruise ship medicine for a couple of years for grins.

MM MD

Need advice!

Mother in law immigrated here from Colombia last April and wasn't insured for a stretch but now we really need her covered as she's diabetic and has some new health problems. She has a green card but speaks no English and is a 69 yo woman with no education and poor health. My understanding is:

1) She's not eligible for subsidies because she earns $0. Learned that yesterday when we tried to apply.

2) She's not eligible for Medicaid or Medicare for various reasons related to not having paid into the system, not being a citizen and not having lived here long enough.

3) We can't add her to coverage we get through our employer.

4) Cheapest catastrophe plan on the marketplace for her is $1100/month premium.

We're at a loss as far as what to do. Don't think she'd be eligible for any work other than maybe childcare for an infant that we'd need to have above the table so tax info would verify her employment and she could get subsidized marketplace insurance; think she needs to earn at least poverty level income to qualify.

Another unknown is...

5) Whether the wife and I are on the line for medical care debt she might take on if she needed hospital care and wasn't insured. We sponsored her immigration and are on the hook so to speak until she achieves citizenship.

Best option we've identified is 'employing' her as child care but still sending kid to daycare which is much better for him than being home with a grandma who can't even drive. We'd pay her as much as would be needed to qualify for subsidies and pay taxes on that quarterly. Would be a massive expense but might be best available option...

TIA

This is all highly state dependent in terms of what resources are/aren't available. My best advice is to get a day free (this stuff is time consuming) and call ahead to the biggest health care facility in your area - even better if it's a University affiliate and make an appointment with a case manager - in our system they are accessed thru the Emergency department, but you might have to fish around a bit. Bring in EVERY GODDAM PIECE OF PAPER you have on this woman. And pray you get a good one - they understand how to access the system and manipulate it. Be prepared for a long drawn out process, and stay patient - you'll need to be.

The reason I suggested a University system is they generally have a number of free/low cost clinics run by the residents (overseen by attendings) where you can get pretty good care for minimal cost. If for some reson specialty care is needed, they have ways to access it. Dental schools do the same thing, if dental issues come up.

Good luck

MM MD

Thx appreciate your thoughtful post. I'm in Virginia FWIW.

Unrelated, but just took a job as a licensed social worker for the emergency room at a big children's hospital down here and it seems super interesting but potentially too emotionally draining. Time will tell.

Since you probably have good insurance through the hospital, you may be able to get her on that policy. You'd have to check those documents, but it sounds like you could claim her as a dependant on your taxes if she has a green card. https://www.thebalance.com/claiming-...-rules-4129176

Advice to call the case managers is a good one.

You might want to also look into Colombia's national health insurance and get some of the more expensive work and possibly diabetic supplies in Colombia. It's not ideal but it may make sense financially because she sounds uninsurable in the US.

It's not a permanent solution but after her 5 year waiting period expires, Medicaid can take over.

Dude:

In addition, you might check into going to a community health center:

https://www.healthcare.gov/community-health-centers/

It might not give you everything you need, and entail long waits. But might get access to a semblance of care for your mother-in-law without breaking the bank.

Just finished my Marketplace shopping for the year. Before subsidy premium went down a little, after subsidy premium went down a lot, deductible went down, doctor remains in network. Thanks Obama!

Doing my shopping... My premium would go up by about 20-25% to $475 if I kept the same plan. Unfortunately, it's a Kaiser Permanente plan. Their prices/value are good relative to the marketplace, but I wasn't happy with the medical side of the operation and the fact that they control it from both ends (too many hoops to jump through to get stuff covered, with a copay each time, and it's not like your provider is helping you minimize the hoop-jumping since it's the same entity)... As a result, I'll likely end up going with a cheaper plan that covers less and paying out of pocket for certain things.

One thing is clear, though. Obamacare was always a band aid on a hemorrhaging wound in terms of cost control. My guess is we'd be going up about 10% more per year without it, but the main benefits of the ACA remain that everyone gets access. Of course, the subsidies helped, but they again just mask the problem.

20% year over year growth in monthly premiums (which has been consistent, for me at least) is not sustainable in this market... It would look like this starting in 2018: 476, 571, 685, 823, 987, 1184, 1421, 1705, 2047, 2456.

That's nearly $2,500/mo for a single person who doesn't smoke.

The question I have is at what point will the GOP stop blaming Democrats for the rising costs without any plan to reduce them, or at least come up with a plan while they blame Democrats? And cutting the quality of care significantly to reduce costs a little doesn't count.

Obviously, most of us think the answer to those questions is never.

So if the status quo holds, either the GOP is going to get wrecked over it in the next 10 years as their lack of a plan goes up against single payer proposals, or they will have such a hold over the electoral system through gerrymandering and voter suppression that nothing matters at all... in which case I predict a significant brain drain from the US in the mid 2020's.

You're looking at healthcare for single people going from $6,000 a year to nearly $30,000 a year in that span. You're looking at health insurance going from something we expect to have to a luxury purchase for the wealthy. I think a lot of us would GTFO and go to a country with socialized healthcare.

To be clear, the above is not a repudiation of Obamacare. It's a repudiation of blaming the ACA for rising costs, and doing so with no alternative. It's a repudiation of anything other than single payer, and a prediction that if we don't move to single payer in the next few years, it'll damage our economy due to a brain drain.

My sister is unable to buy gifts for Christmas because medical bills related to a leg injury she suffered have sapped basically every spare cent she has.

My mother still supports Donald Trump.

I'm really sorry to hear that - how's your sister handling it? That's gotta be tough.

I thought you were intelligent, by that post it leaves to to question what I thought before.

Until both political parties are willing to sit down and find a solution that works for the people of this country things will not get better.

Meanwhile Amazon and CVS are doing things that will drive down the cost for the average person more than anything the gov't will do.

One of those political parties is doing just about everything it can to actively sabotage things so that it doesn't work for the majority of people in this country.

Of course, you already know this; you're just being intentionally obtuse.

COOPERATE while we wring every last cent out of Medicare / Medicaid, defund PP, sabotage Obamacare and dedicate billions to propaganda campaigns designed to make the nation's drooliest bigots believe that current health care policy problems are anything besides the direct result of GOP actions.

GFY

**** you.

Has that secret forum that has been mentioned in ATF been created yet for the deplorables like rara?

Rara always resorts to the use of dog whistles in his posts. His "arguments" are terrible, and I legit have no idea why anyone ever responds to him. The forum would improve immediately if everyone ignored him.

sometimes I think RARA is getting better.

Then he posts that.

You are either a troll, a really dumb person, or a dickhead



There is no compromise with a party that is running up the debt to give tax breaks to billionaires, and then immediately turn around and say the deficit is too big for medicare.

Maybe someday you'll get it.

The deficit is only too big for Medicare because without touching either entitlements or military spending (LOL) they are never going to find the savings needed to make the cuts permanent and/or even deeper.

cuse - the 20% your seeing is still short-term and is heavily fueled by anti-selection and the changing of how the government is reimbursing. It's unlikely, though possible, that the 20% will continue. If it does, it means the entire individual marketplace is in a true death spiral situation. All told, I wouldn't bet on that scenario. That being said ... is 7% growth that much better considering wage increases? Not really ... but at least it's not 20% (The 7% is on the high end of trend I've seen over the past few years, so hopefully it's actually underneath that, but considering the risk in the individual marketplace I do tend to doubt that as well)

"Meanwhile Amazon and CVS are doing things that will drive down the cost for the average person more than anything the gov't will do."

I mean, there's a lot wrong with this statement, but to start with, while Amazon is in the planning stages to move into the market, they haven't moved in yet. So you are just estimating they will have a net positive impact. But I'm curious, what impact do you think they will have?

As for CVS, this is a group that wasn't even able to predict the Hep C spend back in 2015. Nor did they do a good job of getting in front of compound drug spend. So what do you think they are doing that's so great? Again, just curious. If they acquire Aetna, it will give great data mining opportunities ... but how do you think they'll push that to the market?