Affordable Care Act Scene 2 - Insurance Premiums

<p>Last mammogram I had is the first time they ever saw something for me. They ended up deciding it was just the way my arm was placed.</p>

<p>I don’t know why anyone gets excited about these relatively inexpensive things being “free”. Birth control pills are 9-dollars at Wal-Mart.</p>

<p>I only get diagnostic ones now so we can figure out what it is that day. First time scared me to death.</p>

<p>Or you can get the pills and an exam at PP for even cheaper.</p>

<p>Its kind of funny some of the answers you get when googling what is the cost of a mammogram. ask says since the healthbill passed, it is free.</p>

<p>[How</a> Much Does a Mammogram Cost? - Ask.com](<a href=“http://www.ask.com/question/how-much-does-a-mammogram-cost]How”>http://www.ask.com/question/how-much-does-a-mammogram-cost)</p>

<p>According to this website, it is can be whatever people want to charge.</p>

<p>[How</a> much does a mammogram cost? Prices, payments vary widely, our survey with WNYC finds | Clear Health Costs ? Beta](<a href=“http://clearhealthcosts.com/blog/2013/05/how-much-does-a-mammogram-cost-prices-payments-vary-widely-our-survey-with-wnyc-finds/]How”>What's the price of a mammogram? Our survey with WNYC: $0 to $2,786.95! - ClearHealthCosts)</p>

<p>I love that, free. Your insurance costs may go up thousands, you lose your doctor, you’re a guy…but hey, the mammogram is free. Ain’t nothing ever free, somebody always pays.</p>

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<p>Not according to some…</p>

<p>Sandra Fluke, a then-resident of DC:
“…for some women contraception can cost as much as $960 per year ($1,210 with the doctor’s appointment), according to the Center for American Progress.”</p>

<p>Well, of course it can…or not if you go elsewhere. I’ve done both.</p>

<p>I am curious how that would work under ACA as a guaranteed benefit if the price difference is 110 v 960. What would the insurance actually pay?</p>

<p>TEx, different pills can cost different amounts. Because they are hormones, not all women can use the inexpensive ones. The less expensive, generally speaking, the older the drug research, generics, etc… With the pill, the older ones, the ones developed longer ago have stronger or even different levels of the hormones.</p>

<p>For certain chronic medical conditions, which is what Fluke has, the best treatment is a pill that doesn’t yet have a generic.</p>

<p>That’s why the fluke thing was so ridiculous. She was talking about a medical condition, not even birth control. </p>

<p>If the doctor says they have to take the certain pill, I’d imagine they’d get to use it.</p>

<p>But, actually, a lot of drugs and not generics are mandatory in the new law. A big part of the pharma agreement with the legislation had to do with them getting guaruntees for coverage of their drugs. I posted an article about it a ways back.</p>

<p>I’ve been lucky so far. My mammograms always been completely negative.</p>

<p>Texaspg, as to what insurance pays your doctor/druggist for your birth control: whatever price they negotiated.</p>

<p>Giving up on the healthcare.gov page, I called BCBS this weekend to sign up directly. </p>

<p>Their systems were down so they couldn’t sign anyone up. They said they’d call me back this morning. No call. Yippie :rolleyes:</p>

<p>For the life of me, I do NOT understand why insurance companies weren’t providing “free” contraception coverage before. Heck of a lot cheaper to pay for birth control than pregnancy/childbirth. (Oh yeah, because many didn’t cover that…)</p>

<p>Hmmm … anthem never called me back. Forgot. :)</p>

<p>Romani, whatever happened to medicaid in Michigan? I forgot.</p>

<p>dstark, no Medicaid expansion until late March/early April, despite pleas from the governor for his party to make it go into effect on Jan 1st. </p>

<p>In the meantime, I don’t know if BCBS knows what to do with us that qualify for Medicaid but don’t want it. The BCBS rep told me I qualified for Medicaid. I said yes, but that I didn’t want Medicaid. That’s when he said the system was done and they’d call me back. I mean, I don’t really care if I go back on Medicaid, but given the fact that I don’t know what my income will be next year, I’d rather stick with BCBS (though definitely not the plan I have… which is good since it won’t be around lol). </p>

<p>Do the great people on here know what our options are? Those of us that qualify for Medicaid but want private insurance?</p>

<p>Well, my question is a bit different. When I go to the pharma today with a prescription, they tell me my doctor prescribed something costing 300, insurance covers 150 but if I picked a generic it might be free as long as me and the doc are ok.</p>

<p>When a medicine is guaranteed like this one, would insurance cover the drug with a substitute whether it is 100 or 1000 with no cost to the patient because it is a mandated benefit?</p>

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<p>I’m not so sure it’s cheaper for insurance companies to supply birth control without copays. :slight_smile: They knew that many women don’t want to get pregnant, and will buy birth control if it isn’t provided for free.</p>

<p>Texaspg,
No.</p>

<p>[The</a> Affordable Care Act](<a href=“http://www.plannedparenthood.org/about-us/newsroom/politics-policy-issues/affordable-care-act-39966.htm]The”>Campaigns | Planned Parenthood)</p>

<p>Romani… You would think buying a plan with a subsidy instead of a medicaid plan would be a piece if cake. You are going to tell us what happens after you talk to bcbs.</p>

<p>Romani, you can buy insurance if you want; the insurance company will be happy to take your money. Or maybe they won’t be happy, but they have to sell it to you anyway.</p>

<p>Nominally, you can’t get subsidies if your income is too low. Calmom says if your income is close to the subsidy level, you can give an optimistic estimate of it and get subsidies. Then at tax time, if your optimism was unjustified, you only have to pay back $95 of the subsidy.</p>

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<p>It is cheaper to supply birth control than cover maternal health care (assuming both are done 100%)- especially if they push a LARC rather than the pill. </p>

<p>dstark, I’ll be sure to let you know… if they call me back haha. The BCBS guy seemed COMPLETELY clueless.</p>

<p>CF, I know that I can buy it, but I can’t afford it without the subsidy. I am wondering what happens to those of us who are under the subsidy cap and should be covered by Medicaid but don’t want Medicaid. Isn’t the subsidy supposed to be for those between 100% and 400% of poverty? I’m well under 100%.</p>

<p>ETA: Whoops somehow I missed this part of your post:

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<p>I can do that. The other problem is I have absolutely not a clue what my income will be next year (it could literally range from 2k to 20k). The life of a student without guaranteed income… I know it will be MUCH less than this year, but if I use this year’s I will be above poverty.</p>

<p>I really don’t mind paying for insurance- I just can’t even afford the crap plan I’m on (it’s over half of my income right now) let alone a new plan next year, but I don’t want to be on Medicaid because I’m not THAT needy.</p>

<p>“I really don’t mind paying for insurance- I just can’t even afford the crap plan I’m on (it’s over half of my income right now) let alone a new plan next year, but I don’t want to be on Medicaid because I’m not THAT needy”</p>

<p>That is an admirable sentiment, good for you, but…once you finish school and start working, you’ll probably never qualify again, plus you’ll be paying tons into the system. Figure out what you need to do to stay healthy and not break the bank, even if you have to go on Medicaid…and I guarantee you, you’ll be paying it back to Uncle Sam in many multiples, soon enough.</p>