<p>So, interesteddad, if your online numbers weren’t good, you’d stay home or go to the doc? No perfect-world scenario informs us. My doc’s office wouldn’t even call me, if the numbers were good. </p>
<p>Does anyone see how the inflammatory comments, early on, that this was “socialized medicine” that took us too close to losing rights, altered how this could be rolled out?<br>
Ya know, born outside the US, Muslim, taking us to a communist state?</p>
<p>
</p>
<p>If the numbers had been high, I would have called the doc’s nurse and asked her to call in the next higher dosage. If doing so required keeping the appt. (so the doc could bill something), I probably would have gone, but it would have been stupid. </p>
<p>I always get all my lab results mailed directly to me (or available quicker online now). I want to review them before discussing them with my doctor. So I always get the blood tests done a week before my physical. </p>
<p>I have also asked my doc to order a couple of additional tests that i was interested in (NMR LipoProfile and Vitamin D). It’s a lot cheaper if he orders them (and I get the discount insurance rate), even though I’m paying out of pocket. We never discussed the results of those additional tests, but they were informative. The Vitamin D test helped me dial in the vitamin D supplement dosage. The NMR test is a very advanced lipid/cholesterol test. The results were exactly what I expected to see, but I had been reading about this test for a while and was curious to see my actual numbers – it gives particle counts and sizes for LDL and HDL along with an insulin resistance score. I doubt my doc has ever ordered it before. Since I was paying out of pocket, I just had him order this one instead of the standard cholesterol test for my yearly physcial. He got the simple numbers he would have gotten (total cholesterol, LDL, HDL, triglycerides) and I got the more detailed information.</p>
<p>In order to qualify for Medicaid you really need to have very few assets. That is not a real option for anyone near the middle class in this country, nor was it intended to be.</p>
<p>
That’s history - ACA did away with assets testing, at least for every state that chose to accept the federal $$ to implement the program. In medicaid expansion states, it’s a simple income test, for everyone up to 138% of the FPL.</p>
<p>
No, it is not intended for the middle class – it is a program for the poor. But the expansion will protect people who were once middle class but have suffered an economic setback – such as unemployed, or people whose earning capacity is impaired because of their health needs. They will be able to get on Medicaid immediately rather than being having to liquidate or exhaust whatever assets they have.</p>
<p>Moderator’s Note</p>
<p>Closed for now since people are too keen to fight their political view points and not discuss premiums.</p>
<p>**Moderator’s Note</p>
<p>Thread reopened with some ground rules</p>
<p>Capitalism, Canada/European countries, elections, political leaders names, bills under discussion, and few more trigger words will result in unilateral impeachments and sanctions.
**</p>
<p>how about a list of state insurance commissioners that will allow the ‘fix’ and those either not allowing or no decision as of yet:</p>
<p>States saying no:</p>
<p>Arkansas
Washington</p>
<p>States saying yes:</p>
<p>California
Florida
Kentucky</p>
<p>States undecided:</p>
<p>Minnesota</p>
<p>source:</p>
<p>[State</a> Insurance Commissioners Are Split on the Obamacare Fix - Arit John - The Atlantic Wire](<a href=“http://www.theatlanticwire.com/politics/2013/11/state-insurance-commissioners-are-split-obamacare-fix/71622/]State”>http://www.theatlanticwire.com/politics/2013/11/state-insurance-commissioners-are-split-obamacare-fix/71622/)</p>
<p>I’ll be interested to hear whether our posters’ good but cancelled insurance is reinstated.</p>
<p>This lists the hospitals with the highest costs. Not only does this effect networks, but maybe this can effect our choices of where to get treated. </p>
<p>“This data shows what more than 3,200 hospitals in the United States were being paid for the most frequently performed 100 inpatient procedures. The variations were extraordinary. Some hospitals in the New York State were being paid 40 times as much as the world-famous Mayo clinic for some treatments.”</p>
<p>[Fix</a> the Handful of U.S. Hospitals Responsible for Out-of-Control Costs - ManMohan S. Sodhi , and Navdeep S. Sodhi - Harvard Business Review](<a href=“Fix the Handful of U.S. Hospitals Responsible for Out-of-Control Costs”>Fix the Handful of U.S. Hospitals Responsible for Out-of-Control Costs)</p>
<p>RE: Husband/wife businesses and qualification for group insurance under ACA.</p>
<p>Rather than list previous posts I’ll recap: H and I currently hold a small business health insurance policy through BS CA. Another poster provided info which showed that husband and wife businesses, in which they are the only employees, will no longer qualify for small group plans under the ACA. To complicate the question further, H and I had just received the option from BS to reset our renewal date to December 2013 and to continue our group plan (with increases based on age bands ) until December 2014. </p>
<p>The question was asked why we were allowed to renew as a group since the ACA no longer allowed sole proprietorships, husband and wife only businesses or LLP’s to hold group designation.</p>
<p>Turns out…the answer is complicated…H and I do not ‘own’ a business, we are share holders in an LLC. Now, we happen to be the only share holders in this particular LLC. However, an LLC is an independent entity (corporations are people too!) as per the IRS. And, as per the IRS, ‘we’ do not ‘own’ the entity which produces the K1 income. As such, we are still considered a group. It is to early to tell what the lay of the land will be next year, but as of right now, members of an LLC who draw K1 income will continue to qualify for group coverage. It is my understanding this also holds for C-corps and S-corps.</p>
<p>FWIW…our broker, who clarified the above, stated they are evaluating each renewal on a case by case basis. So far they have sent only one individual to the exchanges…the two cases which stand out most in his mind so far is the individual who’s premiums tripled and the group whose premium dropped by 19%.</p>
<p>Oh, my gosh, dietz! Do you know if the husband/wife business exclusion from group policies applies to S corps? My husband and I are the only shareholders in our S corp, and we’re the only employees.</p>
<p>Dietz199, your group is very small. :)</p>
<p>Does your group buy insurance with larger organizations?</p>
<p>What happens if one of the members of the group comes down with a serious illness?</p>
<p>Edit: I see your fwiw.</p>
<p>Our group is small, too. My husband had expensive surgery and our son was hospitalized for 32 days. I don’t know what will happen to our group rates next year. The exchange might be cheaper, anyway!</p>
<p>MaineLonghorn, you had a tough year. Wishing you a much better year in 2014.</p>
<p>“how about a list of state insurance commissioners that will allow the ‘fix’ and those either not allowing or no decision as of yet:”</p>
<p>Even if they allow the fix, it is still up to the insurance companies to decide if they want to or not. </p>
<p>They also have to do this:</p>
<p>“The temporary fix allows insurers — if they so choose — to reinstate canceled individual policies for a year or two instead of having them expire at the end of 2013. They can extend the policies only if they first take two crucial steps — inform the policyholders of all the consumer protections their current policies lack (like yearly limits on a patient’s out-of-pocket expenses), and make them aware of their options to buy better policies in the exchanges, often with the help of federal subsidies. This option would apply only to people who have had their current policies canceled. It does not apply to others who might want to buy similar plans.”</p>
<p><a href=“Opinion | A Health Care Fix - The New York Times”>Opinion | A Health Care Fix - The New York Times;
<p>No word from BCBS about whether or not my plan is going to get renewed (it was one of the cancelled ones). I sincerely doubt it will- it will be far more profitable for them to force us all into other plans I believe. </p>
<p>We’ll see. I’m going to hold off calling them until next week though. Their staff is very poorly trained and I don’t want to get more conflicting answers.</p>
<p>
</p>
<p>I am pretty sure Minnesota will be yes (eventually). Our governor said that he supports the fix. So he probably will pressure insurance commissioner. </p>
<p>That being said, MN has very good rates on exchange, albeit small networks, so I am not sure this tweak will make a big difference in MN.</p>
<p>“Some hospitals in the New York State were being paid 40 times as much as the world-famous Mayo clinic for some treatments”</p>
<p>I am a bit surprised to see Johns Hopkins on this list almost near top. It sounded like MD set prices in the State and JH could not charge a lot more.</p>
<p>Romani,</p>
<p>I thought you did not want your old plan?</p>
<p>Regarding small groups and rates.</p>
<p>This is what our agent did for my H’s small business. He made us a member of a larger pool of similar small business and thus spread the risk. We are still on a separate schedule for renewals and I have no idea what other small business are in that pool, but it worked for us for the last 8 years.</p>
<p>I am also not sure if this is possible only in our state.</p>