Affordable Care Act Scene 2 - Insurance Premiums

Parent Cafe
5681

<p>So don’t vote for her again. Really, I don’t trust much just because someone says it or it’s in the media. Funny, because each time Emily links NYT I have that little moment, then I do go off and read it- and see if it passes my muster. I’ve learned so much about this whole healthcare situation, both from informative posts and how it triggered my own research-- part of becoming informed is the way you dig in. NOT that you heard it somewhere.</p>

<p>I’ve still got a lot of questions, am dismayed a 60 year old, 60k couple will pay so much. Or that your costs and others’ are going up. But my purpose right now is to make the best informed decisions I can. Should be, for all of us. Not to get mired in who said what when. Not get bogged down by a look-back. Especially not when so much that’s anecdotally noted on this thread seems like a sidebar. And, since so much of it has ended up shot down.</p>

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<p>lookingfoward, I am not bogged down in the past. I am responding to someone who is claiming I should take responsibility for my mistakes and somehow I should have known in early 2012 what was going to happen in 2014.</p>

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<p>another xpost</p>

<p>GP, c’mon, no one was supposed to make an informed decision about the Oct-December 2013 enrollment period, back in 2012. Not going to play the hindsight game with you, about what you could have done with- or without- a crystal ball. Or whether you should have assumed you had sufficient info. What’s done is done. We all have times when we need to deal with prior decisions and move forward, as best we can. Now.</p>

<p>I have a nagging question: why did you relay questions to dstark to ask Anthem? Was it to make a point or become informed? You have checked every-which-way on your own, right? Made the calls, researched stray questions, double checked your thinking, run the numbers, etc? Sorry if I missed some background on that. I had been off this thread for a while, but thought I had caught up on all posts.</p>

<p>[And, I didn’t interpret what calmom said as you do. You are bogged in the past if you return to how someone lied to you, in the past, or something wasn’t properly presented, in the past.]</p>

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<p>Believe me, LF, I am going to make the best decision for my family with the limited options available nowadays. I don’t need to call Anthem or BS now because I have 3 months before I have to make a decision. I am also not sure we have seen the last of all the changes made for 2014. If things continue to get worse, our govt may be forced to extend the individual mandate and/or non-grandfathered plans for another year. </p>

<p>I am going to give it another 3 months before I change plans. I would really be miffed if I changed plans now and then learned I could have kept my 2013 plan because of some govt action in the next 3 months. No, I am going to be patient and wait to see how things shake out. If I learned anything from what happened to me in 2012, is that I am not going to trust any of the stuff coming from our govt. Our politicians and govt officials in Washington and Sacramento are more than capable of doing 180 degree turns, regardless of what they are telling you now.</p>

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<p>GP, you should have known in 2012 that you were signing onto a plan that would not be renewed after 2014. That the difference between a “grandfathered” and non-grandfathered plan was that only the grandfathered plans would continue. </p>

<p>The fact that you didn’t know what insurance rates would be after full implementation of Obamacare is the reason that it was a very risky decision in 2012 to give up the plan you had. </p>

<p>It’s not that you should have known what would happen – it’s that you should have known what could happen. </p>

<p>Obviously all things could have happened with Obamacare: the rates could have gone up, they could have gone down. The one thing that you did know was that change was coming, you were enrolled in a policy that you were entitled to keep, but you didn’t like the rate increase on that plan.</p>

5686

<p>GP, I didn’t rely on govt promises. I checked healthcare.gov, when it and Kaiser FF were all we had. I knew it was coming, but didn’t know what and didn’t assume what, even with those sources. I looked at advocacy reports, googled a lot for info on terms (eg Tier providers, Tier Rx,) found the Healthcare Blue Book, to understand relative prices for medical services, called BCBS for some clarification, etc. I also checked the financial gurus, to see how they were reacting- because I worried this might cause a stock market drop (considering the naysayers.) </p>

<p>After Oct 1, I called the health exchange and looked at their web info. All along, listened carefully to calmom- though she focuses on CA, her logic helped. The Sebelius transcript- ok, that was govt, but just a few days ago, and to show a quote was wrong. </p>

<p>I am saying, you have got to be informed, got to go through this- and you say you are not going to call Anthem now because you have 3 months. You relayed questions to another poster. </p>

<p>Totally agree with calmom: the one thing that you did know was that change was coming. You leapt.</p>

<p>I don’t find fault with that, can assume you thought it was a best choice, at the time. But, learn from it. And I don’t mean “learn” that, hey, it was confusing before. I mean learn to go after this info, all along. For yourself.</p>

<p>Lots of posts on this thread are from folks who assume, run with some wild thing they “heard.”</p>

<p>In my case, I haven’t scrutinized yet, but am told I can decide any time between now and (what is it?) March, that I want to change my December choice. And, if something changes in my family, kid gets a great job, eg, I can call in and discuss a plan change, during 2014. Before I do the final enroll, I will confirm that. But it is not stopping me from digging.</p>

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<p>

I think that once you make the payment for a plan, you are locked in for the year. (That’s what I’ve been told about Covered California, and its what makes sense to my lawyer brain as well: the payment part is what seals the deal)</p>

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<p>Moderator’s Note</p>

<p>This thread is now trending very political and against TOS. </p>

<p>Discussing your vote, congressman’s vote in congress, anyone’s support for single payer system etc are political topics. </p>

<p>GP - Please move on. Your premium went up and you made your point about it. If you still need to keep discussing your premium after so many posts here this is not the right place since you no longer need any help on this thread.</p>

5689

<p>"Even in a company of thousands of employees, when someone’s gut gets shot full of holes on accident, word gets out pretty quick. (And this was before the Internet was invented by you-know-who!) But beyond word of mouth, the ee in question had to get all kinds of approvals for extended leave. Local offices would put on fund-raisers to assist. It is hard not to ‘know’.</p>

<p>To be clear, we only had access to medical claims data at corporate, with no personal identifiers, other than basic demographics (age range, sex, etc.)."</p>

<p>I worked in the employee benefits department of my fathers company (250+ restaurant fast food franchise ) and back in the day (mid 80’s) we filed most of the claims to the insurance company for the employees. It was impossible not to know what the situation was with an employee and what the bills were - as we also had to retain copies of everything we sent into the insurance company in case there was a problem (and there was always problems that cropped up.) We were who argued with the insurance company when a claim was denied. It may seem weird now, but employees were much less concerned about their privacy and came to my department for assistance in dealing with the insurance company, all the time. We also knew the medical reason when employees had to file for long term disability - because we assisted and submitted all the paperwork for the employee.</p>

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<p>My guess is all that ^ trust stopped when ees started getting fired for costing too much in medical claims.</p>

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<p>^ and the advent of computerization. When was the last time you filled out a medical claim? I know I haven’t in years. Even for out of network the doctor’s office submits my claim. </p>

<p>I also was on the negotiating team for insurance renewal. Every time our contract was up, we had to switch insurance because of expensive claims during the contract period. Preemies were a big killer and we always had a few each year as our employee population was very young. It was always better financially to switch companies because the new company weren’t responsible for claims filed under the old insurance and it was worth their while to get new business. Rinse and repeat every 3 years or so. That is why companies are constantly switching insurance company and changing plans and what is covered under those plans. Even doing that, it has now become impossible to keep the cost of premiums down and the benefits the same - the cost of health care has risen so dramatically.</p>

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<p>Just considering the testing costs:</p>

<p>I am not so sure the cost has actually gone up so much as possibilities of lifesaving measures due to improvement in knowledge and technology which in turn drive up the number of tests being performed because they exist. The newer tests just cost a lot more but the prices start going down as they become more prevalent.</p>

<p>I had a nuclear stress test around 2005 after a bad EKG. I saw the bill was around 8k, discounted to 4k with my portion being 600. I was asking someone at a cardiologist’s office couple of months ago what it is billed at and was told 2500, reimbursement lower than 1800 or so. Many internists have one of these machines now as opposed to just cardiologists.</p>

5693

<p>“So basically it seems he is a proponent of individual responsibility and bearing the consequences of one’s choices, except when it impacts him and he doesn’t like the results.”</p>

<p>I certainly can understand people being irritated with the pooch belaboring his point, but it seems odd to give a lecture about individual responsibility to someone who is paying the full boat for health insurance, and also paying for others.</p>

5694

<p>I was just reading about the company that owns eHealthInsurance.com, eHealth. Apparently they are doing quite well, and their stock is up considerably. Anyone follow that company? Seems they may have even more business than expected if the govt can’t get their website to run.</p>

5695

<p>Looks like faulty logic to me…</p>

<p>Part A…person doesnt take personal responsibilty for a decision.
Part B Person pays full pop and maybe subsidizes others…</p>

<p>Therefore…person takes personal responsibilty for both A and B.</p>

<p>That is what is being said.
That is not logical. </p>

<p>I have always found it bizarre that somebody that can afford something is takng personal responsibilty and someone who cant is not taking personal responsibilty.</p>

<p>Somebody who is being subsidized is being helped… That is different than not taking full responsibilty for his own decisions. </p>

<p>Maybe the guy just cant afford something society wants him to have so others in society are helping to pick up the tab.</p>

<p>The last couple of posts are insulting to people who are on financial aid so they can go to school. </p>

<p>My daughter is renting an apartment at 50 percent of market rates. Therefore, she is not taking responsibility for her actions? Really?</p>

<p>No.</p>

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<p>^^dstark, the point is not to slam people getting subsidies. The point is lecturing people about individual responsibility seems odd to me, in this case.</p>

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<p>Dstark,</p>

<p>You misconstrued my post.</p>

<p>I don’t want to get political, but I feel that many people on this board were insensitive towards GP situation. It is understandable (at least to me) that people like GP get upset that not only do they have to pay more now, but they have to pay more for what they consider an inferior product.</p>

<p>P.S. Also what busdriver said. I could not put in words the way she did it.</p>

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<p>I hope I explained why it isnt odd.
There are two events… Not one. </p>

<p>Also… Being forced to so something is not making a decision.</p>

<p>Really, in this case, only one decision was made. Part 1.</p>

<p>I think it is pretty clear for part 2, if there was a choice, the decision would have been different than what is going to happen.</p>

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<p>Well Lerkin, you agreed with busdriver11. ;)</p>

<p>I hope my posts are understandable.</p>

5700

<p>I see what your point is, dstark, but while people can guess the future, what really happens is anyone’s guess. People can believe what they’re being told in the media by those with the loudest voices, they can be suspicious and read the fine print, but in the end they merely make their best guess. Plus, a grandfathered plan can still be dumped by the insurance company at their whim, so how many of those plans will even make it to 2015? It just won’t be considered to be the fault of the govt, but the result is the same.</p>

<p>Those in the individual market who are having to pay for their policies are getting their butts kicked. The loss of networks and the steep increases seem to have taken many people by surprise. A small segment is the hardest hit here in paying the big bucks to the insurers, and these are the people that many had thought would be helped. Companies are still getting their tax writeoffs.</p>

<p>To those people, I say thank you. And sorry for this.</p>