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<p>I have no idea what most young people think (and I didn’t write the first statement), but if they did think it was free, they wouldn’t be completely wrong. Expanded Medicaid for young people is free, coverage on your parents plan until age 26 is free (unless your parents make you pay for part of it), and preventive care and contraception is now free, which are probably what most young people use most often.</p>
<p>The doc’s coding is important.</p>
<p>Folks have got to check with their ins compay reps, for clarification. </p>
<p>Here is what BC just told me (was calling about something else, but asked.) These are my answers from my rep, based on my 1/1/14 compliant policy, my limit of what I asked. Ask yours. </p>
<p>By mandate, you get one routine mammo per year, ages 50-74, covered at 100%, regardless whether anything was ever found, in the past. If you require something addl, based on your own history, ask your rep. (A couple of times, I had a second read. I asked and the rep said, it depends on how your doc codes it. If you expect something like an ensuing ultrasound, ask your rep.)</p>
<p>Colonoscopy: covered at 100% every 10 years- or every 5 years if there is a family history. It’s worded, ‘FH of colorectal cancer or polyps.’ You will need to clarify whether benign polyps count. Or if it is only where a cancerous polyp was found. And how they discuss who in you family qualifies you for this. If your doc, for some reason, wants a repeat in a shorter timeframe, diagnostic.</p>
<p>Basal: I suspect a dermotologist may have a “preventive” code, but dermo is usually at the specialist co-pay. If they remove a suspicious cell, it is usually diagnostic.
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Yes, some aspects of follow-up may be diagnostic. You need to see how your own policy covers whatever it is. There is a difference between what the insurer must cover at 100% (eg, pap smear) versus what they must cover, in general. While some of this is spelled out, there may be instances where ymmv.</p>
<p>OK: people who don’t like reading about California can ignore the following post – this pertains to another one of those letters I got from Covered Cal. </p>
<p>The latest message was was a reminder to choose a plan, because according to the letter their records show that I have not yet done so. ***? I chose my plan in November and confirmed it with a Covered Cal rep last month, and when I log in to my Covered Cal account it clearly shows that I selected a plan. Of course it is impossible to get through to Covered Cal.</p>
<p>However, I was able to get someone at Blue Shield on the line today with less than 5 minutes hold time-- and they DO have my records. He gave me my new policy number & said I should receive a bill within the next couple of days. </p>
<p>So I’m just posting this in case others get odd communications… I think there is a problem with the boilerplate going into form letters.</p>
<p>I signed up for a plan with Anthem Blue Cross in Ca. I was told I would get a letter by Friday acknowledging my purchase of a new plan. Didnt get the letter. Checked online. No acknowledgement of my purchase. I called Anthem. I was surprised how fast they answered the phone. I hope this was because they hired new people and not because ACA isnt seeing the signups. :)</p>
<p>Anyway, the first person I talked to did not see my purchase. I was transferred and the next person did see my purchase. It is floating around.</p>
<p>I hope I get a written response this week. I dont want to end up with the plan Anthem suggests.</p>
<p>Re TPG’s debit card:</p>
<p>TPG, FYI, it is possible that your company has implemented a FSA (flexible spending account) or HRA (health reimbursement account) – these two programs would cause the creation of a debit card to use.</p>
<p>Oh, and ps, I was incorrect about the OOP deductible on a 94 plan – it’s actually $500 OOP for an individual at 150% of poverty level – not $325…I had just subtracted out the deductible of $125 as its included in the OOP max ;)</p>
<p>Update - yes kmc. I started reading up the program since I don’t want to sound too dumb here and it says HRA. I have a build my own plan thing which adjusts premiums based on my deductible tolerance. So why exactly do they want to give me money again?</p>
<p>dstark - working spouse went upto 1200 from 720…</p>
<p>Bay, if they’re on their parents plan, it’s not free. Most young people know that their parents are paying for their insurance. Yes, it’s no cost to them, but it’s not free. </p>
<p>Most young people are not going to qualify for Medicaid. Working full time at minimum wage just barely puts you above poverty. If you’re not in an expansion state, you’ll be above that 100% FPL. If you’re in a Medicaid expansion state, you’re going to be right around the 133%. </p>
<p>Most people that are NOT getting insurance are doing so because of costs. Young people included. I’ve posted several links showing this. Which is why I called bull on that statement. If young people thought it was free, I bet you a shiny internet cookie that they’d be signing up.</p>
<p>Texaspg…1200 from 720 is a nice bump.</p>
<p>I like this article…</p>
<p><a href=“Enhanced Medical Care for an Annual Fee - The New York Times”>Enhanced Medical Care for an Annual Fee - The New York Times;
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<p>You can’t end up with a plan you don’t pay for. I had the same concern about Blue Shield but I just turned off the “autopay” feature for my former account and removed my credit card info, as soon as I verified that the December payment had gone through. So either everything will go smoothly, and BS will match up the accounts and roll me automatically into Covered Cal one, or I will get signed up for both and get a termination notice in January for the policy I don’t want when they don’t get a payment. </p>
<p>For me it’s actually the same plan but I need to sign up via Covered Cal for the premium/tax credit eligibility.</p>
<p>Also, apparently the standard deductible on my plan for next year is $1650. I don’t know if there’s any difference for me because of the subsidy. </p>
<p>I don’t plan on reaching it given the fact that most of my health care issues are all cleared up, so it’s a moot point. If I do, I do. It’s not like knowing it is going to change anything for me personally.</p>
<p>I can’t think of any surgeries I’ll need next year. I’d be fine with not going under the knife for the next 10-20 years. Too many surgeries already for this young person ;).</p>
<p>Romani - Although you called bull on my comment, lol, we agree more than you think. To clarify, right now I don’t think most young people are paying much attention at all but when they find out it’s not free they may think twice because of the costs.</p>
<p>"and there will be no more than 400 — will pay $25,000 a year for unfettered access to the doctors. Patients will be able to call and see and text the doctors whenever they want; they will be able to receive home visits, though those will cost extra (and so will lab work). They will be able to ask their doctors to travel to them should they suspect the onset of illness in June in Umbria. Various young Internet moguls have already expressed interest in becoming patients of the practice, which will start next month, Dr. Goldberg said. "</p>
<p>400 x 25,000 = 10,000,000. Not chump change if there are only 2 doctors in the practice.</p>
<p>I want things to go smoothly. The last time I switched plans it took Anthem several months to get the correct billing. I kept getting cancel notices even though I was paid up. </p>
<p>Those cancel notices bothered me a lot more than the one I received this year. :)</p>
<p>I want to be signed up for the plan I actually want. :)</p>
<p>I hope things go smoothly for you, calmom.</p>
<p>“400 x 25,000 = 10,000,000. Not chump change if there are only 2 doctors in the practice.”</p>
<p>I didnt even think of that when I read the article. </p>
<p>How much can it possibly cost to run an office with two doctors?</p>
<p>Well, knowing whether you have hit your deductible or not may impact decisions you make on some choices, as well as timing of some tests or procedures. One year a long time ago we went ahead with a probably unnecessary MRI for my son in December because we knew we had used up the deductible for the year and the test would be paid for if we had it then, but not if we took the more conservative wait-and-see approach and ended up needing the test 6 months later. But that was in the days when deductibles were a lot smaller – and MRI’s were brand new technology that cost a lot more - we probably had a $300 deductible. </p>
<p>Of course none of us ever know when a need will arise. I certainly hope your health care issues are cleared up for a long time – but even a relatively minor injury like a bad strain or a fracture can quickly run up a deductible.</p>
<p>BCBS sent me a form to fill, confirming my direct-purchase choice or cancelling the 2013 plan a/o 12/31. Due by the 23rd, I think.</p>
<p>I’ve gotten cancellation notices over payments I’ve made, too – in fact that’s one reason I went to auto-pay & credit card billing-- and I’ll set up auto-pay again as soon as I’ve got an account to do that with. (The other reason for auto-pay was that I was putting it all on an air miles car — I earned so many free flights that I lost count, and the monthly insurance bill was a nice addition to my point count.)</p>
<p>I should change my credit card. I like what you did calmom. Getting miles is sweet.</p>
<p>Me, too. I knew someone who could get everything on her card, incl pricey mortgage payments and med expenses- and reaped plenty o’ returns.</p>
<p>“and there will be no more than 400 — will pay $25,000 a year for unfettered access to the doctors.”</p>
<p>But the people who are paying the $25K for these doctors still need to have insurance on top of this. These two doctors cannot take care of all their medical needs.</p>