<p>GP - whats up with the cryptic messaging? You were much clearer when speaking your mind…</p>
<p>Texas, I have said on a number of occasions earlier in the thread that I was working on a way to escape the limited network plans that one must take in the individual market in Ca. I have managed to join a group plan which has the wide network that I have been accustomed to. The enrollment was finalized this past week. Obamacare has driven me out of the individual market for insurance. Until this week, I have been an individual subscriber for over 20 years.</p>
<p>That sounds like pretty good news for you. How were you able to get in?</p>
<p>How do you see the premiums working compared to the group vs what you were being asked in the individual plan?</p>
<p>What kind of group plan GP?</p>
<p>It is an employer-provided plan. I am paying more than I would have paid if I was allowed to keep my 2013 non-grandfathered plan. However, the deductible is only $500. I would have preferred the higher deductible and lower premium but that option wasn’t available to me. I will miss the tax break I got from contributing to a HSA acccount.</p>
<p>We now have a two-class system in Ca and other states. In the individual market you are stuck with limited networks and high premiums, whereas the wide networks are still available to employer groups. This is so unfair to the unsubsidized subscriber in the individual market who has no options. Why someone in the individual market should be treated so differently than another person getting employer-provided insurance is a mystery to me. Until 2014, the networks were the same in both markets.</p>
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<p>I guess mileage does vary. I’m annoyed at Anthem for reducing the number of office visits that require merely a copay, but otherwise, I have found them to be responsive and easy to deal with. I have had a LOT of contact with them over the past couple of years. My son required out-of-state psychiatric appointments and hospitalizations, and Anthem handled everything well. We have had in-state hospitalizations, surgeries, and meds that cost $23,000 PER DOSE. Anthem never balked at paying. My son’s two psychiatric hospital stays last spring totaled 32 days, and Anthem never suggested he needed to get out quicker.</p>
<p>We’ll have to see how MCH performs, but at least in the Portland area, their provider list IS very skimpy.</p>
<p>“meds that cost $23,000 PER DOSE.”</p>
<p>I doubt that drug will be in the formulary of Maine Community Health or most other exchange plans throughout the country.</p>
<p>So, GP, it’s an employer-provided plan but you are paying the entire premium?</p>
<p>CF, I am not going to go into all the details but I am paying more than what I paid in 2013.</p>
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<p>Goldenpooch, you’re still smarting about your pricey hospitals not being included in the exchange network? Don’t blame “Obamacare”, or sick people, or poor people. It’s the outrageously expensive providers you favor. If their prices were more in line with the hospitals around them, they’d be in the network.</p>
<p>I do agree with you that, in some ways, the individual market isn’t the same beast as the employer-sponsored market. Individuals are still discriminated against. But may I suggest that the new discrimination of not being able to go to a hospital with sky-high prices isn’t quite the same as the old discrimination of not being able to get insurance at all. Of course, there’s a perfectly obvious solution to this discrimination problem, but it’s not one that you like. But it seems you’d rather return to the past, where you got everything you wanted and never even had to think about the millions of people who got nothing at all.</p>
<p>“never even had to think about the millions of people who got nothing at all.”</p>
<p>There will still be millions of people who will get nothing at all. Today, there are probably more people uninsured than there were on Dec 31. Almost everything else you said is untrue.</p>
<p>On one hand, some are fussing to get what they think is the perfect network, while healthy, not needing those specific providers, today- and especially, in a state that generally has an abundance of providers, including top-notch (even renowned) specialists-- then there’s ML, trying to get what she knows is mandatory for her kids, what they DO need today, plus looking at recent, real medical history-- and in a state without the same wealth of provider numbers- or choices- in the first place. </p>
<p>I hate it when arguments boil down to: well, you won’t get that now, heh heh. As if someone could predict for the next family, in another state. As if one, with minimal experience (or, ha!, the authority of some media article,) could predict. </p>
<p>We did not get the full-on ACA that was envisioned. I find it hard to blame the visionaries for the ways subsequent handlers broke it down. My heart goes out to the MLs here.</p>
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<p>Of course, the CBO estimates that even after ten years of implementation, “millions of people” will still have “nothing at all” (i.e., no insurance).</p>
<p>When are the winners on cc gonna start singing for them?</p>
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<p>You just made that up, GP. You have no way to know whether there are more people uninsured now than on Dec. 31. You can’t assess the probability.</p>
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<p>I was wondering how the full cost of your new insurance policy (counting what you pay, and what the employer pays) compares to the premiums of the individual policies now available. I have no particular interest in how that premium is divided between you and the employer; that’s your business.</p>
<p>Are group policies way cheaper than individual policies? If they are, why? I understand that group policies would be somewhat cheaper, say 10% cheaper, just on the basis of bulk discounts, as it were. But if group policies were 30% cheaper, say, that would be more interesting.</p>
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<p>Well, let’s see. I live with two people like this. You can bet your bottom dollar I’m singing for them. </p>
<p>I just don’t do it on here because that crosses the line into “political” :rolleyes:</p>
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<p>[citation needed]</p>
<p>Have you guys been following the news about ACA or are you living on another planet?</p>
<p>Are you throwing chaff instead of giving any evidence to support your assertion about the number of uninsured, GP? </p>
<p>Now, I’m sympathetic to your reluctance to supply evidence to support your claim that “probably” there are more uninsured now than there were in December. There is no such evidence. As of now, we just don’t know whether there are more uninsured or not. We don’t have a handle at all about how many people signed up for private insurance off the exchanges. We don’t know how many of the new enrollees on the exchanges and the new Medicaid enrollees previously had insurance. Also, Medicaid has a lot of churn, so we don’t know how many people dropped off Medicaid this month. Worse than that-- the payment deadline for some states, for Jan. 1 coverage, is Jan. 15, so the number of people who have coverage today isn’t even knowable yet.</p>
<p>Still, you shouldn’t make claims you can’t back up.</p>
<p>Goldenpooch, I’m with Fang. I’d like to see the evidence for your claim that fewer people are “probably” insured now.</p>
<p>I’m guessing your “other planet” comment refers to the botched rollout, jammed phone lines at the insurance companies, shifting deadlines, restricted networks, etc. Yes, we’ve noticed all of that. Please show me where anyone has said that everything is working smoothly and perfectly for everyone. You may remember that Anthem held me captive for 6 hours last weekend, and I was not happy with that.</p>
<p>Still, none of that changes the fact that there is good. My D has gotten insurance that she can afford. My H got a good policy despite his pre-existing conditions. Neither of these things could have happened 6 months ago. And that’s just my little family. You seem determined not to notice that millions of people were totally shut out before Jan. 1, and can now get in. But your refusal to acknowledge that significant benefit about ACA doesn’t change the fact that it exists.</p>
<p>I would also caution against making assessments about ACA right now. This is the period of maximum confusion. This is the period when, for example, it’s almost impossible to get through to Anthem’s customer service. These are not permanent conditions. The dust will settle in a few months, and then you can pronounce ACA a failure if you wish, without having to resort to made-up facts.</p>
<p>Are we sure this is the period of maximum confusion? Because I’m hearing many more millions are going to be dumped from employer plans in October. We’ll see. Sigh.</p>