Welcome to DU

But thanks anyways. Better late than never I guess.

The 'news' media was full of stories of people losing healthcare coverage, facing cuts to their coverage, facing drastically increased costs, etc. etc. etc. Average people who don't pay much attention to politics saw that and accepted it as fact.

Now all that BS has been debunked I'm sure the 'news' media will be awash with stories about all those false claims, as well as constant coverage of how Obamacare has helped people.

I'm waiting for the good Obamacare stories.

OK, still waiting.

Still waiting.

Still waiting..............

So once the narrative changes, which I feel is inevitable, those numbers should get even better. Yes, the damage has been done. But it isn't that bad. 56% for keeping it v 31% for repealing it is a pretty good advantage. 58% - 29% is very easy to imagine and that is a clear 2-1 advantage.



http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-february-2014/

^snip^

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I still think it works well for millions of people, and i am tired of the lying liars put up by the Koch brothers to cast doubt on the law.

That said, i just spoke with my dgtr-in-law about her and my son's foray into ACA. We're Maryland based. She's got a large student debt. Neither make a great deal of money, but together they make enough so they are disqualified for subsidies.

She's facing a hobson's choice, according to the Maryland state exchange. She can pick up an HSA-plan for $276 a month, with a $12,000 deductible ($6,000 each, but the full $12,000 must be met before the plan kicks in). Or a $397 annual penalty.

Last year, she and her husband made use of local Urgent Care facilities at about $100 a visit about half a dozen times, maybe 7.

If she takes the $276 plan -- the cheapest on the State list -- she and my son will pay $3,312 in premiums and still not get any service from the insurer until after they've piled up $12,000 in medical costs they'd have to pay out of pocket-- that's a total of $15,312.00! Last year their out-of-pocket expenses were a little more than $700 -- there were a couple of prescription costs added on to the $100 Urgent Care cost per visit.

If she had the low-end health insurance (It's BC/BS Carefirst) they would have paid the equivalent of the Urgent Care costs, plus $3,312.00! So $3,312.00 plus about $800 in Urgent Care = $4,112. To carry the comparison forward, if they do not sign up this year, they can expect to pay that $700-$800 in urgent care charges, plus the ACA imposed penalty of $397. A total of $1,197.

I've asked her to check with a health insurance broker to see if there's a way out of this dilemma. They are willing to pay a reasonable premium -- reasonable being about $150.00 -- for a policy that only covers catastrophic health costs. Incidentally, she was paying about $60.00 a month for an individual plan in Vermont while she was living there.

I have to admit to being baffled and dismayed by this situation. Am I missing something here? Because if I'm reading this situation right, my son and dgtr-in-law have just fallen between the cracks and, as far as ACA is concerned, are S.O.L.

Are you confusing the out of pocket maximum with the deductible?


I had to guess about age, smoker or not and income level... but..... This seems to be the plan you are talking about: https://www.healthsherpa.com/health-insurance-plans/MD/3231/bluechoice-hsa-silver-1-300?premium=218.00&csr_type=none&zip_code=21105&fip_code=24005 (I put age 35, 2 in family, non-smokers with an income of $60,000)


BlueChoice HSA Silver $1,300
by CareFirst BlueChoice Inc.


Premium
Due monthly, regardless of your health care usage, total for all people to be covered.

$218.00 / month




Deductible
You are responsible for all costs up to this amount per year. You pay part of your costs above this amount, until you spend your out of pocket max. See cost sharing below.


Medical
$1,300 / person-
$2,600 / family-




Out of Pocket Maximum
This is the most you will spend per year for your healthcare costs.


Medical
$6,350 / person-
$12,700 /




Medical Cost Sharing
You are responsible for paying these amounts for medical service usage.

Primary Care$30 copay after deductible
Specialist$40 copay after deductible
Emergency Room20% coinsurance after deductible
Hospital Stay - Physician20% coinsurance after deductible
Hospital Stay - Facility20% coinsurance after deductible
Drug Cost Sharing
You are responsible for paying these amounts for prescription drugs.

Generic20% coinsurance after deductible
Preferred Brand30% coinsurance after deductible
Non-preferred Brand40% coinsurance after deductible
Specialty Brand40% coinsurance after deductible


Additional Resources
The insurer has provided these additional resources to help you research this plan.






As you can see, the out of pocket max. is around $12,000. Not the deductible.


Edit to add: check with a navigator, not a broker.

$12,000 -- and it had to be reached completely. No splitting in half so one person could reach $6,000 and be OK.

The Out of Pocket (OOPs!) was also $12,000.

It was a terrible, terrible deal -- and not at all cheap.

I did not find the plan you referenced and will forward it to my son and daughter-in-law. It's closer to what they were looking for.

Thanks!

on Maryland's exchange site and never stumbled on it. Maybe we're both just confused noobies -- but I really think the site is poorly designed.

Thanks again for the skinny!

I spoke with one back in December and she was very helpful.

http://marylandhbe.com/navigator-program/

Thanks for the info. It will help, I hope.

In any case, I'll keep you posted!

Every time the conservatives find one of these stories, it turns out to be false. Facts do matter (except is you watch Fox News)