Anthem carried my COBRA plan and also happened to offer a self-employed plan I liked for less than half the crazy $1300 bucks that was COBRA.

Paperwork, doctors statements and records, all kinds of shit, then rejection, then I'd try to cure it, rejected again, then was told to start over.

Bullshit runaround, it took way more than a day out of my life and some money, too, because they insisted I missed a follow up appt with eye ear nose doc, so disqualified me unless I went in for that.



With ACA it took about 45 minutes on the phone, maybe 55.

I'd done my shopping then got on the phone while taking my morning walk. 30 minutes into it I had an answer.

"Hello, my name is Osama."



And we walked and we talked and I made a three-way call to make sure my doctor was in the group.

Then Osama down-sold me from a gold to a silver plan because it would save me money and get the same coverage.

Incredible.

I guess it's not that way everywhere, but I'm glad you and I both got our ObamaCare!

Better than a pony!

companies--and I can tell you they are the devils spawn. I shit you not.

We'd get claims and the first thing you did--try and figure out a way NOT to pay. One of the two I worked for was much better. Not perfect...but light years better than the other.

Insurance has changed so much since I stopped working...and definitely not for the better.

I'm happy your experience was a good one.

I knew I'd have wait times since I was doing it at the last minute.

I'm grateful for Obamacare!

One I read years ago on insurance companies.

One chapter the author interviewed the found of a HUGE insurance company in Chicago. Asked him how he was able to survive and become a huge insurance corporation.

The guy's answer was clear and straightforward: "I didn't pay any claims."

Did exactly what you described. Refused to pay claims, ultra fine print in the agreement, etc. For years he only paid if he was taken to court. After a decade the courts caught on and came down on him, but by then his company was off and running.

Story said so many never fought back when their claim was denied. Looked at the agreement and rolled over.

Word!

is ridiculous.

They ask for more information over and over...then they deny....you appeal...they deny...this goes on for a while and eventually they bank on people giving up--which happens A LOT. Even if it's covered it doesn't get paid.

It's a science I swear.

Last edited Sun Mar 30, 2014, 07:02 PM - Edit history (1)

I hate to tell you, but we're done fighting. This is it. No one is going to kick the drug companies in the ass. No one is going to do anything if Big Insurance ends up taking 25% instead of their legal (20% = half trillion dollar) rake. People are still going to have to beg to get the meds their doctor prescribed. People who like me with work plans who saw their deductibles go from 500 to 8500 are pretty much stuck. I am hoping either I make it to 65 without a major illness, or take Alan Grayson's advice and die fast.

The time line for the optimists (those who think that Heritage care will "lead to SP" ) is 50 years. Long before then PHARMA and Big Insurance will figure out how to get more.

Congrats on getting insurance. The ACA is great for those who couldn't get any due to pre-existing conditions. But you need to think of this part differently:



True as far as it goes, but if we had health care like all of the civilized countries have, you'd both have care without the blood-sucking middle men, the silly enrollment hoops, or the hassle you're going to have trying to actually get care.

Best wishes.

and next year that maximum out-of-pocket will include both medical and drug costs.

well, that didn't come out right, but you get the drift. On the upside, if we both get sick, the financial hit will be the same as if just one of us does. My glass is half full on that front.

You had to realize that Big Insurance would collect their obscene death taxes from somewhere, and it wouldn't be from the rich. That leaves working stiffs like me who will be out more than 10 times what I would have been last year if I get sick. A 2-night hospital stay that begins on 12/31 will set me back about half of my annual take-home pay. Luckily Mrs. D_J also has a good working-class job so we won't go under, but I resent mightily that 1/5th of the health care money of the entire nation was guaranteed to slimy death merchants who contribute nothing, but whose lobby is just more powerful that either the needs of the American people or of the president's dignity. And there is absolutely no reason the OP should have to spend a day getting enrolled, sign up for big deductibles, or (in the future) spend time on the phone getting the bloodsuckers to pay what they said they'd pay.

You might want to officially select your primary care doctor right away. My plan says you don't have to but if you don't they charge you co-pay for a specialist. Yours may be the same so heads up.

it's a 40% coinsurance (before deductible) to see him. All my other docs are in network..I checked a head of time. Even checked docs I'm not seeing in case I need them in the future.

I won't switch my pcp--been with him for over 30 years. I'll take the monetary hit.

We should point out the successes, then talk about the gaps we still need to close ...

That should be the GOTV message.

Me Jets struck it rich with Mike..LOL

... Nothing for action Jackson!!!

Similar to what the Born Agains have given me..

I don't qualify for a subsidy, even though I'm unemployed and have zero income.

None of the plans available is even remotely affordable.

I need a health care plan, not a health insurance plan.

I'm not as well versed as other are on the ACA.

I don't get why you wouldn't be eligible for a subsidy.

I'm sorry it worked out like that for you. I want everyone to have decent coverage.

If your income makes you eligible for Medicaid, it also makes you ineligible for subsidies. So low-income individuals in states that opted out of the Medicaid expansion are SOL.

My wife is a near minimum wage worker, and her income qualifies her for Medical (in Ca).

Im disabled, so I already get Medicare (and not a great deal of money per month), but to sign her up on the CoveredCa website they count my non taxable disability as income, which throws her above the amount for Medical.

Sure she gets a subsidy of $383, but the crap plans available with low out of pocket costs have huge hidden deductibles, and she will end up paying more per doctor visit (pre deductible) and generic drugs than she has ever paid before.

I would think $383 per month would easily cover typical costs of a Medicare patient, so this cant save the government (or us) any money.

She is supposed to be covered there but Roberts & Republicans have made that a black hole.

some others have said the same.

That's messed up--this is why we need to keep fighting for single payer.

We've made good strides but still have a ways to go...we can't stop now.

Vote, vote, vote!

Millions will remain uninsured because of blocked Medicaid expansion in states
By Editorial Board,

....
But a factor that the law’s authors couldn’t foresee was Republican intransigence combined with last year’s Supreme Court ruling. The justices proclaimed that states could opt out of an expansion of Medicaid, a partnership between states and the federal government that provides health care to poor people. The law aimed to cover a larger percentage of low-income people by raising Medicaid’s eligibility limits across the country, with the federal government paying for nearly all of the cost. It was a bargain that no state leader should have passed up. Yet Republican politicians have blocked Medicaid expansion in half the states.

Their refusal is going to have just the result that the attack ad rails against — millions will remain uninsured, and in states with some of the highest rates of poor uninsured people, such as Texas, Florida and Georgia. Many who should have been eligible to obtain Medicaid coverage won’t qualify for government help to buy insurance on the marketplaces that have begun to operate around the country. The law’s authors assumed that Medicaid would take care of them. In an analysis separate from the CBO’s, the Kaiser Family Foundation last month calculated that about 5?million adults will fall into this “coverage gap.” Another recent Kaiser study found that impoverished people in the South and people of color will be hurt the most.

Despite all this, the CBO projects that phasing in the Medicaid expansion in participating states and opening the health-care marketplaces will still result in about 25?million currently uncovered people getting insurance. That’s vastly more than the number of people who might have to pay some more for their coverage next year to help finance the new system, on whom attention has focused lately.

An achievement of that scale comes at the price of disrupting the insurance market some, as the law’s critics have reminded the country over and over again. The costs are real. But if the Obama administration can get the system working, the price will have been worth it. And if Republican leaders would halt their misguided opposition to expanding Medicaid, millions fewer would be uninsured.

http://www.washingtonpost.com/opinions/millions-will-remain-uninsured-because-of-blocked-medicaid-expansion-in-states/2013/11/15/9629bcfa-4b1c-11e3-be6b-d3d28122e6d4_story.html

-Laelth

They have lowered costs based on income.

It might be worth double checking your choice.

but to go with the silver plans they offered would mean many of our drugs wouldn't be covered until the deductible was met.

I can't see paying five hundred for insurance and another 500 for meds...it's was less to get one of the gold plans and the drugs were covered without the deductible.

thanks for the head's up though!

I enrolled via Covered California quite a while back, and quite painlessly on the phone. (covered since January)

Very happy with my plan for the $$.

who now have health care who wouldn't without Obamacare.. and insurance companies can't deny pre-existing conditions which is such a line-line for so many people.