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zinnisking

(405 posts)
Fri Nov 21, 2014, 08:20 PM Nov 2014

Because of new Govt. regulations health insurance will pay only up to $1million of your bill?

My employer holds a benefits meeting once a year. Health insurance costs have been rising every year since I entered the workforce over a decade ago. But the past two years they have been excited that they get to blame the rising costs on the government. They love getting ignorant people worked up here. Surrounding the break room with large screen TVs and Faux News isn't good enough.

My boss told me the other day health insurance will no longer pay more than $1million of your health care bill. If its more than a million, you have to pay it out of your pocket.

I find it strange that Obama, a Socialist-marxist-mouist-leninist-stalinist, would help the private insurance industry by putting limits on how much $ they have to fork over.

I've searched the Google and found nothing. Does anyone have details on this?

12 replies = new reply since forum marked as read
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Because of new Govt. regulations health insurance will pay only up to $1million of your bill? (Original Post) zinnisking Nov 2014 OP
that is not correct drray23 Nov 2014 #1
Obamacare prohibits lifetime limits itsrobert Nov 2014 #2
That was fast. Thanks. zinnisking Nov 2014 #10
B is gobbledygook and thus there are still some annual caps. Lifetime? No. Annual? Maybe. TheKentuckian Nov 2014 #12
About 18 years ago..Blue Cross Blue Shield..put a million Peacetrain Nov 2014 #3
Opposite is true...there was a cap, no more. randys1 Nov 2014 #4
WTF? Spazito Nov 2014 #5
Let me add this.. the insurance companies ate every little raise we ever got Peacetrain Nov 2014 #6
Its possible they applied for a waiver. Travis_0004 Nov 2014 #7
There are still insurance plans not under the ACA umbrella Samantha Nov 2014 #8
You found nothing because your employer is MineralMan Nov 2014 #9
That limitation was removed by the ACA still_one Nov 2014 #11

drray23

(7,634 posts)
1. that is not correct
Fri Nov 21, 2014, 08:23 PM
Nov 2014

One of the most important provisions of the ACA is that there is no lifetime limit anymore. So, your employer is mistaken or plain lying to you.

itsrobert

(14,157 posts)
2. Obamacare prohibits lifetime limits
Fri Nov 21, 2014, 08:24 PM
Nov 2014

Obamacare prohibits lifetime limits (A cap on the total lifetime benefits you may get from your insurance company) on most benefits in any health plan or insurance policy issued or renewed on or after September 23, 2010. In 2014, Obamacare prohibits new plans and existing group plans from imposing annual dollar limits (a cap on the benefits your insurance company will pay in a year) on the amount of coverage an individual may receive.


SEC. 2711 [42 U.S.C. 300gg–11]. NO LIFETIME OR ANNUAL LIMITS. [Replaced by section 10101(a)] ‘‘(a) PROHIBITION.—

‘‘(1) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish—

‘‘(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or

‘‘(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary.
‘‘(2) ANNUAL LIMITS PRIOR TO 2014.—With respect to plan years beginning prior to January 1, 2014, a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, as determined by the Secretary. In defining the term ‘restricted annual limit’ for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums.

‘‘(b) PER BENEFICIARY LIMITS.—Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, to the extent that such limits are otherwise permitted under Federal or State law.

- See more at: http://thanksobamacare.org/index.php?id=11#sthash.3ATKUIz4.dpuf

TheKentuckian

(25,026 posts)
12. B is gobbledygook and thus there are still some annual caps. Lifetime? No. Annual? Maybe.
Fri Nov 21, 2014, 08:53 PM
Nov 2014

I've seen them on major medical and pharmacy benefits in no small numbers this year.

Peacetrain

(22,877 posts)
3. About 18 years ago..Blue Cross Blue Shield..put a million
Fri Nov 21, 2014, 08:25 PM
Nov 2014

dollar cap on our insurance through where my husband worked.. I think the ACA helps with that..

randys1

(16,286 posts)
4. Opposite is true...there was a cap, no more.
Fri Nov 21, 2014, 08:25 PM
Nov 2014

ALL RATE increases will be blamed on Obama...

My hope was the insurers would go too far and raise premiums so much that the people would finally wake up and DEMAND single payer

Spazito

(50,402 posts)
5. WTF?
Fri Nov 21, 2014, 08:27 PM
Nov 2014

"I find it strange that Obama, a Socialist-marxist-mouist-leninist-stalinist, would help the private insurance industry by putting limits on how much $ they have to fork over."

Peacetrain

(22,877 posts)
6. Let me add this.. the insurance companies ate every little raise we ever got
Fri Nov 21, 2014, 08:29 PM
Nov 2014

and that has finally started to subside.. My husband still works even though I am retired.. but at least for the last couple of years our cost of living did not go straight to BC/BS

Samantha

(9,314 posts)
8. There are still insurance plans not under the ACA umbrella
Fri Nov 21, 2014, 08:29 PM
Nov 2014

and the safeguards built into plans wrapped into the Affordable Care Act probably are not applicable to those other plans. This is just a guess on my part, but that would seem to make sense.

Sam

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