We would like to take a cash out...because we don't trust pensions after the law passed by Congress concerning pensions but we are afraid SCOTUS will destroy the ACA...what do you think...I am praying Roberts does the right thing.

the idiots on SCOTUS. I too am worried about what might happen if the ACA is abolished. I, along with millions of others will have to go uninsured. For that reason alone, I feel that SCOTUS will do the right thing. (Crossing my fingers - that's all we got)

The ACA beats the old paradigm all to hell and gone.

Semi-retired, frugal, independent guy...He hasn't had insurance in 5 years because they wanted $700 for it. Got him enrolled for $20 per month.

Unfortunately, a good friend of mine is suffering with constant pain and was recently told "she might die if she moves the wrong way" can't get enrolled because that jackal Rick Scott made Florida an "opt-out state" and my friend doesn't make enough to qualify for that $20 insurance.

I know of someone else on fixed income whose costs dropped from $600 to $220.

I myself am doing well enough, with a good job and decent company-provided insurance, but it would be a great blessing to not have to worry about everyone else around me. Living in a society where people have healthcare, and where minimum wage is a living wage, is in itself a thing of great value.

wouldn't have received ANY subsidy.

http://www.correntewire.com/obamacare_at_400_poverty_you_can_be_on_the_hook_for_10000_more

Do you know EXACTLY what illness/injuries you will get next year so you have in-network doctors and hospitals who can treat you for any possible type of illness/injury you get in 2015?

Nothing you asked about was different before the ACA.

What deductibles do you have? Does it really matter? To some degree, yes. However, some insurance is better than NO insurance. Right now it's affordable for what we need. Working it until 65.

And if you have an UNLIMITED max out of pocket of out-of-network,then what's the point of having insurance?

It does you no good to have insurance you can't afford to use.

It may be "affordable" for what you need -- for now -- IF you don't get sick or IF you don't have a MAJOR illness or injury.

6k for major medical. The normal deductibles(PCP, ER, etc) are reasonable. However, you will see across the nation that deductibles going up. It's the only way the insurance companies can, in theory, still make money. No plan is perfect, including the ACA. When was the last time anyone actually paid 0 for insurance, 0 deductibles? 1980's? I will say this. If it weren't for the ACA, there is no way that I could afford 1250 a month for coverage that I may or may not use. It's at least nice to have some sort of safety net. Obama saved our bacon. If the GOP would have been in there, millions of people, including myself would be screwed. Why any nation, especially the richest nation in the world, would NOT want health care for it's people blows me away.

if you get a chronic condition? Most people wouldn't.

If does you no good to have insurance that doesn't help you for a major accident, major illness, or chronic illness.


So big deal. You have insurance that really doesn't protect you.

as max out of pocket.

In the old days insurance just dumped the chronic and they would never be able to get insurance again.

....is "agitprop" too? I finally reported on him, but the pop-up said it went straight to the Admins, and I have not heard anything back. So he is still here, stirring the pot.

Happy Holidays to you, Sunlei!

If something happens where I need a lot of medical care, I'll 'move' out of the tiny,tiny restrictive 'network area'. Upgrade my insurance.

Nice to have insurance that I can afford

And can you afford a $6,000 deductible every year until Medicare?

Do you not know? That's pretty scary if you don't even know what your risk is.

Do you not want to admit that you couldn't afford the in and out of network out-of-pocket if something happened to you and/or your spouse?

Are you in denial?

Why the silence? Perhaps it's because your ACA plan really doesn't provide the protection you think it does?

thorn in my azz. I do not have to disclose any more information than I already have, and have no intention of doing so. The bottom line, is I'm happy with my coverage, considering the circumstances I'm in. So you're name is "AntiGOP", and sound/act like "ProGOP". WOW.
Please go troll elsewhere.

1) You don't even know what your max out-of-pocket is for in-network or out-of-network?
If you don't know, then you don't even know your risk.

or

2) You DO know what your max out-of-pocket is, but are in denial because you wouldn't be able to handle it if something major happened to your or your spouse. (In which case, your coverage really doesn't protect you.)

Nice going, btw. When you won't answer the questions asked, call someone a "troll". Yep.

I find it really interesting that you tout your "affordable premiums" but refuse to share what your out-of-network maximums are and refuse to answer whether you can handle your deductibles for both you and your wife each year. Maybe because they're not affordable and it wouldn't fit your narrative?

I talk about the plan my husband and I have below but I didn't mention the total out of pocket amount because it is not part of what people are comparing here.

I will say that the total out of pocket of the plan I picked is one fifth of what the insurance my husband's employer has been providing to us for a higher out of pocket monthly cost. And that the out of network out of pocket cost is still less than what his employer had been providing.

The major advantage is that we could compare plans and buy what worked best for us and not have to settle for what worked best for my husband's employer - oh, and that we can now buy private insurance, which we could not get for any price in the past. THAT is the major reason my husband got a job and we stopped running our own business - because we could not get insurance at all.

Maybe you should stop trying to warp people's information into your narrative.

And he probably won't share it because it doesn't fit his narrative.

When they couldn't before. And as I indicated in my other post, individuals now have more control over their selections. For one thing, before we became uninsurable, it was almost impossible to compare plans. Insurance companies would not tell us the bottom line as to deductibles, out of pocket for in network and out of pocket for out of network.

Since my husband started working for insurance he had no control over what companies he had to buy insurance from and the plans were very limited. Usually he could pick from three levels - low cost, high deductible, high out of pocket; mid price, slightly lower deductible, high out of pocket; or high price, moderately low deductible, high out of pocket. In other words, there was NEVER a choice of controllable out of pocket expenses, especially if a specialist was not in network. For every level of plan, the in network out of pocket was $10,000 or more and the out of network out of pocket had no top end.

That doesn't fit your narrative, does it? The ACA made it possible to get insurance for millions, it did not fix the cost suck that health insurance in this country is designed to be. But that is no different than it has been for decades and the opportunity to get some coverage is better than not being able to get any coverage.

I know how no coverage and how regular insurance coverage works. I paid out of pocket to have a shoulder rebuilt twenty years ago. Even with the doctor and the surgical facility giving me big breaks, it cost me well over ten thousand dollars. But oddly enough, WITH insurance, when I had to get much less extensive surgery on the other shoulder fifteen years later my out of pocket wasn't a whole bunch less - because the surgeon who had previously worked on my was out of network and so was the surgical facility. I could have saved some money by using the much lower rated in network specialist but after reading reviews of him and asking around, I didn't want to trust him with my body parts.

When I had to get my knees replaced, the out of pocket was well over ten thousand dollars. As a result, I made sure to have both knees replaced in the same year. And since I was on a roll, and the knee problems had stressed my hands, I got carpal tunnel surgery all in the same year. And even though I had reached my annual out of pocket limit with the first surgery, somehow the insurance company made sure there was more money that had to come out of my pocket all the way to the end of the year.

NO INSURANCE COMPANY will EVER pay once cent more than they are forced to. Coverage through the ACA is better than no coverage at all but I sincerely hope that someday we can get a real national health plan and not a payout to the insurance companies.

Meanwhile, having been without insurance for many years and having been forced to give up a business I loved, I am happy for what the ACA lets us have.

.... AgitProp and not AntiGop.

so we didn't sign up. Hubby is medicare next year, I have another year to wait, so we're flying insuranceless until then. Our med expenses last year were around 3k - less than our deductible would have been, not to mention the ridiculously high premiums here for people our age.

I think it's a great deal for young folks. But we decided to pass. I haven't even logged in to see if things are better for 2015, because odds are they're not.

If we lived 10 miles away, in CA we would have had a much better deal. This state-by-state plan is just one of the things wrong with the whole program. Should have been a single-payer/medicare buy-in offered in the package. Their bad.

We may be foolish to be sitting tight waiting for medicare, but I can't see throwing away another 15k or so on insurance - we're in good health. Barring accident or something unforeseen, we'll be alright.

I am happy for those who benefited from the program. I think it was a fine start. However, it didn't do jack-squat for us personally.

My parents spend about $1,000 extra per month on health care even though they are both on medicare.

People need to look at their deductibles and max out-of-pocket for both in-network and out-of-network before they can call their coverage "affordable".

Having insurance you can't afford to use doesn't protect you.

but their deductible was high. 5 or 6,000. We told them we would cover the deductible if they had a major illness/accident. Otherwise they would be pretty screwed. But it's still better than us having to cover the whole amount if one of them gets seriously ill or injured. It would wipe out both families in that case.

Yes, I am shouting because people don't seem to realize that it's not just the premiums, and not just deductibles.

What is your max out-of-pocket for both in-network and out-of-network?

Read and understand the following article: PLEASE! READ IT!
http://www.nytimes.com/2013/10/19/your-money/out-of-network-not-by-choice-and-facing-huge-health-bills.html

a major illness would require us to help them with whatever their plan doesn't pay for, whether it's deductible or out of pocket. We can handle that.

Do you really understand this?

Do you really understand what you max in-network out-of-pocket and your max out-of-network out-of-pocket really are? Do you really understand your risk?

What is the max out-of-pocket (in and out of network) on their plan?

You have persistently made your point, from many different views. So TY, now that all of us uneducated completely understand, that we're totally screwed.

So what's your answer on how to fix this critical issue? Trash the ACA? Scrap it? It's working for many families, including myself. And it was never intended to cover everyone. It's a start, and it works for me and my wife. We as a country need to get to the point of national healthcare, and we have to start somewhere.

Note: I also have very low deductibles for PCP, ER, drugs, etc.. No, I'm not telling you the deductibles, so don't ask.

maximums.

Since you won't share the info, I have to assume:

1) You don't know -- a really scary thought since you really don't know your risk.
or
2) You do know but are in denial that you can handle the out-of-pocket maximums.
or
3) You are in denial that you will become injured or ill that you will run up high medical bills and hit the maximums.

Regardless, you can only claim it's "working" for you as long as you don't get sick or injured. You can make the same claim going without insurance as long as you don't get sick or injured.

My one p/t job offers health insurance at a cost that leaves me right at the border of qualifying for a subsidy. Too close for comfort, since my other p/t job is per diem so I can't reliably predict my income from that, and frankly I prefer it higher to lower. So that leaves me with a choice of insurance through the p/t job or penalty.

The insurance they offer is through Harvard Health. Some years ago when I had insurance through Harvard Health's HMO I became seriously -- and quite obviously -- ill. In all likelihood I was septic. They left me to die, refusing to even run a single test. I got all my care out of pocket and survived.

Last year I ended the year with just a few hundred dollars in the bank. This year, with just a couple thousand which, had I not chosen the penalty, would have all gone to paying for insurance and left me again with just a few hundred in the bank to pay for any health care I actually needed.

So for the 2nd year, I am choosing the penalty. Fortunately I am healthy and have some money available should I need some health care.

If I need a lot of health care, I'll be bankrupted or dead, but that's the case with or without insurance, in my experience.

It really doesn't provide protection, so it's rather interesting that he would claim it's "working".

We'll be paying $165 a month for a silver plan with $2000 deductible (without the subsidy it would be over $1500 a month for the two of us) . For the first time in years all the doctors we regularly use will be in network. Our out of pocket cost is less than our share through my husband's employer - and with the ACA we could shop for a plan that fit us, not one that was best for the employer.

In addition, we're paying a little less than $75 a month for dental and vision insurance - almost exactly the same cost as from his employer. I shopped for those separately and could pick the companies - last year the employer went to a plan with few providers locally and we had to use a different optometrist for our checkups. After going to the same doctor for years, that sucked, so I made sure to buy a plan that has our old doctor in network.

I'll know in a few months more about how I feel about the insurance we selected - after all, the proof is in what it actually covers when we need it. I don't see how it could be much worse than the employer provided insurance that changed every few years, which meant we either had to change doctors or pay out of network costs. At least with HealthCare.gov we can shop for the plans that best fit us and have advanced warning about which doctors may not be fully covered.

If the Supreme Court guts the ACA - we're in Florida so if they don't allow subsidies for the federal exchange we're hosed - we'll have to dig into our retirement fund to pay the difference. My husband will be eligible for Medicare in two years so it won't be forever.

I fully understand the problems - but the ACA is not the root problem. It just didn't fix the basic problem. I'll still take what it lets me buy over no insurance.

If you won't read and attempt to understand that other people may know as much about the subject as you claim. Or read their messages and respond to the actual content rather than push your agenda, I see no reason to read anything you post. Good bye.

troll for the GOP. His comments are irrational and ignorant to the subject matter. And he's apparently out there to try to stir it up. It amazes me how stupid and ignorant people can really be.

NEXT!!!!!

nt

There's so much spam I need some mustard and bread to make a sandwich.

But you're not trolling. Nossir.

When he insisted I read his stuff, but he obviously hadn't read my posts, any rational discussion was impossible.

Thanks!

I didn't realize the "iggy" option was available. Done deal. Thanks.

DUers who say their insurance is great but seem to have never used it / lack awarenss of the actual details

We need more people posting like you, as opposed to the ignorance by others in this post.

TY for posting.

Last edited Thu Dec 25, 2014, 03:30 PM - Edit history (3)

...as well as an open mind, did your research, and know what you had before and have now.

My husband is still working at 67 (desk job; he loves what he does) so we are okay under the job-based system. It's our daughter I worry about. She's self-employed and has two kids. She's resistant to talking to me about her situation, but I see some of her choices and really wish she would get herself into Covered California.

Here's to a healthier New Year for all!

For me it's working, and it is actually affordable for us. I suggest everyone that might need insurance to check it out. You can apply all you want, but nothing is effective until you make that first months payment. So there really is nothing to lose.

I can only hope ACA does as well for the rest of the country as MediCal has done for me.

Can't claim I have no complaints - just none serious enough to bother airing.

The ACA is a good thing for self employed people, no doubt about it. Before, it was Medicaid or a huge deductible. No sliding scale. The only way to get Medicaid is to be really, really, really poor. Be just really really poor and you're out in the market with everyone else.

This country is supposed to like people being self employed - entrepreneurial and all that.

There's no reason for it to be attached to employers. Employers can go out of business, lay you off. I don't get why people are so satisfied with that situation. It's like they all have these cushy jobs they feel confident they will never lose. Maybe the older generation is against it, now on medicare and worked in the days when you could spend your whole career at one company.

Making a pathetic $26k a year and they wanted $307 for the Bronze package. I thought I would be paying $20-$50 a month maximum with my salary.

We are claiming more as income(not much more), and the two of us are spending less than what you quote here for just one person. Something's not right here.

forever grateful to Obama for it, was so tired of massive deductibles for higher premiums than what I pay now.

I have determined that the ACA was built for anyone making under 32K per person, and can have peace of mind that they can be covered, at a reasonable price. After speaking with several people that qualify for the ACA, it should be noted that these people were working, and the ACA was cheaper than their company provided healthcare. Benefits and deductibles were better too. The ACA is also recommended for families on a fixed income. Retired/semi retired people that have not reached 65, and are on a fixed income, also benefit. It saved our bacon.

First of all I was one of the ones that was promised "nothing would change and I could keep my current plan". So there was no intent to do anything for people in my "class". Furthermore, I've fallen into the "cadillac" class of plans so my employer is having to make adjustments to avoid that classification. Mostly by reducing benefits. In addition, they've had to add features like "no annual/lifetime limit" and "cover kids until 27" (and we already covered until 26).

In the near future, I'm going to be looking at early retirement. That's when things might change. I'll have to compare the cost of "going retail" with the cost of accessing the retirement health insurance plan. It's pretty expensive so the retail may have to cover me until I reach medicare. Probably one of my bigger disappointments was that we didn't get the medicare age lowered, even if one had to buy in at a higher price for some time. It could easily have made the whole transition easier.

I works for me. My plan is the Blue Cross Silver S16e from Blue Cross Blue Shield of Tennessee. $500 deductible and $1,500 max-out-of-pocket. My monthly payments after the subsidy are $116.84 a month. That is basically 3% of my income. This plan also includes no co-insurance for anything. Which is a blessing as most plans have between 20-50% co-insurance. I am a 36 y/o single non-smoking male.

Yes, I realize it was a metaphor, and I'm glad you're happy with your coverage and payments.

We need more people like you spreading the news. You're certainly not going to hear this from the MSM. Or the far right idiots that want nothing to do with Obama. Their loss.


There is just "no fix for stupid".

FOR PUTTING HIS D***K ON THE TABLE; yes INDEED