Obamacare insurance premium increase.

[rickdugan]

Rick Dugans I am not minimizing your situation or anyone else for that mater and I respect your opinion however you and your family are still blessed or you wouldn't be posting here. Be thankful that you woke up and had money to pay your bills in full every time and still have money left over.

Sorry Miss, but I for one cannot approach life with the attitude that I should just be grateful for what I get to keep and blithely accept someone doing me and my family harm. I (and no doubt many others here for their own circumstances) work very hard to take care of my family and I will not just roll over and take it when someone makes it that much harder. To the extent that I am "blessed" it is because I work 80+ hours a week and made a shit ton of sacrifices over many years to get to whatever place I am at. So yes I am very angry at the person who has reduced the value of all of that hard work and the sacrifices by pushing my annual health insurance related expenses north of $20,000 per year, almost all of which is going to paying for other people's health care costs since I get almost nothing in return for it. This has reduced the amounts I can put into college savings, retirement, vacations, private school tuition, etc., so there is a real long-term economic impact here that goes beyond whether I can buy food or pay routine bills today. But to add insult to injury, I cannot buy a plan as good as the one I had before, with as much coverage and the same quality of care, at almost ANY price in the individual market, a fact which just makes me even more angry.

[miss.a.p1600]

Thanks for explaining your perspective rationally.

I wasn't implying you should be glad to take what you can get. Just that despite rising costs you're still better off than most. Just disregard maybe it came off wrong way.

I was hoping to see the thread list some pros and cons of Affordable care act with some viable solutions.

[baer45]

Thanks for explaining your perspective rationally.

I wasn't implying you should be glad to take what you can get. Just that despite rising costs you're still better off than most. Just disregard maybe it came off wrong way.

I was hoping to see the thread list some pros and cons of Affordable care act with some viable solutions.

I would be very interested to see what kind of solution that trump adminstration can provide soon. Honestly, i hope i don't come cross as a defender of insurance company. I just think trump needs to do something about our medical system. When it costs $9500 to have an MRI, you know it's not all insurance companies' fault.

[baer45]

Let's don't get this thread locked. I am sure many people here will have their take of health insurance expense. Many of you will see the new bills very soon.

[eagle2]

I would be very interested to see what kind of solution that trump adminstration can provide soon. Honestly, i hope i don't come cross as a defender of insurance company. I just think trump needs to do something about our medical system. When it costs $9500 to have an MRI, you know it's not all insurance companies' fault.

Insurance companies rarely pay the full price for medical procedures, or anything close.

[lynn2009]

Insurance companies rarely pay the full price for medical procedures, or anything close.

Insurance companies pay 10-15%. It's always the hospitals and doctors that go unpaid.

[gingerstcyr]

Just the facts without commentary.
Here are the average increase in premiums in battleground states.
Ohio: 13.12% increase
Florida: 17.40% increase
Pennsylvania: 32.5% increase
Nevada: 11.74% increase
Maine: 21.24% increase
New Hampshire: 12.44% increase
Virginia: 21.68% increase
North Carolina: 24.30% increase
Iowa: 20.46% increase
Michigan: 16.06% increase
Wisconsin: 20.39% increase
Source: Freedom Partners Chamber of Commerce

Just the facts no commentary.
President Barack Obama lied numerous occasions:
** “If you like your current insurance plan, you can keep it. Period.”
** “If you like your current doctor, you can keep that doctor.”
** “Your premiums will go down an average of $2500 per year.”
** “The cost of this national healthcare program will be less than $1 trillion.”
** “Obamacare would not cover illegal aliens.”
Source: Barack Obama

[rickdugan]

I just want to add that expenses aren't the only thing causing me anger. The amount of time I now must burn on insurance issues each year also really pisses me off.

For starters, every year my plan is cancelled and new options are introduced, so every year I have to go through a policy research project all over again. The first year that Obamacare mandates kicked in and my insurance company gave me a default option, I did not pay enough attention to what was happening. Big mistake. This was the first year that doctors' offices started picking and choosing which policies they would accept from the big carriers and none of our doctors would take the one we were placed in. So we ended up having to take our kids to the local medicaid pediatrician that year, who we never actually met because she ran a high volume operation that relied upon nurse practitioners for almost everything. And for this wonderful care, my out-of-pocket costs increased dramatically because of changes not only in the amounts of co-pays and deductibles, but also to what services they were applied to (including urgent care and specialists).

So now every year I have to go through a time consuming exercise of first identifying which plans are accepted by our doctors and then parsing through the summaries of benefits for those various policies in order to find one that makes the most economic sense in light of the premiums and our routine medical needs. I have a background in finance and I deal with complex documents for a living, yet I still need to devote real time and effort in making sure I understand the ramifications of each benefits package, including the fine print as to how deductibles and co-pays are applied. For example, some plans waive the deductible for urgent care clinics while other don't; some plans apply the deductible to all lab work while others only apply to lab work done outside of the doctors office; some policies apply deductibles to specialists while others don't; etc.,etc.,etc. The hide the ball games now played include cheapening premiums a hair on some policies vs. others, but then making the deductible applicable to virtually everything, which can actually make the policy more expensive if you need any medical testing or services whatsoever.

But even worse, these hide the ball games have become so complicated with my current provider, who offers so many nuanced policy versions that change every year, that even their own people often do not properly apply our benefits. I spent many more hours last year circling back to the insurance company to get them to pay claims that they initially denied because (1) they erroneously treated them as non-covered services under our policy; or (2) they improperly applied the deductible to services for which the deductible was waived in our particular policy. In many cases I was able to handle this using a simple online form, but in a few instances I had to get on the phone and deal with multiple people to get it sorted out. At one point, I learned that some of this was happening because the benefits for our policy were improperly coded in their system, so I ended up having to coax them into going to the actual benefits table in my policy document and then educating them about the benefits I purchased.

The scariest part of this, however, is that there are likely many people who buy these policies who don't understand the documents well enough to properly comparison shop or to even challenge their insurance companies when claims are improperly denied. So they end up buying policies that are more expensive in the long run and/or paying for services that should be covered. Now I am being kind in saying that these claims issues were honest mistakes, but it would also not shock me to learn that my insurer was initially denying these claims knowing that a certain % of people would not fight the denials. Now it is easy to blame the insurance company alone for this, but this whole Obamacare fiasco is the ultimate culprit as my insurance company would not feel the need to play these games if they were not losing money on these policies. I never had any of these problems with this same carrier prior to the year that the mandates kicked in.

Anyway, this is the end of my ongoing rant, lol.

[whirlerz]

Merry Christmas, EVERYONE!

I just missed the 'thought of the day' on the station I was listening to, cause I turned the sound off w/the commercials..

Anyway, right now I don't have a plan, I must cancel a Dr's appt tommorow (for Tues).
I already told the nurse I'd do a skype or something, but she insisted, I agreed, but no sorry I'm not paying 150 - 200 to say hello..(that type of $/transaction's reserved for me):
Also, the last broker I talked to, said I'd have to have an auto withdraw, & I'm not having that! I guess I'll go w/o?
My prev broker, who's a __________ (I left out the word) he has my dental plan on his bus card, I usually pay him by now, but w/the way he talked to me last, he can wait, if he gets it @ all. Jerk.:

Eveybody!

[baer45]

I just want to add that expenses aren't the only thing causing me anger. The amount of time I now must burn on insurance issues each year also really pisses me off.

For starters, every year my plan is cancelled and new options are introduced, so every year I have to go through a policy research project all over again. The first year that Obamacare mandates kicked in and my insurance company gave me a default option, I did not pay enough attention to what was happening. Big mistake. This was the first year that doctors' offices started picking and choosing which policies they would accept from the big carriers and none of our doctors would take the one we were placed in. So we ended up having to take our kids to the local medicaid pediatrician that year, who we never actually met because she ran a high volume operation that relied upon nurse practitioners for almost everything. And for this wonderful care, my out-of-pocket costs increased dramatically because of changes not only in the amounts of co-pays and deductibles, but also to what services they were applied to (including urgent care and specialists).

So now every year I have to go through a time consuming exercise of first identifying which plans are accepted by our doctors and then parsing through the summaries of benefits for those various policies in order to find one that makes the most economic sense in light of the premiums and our routine medical needs. I have a background in finance and I deal with complex documents for a living, yet I still need to devote real time and effort in making sure I understand the ramifications of each benefits package, including the fine print as to how deductibles and co-pays are applied. For example, some plans waive the deductible for urgent care clinics while other don't; some plans apply the deductible to all lab work while others only apply to lab work done outside of the doctors office; some policies apply deductibles to specialists while others don't; etc.,etc.,etc. The hide the ball games now played include cheapening premiums a hair on some policies vs. others, but then making the deductible applicable to virtually everything, which can actually make the policy more expensive if you need any medical testing or services whatsoever.

But even worse, these hide the ball games have become so complicated with my current provider, who offers so many nuanced policy versions that change every year, that even their own people often do not properly apply our benefits. I spent many more hours last year circling back to the insurance company to get them to pay claims that they initially denied because (1) they erroneously treated them as non-covered services under our policy; or (2) they improperly applied the deductible to services for which the deductible was waived in our particular policy. In many cases I was able to handle this using a simple online form, but in a few instances I had to get on the phone and deal with multiple people to get it sorted out. At one point, I learned that some of this was happening because the benefits for our policy were improperly coded in their system, so I ended up having to coax them into going to the actual benefits table in my policy document and then educating them about the benefits I purchased.

The scariest part of this, however, is that there are likely many people who buy these policies who don't understand the documents well enough to properly comparison shop or to even challenge their insurance companies when claims are improperly denied. So they end up buying policies that are more expensive in the long run and/or paying for services that should be covered. Now I am being kind in saying that these claims issues were honest mistakes, but it would also not shock me to learn that my insurer was initially denying these claims knowing that a certain % of people would not fight the denials. Now it is easy to blame the insurance company alone for this, but this whole Obamacare fiasco is the ultimate culprit as my insurance company would not feel the need to play these games if they were not losing money on these policies. I never had any of these problems with this same carrier prior to the year that the mandates kicked in.

Anyway, this is the end of my ongoing rant, lol.

Yup, insurance policies are as complicated as a divorce paper. Actuaries in the health insurance company designed those products with many riders and options. The marketing sales people would have a user manual for each product with explaination of all the features. The truth is that actuaries don't really understand how the features apply in the real life, to them it's all numbers and possibilities. To marketing sales representatives, sometimes they don't have enough time or resource to be trained well. They won't be able to help the customers with all the correct answers. Plus some of them are snake oil salesman. They will take your money and leave you hanging.

[Optimist]

All right folks, the thread has been cleared of predictions of being called racist/attempts at mind reading, and policing each others posts. Feel free to continue the conversation.

[Eric Stoner]

Yep!!!!
Socialized medicine might work in Sweden or Norway, but you have to keep in mind they have a much smaller population. I don't believe socialized medicine is feasible the in US. What needs to stop is the overcharging of everything. Luckily this was before Obamacare and I had good insurance but a scan to check for Appendicitis would have cost me 5k out of pocket. For a 20 second scan. Really.

Scandinavia has smaller , more homogenous populations. They have less obesity , fewer smokers and much more physical exercise. They have much lower gun violence ( in fact it is almost zero ) much lower teen pregnancy ; fewer homeless ; fewer dirty houses and buildings ; uniform immunization and thus a healthier population and lower overall health care costs. The same goes for the Benelux countries. Germany , France , the U.K. and Canada all have national health care systems of various forms and each with its problems. All have lower health care costs than we do.

Part of the problem is the design of the Medicaid program. It splits the costs of providing care for the poor between the states and the Feds BUT the Feds make the regs and decide who gets paid how much for what. Another flaw is that it was designed from inception to give the poor the same level of care as everyone else. It's proponents stated during the Congressional debate that it was designed to provide "Cadillac level " care for the poor. First of all it never happened. Especially in the poorer Western and Southern states. Secondly Federal control not only stifled innovation but when states like Oregon tried to innovate and control costs the Feds joined the lawsuit that went to the SCOTUS which said that under the law as written there could be no cut-off points , no rationing of care regardless of the cost to various states.

Another part of the problem is that our E.R.'s have become the primary care facilities for the poor , the uninsured ( we still have a LOT ) and ( what is the au courant P.C. term ?) the undocumented immigrants. Who pays for their care ? Those of us with insurance. A couple years ago I had a minor household mishap and needed a couple stitches in my leg. For two sutures put in by a resident and a tetanus shot my insurance was billed for just over $4,000 ! I was in and out of there in less than an hour. It's also why hospitals charge $20 for one aspirin and $50 for each of those delicious meals they serve. The hospitals are cost shifting to pay for the services provided to those who can't pay and to soften the hit from the low reimbursement rates from both Medicaid and Medicare and many HMO's and other insurers.

[RyanXO]

Scandinavia has smaller , more homogenous populations. They have less obesity , fewer smokers and much more physical exercise. They have much lower gun violence ( in fact it is almost zero ) much lower teen pregnancy ; fewer homeless ; fewer dirty houses and buildings ; uniform immunization and thus a healthier population and lower overall health care costs. The same goes for the Benelux countries. Germany , France , the U.K. and Canada all have national health care systems of various forms and each with its problems. All have lower health care costs than we do.

Yes, exactly what I was getting at. As much as our country pushes "health" we are often forced to work in an environment counter intuitive to health.

[Optimist]

FYI gingerstcyr requested closing the account yesterday evening.

So again, everyone comment freely and stay on topic and enjoy.

[RyanXO]

An update: I just found out my Dad's MONTHLY premium is now 1000k!!! And it is an HMO, and his doctor will no longer see him. He's 55 but he is VERY HEALTHY except he high blood pressure. He used to pay 250 before Obamacare.

[baer45]

An update: I just found out my Dad's MONTHLY premium is now 1000k!!! And it is an HMO, and his doctor will no longer see him. He's 55 but he is VERY HEALTHY except he high blood pressure. He used to pay 250 before Obamacare.

That sucks. what was his monthly premium last year?

[whirlerz]

An update: I just found out my Dad's MONTHLY premium is now 1000k!!! And it is an HMO, and his doctor will no longer see him. He's 55 but he is VERY HEALTHY except he high blood pressure. He used to pay 250 before Obamacare.

Yes, pretty much the standard^

[RyanXO]

That sucks. what was his monthly premium last year?

It was also gross at 700. Before that 500, and before Obamacare 250. And it was PPO. He's getting rid of it. As for me I'm not buying anything either. I don't get health insurance where I work so there aren't any good options.

[baer45]

It was also gross at 700. Before that 500, and before Obamacare 250. And it was PPO. He's getting rid of it. As for me I'm not buying anything either. I don't get health insurance where I work so there aren't any good options.

That's about 14% increase which in line with the expectation.The penalty for no health insurance is $695 or 2.5% of your income — whichever is higher. You can weight your cost of normal out of pocket visti plus penalty compare to crappy insurance from market place. ($270 per month). It sucks.

[Zofia]

Insurance companies pay 10-15%. It's always the hospitals and doctors that go unpaid.

I haven't seen any M.D.s in the poor house lately.

[baer45]

I haven't seen any M.D.s in the poor house lately.

And that makes you wonder how many people will be in the poor house if M.D.s get paid as they requested.

[Eric Stoner]

I haven't seen any M.D.s in the poor house lately.

True. For the most part. Yes , BUT. In the U.S. the primary care physician aka general practicioner aka family care doctor is in danger of extinction. Many have retired or accepted corporate or institutional positions. Fewer and fewer residents are going into primary practice. We already have a serious shortage of such doctors and it is getting worse.

[RyanXO]

True. For the most part. Yes , BUT. In the U.S. the primary care physician aka general practicioner aka family care doctor is in danger of extinction. Many have retired or accepted corporate or institutional positions. Fewer and fewer residents are going into primary practice. We already have a serious shortage of such doctors and it is getting worse.

I've thought about this. Who wants to spend years in med school and pay for that education to make what you could on a shorter, cheaper education?

[Zofia]

I've thought about this. Who wants to spend years in med school and pay for that education to make what you could on a shorter, cheaper education?

I've seen that going on around here. Now GP's are nurse practitioners or physician's assistants. My go to ortho guy is a PA and is awesome. (Cute too, but that's another issue.) He knows PT better than anyone I know and always has a ton of great exercises for every ache and pain I have. I've met the M.D. he works for. Excellent surgeon. But, that's all he does is cut. The PA does everything else and from the looks of things at their practice, it's a good division of labor. Oh, and the P.A. makes a nice six figure salary.

Z

[baer45]

Trump has already token action on Obamacare. I guess he meant business. Trump signed an executive order late Friday that directed federal agencies to use their authority to relieve individual Americans, businesses, state governments and others from “burdens”.

From my understanding, this means two things for now.

1. No more penalty if you can not afford the suitable health insurance

2. Obamacare will be replaced as its current market will collapse. That gives trump administration one year to draw/ implement the frame work of the replacement.

IMHO, we should prepare for adversary cases. The initial stage of replacement will be a rough ride for some of us (if you currently under medical care) because the impact of the collapse of oabmacare. I believe the insurance companies will reflect this years loss in next years pricing. We will have more info on this topic later this year.