Affordable Care Act (Obamacare)

[mitch5252]

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Has anyone applied for, and received, coverage through the marketplace?

I will lose George's COBRA coverage on 11/30/14 and thought I would look into trying to apply before the this year's ACA open enrollment period ends (3/31). My COBRA plan is a top-notch plan, although a bit pricey at $920/month. When I had my boob job (6 months ago tomorrow! YAY!), I never saw a bill - didn't pay a nickel.

I take 7 prescription drugs, and they all have a co-pay, I believe (they are not all for the boob job, of course).

What a confusing world it is out there in The Marketplace!
YIKES - I have the option of 37 different plans.

My main concern right now is the prescription drug coverage. I currently get all of my drugs through Caremark Mail Service. I was wondering how prescription drug coverage works with ACA?

If I do not enroll in ADA by 3/31/14, I cannot enroll until George's COBRA terminates in December. Termination of COBRA coverage is a qualifying event that allows enrollment outside of the Open Enrollment period.

My head is spinning.

[RitaMc]

Mitch, Can you contact your home or auto agent? While they might not carry health insurance they could recommend a reputable agent who works with health care. When I went on Medicare 5 years ago my head was spinning with facts and figures. The agent that handles our IRA's was a big help. Good luck on your choice.

[mitch5252]

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You're saying that I don't have to get coverage through healthcare.gov?
Tennessee opted out of providing coverage through the State...left it to the Feds.

Would it matter that under "regular" insurance, I am uninsurable (cancer and diabetes are game changers...)

I most surely would have been screwed post-COBRA had ACA not taken effect.

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[Olive6001]

I used the marketplace. I was uninsurable but now I have silver-level insurance at a price I can afford.
Once you eliminate all the lower level plans that don't have the kind of coverage you need, you'll have fewer choices.
My overwhelm was more about fear and the unknown than using healthcare.gov, but it took me a while to figure that out.

[RitaMc]

I'm not sure about not having to use Affordable Health Care act We oldies don't have to use that so my information is minimal. My thought was someone with insurance knowledge could tell you what you insurance coverage you should have. With that information you would be armed to choose. Knowledge is power. Does the AHC have customer service you could talk to? Hope I didn't confuse the issue.

[mitch5252]

Nope, didn't confuse the matter at all. All food for thought!

[Irmi]

Mitch, when I took early retirement in 2011, I got coverage with Hartford Insurance through AARP. Our deductible is high but the premiums are affordable. We also now have our automobile insurance with Hartford and cut our premiums by over 50%.

[gingerK]

Mitch, my DH and I are covered under the ACA. I applied back in October when the system was so screwed up some days I couldn't even pull up the website let alone log in. I called their 800 number and talked to several different folks who helped me work my way thru it until I got coverage. Both DH and I have pre-existings so our previous healthcare (BCBS) was going up by leaps and bounds. We're self-employed with no employees so it was really hard to get us covered.

Now for the bad news: yes, we got coverage from Obamacare and it was a gold plan where we previously had a lower plan BUT our deductible is 4500 (was 1750 for each or 3500 both) and our out-of-pocket is now 9000. This is what nobody tells you when they're yappin' about healthcare for all-yes the insurers have to take people who have pre-existings, but nowhere is it written that they have to make it affordable. We do, however, qualify for a subsidy that helps pay our premium (over 1000 without subsidy), and brings the payment down to 400. So we took the plan even tho I'm not very happy with the higher deductible and out of pockets. It is still a BCBS plan. My state (IL) also opted to let the feds run things. After putting in my info, there was only BCBS, one Aetna plan and two insurance companies I'd never heard of available to us.

Regarding prescriptions, between us only my DH takes a generic bp med, which I get at Target in 90day refills for $8. So I can't speak to what scripts may cost you. I remember in looking at my plan that it seemed like prescriptions were pretty reasonable.

Did you also know that EVERYONE who gets insurance now is required to carry pediatric dental coverage, regardless of if you have anyone on your plan who may ever use it? I have no idea what else we are ridiculously required to carry but I'm sure there's more than this.

There are people who can help walk you thru signing up. If you call the 800 number on the website I believe they can direct you to the nearest center.

I'm not sure on this, but I think you can apply for coverage and see what is available and if you qualify for a subsidy without accepting a plan. Also not sure how Medicare plays into this whole situation either. Neither of us is eligible for Medicare yet so we have to remain self insured. Hope this helps you and doesn't scare the bejeebers out of you! I haven't heard that anyone who is trying to sign up online is having the same problems that I did back in October, so hopefully they got all the bugs out of the system by now! Good luck!

[longdog2]

Although you are not a full time RVer, one of the big issues RVers are having a problem with is coverage outside their home state. Make sure you ask that question as I know you will want to be free to travel with that new RV.

[MandysMom]

Mitch, was your husband ever in the military? If so, you are eligible for USAA and they are very helpful with all insurance. If they don't do that insurance they will refer you to a approved partner. Also check with any clubs or organizations you may belong to from AARP to FMCA, Escapees, and so on. Many have deals with insurance companies which confer you group status. Hope this helps. We are so lucky in that we now have Medicare primary, BCBS from hubby's state retirement, and Tricare the military insurance. He has had over $300,000 worth of surgery and treatment since last June and I have spent less than $100 for odds and ends! I wish you well in your search.
Velda

[Bethers]

I just took new insurance before ACA and have a gigantic deductible. The ACA choices I looked at after were better. SD health insurers were bad with full timers. in fact the company I'm now with said they didn't take us, then approved me and said I'm covered nationwide. I think they did that to grab me before I'd have to go to ACA. now at least one other is covering full-time rvers in SD.

Good luck, and go through and look at them all. Chances are you won't get anything like what you have with such complete coverage, but hopefully you'll find something that will work. With my high deductible, I'm only paying a tad over $200 a month which is an ok trade-off for me.

[Acadianmom]

We are lucky to both be on Medicare so don't know much about the Affordable Care. Obamacare can say that a plan has to cover you but they can't keep a company from not selling a policy at all. My DH lost his Blue Cross Drug policy because they no longer offer it so had to change. What I have heard is that most policies have such a high deductible that you have to come up with before they will pay. Louisiana didn't go along with it either so there aren't many choices. Our lovely governor has gutted the Medicaid system so I don't know what people that have to go on Medicaid do.

Martha

[gingerK]

. What I have heard is that most policies have such a high deductible that you have to come up with before they will pay.

Exactly correct. Both my deductible and out of pocket co-pays increased dramatically. My insurance broker told me this would happen when it was first talked about. He said costs were going to go up for everyone because insurance companies don't want to have to cover folks with pre-existings. So they jack up rates for everybody to cover their losses.

[mitch5252]

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The TN plan I am considering is $630/month, with a $2,100 deductible and a $2,100 out-of-pocket max. After that, there is no cost to me, including prescription drugs (of which I take 7).

Considering my health issues, it's not so bad...

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[rvgrammy1953]

Mitch, was your husband ever in the military? If so, you are eligible for USAA and they are very helpful with all insurance. If they don't do that insurance they will refer you to a approved partner. Also check with any clubs or organizations you may belong to from AARP to FMCA, Escapees, and so on. Many have deals with insurance companies which confer you group status. Hope this helps. We are so lucky in that we now have Medicare primary, BCBS from hubby's state retirement, and Tricare the military insurance. He has had over $300,000 worth of surgery and treatment since last June and I have spent less than $100 for odds and ends! I wish you well in your search.
Velda

We also have Tricare (Standard) via Ernie's 24 yrs.retirement from the military and since both of us are Vets we use the VA for our routine care....last year my surgery, etc.was over $50,000 total of which we were responsible for about $1,400 out of pocket.....No Medicare here for a couple more years, so figure we made out pretty good... Our meds are covered thru Tricare for generics....

Just heard on the news that "Obamacare"/ACA" will only cover 4 out of the 19 or so Cancer Centers in the country.....I'll stop for now cause I don't want to get started on how I really feel about all this....