Affordable Care Act (Obamacare)

[Queen]

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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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Holy cow!!! I have a cadillac plan though work, when I retire from here I won't have a full 20 years in so I'll have to pay a chunk to keep my insurance... but it won't be anywhere near $630 a month!! I figured I'd us ACA and it would save me money; guess not.

[Deeann]

Find out what they consider "out of pocket" costs to be. With some insurance policys an MRI or Cat Scan, etc. do NOT count towards your out of pockets costs. You could have a dozen MRI's at a cost of $12,000 and still not meet your $5,000 deductible. So find out exactly what expenses count toward your deductible.

[mitch5252]

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The SBC (Summary of Benefits & Coverage, which, by the way, no matter the provider, must be written in exactly the same format).

Anyway, SBC says X-Ray, Blood Work, Imaging = 0% co-insurance (prior authorization required) and Out-Of-Pocket is defined as "the most you could pay during a coverage period for your share of the cost of covered services."

I HATE THIS CRAP!!

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[Acadianmom]

Deeann, I didn't know that an MRI wouldn't count toward a deductible. My son had one about a month ago and I have been looking at his paperwork and it has never showed up in his deductible. That's the pits.

Mitch, I feel the same way…I HATE THIS CRAP!

Martha

[Rufflesgurl]

All insurance was difficult and bad before but now with AHC - YIKES!! Even worse.

Linda

[Bethers]

The insurance companies have a racket, with or without Affordable Care. Insurance has been a disaster in this country for all times. Mitch that doesn't sound too bad for what you need. And if I read that right, the MRI Would be covered 100%? If so, then I understand it not applying to the deductible. You have to put in the amount for it to apply.

[mitch5252]

The insurance companies have a racket, with or without Affordable Care. Insurance has been a disaster in this country for all times. Mitch that doesn't sound too bad for what you need. And if I read that right, the MRI Would be covered 100%? If so, then I understand it not applying to the deductible. You have to put in the amount for it to apply.

An MRI would be covered 100% AFTER I meet the $2,100 deductible.

[Colliemom]

Mitch,

You might want to contact the company that has George's COBRA or even yours and find out if they offer something that way. I was with BCBS and was told that my current insurance was going to be discontinued as of 12/31, so I got with a Blue Cross agent and we found another insurance for me, similar to what I had before and I qualified for subsidy on it. So my payments dropped from $384 to $165 a month. I went with the Silver package. Deductible is a bit high, but I only need it for 5 months. In a couple of weeks I will be sitting down with our Council on Aging rep and going over Medicare Supplemental policies as I will change to Medicare on June 1st, so back through it all over again. But there are insurance agencies out there who handle that kind of stuff and you can get with one of them and see what's to offer. My two cents anyway.

[Gentleladybear]

Mitch also check out the plan AARP has. They have several options. They do have a plan that includes a good drug coverage. So might want to check into that one as you are looking.

[mitch5252]

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Does anyone know if ALL health insurance companies now MUST insure people with pre-existing conditions?
Or is it just the ACA Marketplace companies?

If it's just ACA companies, then nothing else will work for me...
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[Gentleladybear]

I THINK, if you are moving from one insurance coverage to another with no break they have to cover. You would need to call one of the companies to verify.

[bluepinecones]

I believe only some grandfathered policies can still exclude pre existing conditions. Not many of the grandfathered policies left so might not be too big a deal.

WebMD had some interesting advice for those who might still have a problem depending on where you live:
"Start a business. Some people with pre-existing conditions use an interesting method to get insurance. They start up a business, hire themselves as the sole employee, and get group insurance. Using this “group of one” approach, you have the protections of any group insurance -- and can’t get turned down because of a pre-existing condition. You’re also protected by controls on how high the rates can be. However, it’s only an option in 13 states. Visit Georgetown University’s web site at http://www.healthinsuranceinfo.net/ for more information."

[dayspring39]

Hi Mitch,
I read only a few of the comments but here is a site you can check out and you can find the cost of the medications.
I have coverage but my friend Molly gave me this information for checking out if my deductible is high...

goodrx.com

Me and My Shadow

[gingerK]

All insurance was difficult and bad before but now with AHC - YIKES!! Even worse.

Linda

Agreed!

[mitch5252]

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Although I'm a pretty hard-core fiscal conservative, I, personally, am thankful for ACA. Cancer AND diabetes would make me totally uninsurable in the old insurance world.

Without insurance, having to pay for my cancer diagnoses, surgery, and follow-up care beginning six months ago would have gone a long way toward wiping me out financially. I suppose I wouldn't care if I had nothing to lose, but I do.

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