#606944 - 11/18/1306:56 AMRe: Question about ACA (serious ones)
[Re: John Rougeux]
garyW
mid-century modern
Registered: 04/19/02
Posts: 8335
Originally Posted By: John Rougeux
I entered in some information on that Kaiser site and wow...out of pocket expenses are not cheap! "Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $12,700. "
Ouch! Ours just went up to $2500, so not sure how this is more affordable?
From my experience on the CA exchange, Kaiser is way of line and almost twice as expensive as plans offered by Blue Cross, Blue shield or HealthNet.
For all the Silver Plans I looked at, maximum out of pocket is $6350 per individual. The $12,700 is for the two of you combined. The maximum out of pocket includes premiums and deductibles as well as copays & percentages paid for hospitial stays and ER.
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I don't know what premium we are paying right now, since they just changed it, but under the ACA, we would pay: "Amount you pay for the premium:$4,112 per year" after the tax credit.
I'll have to find out what we pay per year.
I wonder how the premiums would work if I had to claim my UI too in that?
If UI you mean Unemployment Insurance payments? When you complete the personal financial section of the application it will ask for "other" forms of income. That's probably where you plug that in.
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ER visits are supposed to be limited to certain things, which is totally understandable, otherwise, you would get denied coverage and you have to pay. Currently a person with limited means can go down to the ER for a cold or to seek drugs and never pay a dime. And if you don't think people go to the hospital to get drugs, then talk to a medical professional like a nurse who works on the floor.
How will this change things? What happens if the ACA runs out of pool money? Will rates be raised then?
The ACA cut $400B from Medicare abuse and overcharges (without touching benefits) and puts that money toward the states to pay for Medicaid for the uninsured to keep them out of ERs. If just 10 million sign up for it (they say there's 30 million nationally that would qualify) then there's the outrageous price inflations won't be charged to taxpayers… or used to keep everyone's premiums sky high.
The reports from the nonpartican Congressional Budget Office states that the ACA will save $800B over 10 years.
Of course Red States are doing everything they can to f*ck this up. I don't know how that imbalance will mess up the financing of this, but that the GOP's goal to inflict maximum damage is a serious problem. Can you imagine if all states were acting as competent as California and succeeding in making this thing work seamlessly?
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I mean, that's how health care really got out of control before ACA...people go to hospital/ER for really minor stuff and never pay for it. Or they fake neck/back pain and get a free ride to the ER via ambulance and never pay. Talk about expensive! All that lost money plus other factors and we ended up in a mess.
Can someone please explain how this will be avoided with the ACA?
The ACA enacted pricing regulations on hospitals and ERs back in 2010 with a 2014 deadline to have them in place or pay penalties. The ACA regulates price gouging by the insurance companies, the hospitals and the medical device suppliers.
Yeah the same with CDC... they had several 100,000 hacking attempts each year. We had to change our passwords every 60 days AND we could not use any previous one or part of one for the last 20 PWs !! SO If I put in 12810WindingOak one time and then tried to use WindingOak12810 in the next 20 PWs, it's a NO GO ! sees the similarity and kicks it out !!
so 16 hacking attempts is laughable and insignificant !!
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