ACA in real time

Posted by: garyW

ACA in real time - 11/15/13 10:50 AM

Today, Nov 15, I received notice from Anthem Blue Cross that my policy is cancelled as of Jan 1, 2014. 6 weeks, thanks Blue Cross! It's not a "junk" policy in any regard, and there was no specific reason given for its cancellation other than the possible ACA requirement on pre-existing conditions … that seems like all it took. The letter directs me to find a new policy on the Covered CA exchange.

This cancellation letter really is just a motivational letter, I was planning to shop the exchange anyway. But now I've got a looming deadline. Procrastination is a pre-existing condition.

I looked briefly on the Covered CA website to see a wide range of options. The Healthcare.gov and Covered CA were wicked fast …. what's the problem? grin I'll see if it continues this way as I complete the enrollment process.

I just got off the phone with my doctor's office to confirm that they will accept the various PPO's from the exchange …. they will. I can keep my doctor … he's part of a "365 membership" or conciege service that has an annual fee but has proven to be worth every cent. My wife can keep her doctor too.

So, this weekend my wife and I will shop on the CA Covered exchange and compare avaliable policies for the two of us and our 19-year old daughter. California seems to be a leader nationally in competent ACA implementation, so hopefully there will be a positive experience and maybe even a better policy to be found.

I will follow up here in the next several days to discuss what I find.

<yikes!>


Posted by: KateSorensen

Re: ACA in real time - 11/15/13 11:00 AM

.

This is going to be a real and believable exercise for the folks here to watch, including me. Sorry you have to go through it, but I hope the results are positive for you and in reasonable time.


.
Posted by: garyW

Re: ACA in real time - 11/15/13 11:10 AM

Wait, there's more!

My sister-in-law (recently single, 50, unemployed) has asked for our help with ACA enrollment because computers are not her friend. I suspect she's going to find total coverage under Medicaid. She hates Obama …. but I bet that'll change quickly. We've scheduled Sunday brunch to see what works for her on Covered CA.
Posted by: steveg

Re: ACA in real time - 11/15/13 11:20 AM

Yesterday I sat in on an AARP webinar to learn about the improvements to Medicare that the ACA has delivered. Pretty good stuff. I'm waiting a few more weeks to go to healthcare.gov to shop a plan for my daughter. Ohio didn't set up a state exchange, so we have to fly the mothership. But Guv K-sucks did opt in for the Medicaid expansion in Ohio, and just for ya-yas I may see if she qualifies. That goes into effect Dec 9.
Posted by: six_of_one

Re: ACA in real time - 11/15/13 12:21 PM

Yeah, I'm hearing really good things about California and basically most of the states that actually have tried to make the ACA work. Unfortunately, Virginia is not so enlightened and has neither a state-sponsored exchange nor expanded Medicare (although McCauliffe ran on Medicare expansion, so we'll see if that changes any), so my experience has been solely with healthcare.gov …

I actually managed to create an account on day 1, although that account seems to have been borked from the get-go: I was never able to actually sign-in with it. So I waited a couple weeks for things to shake-out and was able to create another account and get to the actual insurance offerings. At this moment, healthcare.gov is working flawlessly for me.

The downside is that all of the least-expensive offerings are about $80/month more expensive than what I have right now -- I make too much $$ to qualify for any subsidies, so I have to pay full-boat. What I have right now I would classify as catastrophic coverage (i.e. high deductible, few benefits -- basically intended to keep everyone from going bankrupt if something terrible happens, but beyond that very few bells and whistles). The new offerings are undeniably more comprehensive (I'll get tremendous value from the maternity provisions =P) but there doesn't seem to be an equivalent tier available to me (apparently catastrophic coverage is only offered to those under 30) …

So it looks like I'll probably be paying more -- and getting more (even though I don't necessarily want more), which I guess is probably a good thing in the long run. But if this is my contribution for people not having to use the Emergency Room for colds and stuff, I'm willing to foot that extra bill …

If it turns-out that I'm just paying more for the same-ol' same-ol', though, I'll be pretty disappointed ...
Posted by: garyW

Re: ACA in real time - 11/15/13 05:19 PM

FYI, about 7 weeks ago I had a trip to urgent care which led to a diagnostic ultrasound. (Blue Cross Anthem paid most, but I later got billed for about $300 for the complete visit.) Urgent care physician sent me to the emergency room with ultrasound results in hand thinking I need to be admitted … at the ER they asked why I was sent there, a doctor talked with me for 5 minutes and wrote me a perscription, a nurse came out and gave me a single injection. I was in and out in 30 minutes. Total ER hospital bill was $4600, Blue Cross Anthem paid all but $1800. Pissed me off big time but realized it probably saved my life. Blue Cross was not interested in looking into it further, that's how the system rolls. They paid $2800 for 5 minutes of the doctor's time and a single injection (which I continued with for a week and cost $16 each at the pharmacy.) This is why the system is broken. I got the experience first hand.

Current policy had gradually declined in benefits and I had previously accepted a higher deductible to keep premiums about the same. That decision has now come back to kick my @ss.

After that incident I became a patient of a great doctor, highly recommended and I know why. So now that I need him I find myself current in the political debate … because I want to keep him. So this is a very strong consideration in finding a new policy.


Step One : comparing plans on the exchange.

Spent a total of 20 minutes on CoveredCA website looking through 22 competing plans that my family of 3 qualified for. Range was from a Blue Cross Anthem Bronze at $258/mo to a Kaiser platinum at $1014. Yes, for $258/mo I can insure my family with a maximum out of pocket of $6350. I believe this means if I'm hospitalized for a week that's the most it's going to cost that includes the deductible. Wow.

After the first run through, we chose a Blue Sheild policy at $455/mo with no deductible. It compared exactly with Blue Cross Anthem plan at $567/mo. These rates reflect a premium assistance of $696! Thank you Federal Government. Will dig further into the details of the competing plans and confirm our local doctor, labs & hospital all accept the insurance policy.

From first appearances this could save us about $250/mo. in premiums with the higher plan. No deductible, unlimited lab work and doctors visits at $45 copay. X-ray and imaging at $65 co pay. Perscriptions at $19 copay. This is going to save us a lot.

I. Am. Impressed.

Now, on to the application process.
Posted by: DLC

Re: ACA in real time - 11/15/13 06:21 PM

Saw a comparison the other day that shocked me but not too much..

In Texas and I hope other places, they have these 24 hr Urgent care clinics... you know the ones you go to late at night or on weekends when your regular MD is off. We've all heard those with NO insurance always go to the ER since they can't deny you like a regular Doc or these 24 Hr clinics can. AND we all pay for those "unpaid" visits of the uninsured.

Well the average cost even in the 24 hr Urgent care clinics is about $150 ! FOR the SAME treatment in an ER it can vary from $600 -1200 or 4 to 8 X more !! NOW you'd think even a moron would figure if we can get all covered it'd greatly reduce costs for ALL... AND the ER could be for real Emergencies, not mega expensive cold and flu clinics. mad
Posted by: yoyo52

Re: ACA in real time - 11/15/13 07:47 PM

I don't know the numbers, so I'll say that up front. But add up the money we spend for health insurance. Add it up--start with the money that companies pay to cover their employees, plus whatever monthly payment the employees must make. Add deductibles. Add the cost of emergency room treatments. Add the cost of Medicaid. Add the cost of not allowing Medicare and Medicaid to negotiate lower costs for drugs. Add the indirect costs of people whose bad health leads to days not at work or lower productivity. Add the profit that insurance companies must make because they're in it for the profit not for the service. Put it all together and how in the name of arithmetic is it possible that we don't spend enough to run a single-payer health system. The dumbest thing that Obama did was to pass on single-payer.
Posted by: steveg

Re: ACA in real time - 11/16/13 02:57 AM

Unfortunately, at that time, SP had as much chance of passing as a snowball in Hell. But it could be said that the screw-ups and half-assed "fixes" may open the door to SP in a couple of years. Especially if Dems regain the House and retain the Senate and WH.
Posted by: Celandine

Re: ACA in real time - 11/16/13 09:50 AM

Originally Posted By: garyW
FYI, about 7 weeks ago I had a trip to urgent care which led to a diagnostic ultrasound.
<snip>
I. Am. Impressed.

Now, on to the application process.


R U OK? frown
Posted by: garyW

Re: ACA in real time - 11/16/13 10:42 AM

I am fine, thank you. I had foot/ankle injury early in the year. This was likely the cause of a DVT in the area and residual vein damage up through my thigh, a situation which was masked by a torn ligament and a lengthy healing period. There was no pain associated with it, only ocassional then recent persistent swelling prompted a visit to urgent care. Common drug treatment is now a daily routine and all should be good in several more months. Knowing now that I lived for almost 10 months with the real possibility that a vein clot could (and commonly does) result in pulmonary embolism (=death) I have now begun a process of simple medical care and insurance dependency that I've never had to deal with before.

So now I have experienced the real life consequences of having a minor, yet significant, medical crisis to deal with. No hospitalization but a very brief ER visit, nothing other than 2 ultrasounds, lots of lab work, and a half dozen doctor's office visits have cost me about ~$6,000 (in the first month or so, that's all the bills so far) out of pocket in addition to my monthy premiums. Yeah, I haven't reach my deductible yet. <bleh>! The stack of bills, notices of services rendered, etc. is growing daily. Like I said earlier, the cancellation letter of my existing policy is the motivation to jump onto the Obamacare wagon. So far, this looks like this is going to end well for me, and it probably will for many millions of others.




Posted by: yoyo52

Re: ACA in real time - 11/16/13 11:12 AM

Glad you're ok. Those leg/foot/ankle injuries make you aware of how important every single body part is.
Posted by: garyW

Re: ACA in real time - 11/16/13 11:21 AM

Being bipedal has it's drawbacks. laugh Seems human venous physiology has gravity to deal with and hasn't evolved in such an elegant way.

Posted by: steveg

Re: ACA in real time - 11/16/13 11:22 AM

Tell that to the protester with the hammer and nails. eek
Posted by: garyW

Re: ACA in real time - 11/16/13 12:13 PM

Created a user account on CoveredCA. Logged out. Logged back in. I'm good.
Total time less than 5 minutes.

APPLY NOW:
Looked at the list of items I'll need to complete the application process. Tax forms, etc.
I'll get some filed documents together and sit down with my wife tomorrow and complete the application and determine our exact elgibility.

On Monday I'll call the lab I use and pharmacy and confirm they will accept the specific plan we choose on the exchange. I expect to be able to submit our completed application then.

The CoveredCA website has tons of info available on every aspect of buying a policy. I will spend some time today reading through explanations of benefits and try to wrap my head around all of this jargon. I admit that in the last 20 years of buying health insurance I trusted our agent although I never fully understood what I was purchasing. Time to change all that.

Some hindsight about finances from the past few years. I run my own business, my wife worked two part-time jobs in 2012. When we have our joint tax return prepared we have taken every possible deduction allowed by law and planned in all good faith to show the least amount of taxable income possible with a goal to (1) pay as little tax as required, and (2), most importantly, show an adjusted income that qualified us for the largest amount through Federal Student Loan Aid applications each year for our daughter's college tuition. Thank you again Federal Government. The downside is that number made it impossible to get our home refi when the rates were crazy low last year. The good news is it puts us in a better income bracket for the amount of ACA assistance.


Where Obama has failed to get the simple message out through all the political media noise : This is about buying quality insurance from private corporations. It's not government bureaucrats between you and your doctor. You see exactly how these private insurance companies compete in a fair & regulated market place. Your family or individual income bracket is the single factor determining how much the Federal Government pays to help make it affordable for you to choose between the available plans <spread the word>

I predict that after January 1st these insurance corporations will be advertising heavily to get enrollment on their ACA plan in the exchanges. They're competing for the same 30 million shoppers nationally, they're going after the same shoppers within states like California that decided to make this thing work on schedule. Policy prices will probably drop in order for those plans with similiar benefits to get in line with each other.

And yes, the blue state (CA) f*cking website works like a charm laugh







Posted by: Celandine

Re: ACA in real time - 11/16/13 01:00 PM


Glad you're OK
..wouldn't wanna' lose you. smile
Posted by: garyW

Re: ACA in real time - 11/16/13 01:05 PM

It is therapeutic for me to be writing all this. Concerns about afforability and access to care has actually taken more precedent than mortality and worries of the universe expanding. grin
Posted by: Celandine

Re: ACA in real time - 11/16/13 03:28 PM


Well..
..once you dot all the "I"s & cross the last "T"
you can go back to The FUN STUFF.. like allowing
the Universe to Continue to Expand come-what-may.
Posted by: DLC

Re: ACA in real time - 11/16/13 03:52 PM

Glad you could do it ... but Dang thanks to Perry, all we have in my state is "CoverURTex- ass" !! laugh
Posted by: garyW

Re: ACA in real time - 11/16/13 04:03 PM

Originally Posted By: DLC
Glad you could do it ... but Dang thanks to Perry, all we have in my state is "CoverURTex- ass" !! laugh


Does that mean you'll be shopping for a plan on the Federal Exchange? or do you have coverage from your employer? 3 million Texans are being denied Medicaid coverage because Perry wants to run for president. If they would qualify for Medicaid then they can still go to the Federal Exchange and get a plan for almost nothing. I've read elsewhere where redstate low income applicants have gotten policies for less than $20/mo.

From Healthcare.gov when you select TX :

Quote:

If you live in Texas, you'll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Here’s what you need to know before you apply. You can also see if you qualify for lower costs and preview plans and prices. You’ll find out final costs and savings on Marketplace plans based on your specific situation when you apply.



Posted by: DLC

Re: ACA in real time - 11/16/13 04:24 PM

No I have coverage through CDC retirement .... I'm one of the 95%-ers. Just joking.

BUT here's a GOOD Outcome of the ACA... she lost it after she lost her mind ! whistle

Bwah-ha-hah-ha !!! smirk

Posted by: yoyo52

Re: ACA in real time - 11/16/13 07:38 PM

Originally Posted By: garyW
It is therapeutic for me to be writing all this. Concerns about afforability and access to care has actually taken more precedent than mortality and worries of the universe expanding. grin



I stay awake at nights worrying about dark matter and dark energy. So spooky.
Posted by: KateSorensen

Re: ACA in real time - 11/16/13 07:45 PM

..

We'll lucky me, Yo. I don't even know what those things are so no worries for me.

I sure wish all of us could sit in one room and shoot the breeze. I bet it would be such a neat time.

sigh
Posted by: DLC

Re: ACA in real time - 11/16/13 08:04 PM

Gary and Yoyo.... youse guys don't count quarks to help you go to sleep ?? shocked

grin
Posted by: yoyo52

Re: ACA in real time - 11/16/13 08:15 PM

Originally Posted By: DLC
Gary and Yoyo.... youse guys don't count quarks to help you go to sleep ?? shocked

grin



Well, I tried to look at quarks from both sides now, but strings got in my way. crazy
Posted by: yoyo52

Re: ACA in real time - 11/16/13 08:16 PM

Originally Posted By: KateSorensen
..

We'll lucky me, Yo. I don't even know what those things are so no worries for me.




Not to worry, no one knows what those things are.

That's what worries me. eek
Posted by: steveg

Re: ACA in real time - 11/17/13 03:39 AM

In todays Dayton Daily News, there's a long, characteristically hack-ish article a/b how Ohioans are frustrated by healthcare.gov problems. I'd post a link, but you need a paid subscription. So, I posted the following comment (and will now don my flame-retardant tunic wink ):
Quote:
Everyone — not just Ohioans — should be frustrated and angry about the botched and frankly amateurish launch of healthcare.gov. But Ohioans most definitely should be especially frustrated with the State House and the Legislature for refusing to set up a state exchange of their own.

That doesn't excuse the Federal site, but you can file it under "You can't have it both ways." And regarding the criticism from the right a/b low enrollment numbers, part of that is due to the mis-managed go-live, but more to the naturally human behavior of waiting 'til the last minute. In fact, I moved to Dayton from Boston just a few months before the Massachusetts enrollment deadline, and was delaying my own enrollment 'til just before the deadline.

Those of you who would be angered over the website screw-ups have a most valid point. Those of you who know only what Fox news and right wing zealots tell you about the law itself need to get educated, because six months from now, you'll be looking like Chicken Little.

And finally, those Republicans who claim the ACA is their "big opportunity" for 2014 have totally missed the mark. Your "big opportunity" could have been a gift-wraped box full of immigration reform, sensible gun safety legislation, equal rights (at the polls, in the workplace, in the OBGYN's office, and at the alter), and filibuster moderation. But guess what: You've blown it all — worse than a bad website launch. I'll wager that 2014 will a rearview mirror in which the People will see right wing heads getting smaller and smaller and smaller...


I can't wait to see the PeeTardy rage that will likely ensue. smirk
Posted by: DLC

Re: ACA in real time - 11/17/13 07:51 AM

Govna K will send out the black helicopters to yous house shortly !! wink

We'll miss ya Steve !! laugh
Posted by: NucleusG4

Re: ACA in real time - 11/17/13 07:37 PM

Originally Posted By: DLC
No I have coverage through CDC retirement .... I'm one of the 95%-ers. Just joking.

BUT here's a GOOD Outcome of the ACA... she lost it after she lost her mind ! whistle

Bwah-ha-hah-ha !!! smirk



Have you noticed that she keeps saying she will wait till the last minute to do her insurance shopping? I know why. I'm willing to be that she has already done it... and is loathe to announce the better plan for less money that she will end up getting... therefore she will put THAT off till the last minute since it will undoubtedly make her look the fool.
Posted by: garyW

Re: ACA in real time - 11/17/13 07:39 PM

Today's update #1:

My sisiter-in-law (single, unemployed, recently separated from her long-time partner who supported her, but she has always filed her own tax return) stopped by so we could help her with the application on CoveredCA. 15 minutes total to set up her account, household/personal data/ income & elgibility summary indicates that she qualifies for MediCal … scanned her driver's lic & uploaded, her enrollment application is submitted. She's then told that a representative will call her within the week. Easy peasy.

Currently she pays $360/mo for Anthem Blue Cross with $5K deductible. We were curious if her income was higher if she could purchase a policy. She's getting a part-time job so her income will exist change. We plugged in an adjusted income of $20K and it gave her several policies to choose. Bronze Plan Anthem Blue Cross was $9/mo with a $5K deductible. This gives her a much larger choice of doctors than the MediCal option. Silver Plan Anthem Cross was $82/mo, no deductible with maximum $6250 out of pocket. If she chooses the Silver plan she saves over $3300/yr with a better much better policy.

This is a perfect example of why uninsured poor will come out of the woodwork to enroll. I think this also is a pretty good indication of the policies available for part-time workers ….. young people. Thank you Blue State California.




Posted by: garyW

Re: ACA in real time - 11/17/13 08:09 PM

Today's update #2

Application process for me, wife & daughter … 45 minutes to complete the household/personal data/ income & elgibility summary. Wife is employed, her's was simple. I am self-employed and so it was more complicated. I spent at least 25 minutes calculating the current month's income and deductions. I wasn't prepared with that data at my fingertips … finally figured out to include the self employment insurance paid, the self employment tax, and expense deductions (materials, home-office, etc.) all calculated from my 2012 return. Also deduct student loan interest paid. Double checked the summary then electronically signed and submitted.

Two things happened next. I am told that for a policy with an effective start date of Jan 1, 2014 that I must enroll into a plan by Dec. 15, 2013. I must submit documents verifying income …. for me it's IRS Account Transcript summary sheet of my 2012 tax filing I already received from student loan applications, otherwise it would be pay stubs or the full tax return. I can send them that right away unless I feel it's too damn easy and I should wait a day or something. laugh

Then, I'm presented with the eligible plans for me to choose.
I'm going with the Silver Plan and choose between California Blue Shield PPO 70 @ $506/mo. or the Anthem Blue Cross PPO 70 @ $619/mo.

Both have no deductible, $45 copays, $6350 maximum out of pocket.

The only info to find out now is if my doctor & lab will accept the Blue Sheild plan.

Even with the more explensive Anthem Blue Cross plan I will save about $2500/yr on premiums. If I choose the Blue Sheild plan I'll save $3770./yr on premiums.

I would guess that compared to my last 2 months experience and I have similar work in the coming year, lab / xray/imaging/ pharmacy copays will save me another $2000 - $3000.




Posted by: NucleusG4

Re: ACA in real time - 11/18/13 08:29 AM

Excellent info... thanks.
Posted by: DLC

Re: ACA in real time - 11/18/13 09:25 AM

Kudos to you Gary !

I think your analysis of the more successes, the more that will come will be true...

The GOTP is basking in this rollout hiccups and some think it'll save them, but once this passes (and we all know it will) they're still be the wacko, screwed up, bat-sht crazy Party ! We just gotta hang tight for a few more months until the enrollment gets there. eek
Posted by: garyW

Re: ACA in real time - 11/18/13 09:39 PM

Enrolled. <ta da!>




Began earlier this morning making a few calls to the hospital group which my doctor belongs to confirm their acceptance of the two PPOs I was considering. Seems they are not licensed to take California Blue Shield which was the less exensive plan. They accept Anthem Blue Cross for for all doctors visits, labwork & radiology/imaging. It's my choice to pay a bit more to keep my doctor, others might chose to pay less and find a doctor that will accept their plan.

I called the CoveredCA phone line to ask a specific question. I was on hold for 15 minutes, then got the info I needed in less than 5.

In the Silver 70 PPO Plan I chose it listed Deductible (Individual/Family) as not applicable. Most all the Silver 70 plans offered had it listed this way. More expensive Gold & Platinum plans were much more expensive and had $0.0 instead. I didn't understand the difference.

So here's where reading through all the itemized information in your plan can make or break a deal. The "not applicable" listing was there because there is a separate itemized Medical deductible (individual), mine was $2000. So now I see that my plan has this deductible, and all copays and percentage of co-insurance pays apply to this amount. These costs plus premiums paid will never be more than $6350. for me, or $12,700. for my whole family.


Bottom line for me is that I'm paying less than my current plan and have better benefits. The more I've found out about policies offered in the exchange I see that my current policy may not technically be a "junk" policy, but it sucks all the same. Through the exchange I'm buying better and cheaper from the same insurance corporation.

The final decision was to compare my current plan as a point of reference with the new one for my family of three offered by the ACA.
* Premiums are around $2500/yr less
* Current policy with Anthem Blue Cross has a deductible of $7500. the new one is $2000.
* All labwork was 30% of costs, new plan is a flat $45 copay.
* Old plan had no limit to maximum out of pocket, new plan limit is $6350.

This works for me in a big way.

I know we've all read about these slogans and pitches by Obama and ACA advocates, but let me tell you in all honesty that when this reality hits you in the face see the big picture of what's going on here.

I told you guys a few days ago I had a medical emergency that sent me to the ER. If I had been admitted, needed surgery, needed a hospital stay … my current plan (which costs more than the one I'm enrolling in) would still leave me holding a bill for probably tens of thousands of dollars. I would have to cash out all my savings, borrow money, or possibly sell my house, even have my daughter's college put on hold …. with this new plan offered through the ACA none of that could ever happen. I am incredibly thankful the timing happened for me this way, it is entirely possible that without the ACA regulations in place my current policy may have never been renewed because I got sick.


Since I began on Friday, total time on the Covered CA website to enroll was less than an hour.
I spent about 2 hours over the weekend reading up about all this stuff, 10 minutes getting all our income documentation from my files.
I spent 30 minutes on the phone getting info I needed.
My wife & I spent an hour with my sister-in-law signing her up, chatting, and having a glass of wine, talking about the release of anxiety in getting this all figured out.

I've spent maybe 2 or 3 hours writing about all this here. laugh



Posted by: garyW

Re: ACA in real time - 11/19/13 07:32 AM

Edit: Re-reading last night's post I realized the entire time spent on the CoveredCA website was actually more like 1.5 hours because I did an initial look at policies on Friday afternoon. The website always worked flawlessly and on login always had all my prior input data in place. I've tried my best to be acurate with the numbers and give a true account of my experience.

Where I stand today:

The last item from the enrollment was a confirmation notice. Specifically :
"Congratulations! You've completed the checkout process from the Exchange. You information will be sent to the insurance company that carries your plan. They will contact you with billing information to complete the enrollment process, which is finalized when you provide payment."
Posted by: six_of_one

Re: ACA in real time - 11/19/13 08:04 AM

Congratulations! Just goes to show how things actually can work when people take the effort to make them work =)

Just to confirm, since it's my understanding: the $6,300 out of pocket maximum is an annual maximum, not a lifetime maximum, correct? (Still a great thing vs. emptying your life savings ;-)

I'm still mulling-over my options. On the healthcare.gov site, those options are basically some flavor of Blue Cross or Kaiser. There's a third provider, but they're way too pricey. I currently have coverage with Kaiser and sadly they're not offering anything direct that's not already on the exchanges. It remains to be seen if my current coverage will be grandfathered under Barry's recent edict and I can keep it for a while longer, or if I really have to bite the bullet and get one of the more expensive (and better) plans off the marketplace …
Posted by: garyW

Re: ACA in real time - 11/19/13 08:26 AM

Yes, the Maximum Out of Pocket are the annual amounts per your policy, just like deductibles. Maximum out of pocket applies to both individuals and families. For example, my individual out of pocket maximum is $6350. My family of 3 has a maximum out of pocket of $12,500.

I got a letter yesterday that my current policy, previously stated to be cancelled on Jan 1, 2014, would be extended through February. They added 2 months on to the cancellation date due to Obama's actions last week. Too bad suckers, I don't need two stinkin' months laugh


The Bronze plans look like they should be avoided if possible. They all carry a deductible (about $3K-$5k) and that's why the premiums are really low. But if you read the details, copays don't become effective until after the deductible is met. Not so in the Silver and above plans, copays are applied toward your deductible.
Posted by: garyW

Re: ACA in real time - 12/12/13 11:26 AM

Recieved confirmation of acceptance from Anthem Blue Cross earlier this week. Set up payment options, initial payment made and the thing is done.

That's how it rolls. Thank you California for making it simple. Thank you ACA for getting me and my family more coverage, better coverage for less cost. (And I had the choice to keep my doctor.)

grin
Posted by: Acumowchek

Re: ACA in real time - 12/12/13 11:54 AM

You mean, there's hope after all?
Posted by: steveg

Re: ACA in real time - 12/12/13 12:06 PM

Hey, I betcha Daryl Issa would love to have you testify at his ObamaScare Tour. smirk
Posted by: garyW

Re: ACA in real time - 12/12/13 12:08 PM

Also, I wrote here weeks ago, I helped my sister-in-law with her application. She was notified 1 week after the submittal she qualified for Medicaid and had an appoinment scheduled with a state representative to finalize it. She was still considering a Gold HMO Plan that was going to cost her around $90/mo …. she saw how easy the online enrollment was and now that all the info is in her application she said she would meet with a local ACA guide if she chose to go with that.
Posted by: garyW

Re: ACA in real time - 12/12/13 12:12 PM

Originally Posted By: steveg
Hey, I betcha Daryl Issa would love to have you testify at his ObamaScare Tour. smirk


I read an article the other day how FoxNews is now calling it The Affordable Care Act. As many predicted long ago, once the ACA is a proven success the GOP will claim credit. And when they campaign in 2016 on bringing affordable healthcare to all Americans … it certainly can't be called anything with Obama's name attached to it. laugh
Posted by: steveg

Re: ACA in real time - 12/12/13 12:28 PM

Wait for it…

REPUBLICARE! crazy
Posted by: six_of_one

Re: ACA in real time - 12/12/13 12:46 PM

Originally Posted By: garyW
I read an article the other day how FoxNews is now calling it The Affordable Care Act. As many predicted long ago, once the ACA is a proven success the GOP will claim credit. And when they campaign in 2016 on bringing affordable healthcare to all Americans … it certainly can't be called anything with Obama's name attached to it. laugh

Well, to be fair, Obama and Hill Democrats have stopped calling it Obamacare as well, ever since it was obvious the rollout of the website was a cluster. As things progress and the ACA actually (hopefully) starts working for people, we'll see if they start embracing the moniker again.
Posted by: yoyo52

Re: ACA in real time - 12/12/13 02:47 PM

If all the states had cooperated, it would have been a breeze. But . . . no such luck.

I still wish Obama would have pushed for the single payer. But . . . no such luck.
Posted by: NucleusG4

Re: ACA in real time - 12/12/13 03:31 PM

Originally Posted By: six_of_one
[quote=garyW] As things progress and the ACA actually (hopefully) starts working for people, we'll see if they start embracing the moniker again.


And I will NEVER call it anything but ObamaCare.
He owned it.
Posted by: DLC

Re: ACA in real time - 12/13/13 05:38 AM

That's funny Gary... when I google that link, it shows a skull & crossbones and says,

IF you live in Texas, your FSCKED !! whistle

no I have coverage from CDC as a retiree... I'm one of those 90-95%ers !
I think the more it works the more people left out will be pissed !!
I believe in about 6-8 months many are going to see it ain't perfect but it's a damm site better than what most had. WTF good is a $5000-$10,000 deductible if you're seriously sick or have a preexisting condition... the damm premiums are cheaper !!! mad
Posted by: steveg

Re: ACA in real time - 12/18/13 01:42 PM

Got my daughter signed up today. Did it by phone because her adopted status required a little extra ID verification. The verification center referred us to the Marketplace phone line and the whole process took just 20 min. Easy-peasy! cool