Let's talk health plans!

[tripods68]

Another caveat, since it's exempt from ACA, is that it doesn't cover preventative care like mammograms and colonoscopies. You talked about shopping around for that that in another thread.

Otherwise, it sounds like a great option.

People try to cut corners when it comes to health care cost. So people will try to cheapen their coverage cuz they don't like Obamacare. I'd like to see how to this insurance will handle react when it's member developed some kind of preexisting conditions that this insurance will not cover and run back to Obamacare wish they had it all along.

[TexasHusker]

People try to cut corners when it comes to health care cost. So people will try to cheapen their coverage cuz they don't like Obamacare. I'd like to see how to this insurance will handle react when it's member developed some kind of preexisting conditions that this insurance will not cover and run back to Obamacare wish they had it all along.

Which cheaper coverages are you referring to? Obamacare and it’s policies are the law. All individual health plans have to offer Obamacare essential benefits.

[disneysteve]

Which cheaper coverages are you referring to? Obamacare and it’s policies are the law. All individual health plans have to offer Obamacare essential benefits.

He’s talking about the coverage that you have, the one you’re discussing in this thread. That doesn’t offer ACA benefits.

[disneysteve]

Even with ACA-compliant plans, people still choose based on premium, not coverage. They buy whatever the cheapest option is. Then they complain when an ER visit costs them $500 or when they have to pay a big deductible every time they see their family doctor. Paying a little more each week could get them a smaller deductible and lower copays but all they look at is the upfront cost.

[TexasHusker]

He’s talking about the coverage that you have, the one you’re discussing in this thread. That doesn’t offer ACA benefits.

If he’s talking about Medi-share, it is a far superior coverage to that of ACA plans. Our family max out of pocket is $5000 yearly. Plus it’s about one fourth the cost of Obummercare. Now if you’re on $2000 a month in drugs, Obummercare might be a fit.

Overall, Obummercare is a joke for coverage.

[TexasHusker]

Even with ACA-compliant plans, people still choose based on premium, not coverage. They buy whatever the cheapest option is. Then they complain when an ER visit costs them $500 or when they have to pay a big deductible every time they see their family doctor. Paying a little more each week could get them a smaller deductible and lower copays but all they look at is the upfront cost.

“A little more each week?” I believe my last family quote for obummercare was well over $2000 a month for the bargain basement bronze plan.

[disneysteve]

“A little more each week?” I believe my last family quote for obummercare was well over $2000 a month for the bargain basement bronze plan.

I mean the difference between the options they have.

For example, I have 3 plans available to me. These are the individual rates.
HMO - $69/pay
POS - $86/pay
PPO - $100/pay

Obviously, as the price goes up, the coverage improves. I'm willing to bet that the vast majority of employees take the cheapest plan simply because it is the cheapest plan. Most probably don't even bother to look at the coverage terms.

Those are the same folks that will later complain about their out of pocket expenses. For an extra $17 or $31 per pay, they could have better coverage.

Personally, I do have the cheapest plan but I chose that only after studying the options and what my out of pocket costs would be. I determined that I was willing to "self-insure" for the difference and save on the premiums. Otherwise, I would have been perfectly willing to pay a little more to get more.

[TexasHusker]

I mean the difference between the options they have.

For example, I have 3 plans available to me. These are the individual rates.
HMO - $69/pay
POS - $86/pay
PPO - $100/pay

Obviously, as the price goes up, the coverage improves. I'm willing to bet that the vast majority of employees take the cheapest plan simply because it is the cheapest plan. Most probably don't even bother to look at the coverage terms.

Those are the same folks that will later complain about their out of pocket expenses. For an extra $17 or $31 per pay, they could have better coverage.

Personally, I do have the cheapest plan but I chose that only after studying the options and what my out of pocket costs would be. I determined that I was willing to "self-insure" for the difference and save on the premiums. Otherwise, I would have been perfectly willing to pay a little more to get more.

You’re paying for your copays either in your premium, or at the office. Same dollars.

And as far as I’m concerned, all ACA plans fall under the category of “POS.”

[LivingAlmostLarge]

Actually not true. There is a lot people like myself who have never had a hdhp except when we bought it ourselves. So we have no HSA. Our companies have always done HMO/PPO. We go with PPO. Need the freedom.

So personally I'd love a hdhp with no premium and my company putting money in. But it hasn't happened. I don't think it's going that way either.

I think to truly get obamacare or any insurance free market to work we have to decouple employment and health insurance. That will force everyone to go to the marketplace and make plans comepetitive. Isn't it something like 65% of people are covered by workplace plans?

If no one had a workplace plan then how would the markets really fair?

[disneysteve]

You’re paying for your copays either in your premium, or at the office. Same dollars.

And as far as I’m concerned, all ACA plans fall under the category of “POS.”

You're certainly entitled to your opinion. Just understand and accept that there are tens of millions of people who feel otherwise.

We love our current insurance plan. It's easily the best coverage we've had in 20 years.

As for paying the copays one way or the other, that's simply not true. For example, our old insurance didn't cover my daughter's therapy. We were spending $185 per week out of pocket for that. The new plan covers it with just a $15 copay. So we're now spending $60/month instead of $740/month. And my premium is actually lower than it was with the old plan. I'm certainly not complaining about that.

[TexasHusker]

You're certainly entitled to your opinion. Just understand and accept that there are tens of millions of people who feel otherwise.

Most of those tens of millions are being subsidized.

Anyone who is paying full freight for these things is dying.

[disneysteve]

Most of those tens of millions are being subsidized.

Anyone who is paying full freight for these things is dying.

Fair enough, but anyone who was buying their own coverage before the ACA was struggling too. That’s part of why about 48 million people were uninsured. Since the ACA, that number has dropped by 20 million. And lots of people who had insurance before now have better cheaper insurance. Like me.

[TexasHusker]

Fair enough, but anyone who was buying their own coverage before the ACA was struggling too. That’s part of why about 48 million people were uninsured. Since the ACA, that number has dropped by 20 million. And lots of people who had insurance before now have better cheaper insurance. Like me.

Barring a new 5% tax on every working American, the shell game is over. Insurers have run for the exits and the whole thing is collapsing just like everyone knew in the very beginning. The math wasn’t ever there. This was just a political deal, nothing more or less.

[disneysteve]

Overall, Obummercare is a joke for coverage.

as far as I’m concerned, all ACA plans fall under the category of “POS.”

Barring a new 5% tax on every working American, the shell game is over. Insurers have run for the exits and the whole thing is collapsing just like everyone knew in the very beginning. The math wasn’t ever there. This was just a political deal, nothing more or less.

You're arguing completely different points. I was responding to your comment that the coverage isn't good, that "all ACA plans" are lousy. That has nothing to do with whether or not people are being subsidized or whether or not you agree with the program overall.

I totally understand that you are opposed to the ACA. That's fine. But I disagree that all of the current insurance plans are awful. We have great coverage, the best we've had in a long time, and the ACA is part of the reason for that. Plus, as I've said, millions of people went from NO insurance to an ACA plan. I highly doubt that any of them would prefer going back to no coverage even if what they have isn't perfect.

[disneysteve]

Barring a new 5% tax on every working American, the shell game is over.

If a 5% tax would result in universal coverage, sign me up.