Medical / Health Insurance

[Carl n Susan]

Below is a link to an analysis of the ACA and its impacts on full timers. It is written by a full timer. It appears South Dakota may not be the best state of residence if you want an ACA supplied plan. Read it and make your own decisions.

http://www.technomadia.com/2013/11/c...on-the-road-2/

[TYR]

We were among the millions whose self-insured health insurance plans were cancelled thanks to the ACA. These were good plans with major carriers which fit our needs and budget. Premiums of offered replacement plans were triple what we had been paying and simply not affordable. We had no option but to go through the Federal Exchange. We're a few years shy of Medicare eligibility.

There was one carrier for our county (we are full-timers and Escapees with residency in Texas), although various plans were offered. I secured a PPO Multi-State Plan for us for about $60 less per month than we had previously been paying. We were eligible for a subsidy; we don't make a lot of money in this lifestyle but our needs and wants are simple due to our personalities and our lifestyle. Without the subsidy . . . well, we'd probably have some sort of hospital indemnity plan or the like . . . not a good scenario considering I'm a 2-time cancer survivor. I've never, ever been without health insurance, either self-insured or through an employer. I will mention that we were fine financially carrying private insurance prior to the ACA. Prior to going full-time in 2010, I researched and found plans that fit our health needs and our budget. We were totally good.

I've worked in the medical field and medical insurance field - been a caregiver, patient, professional and had my own medical insurance billing business years ago, so I have an understanding of how all this works. Or is supposed to work.

As a full-timer, be sure you get a policy that will cover you as you travel. Many of the plans offered are HMOs or are otherwise limited in coverage area. I researched coverage for the plans I was considering on the insurance company's web site prior to going on the Exchange to enroll. I compared plans, did more research and knew exactly which plan I was going to select prior to starting the enrollment process on the Exchange. After a few failed attempts to get in the system due to it being down, the entire enrollment process took 45 minutes. Again, I knew exactly what I was going to get and did not have to spend time "shopping."

I'd also suggest contacting the insurance company after your enrollment if you do so via the Exchange. You will most likely receive a welcome email directly from the carrier shortly after enrolling. Something as simple as logging into the insurance company's web site to verify your coverage is a good idea.

Check with providers (doctors, clinics, hospitals) yourself to make sure they will accept your insurance. Remember, just because it says they are a provider on the insurance company's web site . . . that doesn't guarantee it in today's environment. Discrepancies abound.

Point is, if going through the Exchange, do your homework up front and your follow-up afterwards. The ACA and its roll-out are, indeed, one huge train wreck. Good luck!

[richfaa]

"We were among the millions whose self-insured health insurance plans were cancelled thanks to the ACA. "

Just curious .
Why was the health insurance plan cancelled. Did it meet the 10 essentials?? we are told that companies that did not meet the 10 essentials could upgrade to meet them or cancel the plan. Many chose to cancel rather than meet the standards.

[steves]

V O T E !

[PackerFan]

Getting some great info here (which is the Norm for the MOC!) Have called and left messages at several organizations for assistance but none of them so far care to return the calls.

Carl n Susan: Thanks for the link. I will read it all tonight.

[richfaa]

Health Insurance is costly and always has been. I can not remember many years when our premiums did not go up over the last 40 years. We pay nearly 7K a year for BC/BS for both of us and Medicare for myself.
We were fortunate to have employer provided Health Insurance over the years through the Federal Government which we both worked and retired from. I also have Medicaid. Between the two plans I have zero expense. Helen still has some co pays as she is not yet 65.
The ACA was of no benefit to us as both our plans met the 10 essentials and always have. We did apply just to find out exactly how it works but since our plans meet the essentials and we do not qualify for any subsidy ACA did nothing for us.

So many lost their coverage because of their employers going bankrupt because of poor business practices or outright criminal activities. Many lost their retirement plans also. Health Insurance as we get older is a necessity. It is a shame that the private sector could not provide us affordable health Insurance that provided adequate coverage and the Government stepped in.

[TYR]

quote:Originally posted by richfaa

Just curious. Why was the health insurance plan cancelled. Did it meet the 10 essentials?? we are told that companies that did not meet the 10 essentials could upgrade to meet them or cancel the plan. Many chose to cancel rather than meet the standards.

My original plan was with AARP/Aetna. AARP chose not to participate and the plan was discontinued. (Needless to say, I won't be renewing my AARP membership this year.) Got on a different plan with Aetna that I could keep through the end of 2014, albeit for a bit over $100 a month more. Both mine and Dave's apparently didn't have all the wonderful extended maternity and mental health benefits now required. Dave's plan is set to be cancelled - with replacement options - in a couple of months.

Neither of us needs maternity coverage. (The policies had coverage for this, just not to the extent now required.) We do not need expanded child care benefits. We have no children under our wings.

At any rate, the monthly premiums for these plans were going to skyrocket - triple-plus - at the end of the extended coverage period (2014).

When we got these plans in 2010, they were just about $400 a month for both of us. Comprehensive plans, 80/20 coverage with deductibles we could handle and benefits we needed without the ones we cannot use. Rates typically go up every year; increases were built into our budget to handle that with the base starting point of the initial combined premiums. We would have been good to go for years in the former environment.

To be hit with a 200% + increase all at once . . . we simply can't do it. Hence, forced onto the exchange.

Don't even get me started on my opinion about all this. It's not just about higher premiums. Continuity of care, quality of care, availability of care, invasion of privacy, dictating my health care choices, the obvious issues with the Exchange, etc. . . . again, I've seen the medical/insurance world from all different aspects. What's happening . . . well, folks, it ain't pretty. And we're just getting started.

I hope I am proven wrong. I have written and spoken with my representatives - Senators on down - starting almost a year ago - to no avail. You might have even heard one of my letters during a break from Green Eggs and Ham. I have been assimilated and am accepting it while looking out for our interests.

And yes, I'll be voting.

[TYR]

And here is another prime example of issues with the Exchange site just seen in today's news . . .

http://www.foxnews.com/politics/2014...fo-on-premium/

I agree we need healthcare reform; however, the ACA was poorly conceived and poorly implemented.

[richfaa]

Understand what you mean We had 5 kids and appreciated the maternity benefits that I am sure some older folks paid for. We now have no kids but have been paying for the maternity benefits for others for years now. We have no need for the mental care ...yet but who knows. I don't think I will need a monogram or Helen a PSA test but we are paying the premium for them. Why should my premium pay for a hysterectomy that I will never need. we are again fortunate that the quality of our health care has not been affected and our premiums have not sky rocketed. They went up 8.24 per month for the two of us. We have the same dr's .We count our blessings every day.