healthcare.gov is an absolute nightmare

[Wreckem]

my response was strictly to the poster that was using the Forbes article saying costs were decreasing.

The deductible number was part of a quote from forbes.

Personally. I've never said this wont help some people. It will.

But it doesn't fix health costs. And it going to be a disaster for anyone in the middle class that makes to much.

After the income cut offs, health insurance costs turn into a terribly regressive tax.

and if your younger. your f-ed

I am fairly young, 31. I am solidly in the middle class. I do not get a tax credit because one of the other HUGE oversights, which is if your spouse has affordable insurance through work you are deemed to as well because the law only looks at your spouses employers single coverage cost($25) not spousal/family cost(an extra $500 a month just for me). The healthcare plans are NOT a disaster for me. I tried to get a 2013 plan. Only 1 of the 5 companies I checked in Texas would even cover me. The one that would cover me wanted to charge 25% extra because I am overweight. For the other companies I was 3lbs, 5lbs, 8lbs and 15lbs past their respective auto decline weight limits. My weight is my only issue. The plan I was looking at had similar out of pocket/deductibles as a silver plan, it was $198 after the 25% premium increase. A comparable silver plan is only ~$40 more a month. A better gold plan is ~$150 more month. A silver or gold plan would hardly be a disaster. That said I am actually only going to be on a non exchange bronze plan that is fairly similar to what I would have had on my wifes plan which makes you pay out of pocket for everything before the deductible, a $5000 deductible, and $6350 max out of pocket that is inclusive of said deductible. The bronze plan is a lot cheaper(over $300 cheaper per month) that what I could have got through my wifes job. My plan have few providers but this is only going to be temporary coverage until I get employer provided coverage. I originally tried to get short term coverage but was rejected by everyone with a decent short term plan. But if I had to indefinitely have a metal plan, I would be able to afford a gold plan without a problem. We would however have a problem if we tried to cover both of us on my wife's companies mid level plan. And her works highest level plan would cost us over $1500 a month for the two of us. Only suckers bad at math choose that highest level plan(for single or spousal/family coverage).

 

[CPA]

No.

Policies through the exchange are by the same old private insurers that provide insurance outside of the exchange. You've been misinformed, or you're thinking of Medicare/Medicaid or you're making things up.

Yeah, I just make things up. Providers contract with the insurers. They can move in and out of plan contracts practically anytime they want.

That narrower network comesas particularly bad news for the residents of Concord, New Hampshire.
Concord's one hospital won't accept any policies offered by the marketplaces. To see a doctor, specialist or primary care provider affiliated with the hospital, patients on these Obamacare plans will have to pay out of their own pocket. The closest in-network hospital is in Manchester.

Jeebus, get your heads out of your asses and understand how ACA is a loss/loss for everyone involved.

 

[Wreckem]

Yeah, I just make things up. Providers contract with the insurers. They can move in and out of plan contracts practically anytime they want.



Jeebus, get your heads out of your asses and understand how ACA is a loss/loss for everyone involved.

Actually you are the one that needs to get your head out of your conservative talk radio ass because IT IS NOT a loss/loss for everyone. There are clearly winners, losers, and people that not effected in any meaningful way.

The metal plans, on or off the exchange, could be a loss for some and a win for others, and at the same time it will not have no meaningful impact on most. But a lot of people win under a multitude of ACA provisions. There are winners and losers with everything, the ACA merelly shifted/shuffled the winners/losers in the health insurance scam.

Also it would behoove them to take the metal plans, as the metal plans off the exchange are the same plans that are on the exchange for the most part as there are few metal plans that don't also exist on the exchanges, well atleast in Texas. They would atleast get paid by the insurance company, unless the person was gaming the system, but a person trying to game the system probably wouldn't pay their bills if they had to pay out of pocket either. Basically they have a better shot of collecting money if the accepted metal plans, than if they were trying to collect from people out of pocket.

See Parkland Hospital in Dallas. They not only accept metal plans, but they are planning on paying the premiums of their chronically ill patients, because instead of not getting paid for anything, they would then be getting paid for most of the treatment they provided. They are still in the planning process but they believe they can potentially collect hundreds of millions a year in money they otherwise would not be able to collect.

 

[theeedude]

Well, the employer mandate was conveniently pushed back until after the 2014 midterms. Pray that some bureaucrat didn't arbitrarily decide your insurance is sub par.

What if it actually is subpar?

 

[CPA]

Actually you are the one that needs to get your head out of your conservative talk radio ass because IT IS NOT a loss/loss for everyone. There are clearly winners, losers, and people that not effected in any meaningful way.

The metal plans, on or off the exchange, could be a loss for some and a win for others, and at the same time it will not have no meaningful impact on most. But a lot of people win under a multitude of ACA provisions. There are winners and losers with everything, the ACA merelly shifted/shuffled the winners/losers in the health insurance scam.

Thanks, but I 1) don't like be called a liar as the poster above insinuated, and 2) stopped listening to conservative talk radio some time ago, but thanks for painting me into a group.

the government shifting winners/losers is in itself a loss/loss for this country.

You may end up being right that providers will change their stance, but I know that my urologists are definitely not accepting for at least 2014, then they will re-assess the situation. They may never accept the exchange plans.

 

[Train]

Your social security number is not stored(your other data is). The social security number is only transmitted through the hub in order to verify your identity and income. The hub would have to be actively hacked when your data is being transmitted. The only other way your SS would be compromised is through click jacking.

Do you have a source for this info? Do you have a way to verify this?

 

[Wreckem]

Thanks, but I 1) don't like be called a liar as the poster above insinuated, and 2) stopped listening to conservative talk radio some time ago, but thanks for painting me into a group.

the government shifting winners/losers is in itself a loss/loss for this country.

You may end up being right that providers will change their stance, but I know that my urologists are definitely not accepting for at least 2014, then they will re-assess the situation. They may never accept the exchange plans.

If government shifting winners/losers is a loss/loss, well that loss/loss happens all the time and has for as long as this country has existed. Not to mention said shifting is REGULARLY backed by republicans. So that would call a loss/loss is actually the status quo.

 

[Wreckem]

Do you have a source for this info? Do you have a way to verify this?

That it is not stored has been widely reported.

And no I cannot verify it. And before you say anything else I will ask you, do you have a way to verify that it does store? Nope. Nor do you have anyway to verify that any of your information the govt(SSA, IRS, etc), or really anyone(private companies, banks, universities) has is actually secure. They say it is, but you have to take them at their word. There is so much non-compliance(that goes way under reported) with privacy and confidentially policies across all sectors both private and public.

And in all honesty, if someone wanted your social security number, they can likely find it without having to hack into the healthcare.gov site or a federal agencies server. The reality is no matter how careful you are social security numbers just aren't all that secure and never have been. Thats not to say they shouldnt get their shit together and fix the security issues but that is the reality.
It is inexcusable that the site has the problems it has. However it should also not be surprising because that is what you get with govt contracting. Most govt contractors are not worth a damn. Especially when it comes to IT contracting.

 

[Train]

So your response is basically no, and even went as far as to try to and reverse the burden of proof.

 

[Train]

You should read this guys blog: http://blog.isthereaproblemhere.com/search/label/Healthcare.gov+Security

With what he has VERIFIED to be insecure about the site... any claim that your SS is safe is an absolute joke.

 

[sactoking]

Concerning whether providers know if you're on an exchange plan or not: it depends. While exchange plans may be sold off the exchanges, it's been my experience that insurers offer different plans off the exchanges. So long as the plans are different that can have different provider networks.

Why wouldn't a provider want to be in an exchange plan network? As was mentioned, the ACA has a mandatory grace period for consumers getting tax credits who fail to pay their premium. When the tax credit recipient misses a premium payment it starts a 90 day window. During the first 30 days the insurer must pay claims regardless of whether the premium is ever paid. During the last 60 days the insurer is allowed to pend claim payments. If the premium payment is made before the 90 days expires then pended claims are paid in full. If the payment is not made then pended claims are denied and the provider essentially takes a loss on the services rendered. Some providers don't want to take the payment risk inherent in accepting exchange plans.

 

[sactoking]

Concerning whether providers know if you're on an exchange plan or not: it depends. While exchange plans may be sold off the exchanges, it's been my experience that insurers offer different plans off the exchanges. So long as the plans are different that can have different provider networks.

Why wouldn't a provider want to be in an exchange plan network? As was mentioned, the ACA has a mandatory grace period for consumers getting tax credits who fail to pay their premium. When the tax credit recipient misses a premium payment it starts a 90 day window. During the first 30 days the insurer must pay claims regardless of whether the premium is ever paid. During the last 60 days the insurer is allowed to pend claim payments. If the premium payment is made before the 90 days expires then pended claims are paid in full. If the payment is not made then pended claims are denied and the provider essentially takes a loss on the services rendered. Some providers don't want to take the payment risk inherent in accepting exchange plans.

 

[Wreckem]

You should read this guys blog: http://blog.isthereaproblemhere.com/search/label/Healthcare.gov+Security

With what he has VERIFIED to be insecure about the site... any claim that your SS is safe is an absolute joke.

And none of that shows anything about a SS number being stored one the website or sent back to the browser. That website is NOT claiming that you can get a social security number, just look at its last sentence... Paraphrasing, if you already have someones social security number you can get more of their information. It doesnt say anything about actually getting someones social security number. Even the GOP is mainly harping about SS number security being compromised by the navigator system(lack of background checks and training), not so much the website.

 

[Wreckem]

Concerning whether providers know if you're on an exchange plan or not: it depends. While exchange plans may be sold off the exchanges, it's been my experience that insurers offer different plans off the exchanges. So long as the plans are different that can have different provider networks.

Why wouldn't a provider want to be in an exchange plan network? As was mentioned, the ACA has a mandatory grace period for consumers getting tax credits who fail to pay their premium. When the tax credit recipient misses a premium payment it starts a 90 day window. During the first 30 days the insurer must pay claims regardless of whether the premium is ever paid. During the last 60 days the insurer is allowed to pend claim payments. If the premium payment is made before the 90 days expires then pended claims are paid in full. If the payment is not made then pended claims are denied and the provider essentially takes a loss on the services rendered. Some providers don't want to take the payment risk inherent in accepting exchange plans.

My off exchange plan seems to have the same providers as the exchange plan. It might not be like that for everyone, but it seems that is the way BCBS Texas is doing it with their plans.

 

[werepossum]

Your social security number is not stored(your other data is). The social security number is only transmitted through the hub in order to verify your identity and income. The hub would have to be actively hacked when your data is being transmitted. The only other way your SS would be compromised is through click jacking.

So far there haven't been any reports of someone being click jacked in the wild nor has their been a breach of the hub. If you have already had your identity and income verified you are probably not going to have your SS compromised(other personal data is still in danger).

And again the ONLY PEOPLE WHO SHOULD SIGN UP THROUGH THE EXCHANGE ARE THOSE WHO QUALIFY FOR TAX CREDITS.

That said its a good idea for anyone that has homeowners or renters insurance to have an identity theft rider as its only pennies a month. What am I saying though, most adults aren't responsible enough to watch their credit or have an identity theft rider, and most of those are likely to be compromised someway somehow anyways.

And if social security numbers are at extreme risk, god I'd hate to be a GOP staffer. Almost every GOP congressional staffer has been forced onto the exchanges by their Bosses. I'd fucking quit if I was a GOP staffer. Boss forcing you into a program your "boss" doesn't believe in and has the option of not forcing you into it, but the boss does so anyways is a shitty. Boss is also a shitty human being as well.

I believe its on monthly premium payments. Prior to the exchanges, health insurance has always given you a 30 day grace to get your account current. IE: They will cover those 30 days so long as you pay your premium before the end of those 30 days. The exchange/metal plans are 90 days. Basically it goes like this,

A person gets a procedure done during their first 30 days of grace, they go back and get several more procedures done between 31-90 days. Before a Dr would not end of doing the treatments beyond the first 30 days because the person would no longer have insurance. Now they have no way of telling if a person has insurance after those 30 days, so they could potentially lose a lot of money if someone gets treatment during their 90 grace and never pays their premiums. Its one of many huge oversights and needs to be fixed, but likely wont because Republicans want to tear the system apart not fix problems with it.

I am all for tearing up the ACA, but we need to come up with something else to replace it with. Going back to the old system doesn't fix anything.

Thanks for all the info. Looks like I was doubly wrong and those providers have a valid reason to never accept exchange plans, those being inherently riskier than identical non-exchange plans. I can't imagine Obama not vetoing a bill fixing that though, as it helps poor people (i.e. those unable to pay their premiums) at the expense of rich people (i.e. health care providers.) I'll have to look into that identity theft rider - I didn't even know such a thing was available. Looks like with Nationwide it's a separate policy though, not a rider.

WRT your social, I don't trust the clowns who built the web site with my social, period. Though if I were getting a substantial subsidy and that's the only way I could get health insurance I'd jump on it.

 

[beginner99]

And what are these costing cutting measures of ACA- Ultra high deductibles

So the ACA jacked up for deductible 1200-2000%, and now people are getting less care. Yup that's cost savings. Get less, pay more.

I had a CT Scan on my chest and a MRI on my shoulder this year and they cost me $96 and $87 respectively. I'm happy the company I work for is self insured and my policy will be the same next year as I couldn't imagine having a $3,000 to $5,000 deductible as mine is $300.

An insurance is meant to insure you against the very expensive stuff no normal person can afford. Meaning $100k a pop surgeries and such things and not a single visit to your local doctor.

A high deductible makes sense because then people will think twice before doing MRIs for every harmless little scratch.

If you have a preexisting condition, you may be uninsurable for what you can reasonably afford.

That's stupid. Here the law says that all insurance companies must accept all people for the most basic plan. The downside being that getting a better plan is hard to impossible with preexisting conditions.

 

[michal1980]

What if it actually is subpar?

Subpar in a liberal mind -

Insurance for males not having maternity coverage.

 

[michal1980]

An insurance is meant to insure you against the very expensive stuff no normal person can afford. Meaning $100k a pop surgeries and such things and not a single visit to your local doctor.

A high deductible makes sense because then people will think twice before doing MRIs for every harmless little scratch.
.

You missed the point didn't you.

The savings these people are claiming are due to the new insurance plans having far less coverage.

Lets make this simple for you.

Before ACA (affordable cereal act) you go to a store and for 3 bucks you got 16oz of cereal, but some people couldn't afford it.

After ACA you go to a store, pay 3 dollars for cereal but only get 2oz of cereal. But now someone else gets 2oz of cereal free.


How have you saved any money? To get the same amount of cereal you have to pay 8x as much.

 

[boomerang]

how old are you and how much have your deductibles increased?

I asked him the same question weeks back and he never answered. So we can assume that he condones the government's method of only talking of the positives and pretending the negatives don't exist.

We've got a whole lot of people in this country that don't want to deal with reality. They look at things from one perspective and one perspective only.

They see a very fast, very sleek sports car. They want it so bad they ignore that it's a two-seater, they have a family and that it that gets horrible gas mileage. They just want it.

They just love wind power. They ignore the bird deaths including bald eagles. They just want it.

They ignore all the negatives associated with Obamacare, which many of us have been harping on for many years now, and concentrate only on what they perceive to be the good. They just want it. Or worse, as many do here, they only really care about how it affects them. Oh, they make the PC noises about helping the uninsured but it doesn't take a lot of analysis of their words to understand that it's really only about them - or their sister. Those of us concerned about the bigger picture, the long term consequences are dismissed as racists.

We have a nation of selfish brats that have been taught that some socialism is good and far, far more socialism is better. They don't get the bigger picture, they ignore the crumbling of nations in Europe due to aggressive social programs and their move away from the socialist model. Their revamping of their socialized health care systems after the experiment has been shown to be a failure. Much of their desire is rooted in jealousy of what they perceive others to have that they want.

They don't get that those of us that harp on the dangers of too great a socialistic government are part of a checks and balances system. Not wittingly, not purposefully put in place but there naturally to make those willing, to stop and think a little bit. We're just racists.

Regardless, none of this really matters IMO. We have another bubble coming. The signs are all there staring us in the face daily. The market is being buoyed not by positive factors but by negative ones. It will burst, only this time our nation will have exponentially more debt than has ever been had before and we will not have pulled out of our last bursting bubble. We won't have time to think about silly things like Obamacare.

 

[BikeJunkie]

Jeebus, get your heads out of your asses and understand how ACA is a loss/loss for everyone involved.

It's Obama's only real achievement while in office. It conceals one broken promise after another and even obscures Benghazi and the NSA a bit. If the ACA isn't successfully defended, it looks like we wasted two terms on an empty suit who couldn't outperform who was once the most embarrassing president of modern times, Bush 43.

Whether or not the ACA works or does what what was sold to the American people is wholly inconsequential to Obama and his Demorats. This is now a fight for saving face on numerous angles and a fight for maintaining seats in the future.

And we haven't even discussed the fact that we sourced a $500M website from a corporation in CANADA known by everyone and their mother to be the hapless clown of the IT world.

 

[Londo_Jowo]

A high deductible makes sense because then people will think twice before doing MRIs for every harmless little scratch.

It's obvious you have absolutely no clue what a MRI is and when doctors request one. A individual can't get a MRI without a doctors referral.

Maybe you should take the time to educate yourself.

http://www.webmd.com/a-to-z-guides/magnetic-resonance-imaging-mri

My MRI was done on my right shoulder and confirmed that I have a full thickness tear of my supraspinatus tendon (rotator cuff).

 

[rcpratt]

It's obvious you have absolutely no clue what a MRI is and when doctors request one. A individual can't get a MRI without a doctors referral.

Maybe you should take the time to educate yourself.

http://www.webmd.com/a-to-z-guides/magnetic-resonance-imaging-mri

My MRI was done on my right shoulder and confirmed that I have a full thickness tear of my supraspinatus tendon (rotator cuff).

Pretty sure he was being sarcastic about the "scratch."

Nobody said MRIs aren't important, needed, or valuable. Calm down.

 

[Londo_Jowo]

Pretty sure he was being sarcastic about the "scratch."

Nobody said MRIs aren't important, needed, or valuable. Calm down.

The fact of the matter is an individual can't get a xray, CT scan, or MRI without a doctors referral so the deductible amount will have zero effect on a person getting one. The main difference for those with high deductible plans will pay far more than those with low deductible/copay plans.

 

[HumblePie]

Wow, was looking at the plans finally for me, just as a giggle since I have employer provided plans. All I can say is the plans are horrible for me. I looked at all tiers of plans from basic to gold. They were all shit.

For comparison to my current company's "crappy" plan that is literally one of the worst employer sponsored plans I've been enrolled in, here are the comparison to the healthcare.gov plans.

Plan for 2 healthy people ages 35 and 25.

My current plan monthly cost (this was the middle of the road plan I could pick):
$442

Cheapest gold plan cost:
$512

Highest gold plan cost:
$820
-----------------------------------------------------------------------------------
Current maximum deductible/out of pocket on my plan:
$3,000/$3,000

Lowest gold plan max deductible:
$9,750/$12,750

Highest gold plan max deductible:
$3,000/$6,000
-----------------------------------------------------------------------------------
Current co-pay break downs:
Regular doc: $20
Specialist: $40
ER: $40
Generic Prescription: $0

Lowest gold plan co-pays:
Regular doc: $30
Specialist: $50
ER: $400
Generic Prescription: $20

Highest gold plan co-pays:
Regular doc: $25
Specialist: $50
ER: $150
Generic Prescription: $20


The silver plans are even worse for out of pocket expenses, copays deductibles, and so forth. Even if the monthly costs are lower.

I thought my current plan was shit. Last place I was getting slightly better rates and only would pay about $280 for my wife and myself versus the $442 a month I am currently at.

Those are some pretty horrible plan offerings for my area.

 

[Bird222]

Wow, was looking at the plans finally for me, just as a giggle since I have employer provided plans. All I can say is the plans are horrible for me. I looked at all tiers of plans from basic to gold. They were all shit.

For comparison to my current company's "crappy" plan that is literally one of the worst employer sponsored plans I've been enrolled in, here are the comparison to the healthcare.gov plans.

Plan for 2 healthy people ages 35 and 25.

My current plan monthly cost (this was the middle of the road plan I could pick):
$442

Cheapest gold plan cost:
$512

Highest gold plan cost:
$820
-----------------------------------------------------------------------------------
Current maximum deductible/out of pocket on my plan:
$3,000/$3,000

Lowest gold plan max deductible:
$9,750/$12,750

Highest gold plan max deductible:
$3,000/$6,000
-----------------------------------------------------------------------------------
Current co-pay break downs:
Regular doc: $20
Specialist: $40
ER: $40
Generic Prescription: $0

Lowest gold plan co-pays:
Regular doc: $30
Specialist: $50
ER: $400
Generic Prescription: $20

Highest gold plan co-pays:
Regular doc: $25
Specialist: $50
ER: $150
Generic Prescription: $20


The silver plans are even worse for out of pocket expenses, copays deductibles, and so forth. Even if the monthly costs are lower.

I thought my current plan was shit. Last place I was getting slightly better rates and only would pay about $280 for my wife and myself versus the $442 a month I am currently at.

Those are some pretty horrible plan offerings for my area.

That's great that you have an employer based plan. However, how much would you have to pay if you were on the individual market?