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Just as it says...
#425309
This will only apply to US based members, because it's American healthcare, for UK based member, cherish the NHS, it's amazing!

A couple of months ago, I had to cancel my workplace medical insurance because it jumped from $170/2 weeks to $420/2 weeks.

So we signed up for healthcare.gov and bought a plan from Coventry Healthcare of Kansas for $461.21 per month, only to find that two drugs my wife requires are not covered because they are tier 3 drugs, which of course was not explained on the marketplace before I stumped the cash. Bottom line, to get my wife these two medications, it will cost a further $500+ which means healthcare is costing close to $1000 each month before doctors office visits etc.

What I am asking is has any of the Forumula1 members experienced ACA/Healthcare.gov? what are you experiences? any recommendations? tips and tricks?
#425312
Don't worry, open enrollment starts next week and you can switch to a plan that better suits your needs starting Jan. 1, 2015.
I'll start looking around next week as well. I'm pretty happy with my current plan, though it's a bit pricey and goes up 18% next year. Bronze with high deductible, but the first 3 visits to my primary incl. preventative tests are completely free, not even a co-pay. So, that's nice.
The ACA came just in time to afford me my semi-retirement, so a big thank you, Mr. President :clap::cloud9:
#425314
The issue is that the drugs my wife needs are tier 3 which means no bronze plan will cover it in any way, shape or form. After speaking to someone from the Marketplace, I might need to get a platinum plan to be eligible for coverage of these specific drugs, which don't leave much change from $1k.
#425319
I can offer no words of encouragement. It was a scam from the beginning. 1200 unread pages of a law that now has over
10,000 pages of regulations. Does Kansas have a state run marketplace, or did they opt out? Supreme Court has an issue they are going to hear in the spring.
Wait till people start filing income tax returns and realise some of their refund is going to be kept....
#425320
I don't believe it's a scam, it was well intentioned, but has multiple issues, the individual mandate being one of the biggest. It's not really affordable because if you happen to have insurance available to you as an individual through your workplace, you also don't get the substantial tax credit that would bring the cost of the premium down, so they are the comparing the cost of family insurance to insurance for an individual. It's actually cheaper to self pay and take the "tax penalty".

And yes, Kansas did opt out, why they were allowed to opt out without even consulting the people they represent and remain in power I'll never know!
#425321
I don't believe it's a scam, it was well intentioned, but has multiple issues, the individual mandate being one of the biggest. It's not really affordable because if you happen to have insurance available to you as an individual through your workplace, you also don't get the substantial tax credit that would bring the cost of the premium down, so they are the comparing the cost of family insurance to insurance for an individual. It's actually cheaper to self pay and take the "tax penalty".

And yes, Kansas did opt out, why they were allowed to opt out without even consulting the people they represent and remain in power I'll never know!


"The road to well intentions is littered with unintended circumstances."
#425322
Plus, 8 Senators who voted for it were voted out of office.
Premiums were not suppose to go up. Mine went up 10.3% this year. With higher deductibles and higher co-pays.
Anytime you take the free market place out of anything and replace with mother government, the results are likely to be negative.
#425327
There is far more good in the ACA than there was bad. The reasons for it being bad in the first place was because of the lobbying and lowest common denominator crap that's spun on on Fox News that's then regurgitated by the buffoons as talking points in the house. Anyone with knowledge about health care knows it's not an issue with given the ability of someone to buy health insurance (that would otherwise go without health insurance) that's the problem. The problem is that the big censored lobbyist pay their senators and congressmen very well so they do things like prevent the US government from buying their drugs on a negotiated rate. Instead being forced to buy a market rate.

There's a reason why an AIDS drug that goes for 20 bucks in Africa is 200 here. There's a reason why Americans flock across the border into Canada to buy their prescription drugs there. There's a reason why certain drugs are classified they way they are, and it's all to do with the lobbyist, whether they be big censored, big oil or the NRA, are running the country regardless of who you vote for.

I hate when people bad mouth the ACA or talk about flaws without taking the time to dig into the real information or the real reasons why something works or doesn't work.

There are tangible benefits I feel because of the ACA, even though I work for a large corporation that by all definitions provides insurance that would likely classify as platinum under the ACA. I still have to fork over 450 dollars a month for it, and that's not including whatever the company pays on top of that. So your cost MOA is not that much more out of line. Healthcare is expensive because of the astronomical malpractice insurance doctors pay, it's expensive because doctors are in debt for a hundred thousand dollars when they get out of school, and they are expensive because it's precisely the regional and local variances that allow for loopholes. The companies that set usual and customary rates for doctors are owned by health insurers! Talk about letting the fox run the henhouse and you wonder why the chickens keep disappearing.

Privatization is clearly not working, and we should have implemented a single payer national health care system. but how can that happen in a country where politicians are against even taking a vote on whether or not to discuss gun regulations even after 23 kids are killed in a school. :rolleyes:

Government doesn't work, but yet we claim to have the best military force in the planet. Sort of weird, very weird, and uninformed peeps. But the reason health insurance is expensive because of crap like this;

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BTW, this was Dubyah's healthcare legacy... which they forced right into the ACA
“Part D already costs about $80 billion a year and is on track to double by 2022 as benefits improve and Baby Boomers retire. For two reasons, a significant chunk of that money is wasted on overpayments to drug companies: When Part D began, millions of patients were shifted over from Medicaid, the state-federal program for low-income people that gets far lower drug prices than Medicare. Suddenly, the cost of providing drugs to the same people shot up. Congress barred Medicare from negotiating the way Medicaid and the Department of Veterans Affairs do with drug makers to get lower prices. Instead, lawmakers insisted the job be done by private insurance companies.”

This is a quote from a USA Today editorial and it highlights the absurdity of prohibiting Medicare from negotiating prescription prices with drug makers, especially in a time when government calls for cuts in Medicare and ways to reduce Medicare spending. Both Medicaid and the Department of Veteran Affairs negotiate for lower prices, but Medicare Part D, from it’s inception in 2006, is barred from doing this.

This is a very different scenario than in other countries, like Canada and Europe, where all government health plans bargain with the drug companies to protect their citizens. “Per capita drug spending in the U.S. is about 40% higher than in Canada, 75% greater than in Japan and nearly triple the amount spent in Denmark,” according to an article in Health Care for America Now.

And, it’s no accident that the law prohibits Medicare to negotiate lower drug prices. A recent article by the National Committee to Preserve Social Security & Medicare points out that “the drug lobby worked hard to ensure Medicare wouldn’t be allowed to cut into the profits which would flow to big censored thanks to millions of new customers delivered to them by Part D.”

For years these big censored companies have used the argument that negotiating lower drug prices would actually hurt seniors in the long run because it would take away the necessary funds for innovative research and development to “save lives.” Yet, this just isn’t true. “Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies, research shows,” according to an article in Health Care for America NOW. The article also notes that “despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.” In fact, 5 censored companies have reported million-dollar increases in their spending on lobbying the federal government during the 1st quarter of 2014 alone.

Join us and many other advocacy groups in helping Americans and our government save money by urging Congress to allow Medicare the same drug negotiate powers as Medicaid and Veterans Affairs.
#425331
Comrade WB said it how it is :yes:

The ACA is actually pretty close to the current Swiss system introduced in 1996. Just this past September we voted on an initiative that wanted to introduce a single payer system. 2/3 of the voters said no :banghead::(
#425333
I take offense to that! I am not a communist! I feel very strongly the the best type of governance is a mixture of socialist high standard of living that allows for an entrepreneurial economic environment withing a regulated market.
#425335
The issue is that the drugs my wife needs are tier 3 which means no bronze plan will cover it in any way, shape or form. After speaking to someone from the Marketplace, I might need to get a platinum plan to be eligible for coverage of these specific drugs, which don't leave much change from $1k.

I don't buy that tier 3 drugs are not covered by Bronze plans. Mine certainly does - there's the deductible to be met first before the insurance kicks in and pays, but once you've met the deductible, they're covered. Unless Kansas has some different rules, I don't see why they wouldn't be covered by your Bronze plan.
#425336
I take offense to that! I am not a communist! I feel very strongly the the best type of governance is a mixture of socialist high standard of living that allows for an entrepreneurial economic environment withing a regulated market.

Comrade = a fellow socialist (or communist), so get your knickers out of the bunch you dropped them into for no reason :P

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