Obamacare Facebook Erupts with Citizen Sticker Shock

reply to post by xuenchen




I keep hearing people complaining about the cost, but not one of them has applied when I asked, they just said it is what they heard. Well, I just applied, and for a Gold plan, in Pennsylvania, for a family of four, I am paying HALF of what I was paying last year before changing to an employer without an insurance plan. I won't get into exactly what it will cost me but I am happy with the rate.

What factors go into the cost, does anyone know the way the coverage cost is calculated? It has to be more than income and family size. Is PA one of the cheaper states? I can not say that my experience is universal but I don't get why so many are getting outrageous rates when mine is so cheap. I am not below poverty level, actually well above it; I have a pre existing condition and so does my wife.

So I ask, can anyone explain why the prices are supposedly outrageous for so many when mine is so cheap? Is there something in the way rates are calculated that I am not seeing? Anyway, I am not trying to say anyone is lying but is it possible that these people complaining are, for the most part, people who would not have coverage and would complain at any cost? Could it be that they have employee offered plans and have to pay more for the coverage in Obamacare? I really don't know the way it is calculated and every site has a different answer based on the way it leans.

Sorry for the long post, anyone who can help with answers to my confusion would be greatly appreciated.

Thanks
--Blinky--


Just a note I want to add. I am not a Dem or Repub, I have views that fall into each- but I am all for a UK style healthcare system. My parents live there and love it, don't believe when you hear about long waits and refusal to cover something- the long waits only happen in major cities, much like in the US. I am all for socialized medicine and no, Obamacare is nothing like that nor is it anything like the Canadian or UK heath systems.

Believe what you want but try to keep an open mind, the whole left/right fight just makes me sick- neither are good, neither are right- they both only look out for themselves and no one else.

Blinkydoo
reply to post by xuenchen

 

So I ask, can anyone explain why the prices are supposedly outrageous for so many when mine is so cheap?

Check your terms. Deductibles, coverages, provider network, etc....

A plan at half the cost with double deductible is not a bargain.

Also, the government has interstate restrictions on insurance companies which amount to regional monopolies. Government sanctioned and enforeced regional monopolies. So prices vary from state to state. Even though providers may be the same available plans and terms and costs will vary from state to state.

I work for a very large corporation that got aligned with Obamacare a year ago in preparation. Before that the benefits were amazing. Before our daughter was a year old we discovered she had a thyroglossal duct cyst. This required surgery a couple days after her first birthday. The deductible nearly destroyed us. The new insurance is unreal. People who sit here and praise it are not ordinary people who have been caught up in an extraordinary situation. I make too much money for free healthcare so I get to double my out of pocket to pay for others, then on the flip side I was Ill prepared for the costs. This will hit the middle class hard.

reply to post by thisguyrighthere


I did, my cost, over all with that factored in is almost half the cost I paid before. My deductions are slightly higher than before - I had no RX coverage at last employer and high deductions. I feel it is a bargain for me- maybe I just had rotten coverage before so it doesn't shock me. I have only had two full time jobs since college, the rest had no benefits whatsoever and this full time one has no Insurance coverage because it's just me and two other guys operating the business.

What is a typical weekly rate for insurance is maybe where I should start, guess I will look into that. Thanks for the thought though.

reply to post by Blinkydoo


I think you may have figured out why it was reduced. My benefits were amazing before. The company has over a quarter million employees.

reply to post by Krystian


She really makes me frustrated a lot of the time. I feel bad for her, but damn...

For one, I don't know what was going through her head at the time when she was sleeping with the real winner that the father of her kid is. Deadbeat 37 year old, living with his girlfriend in her mother's basement apartment free. Last visitation I am pretty sure he was smoking crack in the livingroom while the kid was playing xbox.... Way she told me was that he was "smoking on a glass tube filled with tinsel", sounds like a crackpipe with a brillo filter to me. In jail again now for failure to get a job and pay support. Total champion of a guy right there.

She works her ass off trying to support the kid, 12 hour night shifts, I know how that goes. It's tough, I was always self employed, never could afford insurance premiums, never considered poor enough for medicaid.

I was lucky enough to have worked on a great doctor's house, we struck a deal with the guy. We did his floors for no labour cost in exchange for the whole immediate family being able to go to his practice for a flat $50 fee a visit. One of the things I miss most about living in NY was that guy and his wife's practice, great people.

I am happy I decided before I was 18 that I would never have kids until I knew for a fact I could afford to give a kid a good life. It sucks growing up poor. If I had a kid when the business went under and the bank stole the house, I don't know what I would have done.

reply to post by Blinkydoo


My employer based "Gold Plan" costs me 420.26 per month + Accident Insurance for on or off work = 23.70 + Dental = 30.00 + Vision = 13.00 (Dental and Vision are "Silver" plans) Total = 486.96 for me and my wife, no children.

My Health plan

Calender year deductible family 3,000.00
Out-of-pocket maximum family 6,000.00
Co-insurance 10%
Office visit co-pay 40.00
Specialist 40.00
Hospital Care - inpatient 300.00 one time payment
Hospital Care - out patient 200.00 one time pay

Prescription co-pays vary from 10.00 to 60.00 per prescription but we mostly pay 10.00 on average per prescription.

These costs are for in-network benefits.

This is just an example of what an employer plan may look like. I pay approx. 487.00 monthly for me and the wife for health, accident, dental and vision. We both have health issues that require multiple doctor visits and prescriptions and we have pre-existing conditions.

Good luck all!

Okay ... I just took a look. FUNNY! The first few days had some 'posters' who came on and asked fake questions and sounded all excited. Obviously they were plants. Then America got posting and the idiots pushing Obamacare are getting an earful.

I bet the gov't is tracking every person who posts on that site and says what they really think of Obamacare. I have no doubt about it.

reply to post by RueBakon


You know, a couple people (myself included) have seemed to get decent enough rates with pre-existing conditions.

I think this points to a major area where some discrepancy may arise. I know that pre-existing conditions are supposedly looked at differently under these new mandates.

I have zero doubt I was being charged WAY TOO MUCH before, but it was the absolute cheapest option that was available to me that actually provided coverage I needed. Every insurance company I called would tell me "Yes, we absolutely accept anyone with pre-existing conditions" and then I could almost hear under their breath "but well charge you out the arse for it because we know you need it!"

I would be interested to see if this is the major difference. I know that they didnt ask too many questions about my pre-existing conditions. As I said previously, it seems like all of this punishes the healthy into a system where they have to pay a "healthy tax" for being in good health and not needing constant medical treatment.

Iwinder
reply to post by Serdgiam

 

but so far in my life I have never witnessed first hand any downside to our system.

Hey there Iwinder, I wanted to ask a question about this if I may;

From a friend, they told me that the downside to the healthcare system in Canada was that they had to wait quite a long time for specific types of treatment (I think one was some type of surgery, and the other was... cancer.. maybe?). They said that they actually prefer the healthcare in the US, which I have some serious doubts about.

What are the typical wait times like for various treatments? Do you have to wait months to schedule a check up appointment or anything like that? It sounds like you have had quite a few health problems, so I think you would be a good person to ask. You said no downsides, so I just wanted to clarify.

I wonder if the government biological 'skunk works' is secretly working on the 'Obamavirus'...an acute, incurable, disease which only effects low-income, healthy, young Americans ages 18-35.

reply to post by IAMTAT


I wonder if things like flu vaccinations will become mandatory for coverage?

reply to post by Serdgiam

Regarding pre-existing conditions.....I did not have to answer any health related questions.

I have participated in either my work's or my wife's employer heath insurance plan for the last 18 years or so. We have been married for 20 years and I am 44 years old.

If I had not had a continuous run with an insurance plan for so long it could be the difference in the ease that I have had participating.

I am a Republican and I vote my will...Having said that...If there were no Affordable Care Act and I did not have the luxury of having an employer health plan I would do what I had to do to take care of my business. I would find that "I gotta get this done" will and take care of my family. I would not wait for someone to hand me a fish when I can still make bread.

I do believe that we need a working health care system that benefits everyone fairly!

reply to post by Serdgiam


I think it depends where you live really. Here it takes forever, took months to get a brainscan for me. Had a cousin that died at 3 years old while waiting to see an oncologist too ~10 years ago. Last year an aunt waited 2 months for a surgery to remove a tumor from her brain.

For regular doctor appointments, got to either make an appointment with the family doctor 2 weeks in advance, or drive an hour and a half to the nearest walk-in clinic.

reply to post by RueBakon


I couldnt agree more with your last line.. From the sounds of it, people with pre-existing conditions might be getting better deals, but people like me were getting outright gouged before..

Seems like what is done in the oil industry where prices are hiked dramatically, and then people are just happy when its lowered 10%.

Having a national healthcare system could even be done by actually investing our tax money back into society rather than just maintaining budget allowances. Truth be told, I dont even think we would need to raise taxes we would just need to get politicians to stop lining their, and their special interest groups, pockets with taxpayer money.

Why put an even greater burden on a strong, healthy person who is productive? The only thing I can imagine is an intentional collapse, which is something I have felt is happening for quite some time. Decades really, and really spun into action with the Rio Declaration in 1992 (also known as Agenda 21). That one piece of "legislature" makes it quite clear what the "end goal" is, but my question was always, "how will it be brought about, people will oppose it?" I think I might have my answer, at least in part, with this seemingly cloward-piven inspired health act.

reply to post by RueBakon


You know, I wish you the best and I'm sincerely happy for you that this helps you. It's fair to ask if that help needed this to achieve it ...but that's not fair to ask you. It's a question for the guy at 1600 Penn Ave.

At least some are benefiting though and it sounds like those who have employers that are participating will be the best served by what has happened here. Those of us without employers or with employers that aren't the right sort or size (with or without the legal issues of state laws now) are looking to get hosed pretty hard it seems.

Not everyone though, as you note and that is fair to include as part of any balanced look at this. Not EVERYONE is losing ....just, in my opinion, too many to ever justify how this is happening.

Again though, that doesn't draw away from feeling good to hear you have improvement. Anything we each can get for good news these days, eh?

reply to post by TKDRL


I can see that happening.. Hearing about the child is rough..

Are there any active initiatives to improve this? Once you actually get in, is the care received decent?

I may not have had issues with wait time, but getting proper care has been very, very difficult. Most of my doctors didnt even read radiology reports, blood tests, bone scans, etc. It has been clear for a while that several vertabrae in my back are not only shattered, but continue to break. One of my doctors told me it was actually "fine" and that there are "two schools of thought about how serious spine injuries are."

Wrabbit2000
reply to post by RueBakon

 

Not everyone though, as you note and that is fair to include as part of any balanced look at this. Not EVERYONE is losing ....just, in my opinion, too many to ever justify how this is happening.

Thats really the point I was trying to get across, but I was called a government rat (wherein the post received quite a few stars as well!).

I am definitely saving money, and at least from a quick glance, it seems people with pre-existing conditions are saving pretty decent sums of money. Thats a good thing!

However, we now seem to have a tax specifically on the healthy middle class individuals which are the backbone of our society. Not only that, but that backbone is struggling as is!

I made a joke with friend that soon they will "tax our every breath, and then we will live in a free world safe from terrorism." I am not so sure thats a joke anymore...

reply to post by Serdgiam


It sucks to be honest. Years ago while we were here on vacation, mom's appendix decided to explode on her. She was in the ER waiting room 7 hours before they got her on the table. They did the lazer surgery to remove it, and screwed it up, they didn't remove it all. Next day they had to open her up from sternum to pelvis, and remove portions of her intestines to clean up the mess.

She has been up here a few years, still trying to get it sorted out. Even drinking water gives her heartburn, she has gal bladder issues. They refuse to even test for gal bladder problems because she suggested they do it. How dare a non doctor make a suggestion to them right? Doesn't matter that it was our real doctor that told her that it sounded like a gal bladder issue. It's a nightmare really, and I am thankful I am pretty healthy and fit and have no use for doctors.

Dental is another story, it is not included in the coverage, and something I really need. Can't wait until business picks up and I can start blowing thousands on getting my mouth sorted out.

Iwinder
reply to post by MystikMushroom

 

"A universal health care system like Canada wouldn't fly in America -- it's not affordable to do so. We can't extend coverage to everyone when a band-aid is $3.00.

Until we somehow stop these drug companies and medical device manufacturers from price gouging the US public, we will forever be stuck between a rock and a hard place. "

That is what I am trying to get at, I have spent many days in the hospital for a non treatable heat condition and our bills were zero/ nil/ zip.

I am talking invasive surgery and the whole lot......I do live in Canada and therefore pay sky high taxes for the privilege of not fearing the doctor nor the hospital.

I believe you are quite correct that if the R&D excuse is toasted the costs would come down dramatically for sure and all would be good.


Looking in from the outside at your health care system, correct me wherever as I am not American.

Regards, Iwinder

edit on 4-10-2013 by Iwinder because: (no reason given)

Right they need to control and lower health care cost, that should have been the main part of the entire package.