Politics Obamacare

I honestly don't know. I live in the Metro area and use Kaiser - so they have to take me if I go.

I guess it's possible that a local doctor might not take certain insurance (for example, since I signed up with Kaiser, I have to use their doctors) but I know that Blue Cross and Humana are also options in the Peach State - I have not heard of anyone running into issues of doctors saying No because it's from the marketplace. But I guess it's possible for a doctor to not take certain "brands" of insurance. But to not take BCBS or Humana seems like it would really inhibit number of clients a doctor would have. Maybe someone can elaborate on this better than I.

 

Ralphie

When you signed up for a plan, it is with a private insurance company. The company should provide you with a detailed list of benefits, coverages, co-pays and any exclusions in a clear and user friendly way. (nothing hidden in small print). Depend on the level plan you selected (gold, sliver, bronze) those benefits and co-pays will vary. It will vary by type of plan, HMO,/PPO but as Red noted, the big insureres, United Health, Blue Cross/Blue Shield/Humana, etc have a wide network of physicians.

The concept of driving down the cost for individuals is based on insurance pooling principles. The ACA insurance exchanges create large groups or pools of individuals. The larger the pool, the more the risk is spread so that healthy people who never go to the doctor offset those who have serious illness and go to the doctor (or doctors) frequently.

I dont know if that makes sense. An insurance guy can explain it better.
--- merged: Apr 16, 2014 at 1:08 PM ---
This is the type of detailed Summary of Benefits form that insurers are now required by law to provide.

http://www.dol.gov/ebsa/pdf/CorrectedSampleCompletedSBC2.pdf

 

The ACA isn't one program that everybody is locked into.
It's different for each state, unfortunately since some governors are being assholes.
If you are poor you qualify for medicare or get subsides for medical insurance.
The medical is like most insurance they have doctors and hospitals in their group and you would have to get permission (or pay out of pocket) to use someone out of the group.
The insurance you get is going to to apply to the area you live in.

 

if more people sign up for it will it drive the cost down?
if more people that have never had insurance use it and are terminal will it drive cost up?
if people pay a months premium and have a high dollar procedure done and back out of plan will it drive cost up?

 

There will be millions of new consumers using health plans this year as a result of the ACA and insurance companies had to determine premium rates in advance not knowing if these people are young or old, health or sick, etc. so they are taking a risk.

This article explains how provisions in the law will help if the insurance companies' rates did not reflect what the consumers health costs will be this year.

Where is our insurance guy when we need him?

 

why in the hell can they charge me more than someine 10 years younger? cause im older and more likely to have health issues? thats bs

 

All I currently know is I have to reach a 6K deductable before my health insurance company starts paying the healthcare provider(s). By the time I spend 6K in one year chances are good I'll be so broke I won't have the money to continue to pay the monthly premiums.

"Dr., is there any way that you could admit me to the hospital?"
"The tests are pretty simple, Mr. Noyb, a hospital stay isn't necessary."
"The situation is, Dr., reaching my deductable and paying the premiums has caused me start living in my car. Thankfully the car is paid for, and I'm lucky that I didn't have to sell it."
"I'm seeing that more and more often. Even if I send you to the hospital, the chances are very good they won't admit you, the insurances companies have really cracked down."

 

Before the ACA, older people were paying premiums as much as five times as much as younger people. The max now is three times as much, depending on your health history. Assuming you are old (over 50>) and relatively healthy, even though you will be paying more than younger people, your premiums should be lower than before the law because of the fact that you are in a pool with all those younger, healthier people.
--- merged: Apr 16, 2014 at 5:13 PM ---
This is a good article on age rating. Before the ACA, 42 states had age rating bands of 5:1 or more. Now the max is 3:1

 

why cant everyone pay the same? wouldnt that be the definition of aca?

 

That would make sense (or at least have a sliding scale based on income like taxes) unfortunately in order to get the bill passed they had to kowtow to the Republicans and the insurance companies.
It would also be nice if everybody had the same blanket coverage but you know that would go over like a lead balloon.

 

ok, i must be an idiot because if you tax people for not having insurance or you make them pay higher or high premiums, how if that fair? the government (obama) is making we the people pay for something that we dont want (in some peoples cases) and making money off of it, why dosent the taxed people that dont have it pay the tax to the insurance companies instead of the government?
just dosent seem fair to MAKE people have something. i know we need it but some people dont want it and i know that drives up the cost at the hospitls and places but its like rape, right or wrong??

 

As RedRavin posted, it was a political compromise. It's too late to completely overhaul the US healthcare system (well, it could be done, but not likely when you consider that politicians want to get re-elected). I don't understand the Republicans whining & bitching, they were the ones who demanded & agreed to the compromises.

 

Sorry man, I don't mean to pick on you but can we stop using rape except when we're talking about rape?
For me it's kind of like using the word Nazi when describing anybody other than Nazis.

As to the tax on people who don't get insurance, it's not my idea of a good plan.
It was actually a Republican plan way back when.
It wasn't until the POTUS said he liked it that they decided they didn't.
Universal coverage would solve that problem but that's socialism doncha know.

So yes, people who decide they are indestructible, can't be bothered, or for political reasons won't get insurance will cost everybody if they get hurt.

 

its all good, my bad.




forgive me for my ignorance, but i thought the democrats wanted obamacare

 

yes that makes since,

dosent canada have a national healthcare plan for everyone?

 

Americans might still not like the ACA, but they trust Republicans on health care even less.