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Mula
Super Nomad
Posts: 1653
Registered: 8-16-2011
Location: San Nicolas y Lopez Mateos
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ACA - Obamacare?
Just wondering how other expats are thinking about the pending Obamacare coverage?
We are out of the US 330 days a year and have Seguro Popular here which we are happy with and have no immediate intention of returning to live in the
US.
I have found this from the Surviving the Yucatan board:
http://yucalandia.com/living-in-yucatan-mexico/aca-obamacare...
Any comments?
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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That was a good report with some good information. We know that the availability of services is for those under medicare is going to diminish,
especially when the reimbursement rates continue to go down. The much touted savings of 758 billion in Medicare can easily be translated into less
money for the doctors and hospitals who accept Medicare patients. Already there have been reports of up to 40% of hospitals and doctors who are
giving up seeing Medicare patients because of lowering reimbursement rates. It gets worse as you go to lower reimbursement rates of Medicaid and
MediCal. During the transition, I have opted to keep my Medicare coverage (part A and part B) in effect and have opted to carry a Medicare supplement
(High F) with Blue Cross and Blue Shield which gives me a yearly deductible of $2,000 for my supplement. For that I only pay somewhere in the
neighborhood of $39 a month. ( I am sure that will go up)
So for Mexico, I carry Seguros Popular for the small stuff and am well aware of the limitations of trying to get any services out of that program.
Same kind of social medicine program. Lets get everyone signed up so that politically we can say we cover everyone in Mexico, but we do not have
enough money to pay any of the doctors or provide any real dent in prescriptions. I can get in to see a doctor but usually don't choose to wait for 3
or 4 hours in the waiting room of our local facility. So, instead, I pay a private doctor when I need something and find the rates and treatment more
than satisfactory. One of the expats in our small village had a bladder reconstruction done by the same doc and it was less than it would have been
to pay the deductible in the US.
I have several good friends who are specialists in the medical field in Tijuana and they claim that they are gearing up to accept more and more
Norteamericanos for treatments and surgeries that they see as more difficult to obtain in the US with the new Obamacare taking over. While it is
certainly too early to tell how that will work out, it is true, historically, that when a vacuum is created in one area, someone will figure out a way
to provide a needed service in another area.
An example of this is that they are closing down the Shriner's hospital in Los Angeles because it has become prohibitively expensive to operate in the
US. By moving the facility to Tijuana under the direction of my friend who is a renowed Childrens Orthopaedic Surgeon, they are able to service a
much larger population of children with the same level of service at a significantly lower cost.
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Bajajorge
Ultra Nomad
Posts: 2604
Registered: 10-13-2005
Location: Topaz Lake, NV/San Felipe
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I'd answer about Obamacare, but it would probably be sent over to the "Off Topic" forum.
 IMO
Why do Liberals insist and demand that achievers pay the way for nonachievers who are to lazy to succeed, or are just failures by their own choice?
Criminals prefer unarmed victims, dictators prefer unarmed subjects.
Why do ignorant people continue their blabbering when it only proves to others how stupid they are.
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dasubergeek
Senior Nomad
Posts: 694
Registered: 8-17-2013
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Wow. I hadn't thought about that... and what crap. If you've got Seguro Popular, that ought to count—and the US government has exactly f@$#-all to say
about foreign plans' worthiness.
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apple
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Posts: 284
Registered: 11-4-2013
Location: SD
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If you don't live in the USA for most of the year, you are exempt from the minuscule penalty for not having health insurance.
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sequoyah
Junior Nomad
Posts: 98
Registered: 11-13-2013
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I am a supporter of the ACA
which, based on some of the replies here, seems like it may be an unpopular position.
I have purchased insurance through the exchange and now have coverage for the first time in 8 years.
I realize that I probably can't use it outside of the US except in an emergency, but I plan to establish my medical care in the US and travel there
when I need to.
The penalty is not an issue - it's small and I want the insurance anyway, but the yucalandia article linked above appears accurate and comprehensive
in terms of ex-pats who are out of the country over 330 days a year or have established residency elsewhere.
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Ateo
Elite Nomad
Posts: 5847
Registered: 7-18-2011
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My current policy is being cancelled. My new one will be $300 more. I still support the idea of universal healthcare.
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oxxo
Super Nomad
Posts: 2137
Registered: 5-17-2006
Location: Wherever I am, I'm there
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Mood: If I was feeling any better, I'd be twins!
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| Quote: | Originally posted by Ateo
My current policy is being cancelled. My new one will be $300 more. |
Is that $300 more per month or per year? Does that $300 include increased coverage that was not included in your cancelled policy, which probably did
not include the new minimum coverage standards.
| Quote: | | I still support the idea of universal healthcare. |
I support universal healthcare too, like my Kaiser Senior Advantage plan. Instead President Obama floated the Republican version of health care
reform to try to get consensus, which is better than nothing, but a far cry from perfect.
My Kaiser Senior Advantage plan premium ($100 per month comes out of my Soc Sec check) remains the same for 2014. Some co-pays have gone up for 2014
while others have gone down, so it comes out a wash. Kaiser has also included several new, no cost preventive care services for 2014.
I am willing to have my premiums increase if it means that fewer of my tax dollars are spent in the emergency room on the uninsured. Presently, about
one million people who previously had no coverage have signed up with the ACA.
[Edited on 12-13-2013 by oxxo]
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Ateo
Elite Nomad
Posts: 5847
Registered: 7-18-2011
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| Quote: | Originally posted by oxxo
| Quote: | Originally posted by Ateo
My current policy is being cancelled. My new one will be $300 more. |
Is that $300 more per month or per year? Does that $300 include increased coverage that was not included in your cancelled policy, which probably did
not include the new minimum coverage standards.
| Quote: | | I still support the idea of universal healthcare. |
I support universal healthcare too, like my Kaiser Senior Advantage plan. Instead President Obama floated the Republican version of health care
reform to try to get consensus, which is better than nothing, but a far cry from perfect.
My Kaiser Senior Advantage plan premium ($100 per month comes out of my Soc Sec check) remains the same for 2014. Some co-pays have gone up for 2014
while others have gone down, so it comes out a wash. Kaiser has also included several new, no cost preventive care services for 2014.
I am willing to have my premiums increase if it means that fewer of my tax dollars are spent in the emergency room on the uninsured. Presently, about
one million people who previously had no coverage have signed up with the ACA.
[Edited on 12-13-2013 by oxxo] |
$300 more each month. I'll let you know more once I take a look at the papers.
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tripledigitken
Ultra Nomad
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Registered: 9-27-2006
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Ateo,
Was there any change to the deductable as well?
Ken
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danaeb
Senior Nomad
Posts: 991
Registered: 11-13-2006
Location: San Diego; El Centenario
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Mood: groovy
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| Quote: | Originally posted by lencho
For what it's worth, I saw something that made me question whether the ACA exchanges will accept someone over 65, so my guess is that
is not an alternative to Medicare... |
You are correct. The ACA is for the currently uninsured, or for those whose current insurance does not meet the ACA minimum requirements.
Experience enables you to recognize a mistake every time you repeat it.
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Barry A.
Select Nomad
Posts: 10007
Registered: 11-30-2003
Location: Redding, Northern CA
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Not sure if this is appropriate to this thread, but for comparison I offer the following--------??
I live in the USA.
My wife and I are on Medicare Parts A & B, and as a Retired Fed. Employee I have my FEHB (fed emp health benefit) Blue Cross/Blue Shield Health
Insurance secondary to Medicare, and it covers both my wife and myself.
Our total 2014 monthly premiums for both my wife and I ---Part B Medicare -----equals $419.60 / mo.
Our total monthly premium for my 2014 FEHB Blue Cross for the two of us equals $444.12. (no vision or dental ins. included)
Total monthly premiums = $863.72
There are no "co-pays" so pay nothing additional when visiting a doctor. (we pay only premiums)
The only deductable we pay (as near as I can figure) is $147 per year for Medicare Part B (a strange amount???)
The Medicare Part B premium IS means-tested based on income, and is higher than normal (like twice the normal amount) for both my wife and I.
Barry
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wessongroup
Platinum Nomad
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Mood: Suicide Hot line ... please hold
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About the same here Barry, we have dental and vision ... but, we both got a decease in SS ..  
[Edited on 12-13-2013 by wessongroup]
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oxxo
Super Nomad
Posts: 2137
Registered: 5-17-2006
Location: Wherever I am, I'm there
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Mood: If I was feeling any better, I'd be twins!
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| Quote: | Originally posted by wessongroup
but, we both got a decease in SS ..
[Edited on 12-13-2013 by wessongroup] |
That's odd! I just got a notice yesterday that I am getting a $25 per month increase in Soc Sec. (with no increase in my $100 per month contribution
to Kaiser Senior Advantage). I guess it depends on how you are registered to vote!
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oxxo
Super Nomad
Posts: 2137
Registered: 5-17-2006
Location: Wherever I am, I'm there
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| Quote: | Originally posted by Barry A.
Our total 2014 monthly premiums for both my wife and I ---Part B Medicare -----equals $419.60 / mo.
Our total monthly premium for my 2014 FEHB Blue Cross for the two of us equals $444.12. (no vision or dental ins. included)
Total monthly premiums = $863.72
There are no "co-pays" so pay nothing additional when visiting a doctor. (we pay only premiums)
The only deductable we pay (as near as I can figure) is $147 per year for Medicare Part B (a strange amount???) |
Barry, Blue Cross does not fare well when compared to a progressive company like Kaiser. Check the Consumer Reports ratings for a start. I realize
that you think that Blue Cross is a "free" benefit of your Federal employment, but you do have other options since Kaiser is offered in NorCal.
However, I think that Kaiser has closed the open enrollment until November of next year.
Our Kaiser Senior Advantage plan does include vision but not dental. We could include dental at an extra cost, but it is not worth it to us. We take
good care of our teeth on a daily basis. Blue Cross appears to be a high cost method of insurance coverage for those over 65 (and that includes
AARP's United Healthcare too) when compared to Kaiser. Kaiser is rated first by Consumers Reports.
Yes, we do have co-pays with Kaiser that you don't have but we do not have $663 of co-pays per month (your $863 versus our $200 per month for
everything but dental for two premiums). Our co-pays for two of us (annual mammograms were just added as a no cost service by Kaiser/wife loves
Kaiser even more than I do) total less than $200 per YEAR!!!!!!!!!!. Doctors visits are $15 co-pay. We have an excellent Kaiser primary care
physician....he even speaks Spanish if I insist! We had a choice of about 20 different Kaiser primary care physicians to pick from. We made a good
choice. In fact my Kaiser ENT specialist ($15 co-pay per visit once a year) is originally from your area, Redding. He threw in the towel of private
practice a few years ago and is making more money with Kaiser. He is a believer.
Barry you need to do your "due diligence" and compare your program to others that are offered in your area. I think you can save a lot of money.
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BornFisher
Super Nomad
Posts: 2103
Registered: 1-11-2005
Location: K-38 Santa Martha/Encinitas
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Ateo--$300 more per month? That is money you could use for your children`s education, your college funds. Our President said you will save $2,400 per
year. He also said you will get more coverage, and pay less. I guess it all makes sense in some imagined World, but in real life, that just won`t
happen. But what`s really horrible to me is you will be forced to buy something you would choose not to buy. What`s next?
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Bajaboy
Ultra Nomad
Posts: 4375
Registered: 10-9-2003
Location: Bahia Asuncion, BCS, Mexico
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| Quote: | Originally posted by BornFisher
Ateo--$300 more per month? That is money you could use for your children`s education, your college funds. Our President said you will save $2,400 per
year. He also said you will get more coverage, and pay less. I guess it all makes sense in some imagined World, but in real life, that just won`t
happen. But what`s really horrible to me is you will be forced to buy something you would choose not to buy. What`s next? |
Yeah, imagine if we didn't require people to buy auto insurance Think of all
the money people would save
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BornFisher
Super Nomad
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Registered: 1-11-2005
Location: K-38 Santa Martha/Encinitas
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| Quote: | Originally posted by Bajaboy
| Quote: | Originally posted by BornFisher
Ateo--$300 more per month? That is money you could use for your children`s education, your college funds. Our President said you will save $2,400 per
year. He also said you will get more coverage, and pay less. I guess it all makes sense in some imagined World, but in real life, that just won`t
happen. But what`s really horrible to me is you will be forced to buy something you would choose not to buy. What`s next? |
Yeah, imagine if we didn't require people to buy auto insurance Think of all
the money people would save |
OK help me out here. So are you saying if you chose not to have an automobile, you still are required to buy auto insurance?
Let me help you out--- when you buy a car, you have to buy insurance. If you are just born and exist in this country, and choose not to buy a car, you
do not have to buy auto insurance.
With the ACA, if you are born here and exist, you HAVE to buy health care insurance. What ever happened to free choice??
Bottom line-- You can choose to buy a vehicle. When you do, you have to also buy insurance. You choose if you can afford both or not.
Now, all people are forced to buy health insurance or pay a fine ($600 by 2016). There`s a huge difference.
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oxxo
Super Nomad
Posts: 2137
Registered: 5-17-2006
Location: Wherever I am, I'm there
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Mood: If I was feeling any better, I'd be twins!
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| Quote: | Originally posted by BornFisher
With the ACA, if you are born here and exist, you HAVE to buy health care insurance. What ever happened to free choice?? |
The free choice is if you don't have insurance and you get sick, then the taxpayer has to pay for your care. Some "free choice." No thanks.
Yes, if you are born here and exist you are now required to get insurance rather than expecting the tax payer to pay for your health care. Whatever
happened to individual responsibility? The US is one of the last developed nations to require health care for its citizens. It makes me proud to be
American.
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Bajaboy
Ultra Nomad
Posts: 4375
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| Quote: | Originally posted by BornFisher
| Quote: | Originally posted by Bajaboy
| Quote: | Originally posted by BornFisher
Ateo--$300 more per month? That is money you could use for your children`s education, your college funds. Our President said you will save $2,400 per
year. He also said you will get more coverage, and pay less. I guess it all makes sense in some imagined World, but in real life, that just won`t
happen. But what`s really horrible to me is you will be forced to buy something you would choose not to buy. What`s next? |
Yeah, imagine if we didn't require people to buy auto insurance Think of all
the money people would save |
OK help me out here. So are you saying if you chose not to have an automobile, you still are required to buy auto insurance?
Let me help you out--- when you buy a car, you have to buy insurance. If you are just born and exist in this country, and choose not to buy a car, you
do not have to buy auto insurance.
With the ACA, if you are born here and exist, you HAVE to buy health care insurance. What ever happened to free choice??
Bottom line-- You can choose to buy a vehicle. When you do, you have to also buy insurance. You choose if you can afford both or not.
Now, all people are forced to buy health insurance or pay a fine ($600 by 2016). There`s a huge difference. |
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