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Paula
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Registered: 1-5-2006
Location: Loreto
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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?
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Because we live in Montana, and don't fit in a pool there, my husband is currently paying $1900 per month for private insurance, and he has a $10,000
deductible. By taking the time to get through the early problems with the ACA website, he has purchased a better plan for just over $500 per month
with a smaller deductible and lower out-of-pocket.
The policies that are being lost due to Obamacare are unsound. 75% of bankruptcies in the US are due to medical expenses incurred by people who had
insurance. Something is wrong here, and Obamacare is a first step in fixing it. A single payer system would have been better, as private insurance
companies are in business to maximize profit, not to help people. They use immoral and inhumane practices to enrich executives and stockholders. We
would all be better off without them.
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bajaguy
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Location: Carson City, NV/Ensenada - Baja Country Club
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Medical Insurance
Medicare part A and Part B....total cost $104/month
United Healthcare Medicare supplemental plan "F", no deductable $132/month
Wellcare Medicare Plan D (RX), no deductable $44/month
Total........$280/month
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Barry A.
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Location: Redding, Northern CA
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| Quote: | Originally posted by bajaguy
Medicare part A and Part B....total cost $104/month
United Healthcare Medicare supplemental plan "F", no deductable $132/month
Wellcare Medicare Plan D (RX), no deductable $44/month
Total........$280/month |
(1) Are there any "co-pays"?
(2) Does this plan cover only you?
If not, then it is about what I am paying to cover my wife and me, and with my means-tested Medicare Part A & B being $210 a month more than you
have to pay.
Barry
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bajaguy
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Forgot to mention that I am not restricted to any geographical area, can go to any Dr or Hospital and most any pharmacy in the US
No co-pays, covers just me
| Quote: | Originally posted by Barry A.
| Quote: | Originally posted by bajaguy
Medicare part A and Part B....total cost $104/month
United Healthcare Medicare supplemental plan "F", no deductable $132/month
Wellcare Medicare Plan D (RX), no deductable $44/month
Total........$280/month |
(1) Are there any "co-pays"?
(2) Does this plan cover only you?
If not, then it is about what I am paying to cover my wife and me, and with my means-tested Medicare Part A & B being $210 a month more than you
have to pay.
Barry |
[Edited on 12-14-2013 by bajaguy]
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Barry A.
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Location: Redding, Northern CA
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| Quote: | Originally posted by oxxo
| 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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Oxxo-------great post, and I truly appreciate it. I have looked into Kaiser Permanente based on info from you many months (yrs?) ago on the same
subject. Unfortunately this is what I run into when I look into Kaiser for the Redding, CA Area-----
"Thank you for considering Kaiser Permanente. We currently do not offer health care coverage in your area. To find the coverage you need, please visit
your state's Health Insurance Marketplace."
I believe the nearest Kaiser plan-coverage is Sacramento, 180 miles to our south.
Our BLUE CROSS insurance costs us $444.12 a month in 2014----the rest of our Health Care premiums are for Medicare Parts A and B and currently are
$419 a month for the two of us, thus the total premium of $863 per month.
Thanks again for your help--------the Kaiser Plan looks great, I admit!!!
Barry
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oxxo
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| Quote: | Originally posted by Barry A.
"Thank you for considering Kaiser Permanente. We currently do not offer health care coverage in your area. To find the coverage you need, please visit
your state's Health Insurance Marketplace."
I believe the nearest Kaiser plan-coverage is Sacramento, 180 miles to our south. |
Barry, I forgot that we had discussed this before. I drink margaritas as a prophylactic for CRS but it appears that it is not helping and I probably
need to increase the dosage! 
Kaiser is the prototype of what a truly comprehensive, "single payer" health care program could look like here in the US. The ACA is just a first
baby step in that direction. The idea is low cost universal health care. I have talked to several doctors in the Kaiser system, both primary care
and specialists, and without exception they love it at Kaiser. They all say they make less at Kaiser than in their private practices, but they have
no overhead at Kaiser, less paperwork, no staff for which they are personally responsible and..........after three years at Kaiser they become
eligible for profit sharing and that puts their income about equal to private practice. Somehow Kaiser finds a way to make reasonable profits while
charging low premiums. Kaiser represents the best of American free enterprise system and a model for what the capitalism should look like.
| Quote: | | Our BLUE CROSS insurance costs us $444.12 a month in 2014----the rest of our Health Care premiums are for Medicare Parts A and B and currently are
$419 a month for the two of us, thus the total premium of $863 per month. |
Again, our total premium per month for both of us is $200 which includes primary care, specialists, vision, and medications - all with various copays.
Our total copays per year for everything including medications is much less that you spend for one month of premiums. For example, this month has
been a "high cost" month for my medications, they (four of them) came due at the same time. I will spend about $50 total in copays this month at the
Kaiser Pharmacy, but those meds will last me anywhere from 3 to 6 months. And by way of full disclosure, I can purchase some medications at Costco
for "retail" at a lower cost than my copay at Kaiser Pharmacy. It is my choice.
Here is a bonus! Kaiser covers me for medical emergencies (no pre-authorization required) while I live in Baja (or anywhere in the
world).......including air evacuation if required! I know, I already had it happen! Total reimbursement less a $50 copay with no questions asked.
Comprehensive health care in the US still has a long way to go but with the ACA we are on our way!
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durrelllrobert
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| Quote: | Originally posted by lencho
| Quote: | Originally posted by Pescador
I have opted to keep my Medicare coverage (part A and part B) in effect... |
What are the implications of
opting OUT of that after you've started?
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... |
www.ask.com/How+Does+Medicare+Work
In 2013, Medicare provided health insurance to over 50 million Americans, and between 15%-20% of them were not 65. Medicare is the
primary payer for between 20% and 25% of all United States healthcare expenditures. On average, Medicare covers about half of health care costs for
enrollees. Medicare enrollees must cover the rest of the cost. These out-of-pocket costs vary depending on the amount of health care a Medicare
enrollee needs. They might include uncovered services—such as long-term care, dental, hearing, and vision care—and supplemental insurance.[1]
__________________________________________________
... and the monthly premium (currently $104.90) is deducted from your social security benefit that was paid for by you and your employer as a payroll
tax.
NOTHING CAN BE FREE so the question is how is the Federal Government going to get reimbursed for the 80% subsidy that the ACA will provide to 17
million Americans? (hereandnow.wbur.org/2013/11/05/aca-tax-subsidy)
Using the Canadian universal healthcare system as a baseline (not really fair since each Province has there own plan, just as each US state should do)
the reimbursement will come in the form of major increases to all forms of Federal taxation, affecting all citizens, rich or poor.
Bob Durrell
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Barry A.
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Oxxo---------that is the most convincing post or argument I have yet seen. I just assumed you were on Medicare-----bad assumption. I have a very
Conservative Republican Doctor friend who has worked for Kaiser in the San Diego area for some time, and I believe he echo's everything you say if I
understand him correctly. He is my age (75), and is even able to work part-time with Kaiser now that he is older and wants more spare time.
Very interesting-------maybe there is hope for true Health Care reform using models like Kaiser. We will see.
Thanks again.
Barry
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Barry A.
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| Quote: | Originally posted by durrelllrobert
| Quote: | Originally posted by lencho
| Quote: | Originally posted by Pescador
I have opted to keep my Medicare coverage (part A and part B) in effect... |
What are the implications of
opting OUT of that after you've started?
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... |
www.ask.com/How+Does+Medicare+Work
In 2013, Medicare provided health insurance to over 50 million Americans, and between 15%-20% of them were not 65. Medicare is the
primary payer for between 20% and 25% of all United States healthcare expenditures. On average, Medicare covers about half of health care costs for
enrollees. Medicare enrollees must cover the rest of the cost. These out-of-pocket costs vary depending on the amount of health care a Medicare
enrollee needs. They might include uncovered services—such as long-term care, dental, hearing, and vision care—and supplemental insurance.[1]
__________________________________________________
... and the monthly premium (currently $104.90) is deducted from your social security benefit that was paid for by you and your employer as a payroll
tax.
NOTHING CAN BE FREE so the question is how is the Federal Government going to get reimbursed for the 80% subsidy that the ACA will provide to 17
million Americans? (hereandnow.wbur.org/2013/11/05/aca-tax-subsidy)
Using the Canadian universal healthcare system as a baseline (not really fair since each Province has there own plan, just as each US state should do)
the reimbursement will come in the form of major increases to all forms of Federal taxation, affecting all citizens, rich or poor.
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Just a brief comment----------keep in mind that Medicare premiums are "means-tested", and the premiums go up dramatically as your income
increases----------in our case it went up 100% monthly from what it was last year. I don't object to that, but it hit us by surprise as we had not
paid proper attention to the guidelines.
Barry
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durrelllrobert
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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 |
Auto
insurance requirements are determined by each state; not the Federal Government and the states do not force anyone to buy it unless they will be
driving on that states highways. South Dakota (and some other states?) does not even mandate that you have to be insured to drive on their roads.
Universal Health Care should also be managed by each state instead of a massive Federal agency and enforced by the IRS (more agents? That's just what
we need.)
Bob Durrell
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vgabndo
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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. |
How about my free choice, Fisher? How about my free choice to NOT pay for other peoples poor life decisions? A quick calculation just made it
possible for me to claim that I've paid right at $150,000.00 over the past 23 years for health insurance. A significant part of that treasure was
charged to me so that hospitals can go on treating other people for absolutely free. People with no insurance, Texas is a shining example, don't pay
their own way. I find it perplexing how often I hear these same people complaining about their taxes being used for welfare. In the end, in our
pre-ACA system, the many where paying more than their share for insurance, (from each according to his ability) making it possible for "hospitals" to
profit, and serve the uninsured. (to each according to his need.) A single payer national health insurance program like Congress has, you'll
remember, was rejected by the GOP as socialistic.
Undoubtedly, there are people who cannot afford to give the anchor of sanity even the slightest tug. Sam Harris
"The situation is far too dire for pessimism."
Bill Kauth
Carl Sagan said, "We are a way for the cosmos to know itself."
PEACE, LOVE AND FISH TACOS
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Barry A.
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I am not positive, Vag, but I don't believe that Congress has a "single payer system". My understanding is that they have the same system as all Fed.
Employees have, and there are many options and Insurance companies involved in the FED Healthcare system, and each member has a choice as to which
company they go with.
barry
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oxxo
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| Quote: | Originally posted by durrelllrobert
Universal Health Care should also be managed by each state instead of a massive Federal agency and enforced by the IRS (more agents? That's just what
we need.) |
Fine, but the States didn't do that, so Obama stepped in to fill the need. In fact about 15 States are still not cooperating with the ACA (all of
them Red States). So what would you say to them Robert Durrell?
How is the IRS involved in health care?
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tripledigitken
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| Quote: | Originally posted by oxxo
How is the IRS involved in health care? |
This should answer that question..
http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-fo...
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absinvestor
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OXXO- Wasn't sure about your comments about Kaiser loving it. My wife and I also have Kaiser. We have different Drs. Both our Dr's love Kaiser but
both think the ACA is a terrible idea. They believe that (not at Kaiser) but in general there will be a shortage of Dr's and hospitals. The ACA does
not effect us but we have children that lost plans that they liked and now are forced into the exchange at higher premiums and higher deductibles. The
administration may call the plans they had junk plans but the plans were what they wanted and what fit into their budgets. The ACA is good for some
but forced many that were happy with their coverage to change with higher premiums and higher deductibles. Had people known that they were losing the
plan that they liked (period!!) I doubt the bill would have passed. There is a reason our president's statement about being able to keep our Dr,
Hospital and Ins was voted the lie of the year.
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oxxo
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| Quote: | Originally posted by Barry A.
Oxxo---------that is the most convincing post or argument I have yet seen. I just assumed you were on Medicare-----bad assumption.
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Yes, Kaiser Senior Advantage program provides ALL my Medicare services. I don't deal with Medicare at all. Medicare takes about $100 out out of my
Soc Sec check and pays it to Kaiser. Kaiser provides my health care needs without further premium cost to me other than what they get from Medicare.
| Quote: | | have a very Conservative Republican Doctor friend who has worked for Kaiser in the San Diego area for some time, and I believe he echo's everything
you say if I understand him correctly. He is my age (75), and is even able to work part-time with Kaiser now that he is older and wants more spare
time. |
Exactly! My Kaiser primary care physician (in his 50's) works 40 hours per week by choice. He said in private practice he worked about 60 hours per
week. The Kaiser specialists I see are primarily part timers over 60. They work around 25 hours per week (it varies). They love their profession and
want to stay involved but as they age up they want to spend more time on golf, fishing, vacations, or just hanging out. And they say they love that
Kaiser profit sharing check coming in each month!
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Pescador
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| Quote: | Originally posted by oxxo
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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Oxxo, you are right that consumer reports and for the most part consumers are happy with a closed system HMO but that system is not for everyone. For
run of the mill general medicine, Kaiser has proven itself to run effeciently and effectively. But when you get into the truly complicated situations
that require the expertise of MD Anderson, Mayo Clinic, Cancer Centers of America, what you find is that there is another step above and beyond. For
the average person, that is an acceptable delivery and works very well, but in many cases (as my many years as a health insurance broder taught me),
it is impossible to say that it is the right solution for everyone. First of all, as Barry explained, there are serious areas of non-coverage for
geographic regions. If you choose to live in a city and metro area, it may well be a good alternative and I had many happy clients who went that
route, but in a major city in Northern Colorado they did not provide coverage at the major metropolitan hospitals and it is not very functional to
suggest driving 90 or more miles for doctor visits or hospital stays.
But after having reviewed the reimbursement rates that will be forthcoming under Obamacare , it may well turn out that a system which provides
slightly less technological advancement, may well become the highest technological treatment available. Time will tell.
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durrelllrobert
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How is the IRS involved in health care?
| Quote: | Originally posted by oxxo
| Quote: | Originally posted by durrelllrobert
Universal Health Care should also be managed by each state instead of a massive Federal agency and enforced by the IRS (more agents? That's just what
we need.) |
Fine, but the States didn't do that, so Obama stepped in to fill the need. In fact about 15 States are still not cooperating with the ACA (all of
them Red States). So what would you say to them Robert Durrell?
How is the IRS involved in health care? |
"Tax provisions included in the Affordable Care Act represent the largest set of tax law changes the IRS has had to implement in more than 20 years,"
the Treasury Inspector General for Tax Administration noted in a recent report.
The ACA has some 500 provisions, and more than 40 amend or add provisions to the tax code, according to the report. It also adds considerably to the
agency's administrative workload.
Among the IRS' biggest tasks will be to:
Collect information from employers and insurers: The ACA requires employers to tell the IRS whether an employee has insurance. Companies with at least
50 full-time employees must also indicate whether they offer "minimum essential coverage" under ACA standards.
At the end of the year, insurers must provide the IRS and policyholders a form verifying coverage status, and individuals must include those forms
with their federal tax return.
While the tax agency will have information on someone's coverage status for compliance purposes, it will not be given personal health information.
Figure out who qualifies for subsidies or Medicaid: The ACA will provide federal subsidies known as premium tax credits to help millions of people pay
for insurance. But to qualify, individuals and families must meet income requirements and buy their insurance on the newly created insurance
exchanges.
When a person applies for coverage on an exchange, the information he provides will be cross-checked with income, job and coverage information from
the IRS. That cross-check will determine whether someone is eligible for a premium credit, or if he's eligible for Medicaid, which the ACA expanded.
While the IRS is authorized to share income and other data with the exchanges and some federal and state agencies, those third parties may only use
that information for determining eligibility for coverage and subsidies, according to the TIGTA report.
Determine who must pay a penalty: Starting in 2014, individuals must buy qualified health insurance or pay a penalty. Some groups are exempt from the
new rule, including those whose income is so low that they're not required to file a tax return.
The IRS must assess who owes a penalty.
__________________________________________________
As for the states being mandated to provide an acceptable health insurance plan for all THEIR citizens the Federal Government has the responsibility
to require same, just as the Canadian Government has done with all their Provinces. The health insurance needs and costs for persons living in North
Dakota ARE NOT the same as for those in New York.
For instance people living in oil rich Alberta Province pay absolutely zero monthly premium while those in neighboring, wheat growing Saskatchewan pay
according to income but both provide the same health coverage. Each hospital, doctors office, clinic and medical center is privately owned and bills
the Government a negotiated amount for each service provided. The government in turn uses tax revenues to reimburse those facilities.
Bob Durrell
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Cypress
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Jeez! Just try to stay healthy and hope my present insurance doesn't drop me. Will the IRS audit me for this post?
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Bajaboy
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| Quote: | Originally posted by vgabndo
| 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. |
How about my free choice, Fisher? How about my free choice to NOT pay for other peoples poor life decisions? A quick calculation just made it
possible for me to claim that I've paid right at $150,000.00 over the past 23 years for health insurance. A significant part of that treasure was
charged to me so that hospitals can go on treating other people for absolutely free. People with no insurance, Texas is a shining example, don't pay
their own way. I find it perplexing how often I hear these same people complaining about their taxes being used for welfare. In the end, in our
pre-ACA system, the many where paying more than their share for insurance, (from each according to his ability) making it possible for "hospitals" to
profit, and serve the uninsured. (to each according to his need.) A single payer national health insurance program like Congress has, you'll
remember, was rejected by the GOP as socialistic. |
Yeah, what he said
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