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The Affordable Care Act


Just Plain Ruff

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KEEP THIS CIVIL

Ok, now that the website is sort of up and running, and the state exchanges are up and running for signups-

What has your experience been with insurance?

Have you received the dreaded cancellation notice?

Have you been able to sign up?

Have you seen a increase or decrease in your premium?

How bout a increase or decrease in your deductible or out of pocket?

If your company offers insurance have they said whether or not your insurance is grandfathered in and OK or not?

Just curious.

Ruff


My insurance will remain the same next year - no real changes.

According to a piece in the Investors business daily today, the real change for employer provided plans will happen next year over a period of many months when the employer plans that you are covered under will begin to be looked at under the ACA microscope and many will be cancelled or forced to change.

If your plan is self funded (employer self funded) those are already being looked at from what I understand and they are really being targeted. So be ready to be told your coverage is going to be cancelled.

But for now, my coverage at my employer is good to go.

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I know I am in a bit of a different situation than most. I am a partner in my group and we pay the full premium for our policy (which is a PPO). It's up a little bit next year, but it is the normal year-over-year increase, nothing out of the ordinary. The copays and deductibles are staying the same. Our HR department looked at a similarly priced plan on the exchange and it has deductibles that are almost double what we have right now. We also have an HSA/HDHP option which I am looking at. I have not personally tried to sign up for the exchange.

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My premiums will increase 20%, co-pays to increase by 10% and some prescriptions will not be covered. I have not been able to really look at alternative pans (ACA), but will likely not qualify for a cheaper plan...

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We recently had a presentation from our American colleagues on the ACA and changes to HIPAA

It went something like this

"So has anybody ever worked or lived in US?"
*Kiwi raises hand

"Oh, so you would have dealt with insurance?"
"No, it was easier not to get sick"
"What do you mean?"
"Exactly that, it was just easier not to get sick"

She was a bit confused, poor thing.

Most of my friends in US are having changes to their premium, some go up, some go down, some get a small refund check because of the 80:20 thing but most people I know still have deductibles of like $5,000 or more, one of my friends' deductible is $10,000. How can you expect an average person to pony up ten grand? WTF?

Edited by Kiwiology
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Currently my Union is keeping the same insurance we currently have. We have been told no changes will occur for the foreseeable future. Hopefully this is true and I don't get a surprise.

With a kid on the way it's a bad time to have the uncertainty :(

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A little more on my insurance.

I have a deductible but I'm not completely sure what that number is because if I use my in network providers(and there is no in-network provider that is not more than 30 minutes from my house) then I do not have to touch my deductible. I only touch my deductible if I go out of network.

It's the University of Maryland Medical System health plan and every one of their doctors that work or are associated with the hospital are on the plan.

So I just pay a co-pay of 15-30 dollars and the rest of the visit no matter how much it costs is covered.

I am slated to go through the bariatric surgery in about 9 months from now and if I do all that is required of me then the insurance will pay for the entire thing and I'm only left with the copay of 100.00

I pay 250 a pay period for this insurance. My out of pocket is 10000 but as long as I stay in network I won't have to meet that either. It's only when I go out of network that I start to have to pay the deductible and the out of pocket.

to say that we are happy with the insurance is an understatement but I'm very worried about when the employer mandate kicks in which it will in the next year or so. From all that I'm reading, no employer plan is safe. But For every one article that says that your employer plan is safe under the employer mandate, there are two articles that say that your employer plan will not be safe.

Only time will tell.

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Richard, they say they have an alternative but I would bet my removed stomach after the bariatric surgery that they don't have a damn thing to replace it with and they want to go back to status quo pre-ACA.

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You are probably right Ruff. Let's also not forget that none of this is about healthcare reform and is all about health insurance reform. The only effect it will have on healthcare is that we will be required to do more and get paid less. I don't think any of it will truly change anything until you start putting some of the responsibility on patients and not just the providers/employers/insurers. (I can't believe I just stuck up for insurers there, I feel sick to my stomach).

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