Insurance nightmare

amother

Lime

Tue, Oct 19 2021, 8:03 pm

amother [ Salmon ] wrote:

We are all healthy bh don't use doctors often. Paying 1k plus a month so that you can have the privilege to pay for 3rd class medical care out of pocket when you need it is a tax. It eats up all your disposable income. The people in this income braxket pay their fair share in taxes already. There is a reason op is complaining. This Obamacare business is just plain evil.

Insurances are evil. They are a billion profit industry whose job it is to deny healthcare and also make you pay more than your share to cover their own costs.

No politician can cut into their profits and survive because they pay for their election campaigns. It’s not Obama’s fault that the entire system is corrupt. If his original plan had been accepted, we would have likely gotten a better deal.

Everyone not on Medicaid pays astronomical sums, even before Obama showed up.

thunderstorm

Tue, Oct 19 2021, 8:05 pm

OP I’m with you. I too just went off of Fidelis onto my employer’s health insurance and it’s been a disaster since. Today alone I received $2500 in medical bills. We have a deductible that will start again in January even though I’ve been signed up since August. I almost reached my deductible with all my bills and now it’s pointless because it will all be starting again. My specialists I’ve been going to for years don’t accept my insurance, neither does the frum pharmacy I always used. I’ve been paying out of pocket for so many things , plus a huge chunk gets taken out of my paycheck , and I feel like we are too poor to pay these bills but can’t meet the Fidelis requirements unless we remain in poverty. It’s crazy. My DH and I have been kvetching about this the last two days, after receiving these bills.

amother

Azalea

Tue, Oct 19 2021, 9:03 pm

amother [ Lime ] wrote:

I’m sorry, is your question why is healthcare so expensive when you’re not on Medicaid? Yes, duh. This is what everyone has been saying for over a decade and the reason why Obama tried so hard to push through some semblance of reform.

I mean, welcome to America? Where you work so hard and all of it goes to taxes and healthcare and crazy tuitions and an astronomical mortgage.

Obama made it worse for us, my parents and so many others I know. Our good plans are gone. We pay more per month, more per visit, more copays, more coinsurance, higher deductible...
Nope, not a huge fan. Huge costs for me plus Obamacare was about redistribution of wealth and a path towards socialism/government healthcare. And when the government controls the healthcare they get to decide a lot about our lives. Alta Fixler, Charlie Gard etc scenarios, elder care/end of life issues, who deserves care to begin with...

amother

Azalea

Tue, Oct 19 2021, 9:12 pm

amother [ OP ] wrote:

K I’m just going to edit here and calm my hysterics- I will Iyh be able to afford life. Bh Bh. But we want to buy a house, I want to go on vacation at some point maybe, I want to be able to buy a new Shaitel (mine is over a decade old). Maybe go out for our anniversary. I want to feel like I don’t have to hesitate before taking my kid to the doctor and that medical expenses aren’t a huge percent of our spending.

Between that, paying off student debt and our increased tuition our actual budget is staying at the student spending level (aka tight). Just with a husband that’s never home.

So you want to buy a house, get a new sheitel, go on vacation.... while I and other working moms pay for your vacation? Because we would be paying for Medicaid so that you can do all that. Nice. Very nice.
Meanwhile I would love to live in a bigger place (we dont own either), go on vacation ever (none since I got married 9+ years ago)... or even stay home with my kids or cut back on hours!!

but I cant because I work full time to pay for my own healthcare coverage and not take government welfare.

amother

Clover

Tue, Oct 19 2021, 9:20 pm

Healthcare is a nightmare. It’s our biggest cost along with mortgage. Costs about 25k a year usually and that’s not counting out of pocket therapy.

I have a loose leaf full of bills we slowly paying off all the coinsurance deductibles and copays on even as I struggle to pay for my crazy premiums.

This is the way life is. It’s not fair, but at least I can reassure you that you are not alone.

The only thing that can ease it is getting a job where they pay some of your premium as a benefit.

I remember being SO JEALOUS of my friend who cut her hours to keep her Jersey care while I was looking for ways to work more hours to afford to pay for my insurance and watching her get new lenses for free while I had no money left to do so…. It’s hard!!!

I can only imagine the transition between subsidized care and paying yourself is very difficult. Hugs.

amother

Carnation

Tue, Oct 19 2021, 9:27 pm

[quote="amother [ Lime ]"]Insurances are evil. They are a billion profit industry whose job it is to deny healthcare and also make you pay more than your share to cover their own costs.

No politician can cut into their profits and survive because they pay for their election campaigns. It’s not Obama’s fault that the entire system is corrupt. If his original plan had been accepted, we would have likely gotten a better deal.

Everyone not on Medicaid pays astronomical sums, even before Obama showed up.[/quot

Not so. My husband and I have been paying for our own insurance for many many years. Nothing was ever cheap but nothing like we are paying now and we had plenty of choices of plans. We could actually PAY for a good plan with a wide network of doctors. We could choose to pay for a plan that did not require referrals. We could choose to pay for a plan that would cover us out of NY state. We could choose to pay for a plan that had out of network coverage. We could choose to pay for a plan with no, with low, or with high deductible (which used to be called catastrophic insurance). Thanks to Obama, we have only one choice : Exorbitantly expensive garbage catastrophic insurance that hardly any doctors will take, requiring referrals and not covering us should we step outside NY. My husband is a successful professional and I have a thriving business that greatly serves our community BH. But every year since ObamaCare the insurance situation has beet getting worse and worse for small business owners like us. Each year since we have lost more and more value in our insurance coverage. At this point we are worse off than illegal aliens because we have to actually pay for the dregs of medical care we are apportioned. The waiting room of the clinic I am forced to go to looks like a third world country. I sit there with the illegal cleaning help and grocery packers. My doctor's medical license is from Costa Rica. It was NEVER like this.

amother

Tue, Oct 19 2021, 9:29 pm

amother [ Azalea ] wrote:

I’m not sure where this is coming from? Maybe deal with your anger, the same way I’m dealing with mine (get your own thread maybe lol).

I guess we all see what we want or I wasn’t clear- I work full time as well... just don’t make enough to have bumped us off medicaid.

My husband was a student till recently (was doing TA work part time as well).

We definitely aren’t moochers. I’d be fine paying for healthcare but I need to atleast get quality care! Equivalent to welfare.

amother

Carnation

Tue, Oct 19 2021, 9:35 pm

amother [ OP ] wrote:

Medicaid is called the "gold card" for a reason. When my son turned 19 I took him out of my household and put him on Medicaid. Even his dental is free Never had a problem getting him great doctors BH. Losing his tax credit cost me $3000. I wish I could pay $3000 for such good insurance.

amother

Violet

Tue, Oct 19 2021, 10:04 pm

You do realize that NY is almost unique in having Medicaid that actually provides excellent coverage. In most areas, if it is even available, almost no medical providers actually accept it. So those of you who hate the "progressives" are reaping the benefits of living in a progressive state. Medicaid in most of the red states is a joke and wasn't expanded so almost no one qualifies.

Regarding insurance rates, prior to Obamacare unless you got insurance through a large corporation, you were pretty much out of luck because you would not be able to get coverage for ANY pre-existing coverage or you would be charged an extremely high surcharge.

Insurance premiums were relatively affordable when you were in your 30's but they escalated rapidly as you hit your 40's - if you could even get insurance since many people by the time they are 40 have some minor health issues such as high blood pressure or Type 2 diabetes even if they are well controlled. Any kind of mental issues such as depression would make you uninsurable.

Women would pay higher rates than men and even higher rates for plans that covered pregnancy. You know how REALLY hates ACA are men because they hate paying for pregnancies.

With the Affordable Care Act you are guaranteed coverage and everyone in the same age range pays the same rate.

There were efforts to make ACA more affordable in terms of premium subsidies but politics made it impossible to pass any kind of amendments that would do it. Hell they weren't even able to negotiate drug prices for Medicare.

You know what plan people in the US really love - Straight Medicare. With a good Medigap plan, no deductibles; no co-payments and almost every medical provider accepts it. They tried to get people above 55 able to purchase Medicare but it would't pass. They even tried to enable people to buy the same coverage that Federal employees have but it wouldn't pass.

amother

Carnation

Tue, Oct 19 2021, 10:25 pm

[quote="amother [ Violet ]"]You do realize that NY is almost unique in having Medicaid that actually provides excellent coverage. In most areas, if it is even available, almost no medical providers actually accept it. So those of you who hate the "progressives" are reaping the benefits of living in a progressive state. Medicaid in most of the red states is a joke and wasn't expanded so almost no one qualifies.

Regarding insurance rates, prior to Obamacare unless you got insurance through a large corporation, you were pretty much out of luck because you would not be able to get coverage for ANY pre-existing coverage or you would be charged an extremely high surcharge.

Insurance premiums were relatively affordable when you were in your 30's but they escalated rapidly as you hit your 40's - if you could even get insurance since many people by the time they are 40 have some minor health issues such as high blood pressure or Type 2 diabetes even if they are well controlled. Any kind of mental issues such as depression would make you uninsurable.

Women would pay higher rates than men and even higher rates for plans that covered pregnancy. You know how REALLY hates ACA are men because they hate paying for pregnancies.

I beg to differ:

As long as you had existing coverage you could continue getting coverage even with a pre-existing health condition. You just could not have a gap in insurance. And my premiums as a women were exactly the same as my husband's. And my husband and I are 6 years apart and we had identical premiums when I was in my 30's and he was in his 40's. ObamaCare is ruinous for some of us.

amother

Moccasin

Tue, Oct 19 2021, 10:25 pm

amother [ Violet ] wrote:

I don't have time to answer in full. But here are a couple of quick counterpoints:

- regarding to insurance premiums. We're not talking about the age escalation. We are referring to young healthy families in their 20s and 30s whose plan costs tripled or quadrupled or more

- women always paid higher rates. That is irrelevant to obamacare.

- pre-existing condition is relevant if you were uninsured before. In some cases, insurance companies had you wait a set period of time before they covered that condition. In other cases, they charged you more for your plan (which makes sense). It was an issue, but it wasn't that much of an issue that you had to upend the setup with one that makes everything else worse.

- With the ACA, everyone in the same age range DOES NOT pay the same rate. That is dependent on your income. If your below the set limit, you get free coverage. If you're above the limits, the plan costs are through thru the roof.

- With the ACA, the guaranteed coverage is worth close to nothing. If you don't get good care, the guaranteed coverage is worth as much as a piece of toilet paper (to quote my father). I think the majority would prefer to have decent coverage rather than something that's guaranteed but worthless.

- those premium subsidies you're referring to is just another term for taxes. It would look like it lessens the plan costs upfront, but in truth you'd be paying the same amount. It would just be coming out of your paycheck.

- These efforts to pass more gov't funded medical plans don't pass, because the people are not that stupid. Where do you think the money would be coming from?

- You're promoting socialized healthcare as the means to solve these problems. This weeks sad story with Alta Fixsler puts that into proper perspective.

amother

Hyacinth

Tue, Oct 19 2021, 10:52 pm

amother [ Azalea ] wrote:

This is a really rude and aggressive post. We all know that’s not what OP meant. And no, you wouldn’t pay for her Medicaid that’s not how it works. Op was just venting about the insane prices and terrible coverage options there are.

A girls allowed to want things and none of what she wants is unreasonable.

amother

Lime

Wed, Oct 20 2021, 1:18 am

amother [ Carnation ] wrote:

I beg to differ:

As long as you had existing coverage you could continue getting coverage even with a pre-existing health condition. You just could not have a gap in insurance. And my premiums as a women was exactly the same as my husbands. And my husband and I are 6 years apart and had the same premiums when I was in my 30's and he was in his 40's. ObamaCare is ruinous for some of us.

So basically, anyone who lost their job would be out of luck.

Before Obamacare, we moved out of state. We couldn't get insurance at all to cover me. The only way I could get insurance would be to sign off on an awful plan and I wouldn't be allowed to get pregnant for five years, otherwise they wouldn't insure me or the baby. Luckily, my husband took a job he hated just for the company insurance. He suffered for that job, and I refused to let him quit for a decade. A DECADE.

My father was uninsurable, because he was an attorney and his law firm had a strict 60-and-you're-out policy. So he started working for himself, and it was awful. He couldn't get any medical care until he turned 65, and we all hoped and prayed he would stay healthy until then.

Obamacare is pretty terrible, but it did do a few good things. For one, everyone I know keeps their kids on their own medical plan until they're 26. They used to get kicked off right away. It also forced the insurance companies to stop using our money for their marketing -there's a cap. It also allowed people with conditions to obtain insurance.

And yes, if you're in any other state than NY and NJ, you're out of luck. Medicaid covers NOTHING. No one takes it.

Maybe instead of wishing you could live in poverty/commit fraud and go back on Fidelis or Medicaid, you could champion actual healthcare reform. It's really a huge issue.

amother

Carnation

Wed, Oct 20 2021, 7:55 am

amother [ Lime ] wrote:

Wish to live in poverty/commit fraud/go back on Medicaid???? I have reread my posts several times to see where I wrote that?? So sorry could not find it. Is there someone out there who wishes to live in poverty? Perhaps you would commit fraud, but please don't project your morals on others. I have never been on Medicaid or Fidelis in my life. My husband is an attorney too. He switched jobs numerous times over the years pre-ACA as he tried to improve our economic situation and we were never out of insurance because there is a law called COBRA. When someone leaves a place of employment, by law, they can keep and pay for their previous coverage for 18 months. You are correct, after 18 months someone would have been out of luck. But after 18 months of unemployment most people would be on medicaid either way I would think. Yes, I had to pay - I expect to pay! I am happy to pay! I wish I could pay for good insurance!
So now it is my turn to have to sign off on an awful plan. With my huge deductible who can get pregnant or afford necessary surgery? And I have worked in a job I hate for 27 years because I need the money. That's what grown ups do. I and the people I am friends with are smart enough NOT to keep our kids on our plans until they are 26. We get them off as soon as they are legal adults and put them on Medicaid until they get a job where they can BH get much better insurance than we have. When I recently cried to my insurance broker about my insurance coverage all she could offer was "how many years until you are 65?" - meaning until Medicare. I contacted RCCS for help and they told me other states are not as draconian (meaning there are more insurance options with a larger in network doctor pool) and if c"v the need should arise they advise people to move. Well I can't move as my husband's license and entire business practice is location based. This is MY reality.
So glad ObamaCare works for you! But know there are many who suffer because of it. And they, like me, actually do champion healthcare reform. WE VOTE. I put my money where my mouth is and support candidates that seem to have my interests at heart. But ObamaCare is here to stay. At some point, if I must I will have to close my business and go work for someone else so that I can purchase decent insurance. I can assure you that would be a HUGE loss to my community as the service I have provided for all these years is desperately needed and my absence will create a huge hole that very few would like to fill. So really, the ripple effects of ACA spreads quite a bit further than what first meets the eye. It hurts society more than you realize.