Obamacare may cost you $$$. Understand what you are buying.

Starting October 1, consumers will be able to shop for health insurance plans. This will be a huge benefit to many people. There are several things you must be aware of if you are required to obtain coverage. Make sire that you fully understand what you are signing up for.

1- If you are required to buy coverage and you do not, you will pay a fine. Fines will increase every year.

2- If you expect a subsidy to help pay for your insurance, you must obtain at least a silver level plan. There are 4 plan levels and silver is the second highest.

3- In addition to paying a premium for your selected plan, you will also be required to pay deductibles and coinsurance. You may receive a subsidy for these costs too, but you will be paying something.

4- Deductibles are the amount you pay before insurance starts to pay. Deductibles may be small (but the monthly premium will be higher) or large. Common will be $1000 and $2000 per year deductibles for an individual. There may be a separate deductible for prescriptions.

5- There may also be a copay each time you receive a service. For example, some plans may not charge you the first few times you see your family doctor, but after that you may have to pay a fee such as $45 for a visit to your family doctor or $65 for a visit to a pdoc or therapist. You may have to pay $250 or more if you go to an emergency room.

6- Also, some plans may make you pay more or will not pay at all if you go to an out of network provider.

7- Some medications may not be covered under all plans, or plans may have a very high copay for some medications.

8- If you or your family make 401% over the minimum poverty level, there are no subsidies.

In conclusion, under Obamacare, you may be paying
premium+deductible+medication deductible+coinsurance.

For example, a single person at an income of 401% of the federal poverty level may pay $3000 ($250 per month) plus $2000 health deductible plus $500 medication deductible plus a copay for each visit and each medication every year!

There is, however an overall limit on the percentage of income you may have to pay for healthcare. I do not yet understand that part fully but I will keep researching this entire topic.

Hmmm. I don't understand at all. I was thinking the Affordable Care Program was something that people would be getting for free, since it would be paid for by the government.

I am wondering how "socialized medicine" works in countries such as Canada and Great Britain. What fees are involved in them? Are people higher above the poverty level getting it more cheaply?

Thanks. I like the idea of helping the poor to get insurance, but I don't get why some folks would have to pay through the nose. I gather it is the wealthier folks who would have to potentially pay all that money?

Of course, regular insurance such as BCBS requires deductibles and a monthly fee. I guess folks would need to compare cost and coverage in deciding which policy to get. I gather that's what you are saying. To not just jump in to the government program, thinking it will be better than private insurance.

I am middle class, paying a fortune for insurance. My salary is just enough to cover expenses on a very high premium, and I am not going to get anything for free/less. sigh.+

Payne and Doyoutrustme,

You are right. Please understand I am not supporting or opposing the program, I am just trying to pass some information on to you, my pc friends. It is very confusing even for people who study it. I was trying to say everyone really needs to be careful when/if they sign up for Obamacare. Even with training, the people who are supposed to be answering questions from the public about the program may not always be 100% correct.

People who already have insurance through work can keep their current coverage (unless the employer changes or drops health coverage) and people on Medicare don' t have to pay for new coverage if they have parts A and B.

What I am still not sure of are people with only Medicare part A and those on Medicaid.

All I understand is that a lot of people may end up paying a lot of money for what they thought would be low cost/no cost coverage. Heck, even a $1000 deductible with a $500 medication deductible scares me. That's a lot of put of pocket $$$.

What I don't get is how so many people are just now figuring that out. Some of us knew that when Obama first got elected.

My husband's insurance no longer covers mental health services or alcohol and drug abuse services. We could still get a plan with coverage for those things, but the cost is too much for us.

The paperwork he received said the changes were due to The Health Care Act. So thanks to Obamacare, it now costs me 100.00 a visit instead of 30.00 to see my pdoc. I can't make changes to my meds because he will want to see me more often and I can't afford that. I really have to hope I stay stable.

This is the first time in my life that a politician's actions have so directly affected my life. I fear this is just the beginning!

Why is it that insurance companies are acting the way they are because of the Affordable Care Act? (Please, let's not bring politics into this discussion.) Why are they taking away coverage for certain things and charging more?

The good thing about Obamacare is that with my Bipolar dx I can finally get insurance, however, the down side is I may not be able to afford it.

very concerned, hub's job insurance dropping my 22 year old son and myself. He'll go on obamacare and I'll go on Medicare, don't think I will qualify for medicaid. He might, but maybe not food stamps. Frankly, I think it's all going to be a lot more expensive now, for us, though I do like many of the things in the bill, such as coverage for adult children and for pre-existing conditions. My hub doesn't make too much, but I think it's too much to get much help for. It's already been so tight and about to get tighter, but I guess I am truly not all that surprised. And still counting my blessings and trying to get paperwork set up. I do try not to worry about things before they happen but have been concerned about disability and soc security. And all this for other folks as well as for us. Family relations have been very shaky and this is some more added stress. I hope we can all keep it together, and I wish the best for all of you. That's just the way it is sometimes, sigh!!!!!

same here, I think!!!!! It's rough! Hang in there!

One place to learn about Obamacare:

https://www.healthcare.gov

It is a program that relies on private insurance companies for coverage. There are some requirements imposed on the private companies, such as making them cover prior conditions, and as compensation they have access to a wider pool of insured people, since most are now required to have insurance, or pay a penalty. There are subsidies for the poorest people to help them pay for the new plans.

In general, if you have insurance now and your insurer is not going to quit or raise its rates excessively, you do not have to make any changes. If you have to choose new insurance, the "exchanges" are the places to go to choose which company or plan you sign up for. Some state governments have refused to set up state-controlled exchanges, so the federal government has to set up exchanges in those states.

Pachyderm,
As I understand, much of the missing substantive info needed for people to make choices will not be on the site until October 1 because negotiations and decisions are still being made by the insurance companies, the states and the federal regulators.

I would expect even after October 1, we will see many more changes as the system must be flexible as new issues/problem appear.

Word of caution: do not try to go through the entire process on October 1. Look at the website once or twice then formulate your questions. It may be quite awhile before someone will answer your questions. But while you are talking with them, also ask if they could recommend a plan for your needs. While they probably cannot actually recommend they are likely able to help narrow your choice and then highlight the difference between plans you are left considering. The people hired by the exchanges to help you have had very little training. Evaluate the program you are interested in based upon all the info you obtained. I would then recommend calling an exchange employee back reciting your reasons and making sure all the questions you asked before are still answered the same way.

I gather that any insurance you choose will not go into effect until January, so you have plenty of time after October 1 to check the site.

The fine the first year is only $96 or so... which will be my option if I have to drop my current private insurance this year...which I had to dumb down / change from Blue Cross/Shield last year because of the exorbitant rate increase.

I personally think insurance companies, like many, tho they are larger than many, like the big banks, will get away with what they can.

personally think it's opportunistic and more profitable, IMHO!

I'm really scared. My Mom is having cancer surgery soon and on top of all the medical stuff, her retiree group insurance is ending and I have to figure out this thing and get her signed up for something else.

I hope and pray that when I have to get my own insurance (which will either be if/when my mom gets a new job, or when I turn 26 -- I hope it's the latter since that will give me more time). I think Obamacare has the potential to be quite good for many people, but in this beginning stage, it seems like a nightmare. I would love it if I had a pdoc that took my insurance though. I used to, but the one I see now doesn't, so instead of a mere $20 copay each visit, it's $150 a visit. Talk about ouch!

Hello everyone!

This is my second post, but since I work for an insurance company that will be working directly with the Affordable Care Act I thought I would chime in on what is going to happen Oct. 1st.

-First off, similar plans to this were suggested by both Republican and Democrats a like.

-Each plan in the Marketplace is required to cover what they call the 10 essential health benefits. This includes maternity inpatient care, substance and mental health disorders, preventative wellness services, prescription drugs and a whole load of stuff that would normally require getting extra insurance or normally isn't covered.

-An insurance company cannot reject some one due to pre-existing conditions. Which will make a huge difference to a lot of people.

-By law, to have affordable coverage, the amount you pay can not exceed 9.5% of your annual income. However, (as mentioned before) if you are lower than 400% of the FPL and with a cost sharing silver plan the amount you pay can be deducted out of a tax credit. For example: If you make 22,000 a year the amount of your premium would be roughly 120.

-Insurance companies are required to spend 80% of their profit on the insured. What was not spent on medical expense with be refunded to those in a cost sharing plan.

-The rate that you will have to pay can not exceed 3x that of what a 21 year would pay. If you are a smoker, the rate can only 1.5x higher of that of a non-smoker.

-Your children can stay on your insurance until they turn 26. Even if they're married, or can be covered under insurance provided by their work.

-Under certain circumstances you will not get a fine for being uninsured, however like it was mentioned before, if you do not have creditable coverage for over 3 months then you will have to pay a 95 dollar fine or 1% of your income, which will raise each year. However, if you live in a state that didn't expand medicaid and you can not afford to buy insurance than you will not have to pay a fine.

After getting my license and learning so much about how health insurance I'm honestly a lot happier how things are going to change. The idea imo is that insurance companies will be encouraged more to spend on the insured. Nearly half of all working Americans are uninsured or under-insured and this has given us more of an opportunity for better healthcare overall. Most insurance companies has always been about profits until this point. There's still a lot of unknowns but I feel it is progressive thinking.

Thanks for letting me rant!

Thanks Rubbish. Valuable info for all of us.

I don't understand forcing people to pay....

I'm starting to feel like the united States is becoming a dictatorship except instead of jail...you pay until you are broke ......

Clever.....

What is considered socialized medicine?

Thanks for this Pachy. I was really worried because there is so much misinformation floating around and it's all so complicated.

I read about exemptions and I am exempt in 3 ways. There are a lot of different ways to be exempt thankfully.

1. I am not required to file for income tax because I do not earn enough.

2. I received a shut off notice from a utility company.



3. I have been unable to pay for recent medical bills.

there are many other qualifications for exemptions.

https://www.healthcare.gov/exemptions/

I went to the site to evaluate this AHCA for myself...to the marketplace and then to the Kaiser site to do a sampling comparison and cost analysis.

Yes, an insurance company CAN refuse to cover your pre-existing condition under certain circumstances. And IF you do have such a condition, the AHCA will charge you more annually (average is $1000 a month) and a higher deductible (to the tune of about ($5000 a year in addition to your regular deductible!) no joke folks.

So I filled in practice paperwork, deleting the pre-existing condition... and the AHCA would then cost me over $1000 a year more, with a $9,000 a year deductible. SAY WHAT??? I would have to pay the first $9000 of medical costs Each Year before this affordable care insurance would kick in.

I don't think people realized how bad this would be. I've been against it from the get-go but had NO IDEA they could pull this farce off...on the American people no less.

I urge all people to get an evaluation for themselves and see...and then rant to their Senator. This tax isn't fair at all! If we have to pay it, then so should Mr Obama and all the politicians!!!!

Okay, calming down. I discussed this with a doctor today and was urged to be sure of my findings. Yeah, good idea, I mean, what I found is UNBELIEVABLE!

What did I discover? AH, I goofed yep indeed...if you're on disability you don't claim ANY of your income... yes, surely that would bring my costs down? NOPE. If I am not allowed to claim my disability income then I am too far below poverty level and must go on Medicaid, which I know for a fact will NOT cover me. This means, for me, if I don't keep the private insurance I have already, I will not have ANY insurance at all as the AHCA will not cover me!

What kind of cure-all end-all problems insurance tax is this anyway?

Politicians, I fully believe, are all going to hell--and soon.