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.

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.

What is considered socialized medicine?

Other people gave good answers, but one point, I think, was not covered. ANd of course each province is different, because healthcare is a provincial matter. So, in my province there is a cutoff point where you'll have to pay 100% of the premiums. Then there are tiers below that 80%, 60%, down to 0% that you would have to pay monthly if you make little money. So everyone can be covered if they register for it.

Looks like right now the rates are $64 a month for one person or 116 for a family of two. And then there's the premium assistance I described above. If you make less than $22K per year, you pay zero:

MSP - Premiums

Of course many jobs cover healthcare benefits, and then you don't have to pay this at all. Some things aren't covered, like physiotherapy. So while Walt would be okay, Hank might still be up the creek (Breaking Bad reference.)

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?

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

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

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!!!!!

One place to learn about Obamacare:

https://www.healthcare.gov

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.

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I'd like to know the answer to this question, too. I just hear that some other countries have it.

socialized medicine

noun any of various systems to provide the entire population with complete medical care through government subsidization and regularization of medical and health services.

Origin:
1935–40

wiki (gasp)

Actually we can't call the AHCA "socialized medicine" see if you can figure out why with this definition:

Medical Dictionary
socialized medicine so·cial·ized medicine (sō'shə-līzd')
n.
A system for providing medical and hospital care for all at a nominal cost by means of government regulation of health services and subsidies derived from taxation.

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Socialized medicine - Wikipedia, the free encyclopedia.........." Socialized medicine is a term used in theUnited States*to describe and discuss systems of*universal health care—that is, medical and hospital care for all at a nominal cost by means of government regulation of health care and subsidies derived from taxation."........"Because of historically negative associations with socialism in American culture, the term is usually used pejoratively in American political discourse." ~~ I noticed JD left that part out but I felt it was important to note. I am not sure that was left out intentionally, but it brings up important factors when talking about a universal heath system and cultural differences that cannot be side stepped easily. Seems misleading to ignore why it is called socilized medicine in America, and if that is really the best way to describe it. Beliefs we hold onto might also very well impact whether something will be a success or failure. ~~"by the 1930s, the term socialized medicine was routinely used negatively by conservative opponents of publicly funded health care who wished to imply it represented socialism, and by extension, communism." It is interesting to note that in the states you have things such as public libraries, not "socialized" libraries.

In Canada we don't call it "socialized" health care. We call it universal heath care or public health care. The word socialized does not seem to carry the same weight here with many people like it does in America. It's not a dirty word. Our health care is not free either. It is free only when you speak in terms of point of service. It's mostly publicly funded through taxes but not entirely. We have a mix of public and private sectors.

This explains Canada's system pretty well. It is not easy for me to explain, it can be complicated. Our system has problems as well, wait times has been a big issue, we have seen wait times dropping. We have shortage of dr's as well which leads to the wait times. Many dr's leave Canada to go to the States where they can make a huge profit not that they do not get paid very well here, but obviously they can make a lot more money in the states because of your system, this was a much bigger problem in the '90's, which we have been working to correct and have seen a big increase of dr's practicing in Canada. Health care in Canada - Wikipedia, the free encyclopedia

I would rather wait a little than not be seen at all. USA does actually have wait times as well for somethings. I would think that knowing you have to wait sometimes (not all the time ) because almost everyone needing treatment is recieving it would be worth it. How comfortable is it knowing that there is often no wait because because so many people who need the same treatment are being denied?

Overall I am very thankful for our system, even with some of the problems. I would never want for-profit health care. We do need to work on our systems short comings, but I personally feel fixing our problems is better than scraping it and switching to a for-profit or private health system. I am pretty sure most Canadians would agree. When I looked at the AHCA plan here, I don't really think it looks like socialized heath care at all. Not to me anyways, or universal heath care. Most Canadians would absolutely freak out if our government completely overhauled our system to a private one (not unlike many Americans reactions), but unlike America I am pretty sure that is because we know what we have.

I have never seen a dr bill, psychiatrist bill, hospital bill. I have never had to check first when one of my children or I needed medical attention to see if I could afford it or if it was covered. I do really appreciate that fact.

Sorry for the wiki links, but I was having a hard time finding an article that explained it well. Hope that helps give you a better idea.

Article below explains some of the major differences. I don't agree with everything said in this article but the differences are there. I don't know if AHCA is going to turn out to be a plus or minus, but it is not a comparable system to Canada's really. I do think AHCA is a least a step in a better direction. I find health viewed as a comodity especially disturbing. Baby steps I guess is how I see the AHCA, which is odd since so many americans seem to view it as a massive overhaul to something completely different. Doesn't look that way to me, look similar to what you already have, with some changes trying to address major holes and pitfalls in the system. In my opinion, it's just not universal ("socialized" if you prefer) enough.

Obamacare vs. Canada: Five key differences - The Globe and Mail

On the prescription end in British Columbia we also have Fair Pharmacair. Other similar programs in other provinces as well...Provincial Pharmacare Programs in Canada

I have looked up before how much I would be paying in the states for certian things I have needed up here like my daughters surgery. If I ever recieved a bill like that there is no way I could have paid it. And the payments would cause futher decline in our health since that money would not be able to go towards preventitve meassures or other health related costs or just plane living necessatites. It would become an even bigger burden on the society at large in many areas then it needs to become. How does people not paying the bills add up? Either way looks like a problem that just spreads.

Ad Infinitum

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