Help understanding this

[Twitchin Kitten]

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OK so Matt has a note in his last pay-stub envelope about his health care. It renews this year on 12/1 and apparently because of the AFA there are changes that have gone into effect, a big part which is changes in the coverage he already has.

The company however, has been able to take advantage of a reprieve for one year allowing them to keep the current coverage. Doing this did however raise premiums.

OK This is a Blue Cross plan. HOW does the AFA affect this private company's coverage? Unless he bought company coverage through the exchange, that's the only way I understand how this could affect his coverage.

Can anyone enlighten me on how this works now? It's very confusing and I'm usually the one explaining it to him.

[Biker Dude]

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How much are they going up? Ours went up by about 10%, which is fairly normal. In general , the rates will ALWAYS go up from year to year. (our pay hasn't gone up...) Here the big push is to get people onto the 'high deductible' plans. Next year I think that will be our only option. Some places that is all they offer for new employees. There IS a tax break for the company for this plan vs the traditional.

The ACA does change some things, they have to cover things and people that they didn't. This represents more risk in the pool paying in, so they raise rates to cover that. But the ACA is hugely complicated, so I could never even come close to saying what the issue is there, just throw out 'what ifs'.

[Twitchin Kitten]

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Yeah, I know it's a given that rates go up. They've been steadily climbing since Obama got into office and started this fucking mess.

he's got a high deductible plan as it is and it hardly covers anything without a huge out of pocket expense. It already covers the things the ACA demands.

I just don't see how the ACA can affect private plans like this. Where is the line between the ACA and private plans now? I wish the republicans would man up and get rid of this thing like they say they're going to, but I don't see that happening. It's always one excuse after another. It's still cheaper to take the fine for not being covered than to buy a plan.

[Twitchin Kitten]

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OH and the high deductible is what is keeping me from going on his plan. It's a gimmick to never have to pay out to the insured! If we both are on the plan it's a $5000 deductible, which EACH of us has to meet $2500. So if Matt never goes to the doctor and I exceed my half, we always will be paying out of pocket and most likely this will go on forever unless Matt ends up in a hospital, which in turn will give us a gigantic bill we most likely cannot pay off ( out of pocket fees, plus the deductible for him AND co-payment ).

AFFORDABLE Care Act my ass.

[LKTraz]

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There is no such thing as private insurance now. It's just a matter of HOW you get the coverage. (Through an employer/employee pool or by it individually from the exchange)

Obummercare mandates that any insurance plan must cover certain things to qualify as an acceptable plan.
Abortions and contraceptives (the pill, subdermals etc) are a MUST cover to qualify. The big bullshit is that if you add up the deductibles, co-pays and premiums......almost all plans come out pretty close to the same expense in the end and many people are now paying MORE overall than what they used to pay.

The UNaffordable DON'Tcare Act is also NOT paying for items, procedures, care methods and meds that were previously paid by providers.

Basically......if you don't have insurance then you HAVE to buy the shitty policies we offer......and if you had GOOD insurance then your provider must make it shitty or it doesn't qualify.

[Twitchin Kitten]

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There is no such thing as private insurance now. It's just a matter of HOW you get the coverage. (Through an employer/employee pool or by it individually from the exchange)

Obummercare mandates that any insurance plan must cover certain things to qualify as an acceptable plan.
Abortions and contraceptives (the pill, subdermals etc) are a MUST cover to qualify. The big bullshit is that if you add up the deductibles, co-pays and premiums......almost all plans come out pretty close to the same expense in the end and many people are now paying MORE overall than what they used to pay.

The UNaffordable DON'Tcare Act is also NOT paying for items, procedures, care methods and meds that were previously paid by providers.

Basically......if you don't have insurance then you HAVE to buy the shitty policies we offer......and if you had GOOD insurance then your provider must make it shitty or it doesn't qualify.

Yeah, I noticed that in the coverages in his plan. The average person cannot afford insurance anymore. I know we can't afford to let me go on his plan.

Top it off the gov't is subsidizing those who can't afford a plan with our tax dollars. Lovely.

[twisteroo]

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Basically......if you don't have insurance then you HAVE to buy the shitty policies we offer......and if you had GOOD insurance then your provider must make it shitty or it doesn't qualify.

That is it in a nutshell.

[AnthonyG]

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There were new requirements mandated on all insurance companies, like no one can be denied coverage and all plans no longer have a coverage cap. So in order for an insurance company to take on new customers with stage IV cancer and have unlimited numbers of chemo treatments everyone's premium had to go up 30% +. I dont mean to sound heartless but there is a line between something thats good for the masses and whats going to bring down the masses.