Affordable Care Act

[MikeF]

We recieved a memo from our home office this morning that my health insurance premium will double next year from 295.34 per month to 644.00.
What are most of you seeing out there, is the Marketplace the way to go or is Barb better off sticking with what we have. My concern is quality of care, we are in the process of sorting through the options. I dont want to leave my employer provided plan to find out Barb wont receive the care she has up to this point.

[yanyan]

Almost 100% increase is quite a lot! Are you and Barb covered under your employer? Usually the broker shops around if their client is getting such a high increase so maybe something cheaper will be a available. Does Barb qualify for Medicare?

[Gerri]

We have POS insurance (HMO, PPO, and Out of Network) through my husband's employer. On Friday we received a letter in the mail stating our insurance premium was going from $308.00 per month to $708.00 per month in the new benefits cycle! The next day we got a letter saying that we had been sent this info in error and our premium will remain the same as before - WHEW!!!! I hope an error was made in your case as well. Not sure if this "error" had anything to do with my husband being in a union with his current contract in effect until 2015, but I am so relieved that it will remain the same - for now at least.

['lizbeth]

Yes, I'm really concerned. I had great affordable coverage before the "Affordable Care Act". Like everyone else the premiums have started up. I expect to lose big in the change up.

[StephN]

In my state the Med-Advantage Enhanced plans are going away, and I had to cut back to the next best thing, with a little more out-of-pocket and lower premium. Not sure where I will net out at the end of next year, but that was the best I could do under the circumstance.

My hubby's HMO premium for their top plan is increasing about 75%, so he is about to cut back to their second-best coverage.

My mother's plan is leaving her county, so we had to get her a medicare supplement plan with a separate prescription coverage.

With three of us to work out, I had to spend some time on our coverage options!

But I have heard some have it a lot worse.

[vballmom]

Be glad you aren't self-employed. Ours is $1000 a month and I haven't seen our increase yet.

[StephN]

We ARE self-employed, and did pay a lot for two of us before becoming eligible for Med-Advantage plans!

I was paying top dollar for a single preferred provider plan when my cancer hit. Found out that the pain of those premiums was nothing compared to what would have been the pain of going bankrupt without the coverage I had.

[Jackie07]

I received a letter from my health plan (affiliated to the hospital）that my Medicare Advantage plan will not change (except the premium which they won't know until next year when all are enrolled). Hubby received a notice from Blue Cross/Blue Shield that he needed to shop for a new plan. But the Website was down when we tried to check it out. Glad the deadline had been extended ...

The affordable care act seems to be something similar to HMO. All the insurance plans offered by my (ex-)employers had been HMO except once or twice when I was offered Blue Cross / Blue Shield. I did not choose the HMO plan of that hospital when I was first insured through my job in the late 80's. I thought the other plan had offered more choices of doctors and hospitals (not realizing the one in town is a top-notch hospital/clinic) After I had had my brain tumor surgery done in the big hospital in town (was fortunate that a Johns Hopkins trained neurosurgeon happened to be there - he stayed there for only 4 years and I was 'lucky' to be his patient. We had to do a special contract [was pushed around by the insurance company clerks until my boss called the Vice President of the Insurance Company and hinted about possible law suit] After that horrible experience, I switched to the HMO offered by the big hospital in town. It now has plenty of clinics spreading in the region and I know I can get top quality care here (My Gamma-knife Radiosurgery in 2001 was contracted out to a facility two hours away in the big city.)

The insurance rules and regulations were pretty good except that patients weren't told of their rights. My neurosurgeon, who happened to be a friend of mine through the local Chinese Club, had told us that "They should pay!" when we mentioned perhaps we needed to try a fund-raising since we couldn't even get through the receptionist on the phone to talk about the special contract (to have the surgery done locally). Yet none of my doctors (including the neurologist who'd told us he would only recommend this particular neurosurgeon and the ones whom I'd known through the Club) would get themselves involved in the process. Hopefully the Affordable Care Act will help resolve some of the issues. The preventive clause/choice of doctors looks very much like an HMO plan to me. I'm wondering whether the 'contracts' between hospitals can still be done when necessary?

[Jackie07]

Was just told that my 90 day Exemestane (trade name Aromasin) is going to be $630.97 (79% or the full $798）because I'd hit the 'doughnut hole! Thought I might try to buy 10 pills to tie it over and defer the prescription to next year. But they are calculated by the full price. So it will hit the 'hole' next year as well - plus there might be other prescriptions eating up the 'quota'! So I guess we'll have to pay the $630.97 now.

[Rolepaul]

Please be aware that many insurance companies will kick you out due to not accepting the renewal if you have severe health issues. That is what the ACA will prevent. Self employed professionals pay the brunt of this if they had catastrophic based plans in the past. I watched the deductible go from $750 to $1000 to $2500 to $4500 over the past four years. That is what is crushing me. I put $2500 into a FSA, but still have to come up with $2000 by the first of February. I have a great employer who pays 100% coverage price, but I still have spent $27,000 plus the last two years on medical expenses due to traveling for treatment.

[fauxgypsy]

I have Cobra Blue Cross Blue Shield and I will have to keep it as long as I can. I have supported the ACA all along and when I saw the reality of it I cried. There is only one company listed for Mississippi. None of the specialists they offer are anywhere near my home. They stated flatly when I called them that they won't pay anything for out of network. None of my doctors are in their network. The nearest oncologist is about three hours away. A marletplace implies options. I am so angry. And of course Mississippi turned down the expanded Medicaid while supposedly having the highest premiums. And then, of course they can charge more because of age. This whole thing frightens me.

[StephN]

That is terrible, Fauxgypsy! I am amazed that there is not more for you there - it sounds like the wilds of Siberia!

Got a letter last week that my eye doctor is closing HIS practice. Guess he figured he could not support his office and staff because he has too many patients on medicare. I had noticed that his office chairs were getting on the tattered side and wondered if something might be up. He is an excellent eye surgeon, which is one reason I have stuck with him in case I would need that service.

And my dermatologist was hinting at an early retirement last time I saw him. I hope it is not due to consequences he sees coming from the ACA.

[evlin75]

Censorship of free expression of worries and concerns is never the right answer.
I think the care act may end up working for all at some point. I hope so. The drug program is not perfect either.
Since I am on Medicare and older none of the ACA effects my personal situation. I don't get the protections either.
However I pay big money each month to have full coverage of doctor and hospital insurance. Then extra for dental and drug coverage. Eye and ear care out of pocket. Besides medicare takes over $100 out of my social security each month.
The local hospital raised its prices over 5 % while social security was increased 1.5, so I pay the price for coverage as I have savings and a home I would not want in jeopardy.
So far my daughter in Florida still has the same coverage. But only one plan was available to her as a supplement to Medicare when she had to purchase.
I had full free coverage prior to the General Motors bankruptcy engineered by the Whitehouse. Part of the workers UAW kept their lifetime health coverage and part of us IUE/CWA lost our life time coverage. I chose an insurance company that offered a decent price to have them more than double the price after I was enrolled and they knew I could not change. The guarantee of not being able to be accepted by another company does not extend to me.
So yes, I think it is OK to talk about it.

[StephN]

We are talking about personal experiences. It is good to know how our members are being affected by the health care changes.

In my state pre-existing conditions have been outlawed for many years so that was not an issue here.

Certainly there are some good points for some families.

[karen z]

I know that our founders, Joe and Christine (regardless of how they voted), did not want their HER2 site to be a place to air political views about policies. For this reason, such discussions were generally pulled. However, perhaps we are now operating under a different set of rules (and there is certainly nothing inherently wrong with that, although it is a bit surprising for a longer term member). I am here to read, learn and help regarding the HER2 experience.

[MaineRottweilers]

I think as long as we stick to FACT and not opinion this is a VERY good thread. There is a lot to learn here.

[MikeF]

We have two options as I see it. One is to keep our existiong plan at 644.00 per month which is double what I paid last year. The other options is I stay on my plan for 94.00 per month and Barb gets her own policy through a broker for 477.00 per month. The only problem with the broker route is premiums are paid after tax and with my employer they come out before tax. Any savings through the broker would be negated. The only way we can afford this increase is to scale down my 401K input now at 5% and change my deductions on taxes also dropping my dental would help. Its sad when you have to forego saving for the future for the now. My whole purpose with this thread was to get a feel for where you all are at financially not politically. If I offended anyone with my initial comment regarding our present leadership in Washington I am sorry. It is what it is and for now we have to live with it. I just pray that Barb has every opportunity to do just that LIVE.

[Becky]

Hi

We do want to keep this thread going as the subject is important - the New Healthcare System, and how it is affecting our members. Keep it nice and keep it unpolitical and be respectful of all opinions. This can be informative and interesting and things we all need to know. I do not want to shut this thread down.

Thanks!

[Bill]

I think this is an important thread, and in my opinion,,,,,,it's a worthy discussion to have. The new laws have caused many to lose their coverage or pay higher premiums. It's understandable that emotions run high in such a discussion, but let's do what Becky says.
As a side note, I've had several of my threads shut down, and sometimes just by commenting on others threads, caused them to be shut down. It's not a good feeling. So let's not do that here.

[MaineRottweilers]

Rhondalea,
Do you know which plan she is using and which provider she chose from Anthem or Maine Community Health Options? I have to pick something and I just don't know where to start.