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Unable to Meet the Deductible or the Doctor
NY Slimes ^ | Oct 17, 2014 | ABBY GOODNOUGH and ROBERT PEAR

Posted on 10/18/2014 12:13:26 PM PDT by Hoodat

Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring.

But her new plan has a $6,000 annual deductible, meaning that Ms. Wanderlich, who works part time at a landscaping company outside Chicago, has to pay for most of her medical services up to that amount. She is skipping this year’s brain scan and hoping for the best.

“To spend thousands of dollars just making sure it hasn’t grown?” said Ms. Wanderlich, 61. “I don’t have that money.”

About 7.3 million Americans are enrolled in private coverage through the Affordable Care Act marketplaces, and more than 80 percent qualified for federal subsidies to help with the cost of their monthly premiums. But many are still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families — the trade-off, insurers say, for keeping premiums for the marketplace plans relatively low. The result is that some people — no firm data exists on how many — say they hesitate to use their new insurance because of the high out-of-pocket costs.

Insurers must cover certain preventive services, like immunizations, cholesterol checks and screening for breast and colon cancer, at no cost to the consumer if the provider is in their network. But for other services and items, like prescription drugs, marketplace customers often have to meet their deductible before insurance starts to help. . . .

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Extended News; Government; News/Current Events
KEYWORDS: liberalism; obamacare
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To: Repeal The 17th

right

In addition to her small premium, taxpayers are shelling out a subsidy of over $350 a month - that pays for her “free” stuff


21 posted on 10/18/2014 12:50:08 PM PDT by silverleaf (Age takes a toll: Please have exact change)
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To: stephenjohnbanker
Don’t worry, the premiums go up next year....

Could be they'll go down...We'll know right after the elections...

22 posted on 10/18/2014 12:59:00 PM PDT by Iscool
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To: Hoodat

I don’t have insurance. I need a tetanus shot. It should be about $15. To see the doc-ina-box is $250 plus the shot. To see my regular doctor...I can’t just specify a nurse, is about the same. So, it’s going to cost $265 or so for a tetanus shot. (Any thoughts on how to get it cheaper? None of the local pharmacies carry them.)


23 posted on 10/18/2014 1:03:52 PM PDT by Gen.Blather
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To: Hoodat

Yeah just more of the same magic hookum hopey changey crap of zero sum game. Nothing is improved. The good gets worse and the bad is still bad.

The cost of everything goes up except for the ones who get something for free.


24 posted on 10/18/2014 1:08:04 PM PDT by Sequoyah101 (You can't get Ebola on a bus but if you are infected you can give Ebola to someone on a bus. WTH?)
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To: Hot Tabasco

How much is the total premium? That’s a bit of an important number as well, since you and I get to pay that portion of the bill, no matter if he uses any services or not.


25 posted on 10/18/2014 1:11:19 PM PDT by kingu (Everything starts with slashing the size and scope of the federal government.)
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To: Hoodat

This is the same thing that happened to my in-laws’ neighbor. He took out the insurance so that he would have coverage. But he said his deductible is $5000 before the policy kick in. He said he couldn’t afford the deductible and is postponing an operation. (Yet he still touts what a great thing Obamacare is.)

These people pay the premiums while having essentially no health care.


26 posted on 10/18/2014 1:11:34 PM PDT by HarleyD ("... letters are weighty, but his .. presence is weak, and his speech of no account.")
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To: stephenjohnbanker

Upon retiring in late Summer, I was faced with the choice of continuing with the Employer plan on my own (COBRA) or selecting a wonderful plan from the Marketplace, which we were told should be much more competitive. Not surprisingly, “Healthy-NY” plans with comparable features cost 10%+ MORE, plus involved new, higher deductibles (already paid under the current plan).

So if I’m going to pay through the nose each month, at least I know what I’ll get through the end of the year anyway. Starting in 2015 though, it will be a whole new ballgame…


27 posted on 10/18/2014 1:11:50 PM PDT by mikrofon (Obama Care features High de-Doctorables)
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To: pallis

This is exactly where we are. Not looking forward to 2015.


28 posted on 10/18/2014 1:14:34 PM PDT by bubbacluck (America 180)
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To: mikrofon

I’m in a similar boat.


29 posted on 10/18/2014 1:24:33 PM PDT by stephenjohnbanker (The only people in the world who fear Obama are American citizens. KILL THE BILL!)
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To: Hoodat

I hate obamacare but a high deductible is a good thing. If everyone had a high deductible there would be a lot less waste of collective insurance funds. Pay for the small stuff yourself.

REPEAL OBAMACARE NOW!

One more thing: if healthcare service providers had to post the cost of services to everyone, not just insurance companies, BEFORE services were rendered then that industry could benefit from free market competition and costs would go way down. As it is, the poor sick individual has to wait until he/she arrives home to learn those 4 days in the hospital ran up an $80,000 tab.


30 posted on 10/18/2014 1:27:36 PM PDT by The Ghost of FReepers Past (Woe unto them that call evil good, and good evil; that put darkness for light..... Isaiah 5:20)
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To: Wolfie

It’s not free. Yep.
It’s very, very expensive yep.

If the gov would get out of the way a true free market could change it.


31 posted on 10/18/2014 1:28:55 PM PDT by right way right (America has embraced the suck of Freedumb.)
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To: Yaelle
The poor will always get close to free or free care. WE are the ones who lost our plan and lost our doctors. Thanks to the lying uncaring schmuck in the WH.

Well, the free care was getting too expensive - so they had to take yours away so they could afford keep that superb vote-buying scam going.

32 posted on 10/18/2014 1:29:06 PM PDT by Mr. Jeeves ([CTRL-GALT-DELETE])
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To: Hoodat

“So basically, it turn out EXACTLY how Conservatives predicted it would back in 2010.”

In every respect.


33 posted on 10/18/2014 1:32:00 PM PDT by Attention Surplus Disorder (At no time was the Obama administration aware of what the Obama administration was doing)
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To: ghost of nixon
Obama are is a pathetic shell game. Fooling nobody

Don’t you believe it.

There are still plenty of true believers out there.

You have to remember that Liberalism is the religion of the self-deluded.

34 posted on 10/18/2014 1:36:23 PM PDT by Pontiac (The welfare state must fail because it is contrary to human nature and diminishes the human spirit.)
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To: HarleyD

“....But he said his deductible is $5000 before the policy kick in. He said he couldn’t afford the deductible and is postponing an operation. (Yet he still touts what a great thing Obamacare is.)

These people pay the premiums while having essentially no health care....”

The people who know, themselves, from their own actual experience, how defective and uncomfortable their situation has become and STILL like 0care just exasperate the crap out of me.


35 posted on 10/18/2014 1:37:54 PM PDT by Attention Surplus Disorder (At no time was the Obama administration aware of what the Obama administration was doing)
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To: Hoodat

Doctors are under a lot of pressure right now. They have become hesitant to prescribe medicines they think their patients cannot afford.

And several times at pharmacies I have seen elderly people who looked miserable because a drug they really need has gone up by $20 a month. “But I really need my insulin...”


36 posted on 10/18/2014 1:38:33 PM PDT by yefragetuwrabrumuy ("Don't compare me to the almighty, compare me to the alternative." -Obama, 09-24-11)
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To: Gen.Blather

Our local W-M sells a variety of shots, I believe tetanus is one of them.


37 posted on 10/18/2014 1:39:30 PM PDT by Graybeard58 (Fear God, and keep his commandments: for this is the whole duty of man. Eccl 12 V.13)
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To: stephenjohnbanker

We are in this boat as well. My husband was a corporate executive and they reorganized and cut his position. (He was making too much money).

So now he’s taken over my one time small business and is making it huge but we have to buy insurance on the market. What a mess. But, fortunately, the Man Upstairs put it into my heart to start packing away cash a couple of years ago for a rainy day He saw forthcoming. My husband did not know I had squirreled away that money until the day he came home crushed and freaked out. Ha! You should have seen his face when I showed him the balance in that account. Although the business is successful in keeping us afloat, insurance is digging into savings.


38 posted on 10/18/2014 1:39:31 PM PDT by SaraJohnson
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To: SaraJohnson

Your husband is a lucky guy.

A friend of mine who owns a business was paying 880 per month(2500 deductible) for a family of 4. He now pays 1240.00 per month, with a 6,000 deductible.


39 posted on 10/18/2014 1:44:58 PM PDT by stephenjohnbanker (The only people in the world who fear Obama are American citizens. KILL THE BILL!)
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To: Hoodat

Even the NYT finally seems to have realized that it’s the “Unaffordable Care Act.” It’s affordable only if you’re already on welfare.

Heck, even the Medicare plans changed - and there’s no way Granny on a fixed income of under $15,000 a year is going to be able to afford a $6,000 deductible in her Medicare plan.

Thanks, Obama! You’ve reduced decent hardworking people to misery.


40 posted on 10/18/2014 1:45:06 PM PDT by livius
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