Posted on 03/02/2016 4:13:13 AM PST by IBD editorial writer
Health Care: The insurance industry must be kicking itself for backing ObamaCare. Several have since posted big losses and it looks like Blue Cross Blue Shield got the losing end of the stick, too.
(Excerpt) Read more at investors.com ...
“Amazing they can lose money when their premiums are high and they don’t cover anything.”
You noticed that also?
I agree. I have the privelage of paying $14,000 a year in premiums and the first $5,000 of both my wife’s and my medical care is on us.
Since we eat responsibly, don’t drink or smoke, and exercise regularly, we never get close to the $5,000.
If this is Affordable Care, I’d hate to see the alternative.
Obamacare is the biggest regressive tax increase ever perpetrated on working people in this country.
Regressive because wealthy people have a small bite taken out of their income compared to working and middle class people.
Wealthy people will be able to fly places and get less expensive healthcare than the trapped workers here in the States.
Powerful business owners will obtain more profits by shifting the burden of healthcare insurance over to the taxpayers.
Regressive because every leftist constituency that has been able: has received a waiver so not to be trapped in this tax.
Members of Congress have lobbied that their staffs have the tax paid for by the government - that is right! The taxpayers get to pay the Obamacare taxes of the people who plotted tax them unmercifully.
Add your take on tax and Obamacare please:
The State’s Role
One thing that does not get talked about with Obamacare is that it is NOT insurance.
If you cannot pay the amount the government decides that the IRS will take from you, then you will be placed into your states welfare roles. And if you get sick, and require care, the state will pay...
...THEN THE STATE WILL GO AFTER ALL YOUR ASSETS TO COVER THE COSTS. AND YOU OR GRANDMA WILL LOSE YOUR HOUSE OR OTHER BELONGINGS.
There is no good side to Obama care and making sure people were covered more than they are now is not what it does.
OBAMACARE MAKES SURE THAT THE MEDICAL-INDUSTRIAL COMPLEX HAS INCOME FROM TAKING HOMES AND ASSETS FROM PEOPLE.
DO NOT FORGET THIS
________________________
Note from CNS News
People whose household income is too small to qualify for the subsidy will be put on Medicaid. People whose household income exceeds 400 percent of the FPL will get no subsidy at all.
According to the IRS, which responded to a CNSNews.com inquiry on the issue, a household earning an annual income that is just $1 more than 400 percent of the FPL is ineligible for an Obamacare subsidy, period.
As explained by both the IRS—which wrote the regulation governing the Obamacare subsidy—and the Congressional Research Service, which published a July 31 report on the matter (Health Insurance Premium Credits in the Patient Protection and Affordable Care Act), the Obamacare insurance-premium subsidy essentially works as a cap on the percentage of annual income an eligible person is required to pay in health-insurance premiums.
my attorney tells me that there is no way to shield my assets from the government/medical/industrial complex. Very painful to hear.
Some consumers take themselves out of the market with healthcare medical bill sharing, I could do that and if they will have me, that will probably be my choice. I am not sure that the complex’s reach won’t make that a futile gesture though.
Thank you for confirming what I have tried to talk to people about to no avail. Interesting that my acquaintance who has lives a rather dissolute life, who never paid off anything including her student loans, owes tons on her house, with a low payment, will be able to keep her house, and I would lose mine. Painful.
One thing that seems clear about the current health care debacle is the control the health care industrial complex and the government will have over my assets. And there seems to be no way around it. Tell me if I am wrong to believe this. It will help me sleep at night.
I am being told that I must have Medicare and an insurance overlay or pay penalties. I pay extra for the overlay. If for some reason I cannot pay for the overlay, and require care I will be put on Medicaid, and given care and my assets forfeited to the state/healthcare complex.
Now I understand that this has been a way to manage folks with small assets, in our community giving a house to the town for taxes and bills has been common for years. Our towns use to let the elderly live in their houses until after the death, then foreclose.
However the current combination of insurers, healthcare entities, and government can provide a very different picture. The government has opened a window to previously untapped assets, older people who have previously been able to cover their healthcare insurance, keep their assets intact and provide a boost for the next generation.
It seems to me that all the government/insurer axis needs to do is change the insurance price point depending on the financial needs of the insurer or healthcare institution. Less people able to afford, more assets turned over.
The other part, is how prices in healthcare do not reflect reality but instead, a very unrealistic and non market based assumption. I see it in my own pricing for services in the market.
Now I am not opposed to paying for my own healthcare, but I damned sure refuse to be subjected to or pay unrealistic, manipulated and dictated prices, which affects everything from equipment, prescriptions and services.
Both these issues combine to provide a perfect storm of assets to be sucked out of the middle class.
I would really like your opinion here. You have a reasoned free market perspective. You are also a good writer, rare in economics. Thank you for your time.
—
“If for some reason I cannot pay for the overlay, and require care I will be put on Medicaid,”
That’s not how it works. You stay on Medicare until your assets are gone. You don’t forfeit anything. You cannot go on Medicaid until your assets are gone.
People who went on Medicaid expansion were allowed certain assets like a 401k and a house but forfeit those things after death for taking the Mark of the Beast,
Insurance companies do not lose money, at least not for long. Their customers get their premiums raised, that’s all.
...
Yep. The article says Blue Cross has already raised rates and Obama is going to throw them some of the taxpayers stolen money to kick his pile of crap down the road another year.
Bingo! Americans spend about ten grand per capita on medical costs. Since a fair portion pay nothing, we can see what insurance has to cost apiece for us payers, one way or another. "It's the COST, stupid."
There was a Freeper a few days ago complaining about this same same thing. His subsidy payback is $12K unless he found a way around it. People closing in on 50 years of age, have to know the rules if they are taking subsidies. Somebody that just lost their work insurance, may not be up to speed on this..
If you have a pre-existing or a chronic on-going health problem (HBP, diabetes or chronic back pain for just a few examples) your annual physical may not be 100% covered (and this was even true before "Obamacare" for plans that 100% covered an annual preventative care exam, i.e. a routine physical - that was true for me in the early 2000's when I worked for a Pharma that had an outstanding, very high coverage and low cost, low deductible and minimal co-pay PPO health plan that 100% covered annual preventative care visits) especially if during your visit you complain or ask your doctor about an on-going or a new health concern or have to be further treated for or are tested and or diagnosed during your annual physical about an on-going or a new health issue; some of those charges and diagnostic tests may not be 100% covered under an 100% covered annual preventative care visit.
http://www.newsmax.com/Newsfront/Obamacare-healthcare-physicals-co-pays/2014/04/14/id/565370/
Doctors told the Journal that seniors have started canceling their annual wellness visits under their Medicare plans when they learn that if they mention a current health issue during the checkup they will likely be charged a co-pay.
Some doctors are even warning patients in advance of the problem and ask them to schedule two visits, one for the "annual" and another for their current health issue, according to the Journal.
Some insurers allow doctors to bill for their preventative and "non-preventative" services during the same visit using a special code called "modifier 25." But that can also lead to co-pays and confusion.
And
Many Blue Cross plans cover preventive care services without cost-sharing when you see a doctor that is in your health plan's network. Be sure to check the details of your plan before you make an appointment with a doctor. Sometimes, your doctor will order tests during your preventive care visit that are not considered preventive care. These tests may be subject to deductibles, copays and/or coinsurance. Your doctor may also treat an existing condition (or you may have symptoms of an illness at the time of your visit). Treatment or tests for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance.
https://www.bluecrossmn.com/healthy/public/personal/home/livehealthy/lh-preventive-care
What you need to do is carefully review your IOB and your insurance billing statements and contact your provider's billing department to make sure they coded the annual visit properly, make sure they didn't code it as a general office or follow up visit in whole or only in part. Where I work, we have a "wellness initiative" that gives employees a discount on their employee paid portion (PR deduction) of our group health insurance premiums if they complete a combination of several things; one being an annual preventative health visit along with a combination of at least four others like getting an annual vision and or dental exam, completing a company paid and on company time on-site biometric screening (checking for HBP, cholesterol, blood sugar and BMI) and or completing an on-line heath assessment, getting a company paid or primary care provider flu and or pneumonia shot and or a preventative age dependent preventative screening such as a mammogram, colonoscopy, PSA test, etc, and or certifying that you are and have been a non-smoker for at least 12 months. You don't have to do everything listed to get the premium (PR deduction) discount but a combination of at least four of them in order to get the discount.
What we often run into on the annual preventative health visits is that if the provider doesn't code it for insurance billing as being a "preventative care visit" - if the employee is being followed up for or being treated for an on-going or a newly diagnosed health problem and the provider and or their billing department codes it as a "general office visit" or a "follow up visit", when HR/Benefits tries to confirm with our insurance company that the EE had an annual preventative health visit, it doesn't come up as such and often the employee complains that they were subject to a deductible or co-pay . (And FWIW, because of HIPAA, we are not privy any of the details or the results of the annual visit or the results of any diagnostic tests or of the biometric screenings or on-line health assessments - only that one was completed.)
What we tell our employees when scheduling an annual preventative health care visit, in order for it to be coded as such and 100% covered and counting for the wellness credit, is to make it very clear when scheduling the appointment and when checking out with the billing folks, that this is what it was. And if part of the visit included non-100% covered billing codes, i.e. not being part of a "routine annual preventative care visit" or if there were issues discussed with their primary care provider about existing or new health conditions or if further diagnostic tests had to be ordered, that that should be billed and coded separately from the "preventative care visit".
FWIW we also have the same issue for some employees getting mammograms or colonoscopies. If it is routine, age appropriate and truly "preventative", it should be 100% covered under our health plan. However, if an employee had been previously treated for breast cancer or was referred to get one before the age of 50 because of a family history or if they had pre-cancerous or cancerous polyps removed during a previous colonoscopy, subsequent mammograms and colonoscopies are now not considered to be "routine/preventative" screenings and thus are not 100% covered as being preventative.
I'm not making a case that they should or shouldn't be 100% covered but that is how it works.
Not those who are not yet on medicare
Get in bed with the Devil...
Thank you for the info. My visit was definitely for preventative care; I have no ailments or take any medication. The doctor and practice are listed in the BCBS directory. I guess I should make a phone call but not sure it’s worth the aggravation that surely will come.
probably got coded wrong by the billing department. That happens with greater regularity when you go from ~10K codes to 60-70K codes.
My local hospital in Virginia billed me $1,500 for... some mysterious procedure known only by its code that I never had done (haven’t been to the hospital in 20 years).
What’s the code? My wife can tell you what it is for, as long as it is a valid code.
I’m counting my blessings after reading this thread. Last year, my husband started a job at a small healthcare company in rural West Virginia. He’s so well liked that coworkers overlook his co-pays. We haven’t paid anything for healthcare.
I get the whole not wanting to go through the hassle. But as jurroppi1 said, it probably got coded wrong. It might be worth a phone call to the doctor’s office. If they made a mistake in coding when they billed the insurance company or the insurance company made the error, it can be corrected any you would be due a refund for the $114 you paid and is at least worth noting for the future when you schedule you next annual exam.
I agree, for 114 bucks it is worth it.
I’ve gone through some weird stuff with coordination of benefits, but last year took the cake with Health partners. Now I have a “coordination of benefits account” that gets credited monies whenever my primary pays for something thus saving the secondary (health partners) money. So I now have to incur out of pocket expenses first where I didn’t have to before, or have the care facility bill correctly (not sure why it matters from one to the other, but I can only assume they write stuff off and others don’t), but I digress.
Obamacare and the employer mandates have made a royal mess of everything. They cost me in premiums and at tax time because I have a “Cadillac” health plan. I am double covered because of all the surgeries I have had and new were coming (2 neck, 2 hip, hernia repair and Cholecystectomy) and potential surgeries I might have in the future (low back / SI).
At this point I am beginning to wonder if it is worth it anymore.
I have nothing at all against medical insurance. But it should be voluntary. If someone doesn’t want it, and wants to deal with the risk of being uninsured, that is fine with me, and they should be able to make that decision without being punished or penalized by the government. However, that person should also be on his or her own if they need medical attention, and not expect or demand that the taxpayers fund his or her medical bills.
These huge insurance companies deserve all the losses that they get
Bump for later.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.