Posted on 08/13/2013 5:49:29 AM PDT by grundle
Rod Coons and Florence Peace pay $403 a month for a family health plan that covers barely any medical care for either of them until he or she reaches $10,000 in claims in a given year. And that’s just the way they like it.
“I’m only really interested in catastrophic coverage,” says Coons, 58, who retired last year after selling an electronics manufacturing business in Indianapolis. Beyond their premium, the couple typically spends no more than $500 annually on medical care, Coons says. “I’d prefer to stay with our current plan.”
That won’t be an option next year. In 2014, plans sold on the individual and small-group markets will have to meet new standards for coverage and cost-sharing, among other things. In addition to providing 10 so-called essential health benefits and covering many preventive-care services at no cost, plans must pay at least 60 percent of allowed medical expenses and cap annual out-of-pocket spending at $6,350 for individuals and $12,700 for families.
Coons is none too pleased, either. “I’m happy with where I’m at right now, but it doesn’t look like that’s where I’m going to be at in the future,” he says. Coons plans to look for coverage through the online state marketplace. The couple may qualify for subsidies available to people with incomes up to 400 percent of the federal poverty level ($62,040 for a couple in 2013).
(Excerpt) Read more at stltoday.com ...
No plain insurance plans anymore under BammyCare. Just rerouted medical payment plans with insurance tacked on.
After I was laid off in ‘97 I got a catastrophic care plan. It cost $1,100 and only covered me if I went into the hospital for an operation or broken bone, etc. It did not cover drugs or office visits, unless they were related to hospitalization. It was a great buy. I spent 20 minutes in surgery for a hernia and the bill was $16,000. But because I had insurance there was a “courtesy” reduction of $4,000 right off the top. Then the insurance company negotiated the price down to $8,000 of which I paid my $2,500 deductible. I feel the whole thing was worth the $2,500 I paid but no more. I was in the hospital building a total of 4 hours but under “care” for less than an hour. The whole problem is the law insists that hospitals fix everything for free. Most of the emergency room visits are people living for free off the system. I watch these people and they’re alcoholics and drug users and their families that are being enabled by the government to indulge their disease and sponge off the rest of us. Obmacare institutionalizes this enabling to the highest degree imaginable.
I can’t wait to see commercials and news stories that show Obama saying,
“if you like your plan, you can keep it”
“your insurance premium will go down by as much as 400%”
“the affordable care act will not increase the deficit”
These actually write themselves, but the right will do nothing about it.
Catastrophic coverage is insurance; everything else is a socialized pre-payment plan. Taken together, the two components make up what we commonly call “health insurance.”
It is also important to realize that government interference so distorts the market that there is another important component to this which I call “club membership.” The pricing of medical services is dramatically dependent on which club (Blue Cross, Medicare, etc) you belong to.
This means that if you are uninsured, you are not in a pricing club. If you’re on the dole and have no assets, then it doesn’t matter. But, if you have some assets, you are charged exorbitantly—you are looted in the most predatory and government supported fashion. We’re talking 50 dollar aspirins, quintuple charges on all tests and procedures. You can see this yourself by looking on your insurance statement and seeing the list charges and the amount the insurance company actually pays.
Even the negotiated amount is inflated from the true cost, because it has to carry all of those who don’t pay at all.
People like these kind of plans because it gives them, as the individual, more control over their healthcare spending.
Obama hates them for the same reason.
I had a low premium/high deductible plan until 2012. Then it became a high premium/high deductible plan. From $3500/yr -$5000 deductible to $12,500/yr - still $5000 deductible. I ask why and the answer is always ACA. (Had previous cancer diagnosis 9 years ago, but no claims after treatment)
Somebody better be getting low cost plans because I’M paying for them.
Obamacare will give this guy his wish, out of pocket caps are being dropped for 2014. He can buy Obamacare and spend lots of money on care too.
If these people voted for Sen. Claire Mccaskill (D-MO) they are getting what they voted for, and they should contact her about their lousy insurance situation. Every Democrat voted for ObamaCare. Don’t let the weasels fool you.
How did they vote?
But they are getting free contraceptives.
And the Monsanto people on FR wail in protest at the mere mention of this eventuality.
I have many friends who pay direct for medical care. They negotiate rates for major care and the costs are often significantly lower.
Bttt
Case in point: I have family members with chronic medical conditions. They are not "frivolous issues" nor do they go away, unless someone were to die. My company forced everyone onto high deductible plans this year. There was no option other than high deductible or cosmic deductible. It effectively reduced my salary by $12K plus premium costs. We hit the deductible within 3 months, but I had to finance the out-of-pocket costs. I really have no idea how I will pay for this next year. Get a new credit card, I guess.
“Then the insurance company negotiated the price down to $8,000 of which I paid my $2,500 deductible.”
Oklahoma Surgery Center does an inguinal hernia for $3,060 if you don’t saddle them with insurance.
http://www.surgerycenterok.com/?procedure_category=hernia-includes-mesh#jump
I agree. They are generally also good for those who are healthy and who fall into a low-risk category. I don't by any means think they should be the only policies available, but I do think they should be available. I also don't think any employer, or our government, should be able to ‘force’ anyone into a policy they don't want.
I'm sorry about your family members having to deal with chronic medical conditions. It's very hard, and depending what you are dealing with can be very, very expensive. I do strongly believe that we need to deal effectively with the insurance issues surrounding chronic medical conditions. If one wound up with Crohn’s disease, or bad rheumatoid arthritis, for instance, those are not due to one’s life choices and could happen to any of us (especially if genetically predisposed). It should not financially ruin a family because something like this happens. Obamacare is not the answer.
My unsolicited advice would be to try to negotiate with your doctors, and also to look for alternative sources for the medications you may be buying. It doesn't hurt to contact the pharmaceutical company that makes a particular expensive medication, and ask if there are ways to decrease the cost. You probably have been through all of that, so I apologize if offensive.
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