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California picks 13 health plans for state-run insurance market


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2013 May 23, 5:17am   13,052 views  66 comments

by Homeboy   ➕follow (0)   💰tip   ignore  

http://www.latimes.com/business/money/la-fi-mo-covered-california-health-plans-20130523,0,2769699.story

In a southern Los Angeles County region, for instance, rates for a 40-year-old person purchasing a "Silver" plan ranged from $242 a month for Health Net Inc. to $325 per month for Kaiser Permanente. Blue Shield would charge $287 a month.

Overall, Covered California said the rates submitted for next year's individual market ranged from 2% higher to 29% below the average premium now for small-employer plans in the state's biggest metro areas.

Up to 29% CHEAPER? Wait, I thought "Obama lied". According to everyone here, rates were supposed to go through the roof.

The agency said the winning health plans whittled their profit margins down to 2% to 3% and negotiated lower reimbursements for hospitals and doctors to help hold down premiums.

Wait, didn't you guys say the only point of Obamacare was to line the pockets of the insurance industry? I'm curious how that's going to happen with only a 3% profit margin.

I currently have HealthNet through my union. It's group insurance, and qualifying depends on how much work I get that pays into the fund. I qualify every 2 years, if at all. On the odd years, I have to either go on COBRA or get a cheap high-deductible plan and go through hell trying to qualify with "pre-existing conditions". I went on COBRA several years ago. Do you know how much it cost? $480 a month. I see that ANYONE will now be able to get HealthNet insurance for $242 a month. That's 50% less.

So what say you, all the Chicken Littles who said the sky was falling, and that Obama was sending us all to the poor house?

#politics

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33   Homeboy   2013 May 23, 6:36pm  

CaptainShuddup says

For example my wife was paying $75 for x-rays, ultrasound, and procedures like that, where as our insurance copay is $250 to $500 with insurance.

Fucking bullshit. The co-pay for an xray is not $500. You are a god damn liar, Ten Pound Ass.

34   Homeboy   2013 May 23, 6:38pm  

justme says

CaptainShuddup says

Oh and I forget about all of the shit that wont even be covered.


Like colonospopies, they cover 0%.

Are you SURE about that? Reference? I think you may be wrong, because in 2013 there was a new rule that ALL California health plans were required to cover colonoscopy screenings. I doubt that will be reversed in 2014.

Captain, I am suspicuous that you have again posted propaganda that is untrue.

No, colonoscopies are covered. It's "colonospopies" that aren't covered. :D

35   Tenpoundbass   2013 May 23, 11:30pm  

justme says

Captain, I am suspicuous that you have again posted propaganda that is untrue.

What since you don't have any clarity on OC, everyone else is lying?

36   Tenpoundbass   2013 May 23, 11:32pm  

Homeboy says

No, colonoscopies are covered.

Sure for people over 52. The Doctor sent my wife we did not ask to go. And what the fuck are we complicated insurance lawyers, that know what's covered and what is not?

37   mell   2013 May 24, 12:46am  

Homeboy says

mell says

Well, part of the increases happened before Obama and part happened since he took office - that's why I didn't explicitly blame him but this trend seems to have accelerated over the past few years.

Do you have any actual evidence to support the assertion that rate increases "accelerated" after Obama took office? Any at all?

Yes, plenty. Do your homework.

38   mell   2013 May 24, 12:50am  

Homeboy says

CaptainShuddup says

For example my wife was paying $75 for x-rays, ultrasound, and procedures like that, where as our insurance copay is $250 to $500 with insurance.

Fucking bullshit. The co-pay for an xray is not $500. You are a god damn liar, Ten Pound Ass.

You are the one talking BS - if you have to take your kid into the ER after hours you pay way over $500 for an xray plus 5 minutes with the doc. Fuck copays, this is real life.

39   Tenpoundbass   2013 May 24, 1:06am  

Homeboy says

Do you have any actual evidence to support the assertion that rate increases "accelerated" after Obama took office? Any at all?

Homeslice, are you saying, Obama didn't say...
"And everybody is going to pay their fair share, so people don't abuse the healthcare we're going to have higher co pays and deductibles and coins payments to discourage unnecessary doctor visits. "

Homeboy says

No, YOU don't fucking get it. Poor people will be covered by medicare - that's part of the ACA.

Many people will qualify for federal assistance toward their premiums based on their income.

In California, individuals earning less than about $16,000 a year will qualify for an expansion of Medi-Cal, the state's Medicaid program for the poor. Above that threshold, individuals making less than $46,000 a year and families earning below $94,000 annually will qualify for federal subsidies.

If you think people making 17K can afford to pay a $44 premium, then the deductibles on top of that, then I can't reach you.
At least some of us here in this thread have actually been to the Doctor lately.
Hint, they aren't the ones calling people liars.

40   humanity   2013 May 24, 1:14am  

CaptainShuddup says

Sure for people over 52

Who wants a colonoscopy before the age of 52 ? That is the preventive maintenance type of colonoscopy is what you're talking about, given after age 52.

If someone is diagnosed to have an intestinal problem that requires a colonoscopy for diagnosis, (under age 52) obviously that would be covered too.

41   dublin hillz   2013 May 24, 1:55am  

To a certain degree the best way to eventually compare the pre ACA with ACA era will be kinda like buy vs rent - lifetime costs. In other words over the course of your lifetime, which policy is going to result in you spending more money? Just like with buying vs renting, with buying it initially costs more up front in terms of down payment and year 1 PITI higher than rent, but over your lifetime it often times is significantly cheaper to buy.

42   Tenpoundbass   2013 May 24, 2:10am  

humanity says

CaptainShuddup says

Sure for people over 52

Who wants a colonoscopy before the age of 52 ? That is the preventive maintenance type of colonoscopy is what you're talking about, given after age 52.

What do you do when your wife's Doctor tells you to get one, because you have Gastroenteritis and he wanted to see the extent of the ulcerations.
We keep telling the ins company that it had nothing to do with Cancer screening? What are we supposed to do, die if you're under 52?

I can understand not paying for it, because hypochondriacs are requesting the screening because they are freaking out because they know someone else that died.

Blood was in the stool and the Doctor ordered the test, that should be the end of it.
And by the way, the list of what is paid colonoscopies are not very clear.
If Obama care is nothing but the death panel that the Republicans warned us about early on. Then keep bitching and call me a liar. If it's not, look more closely and do some research your self, look at your own insurance policy. If you're not insured then shut your fucking Piehole and quit talking out of your Ass.

If you know damn well I'm talking about, but you're heavily invested in the new health economy and you wish that I would shut up and go away, and you think I'm fucking with YOUR money now.

...hehe WELL get used to it.

I'll have plenty of company in 2014, when those other Assholes that believes your Shit, get their Bill.

I will post an image of a bill that verifies everything I've been saying since November of last year, if you will then promise to not post on Patnet ever again and quit what ever Social media Liberal bad news spin rescue organization you belong to now.

Deal?

43   Tenpoundbass   2013 May 24, 2:20am  

dublin hillz says

Just like with buying vs renting, with buying it initially costs more up front in terms of down payment and year 1 PITI higher than rent, but over your lifetime it often times is significantly cheaper to buy.

Let me put to you this way. For 90% of us, ACA will be an extra layer on top of an inflated healthcare system, that you'll be footing the full bill for all medical expenditures.

Gone are the days when you go the Doctor and pay $25, $35, $50 or even $75 copay office visit and have that bee the end of it. Now you will get a bill for...

1)having the blood drawn $50
2)the lab that processed the blood $125
3)the tech who did the blood work $50
4) the tech who read the results and commented $225

Then you'll pay another $75 office visit when you go back to the doctor to have him print out the results.

This has been the pattern, we've found since January. Last year all of those other charges were completely covered. The prices I'm showing are what they say we owe. The lab charge was inflated like $600 or more, then it makes $125 seem like a bargain.

But earlier last year when we went to cash doctors. We just paid $75 to see him , then $225 for a blood test, and he wouldn't charge us to come in and hear the results.

44   curious2   2013 May 24, 2:23am  

dublin hillz says

To a certain degree the best way to eventually compare the pre ACA with ACA era will be kinda like buy vs rent - lifetime costs. In other words over the course of your lifetime, which policy is going to result in you spending more money?

As I said above, the federal government's own projections say that this calculation will be higher overall with Obamacare than under prior law. But, you seem to be saying, if Homefool can shift more of the the cost of his disproved SSRIs onto everyone else via mandatory subsidized insurance, so he pays less personally, then that "benefit" justifies everyone paying more overall.

You seem to overlook other, deeper costs though. For the first time, the federal government has now arrogated itself the power to penalize your "mental activity" (as federal judge Kessler put it in upholding Obamacare) if your mental activity results in you not buying what their patronage networks are selling. Similarly, people whose behavior is identical can be taxed differently depending on whether the IRS certifies their particular religion as a "bona fide" sect. The federal government acquiring unprecedented power at the expense of the citizenry is a cost, and what is the benefit? Those who would trade liberty for security end up with neither.

45   justme   2013 May 24, 3:56am  

CaptainShuddup says

This has been the pattern, we've found since January.

Did you change to a high-deductible plan and not tell us that important fact?

Please state EXACTLY which health plan you have, and if you don't mind, which medical group is your provider. There is something missing in your story. Some parameter has changed.

46   Tenpoundbass   2013 May 24, 4:10am  

It's the bronze plan the same plan being touted in the OP as a smashing success.
I'm saying while Premiums either will or not be affordable depending on who you ask and who's actually paying it.
We ALL will have deductibles. And just how do you expect someone bringing home less than 300 a week to pay over $500 in copay's, when all they did was go to the doctors for a regular check up and preventive maintenance as Liberals said all along we should do, then they will get stuck with a big bill.

Even life saving surgery will be hard to get in many hospitals if one wont have their 20% to 40% co insurance payment. Usually due up front.

47   dublin hillz   2013 May 24, 4:17am  

curious2 says

As I said above, the federal government's own projections say that this
calculation will be higher overall with Obamacare than under prior law. But, you
seem to be saying, if Homefool can shift more of the the cost of his disproved
SSRIs onto everyone else via mandatory subsidized insurance, so he pays less
personally, then that "benefit" justifies everyone paying more overall.

I am not in favor of anyone shifting costs to anyone else and am not a fan of "rob peter to pay paul" policies in general. What I am saying is that previous system had issues such as pre-existing condition denial, inadequate coverage for many and bankruptcy posibilities for many people. I am open to anything that will change the costs/access issues. Some of the reasons for high costs may be the insane amount of money that it costs doctors to aquire degrees - heck some of them graduate with equivalent of a mortgage debt on mcmansion and frivolous lawsuits such as an 85 year old dying on a heart procedure and family suing for "damages". Something is fundamentally broken although to be fair if an american citizen made it to 75, they have the highest remaining life expectancy in the world perhaps due to lack of death panelism....

48   Homeboy   2013 May 24, 5:22am  

mell says

You are the one talking BS - if you have to take your kid into the ER after hours you pay way over $500 for an xray plus 5 minutes with the doc. Fuck copays, this is real life.

You don't seem to understand what the word "co-pay" means.

49   Homeboy   2013 May 24, 5:25am  

mell says

Do you have any actual evidence to support the assertion that rate increases "accelerated" after Obama took office? Any at all?

Yes, plenty. Do your homework.

If you have evidence, then present it. If not, then you are full of shit.

50   curious2   2013 May 24, 5:28am  

Homeboy says

You don't seem to understand what the word "co-pay" means.

LOL - Homefool, you don't seem to understand what the word "insurance" means. Here is a real-life example. "We have two X-ray machines. The old one covered by your insurance uses more radiation and delivers worse results. The new one uses less radiation and delivers better results, but your insurance does not cover it, so you would have to pay on your own. Which one do you want us to use?"

51   Homeboy   2013 May 24, 5:28am  

CaptainShuddup says

Sure for people over 52. The Doctor sent my wife we did not ask to go. And what the fuck are we complicated insurance lawyers, that know what's covered and what is not?

So, let me see if I understand this. You claimed that when the ACA insurance exchanges begin this fall (they haven't begun yet, you know), that "colonospopies" will not be covered. And now, you appear to be basing this belief on what happened to you IN THE PAST, with your insurance policy that is NOT part of the ACA exchange.

Just complete bullshit, like everything else you write.

52   Homeboy   2013 May 24, 5:32am  

CaptainShuddup says

Homeboy says

Do you have any actual evidence to support the assertion that rate increases "accelerated" after Obama took office? Any at all?

Homeslice, are you saying, Obama didn't say...

"And everybody is going to pay their fair share, so people don't abuse the healthcare we're going to have higher co pays and deductibles and coins payments to discourage unnecessary doctor visits. "

I don't even know what this is supposed to mean. It certainly isn't evidence that the rise in insurance premiums "accelerated" when Obama took office. Premiums were actually rising at the fastest rate BEFORE Obama was even president. I mean, DUH! - why would the Obama administration have even been TALKING about insurance reform if the problem didn't already exist? You guys know this perfectly well, but you're trying to deflect from the point with gibberish.

53   Homeboy   2013 May 24, 5:36am  

CaptainShuddup says

If you think people making 17K can afford to pay a $44 premium, then the deductibles on top of that, then I can't reach you.

At least some of us here in this thread have actually been to the Doctor lately.

Hint, they aren't the ones calling people liars.

Again, in other threads, you have complained about the poor getting too many benefits from the government. Now, when the poor will be getting subsidies for health insurance, which they never got before, you are complaining that it's not enough.

What the fuck, man? Do you even listen to yourself?

54   Homeboy   2013 May 24, 5:41am  

CaptainShuddup says

Gone are the days when you go the Doctor and pay $25, $35, $50 or even $75 copay office visit and have that bee the end of it. Now you will get a bill for...

1)having the blood drawn $50

2)the lab that processed the blood $125

3)the tech who did the blood work $50

4) the tech who read the results and commented $225

Then you'll pay another $75 office visit when you go back to the doctor to have him print out the results.

More lies, more bullshit. That is not what "will be", that is what "has been". We all figured out you have some kind of catastrophic insurance plan where you have to pay for everything out of pocket. I had one of those plans last year, and it sucked. Next year, it looks like I'll be able to get a much better plan for HALF what it used to cost. I won't NEED to have that stupid high-deductible plan anymore.

Obviously you are a hypochondriac who goes to the doctor every 5 minutes, so you should be happy that affordable health insurance will now be available to everyone.

CaptainShuddup says

This has been the pattern, we've found since January. Last year all of those other charges were completely covered. The prices I'm showing are what they say we owe. The lab charge was inflated like $600 or more, then it makes $125 seem like a bargain.

Then you obviously have really shitty insurance. That's part of why ACA was passed, to stop insurance companies from bilking suckers like you.

55   Homeboy   2013 May 24, 5:47am  

CaptainShuddup says

I will post an image of a bill that verifies everything I've been saying since November of last year, if you will then promise to not post on Patnet ever again and quit what ever Social media Liberal bad news spin rescue organization you belong to now.

I'm sure I've told you this 10 times or more, but the major provisions of ACA haven't taken effect yet. So what would you be proving? That health care sucked before ACA? I already agree. Show me something that proves ACA has made healthcare WORSE, because that's what you keep saying.

You might possibly be the most obtuse person I have ever encountered.

56   Homeboy   2013 May 24, 5:51am  

CaptainShuddup says

It's the bronze plan the same plan being touted in the OP as a smashing success.

I'm saying while Premiums either will or not be affordable depending on who you ask and who's actually paying it.

The only plan mentioned in the OP is the silver plan. Do you ever get tired of lying?

I don't see how you can have a "bronze" plan, since they don't exist yet.

57   Tenpoundbass   2013 May 24, 6:08am  

There are three tiers do you even have insurance?
Or do you just like the idea of everyone else paying into it, while you work for people who are exempt because they are great at community organizing?

58   humanity   2013 May 24, 6:17am  

CaptainShuddup says

I will post an image of a bill that verifies everything I've been saying since November of last year, if you will then promise to not post on Patnet ever again and quit what ever Social media Liberal bad news spin rescue organization you belong to now.

Deal?

What the...

I don't claim to know how good Obamacare will be. But unlike you, I'm not HEAVILY HEAVILY HEAVILY HEAVILY HEAVILY HEAVILY HEAVILY HEAVILY HEAVILY emotionally invested in it being bad.

I find it fascinating that IF Obama care turned out to not be as bad as you hope it is, THEN you're going to be very disappointed.

I've heard you saying you're for medicare for all or what I think you call socialized medicine. Me too.

The difference is that I understand that Obama didn't think he could get that
(I wish he had gone for it - nut look at the resistance he gets to far less radical change). He thought that would be too much of a traumatic change. So we have a system that has the insurance companies still involved, that attempts to achieve what MIGHT turn out to be impossible.

It is interesting though, that the insurance companies must know, that if health care costs don't drop, they will be replaced by medicare for all.

But here's some logic about Obama care:

Either it's decent,...or

it isn't and we can then take another step closer to the nationalized health care system we should have.

But what the hell is all this emotion you have invested in Obama failing all about ? I'll have to assume it's some kind of "southern" thing.

59   Tenpoundbass   2013 May 24, 6:23am  

Well what in the hell are you worried about then don't worry about everything is fine, Obamacare will be great for you. It's just like they promised, even with a fucking cherry on top.

You don't even have insurance, so don't worry about it.
It will all be free right?

Jack Ass!

60   Tenpoundbass   2013 May 24, 6:24am  

And remember Children I bitch about it first, long before those other clowns even make issue of it...

http://video.foxnews.com/v/2407088496001/growing-concern-over-irs-role-in-implementing-obamacare/?playlist_id=1621774019001

61   Homeboy   2013 May 24, 6:41am  

CaptainShuddup says

There are three tiers do you even have insurance?

Do you? 'Cuz I don't know what the fuck you're talking about. Anthem, for example, has 10 different plans available. There's no "three tiers".

https://www.anthem.com/ca/health-insurance/plans-and-benefits/health-insurance-plan

62   Homeboy   2013 May 24, 6:44am  

By the way, Captain, I don't know why I should help you, but...

If you are getting bills from your doctor for things that the insurance was supposed to cover, the doctor is trying to scam you. They have a negotiated rate with the insurance company, and the doctor wants more money for the procedure than the insurance company wants to pay. It happened to me. They're hoping you'll just send them a check. I had to make some phone calls to get them to drop the charges.

63   humanity   2013 May 24, 6:52am  

CaptainShuddup says

You don't even have insurance, so don't worry about it.

I have insurance.

CaptainShuddup says

Jack Ass!

Was it my logic and common sense that pissed you off ?

Or was it more about the laser like precision of my observations about your heavy investment in Obamacare being a failure as well as Obama in general.

My advice: try to learn to be less emotional about these things. At this point you are far to predisposed to assuming that Obama is bad. It's affecting (notice my proper use of this word) your ability to think straight.

Good thing it isn't an interpersonal relationship. Because with that much bias in a relationship, your negative expectations would be sure to be self fulfilling.

64   Tenpoundbass   2013 May 24, 7:19am  

Sure thing, every thing's coming up roses Ethel.

65   justme   2013 May 25, 3:34am  

Homeboy, should this thread be in HealthCare and not Politics? Can it be moved?

66   marcus   2013 May 25, 4:54am  

Moving it is very easy. Just open edit, for the original post, and find the drop down selector, and change the selection to health.

Maybe he feels like it gets more views here. It is a political issue too.

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