patrick.net

EBGuy says

Our small company group plan went to HealthNet when we jumped ship from our previous plan. I had never heard of them before, but so far, no complaints (after 1.5 years). Well, their insurance cards are cheap (heavy, but non laminated, paper) ... They seem to be taking this whole competition thing seriously. I hope they take share from the turds that refused to participate.

HMO or PPO?

mell says

Without getting into whether overall it's gonna be cheaper or not (haven't done enough research for this) I can confirm the Captain's claims in copays and deductible which have been getting progressively worse every year (which may or may not be related to Obamacare) and so do the denied claims or the portions of denied claims. Also I have had 4 PPOs so far, United Healthcare which was by far the best, Blue Shield of California coming in 2nd, Anthem Blue cross coming in 3rd and HealthNet coming in dead last by far. When your annual copays and deductibles rack up a couple grand each year there is nothing "affordable" about this for lower-middle-class or even middle-class income earners, so I feel for them.

Speaking of "doesn't get it", you are describing all the problems of the OLD system, not the new one. How exactly is Obama responsible for rates, co-pays, and deductibles that were rising every year before he was even president?

HMO or PPO?
HMO $30 co-pay. We were able to keep our existing primary physicians, OB/GYN, and pediatricians (we've hopped insurers every 2 to 3 years with "HMO plans" and never had problems keeping our doctors).

EBGuy says

HMO or PPO?

HMO $30 co-pay. We were able to keep our existing primary physicians, OB/GYN, and pediatricians (we've hopped insurers every 2 to 3 years with "HMO plans" and never had problems keeping our doctors).

Thanks, that's what I suspected. They are generally more cost-effective, but if you have anything that is hard to diagnose or want to get 2nd opinions they are not feasible. Same goes if you have established a great relationship with a good functional doc you can trust they will always be out-of-network, but even PPOs only pay little in that case.

Homeboy says

Speaking of "doesn't get it", you are describing all the problems of the OLD system, not the new one. How exactly is Obama responsible for rates, co-pays, and deductibles that were rising every year before he was even president?

He is serving his second term already if you haven't noticed yet.

curious2 says

dublin hillz says

my coverage is gonna cost.... I can get added to my wife's plan and pay....

You seem to have no idea what it's going to cost, because you don't seem to count the deductions and subsidies that you don't see. Your comment sounds like you would look at the tip of an iceberg or shark fin and think that's all there is to it, just the tip.

What we do know is that previous system had serious issues such as lack of coverage for pre-existing conditions and significant bankruptcy risk for serious illnesses. Thus, it was unacceptable. Regarding new system, it will ultimately be judged (at least by me) on dimensions of access, cost and quality. If it results in collective improvement over the previous status quo, at least it will be a step in the right direction.

CaptainShuddup says

I love this those making 17K will only have to pay $44 a month.

So if you're making 334 a week before taxes, that ends up being like 287 after taxes. About once every 4 weeks you'll have to pony up $44 for insurance.

OK elitists we all get it, $44 is peanuts, since most of can afford to use two twenties as a mainland china makeshift toilet and shit on two crisp twenty dollar bills, then hell I figure everyone can afford 44 bucks a month, right! right?

I mean come on! And well for those not even working, but not registered with the welfare system, well fuck 'em! Who needs 'em, push them over Granny run, I'll fire up the rocket test sled.

You bitch about poor people getting too much stuff from the government, then you bitch about poor people not getting ENOUGH stuff from the government. You are all over the map. You must have done a LOT of acid in the 60s.

mell says

He is serving his second term already if you haven't noticed yet.

I said "before he was president", not "before his second term".

What is your point? You hate Obamacare, but you wish he had enacted it sooner? LOL.

Homeboy says

Poor people will be covered by medicare - that's part of the ACA.

No, it isn't. There were proposals to reduce the age of Medicare eligibility from 65 to 50, or to eliminate the age restriction entirely, but Democrats rejected those in order to enact Obamacare instead.

Homeboy says

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.

You're so committed to Obamacare, you really ought to read it, because otherwise you sound like one of those religious fundamentalists who have never actually read the whole book that they claim to believe every word of. Next time you're sitting at your union hall, use some of that time to read the legislation that they sold you.

Homeboy says

mell says

He is serving his second term already if you haven't noticed yet.

Your point? I said "before he was president", not "before his second term".

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. Or maybe employers switched to crappier insurances.

Homeboy says

mell says

He is serving his second term already if you haven't noticed yet.

I said "before he was president", not "before his second term".

What is your point? You hate Obamacare, but you wish he had enacted it sooner? LOL.

What? Where do you come up with this shit? I don't "hate" Obamacare and I don't "wish" he had enacted it sooner. You need to learn how to discuss in a rational manner, data, observations, input from others without assuming political partisanship everywhere and personalizing everything.

The whole system makes me absolutely sick. Fee schedules have been pretty constant for the last 20 years in areas considered to be elective. Since insurance doesn't traditionally cover things like plastic surgery or IVF, prices are based on actual costs and what people can actually pay for such treatment. What's gone up in price? The drugs! Of course, those are often covered by insurance. Insurance companies inflate the costs of everything they touch. Now, with costs as they are, we are virtual prisoners of the system.

mell says

What? Where do you come up with this shit? I don't "hate" Obamacare and I don't "wish" he had enacted it sooner. You need to learn how to discuss in a rational manner, data, observations, input from others without assuming political partisanship everywhere and personalizing everything.

What??? You described all the problems of the OLD system. When I pointed out that those problems existed BEFORE Obama was president, you whined that it was already his second term.

You need to learn to start making sense.

mesll said: Same goes if you have established a great relationship with a good functional doc you can trust they will always be out-of-network, but even PPOs only pay little in that case.
I've had PPO plans at larger companies; I've noticed no functional difference with the HMO plans I have now. I'm in an urban area so YMMV -- Sutter East Bay Medical Foundation.

turtledove says

Insurance companies inflate the costs of everything they touch.

Exactly. Typically, insurers write that expressly into their contracts with providers, i.e. 'we'll include you in our network if you agree to charge triple to everyone who is outside our network.' Obamacare maximizes those forces, with the mandates controlled from DC and every state and provider lobbyist (the real beneficiaries are the revenue recipients) being issued a blank checkbook to write themselves money at public expense. The reason Obamacare was enacted when it was, is because prices had already exceeded what the market would bear and had to fall; in rush the lobbyists, like cavalry charging over the hill, to keep those prices climbing.

Here are more details, from the official source:

http://www.healthexchange.ca.gov/Pages/Default.aspx

In particular, these documents are useful

http://www.healthexchange.ca.gov/Documents/COVERED%20CA%20-%20Health%20Plans%20PRESS%20RELEASE%20FINAL%205%2023%2013.pdf

http://coveredca.com/news/PDFs/CC_Health_Plans_Booklet.pdf

What is MISSING: Complete rate tables for all age groups. I guess we have to wait for that. But in the meanwhile, let us have a look at available facts before jumping to conclusions.

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.

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?

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.

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

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?

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?

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.

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.

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.

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.

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.

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?

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.

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.

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.

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.

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....

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.

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.

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?"

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.

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.

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?

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.