What it would cost me. What would it cost you?

[Dr.Who]

I have (until the end of the year at least) a personal plan through Blue Cross Blue Shield of Texas. The letter stated that under the Affordable Care Act they will no longer be offering the current plan that I am on. I had a $1,000 deductible, a $20 copay, and it was an 80/20 split. I am young and almost never go to the doctor so it was great for me, and cheap. My wife has insurance through her job.

They stated they could put me on a new plan, which would be much more expensive, or I would probably be better off on the exchange. I won't get any subsidy, and Blue Cross estimated to me (based on what I don't know) that I could expect my deductible to go up to at least $3,000 or $4,000 -- at which point im paying for a plan that essentially has no benefit to me unless something major happens.

Hmmm? I am trying to understand all of this. So with an 80/20 split that means you pay 20% of expenses before or after your deductible?

Did they really state that you would be better off on the exchange? Do you believe that they are telling you what is best for you or maybe there are other motives for saying this?

Would a catastrophic plan be better for you and does one still exist?

 

[Cruella]

Hmmm? I am trying to understand all of this. So with an 80/20 split that means you pay 20% of expenses before or after your deductible?

Did they really state that you would be better off on the exchange? Do you believe that they are telling you what is best for you or maybe there are other motives for saying this?

Would a catastrophic plan be better for you and does one still exist?

Obamacare was designed to get the young healthy people paying more to cover what they are going to lose on older and sicker people who won't be paying much if anything. Without people like BigRob, Obamacare won't work.

 

[Dr.Who]

Obamacare was designed to get the young healthy people paying more to cover what they are going to lose on older and sicker people who won't be paying much if anything. Without people like BigRob, Obamacare won't work.

Well that is simply just true. In fact it is a basic truism here that must be shouted from the mountain and discussed in depth.

The fundamental change in insurance that is happening here is that no longer will the sick pay higher premiums than the healthy based on risk which is as it should be, but the healthy or rich will pay more than the sick and poor. Additionally, there will be other favored groups who will receive favored treatment at the expense of other groups in disfavor. What was insurance is now another program for redistribution masquarading (why is there no spell check icon up there above this text box?) as insurance. Along with the pre-existing condition clause we can now clearly state that any claims that what we have is health insurance are flatly wrong and what we really have is just a buyers club that favors some at the expense of others in which all are forced to buy a membership.

 

[dogtowner]

Obamacare was designed to get the young healthy people paying more to cover what they are going to lose on older and sicker people who won't be paying much if anything. Without people like BigRob, Obamacare won't work.

Even with all the Big Robs it wont come close to working. Even with the massive deductables it wont come close to paying for just the illegals. Justice Robrrys was right to call it a (massive) tax. Its all about getting your money.

 

[BigRob]

Hmmm? I am trying to understand all of this. So with an 80/20 split that means you pay 20% of expenses before or after your deductible?

Under my current plan insurance pays 80% of covered expenses after I meet the deductible. There is cap in there though that once its hits they pay 100%. I forget the exact amount, it is much higher and really basically a safety net should some major thing occur.

Did they really state that you would be better off on the exchange?

I called them and was told that by whoever took my call...it very well might be true maybe the exchange will be cheaper, but the exchange has never worked for me to confirm anything one way or the other -- and given the whole concept of how the system will work, I tend to doubt I will be getting a discount -- but we shall see.

Do you believe that they are telling you what is best for you or maybe there are other motives for saying this?

Not sure. It's hard to say fully without being able to get accurate pricing from the exchange.

Would a catastrophic plan be better for you and does one still exist?

I am under the impression those do still exist, but from the limited info I have seen it would be about the same or more as what I currently pay -- but that again is not based on real numbers that were given to me by the exchange, since it just crashes every time I try to access it.

 

[Dr.Who]

Under my current plan insurance pays 80% of covered expenses after I meet the deductible. There is cap in there though that once its hits they pay 100%. I forget the exact amount, it is much higher and really basically a safety net should some major thing occur.

So you pay 20% of covered expenses up to some cap. Sounds kind of like another deductible - in practice.

Ok then, I think I understand. I have never had an 80/20 split so it is something that has always been a bit fuzzy for me.

Would the obamacare plan have the 80/20 split? If not then it could end up paying more for you if you get sick.

Just looked it up:

bronze - 60/40 split
silver - 70/50
gold - 80/20
Platinum - 90/10

Each plan also has a cap of some sort. It seems to be about 12k for a family.

All that being said the gov website does not really offer insurance at all and there is no reason that you cannot still shop around for yourself. I use an insurance broker who does all the work for me and tells me what plan he has found that works best for me. The broker gets paid a commission from the insurance company (I wonder of the gov is getting a commission) and usually has a previous relationship with a number of companies that he chooses from. Even with his commission he has still always found me better plans for home, health, auto, and life than I have ever found on my own. He is also the one person I can always count on to answer his direct line and help me out whenever I have an insurance concern. I can't say too much good about my broker.

Come to think of it the gov is really doing nothing more than acting as a broker and competing with private brokers all over the country. Why does anyone need the website? I know brokers don't offer subsidies but sibsidies could be provided without the webste.

I hope you find the health care you need. Talking this out has been interesting and hopefully helpful. let me know if you need anything else.

 

[dogtowner]

[quote="Dr.Who, post: 219328, member: 572. So you pay 20% of covered expenses up to some cap. Sounds kind of like another deductible - in practice.

Ok then, I think I understand. I have never had an 80/20 split so it is something that has always been a bit fuzzy for me.

Would the obamacare plan have the 80/20 split? If not then it could end up paying more for you if you get sick.

Just looked it up:

bronze - 60/40 split
silver - 70/50
gold - 80/20
Platinum - 90/10

Each plan also has a cap of some sort. It seems to be about 12k for a family.

All that being said the gov website does not really offer insurance at all and there is no reason that you cannot still shop around for yourself. I use an insurance broker who does all the work for me and tells me what plan he has found that works best for me. The broker gets paid a commission from the insurance company (I wonder of the gov is getting a commission) and usually has a previous relationship with a number of companies that he chooses from. Even with his commission he has still always found me better plans for home, health, auto, and life than I have ever found on my own. He is also the one person I can always count on to answer his direct line and help me out whenever I have an insurance concern. I can't say too much good about my broker.

Come to think of it the gov is really doing nothing more than acting as a broker and competing with private brokers all over the country. Why does anyone need the website? I know brokers don't offer subsidies but sibsidies could be provided without the webste.

I hope you find the health care you need. Talking this out has been interesting and hopefully helpful. let me know if you need anything else.[/quote]
The governments role in this is to be the goon who empowers the extortion

 

[Cruella]

BigRob...did you ever find out anything?

California has a calculator at "Covered California" that might give you an idea of how the exchanges work.

I'm not sure how Calif compares to where you live.