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 Hawty & Nawty
Posts: 20424
 
| My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer. |
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 Hugs to You
Posts: 7551
  
Location: In The Land of Cotton | Taking care of Obama?
Just had to say that. This is going to effect more and more people, sooner then later. |
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Hawty & Nawty
Posts: 20424
| How many different of these "unknown" companies are under this umbrella? |
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 Expert
Posts: 4121
Location: SE Louisiana | I'll tell you the same thing I told my dad when he saw the government buying bonds right after the SC gave the OK for this blasphemy we call obozocare.. He couldn't figure out where they were getting the money to do this and I told him it HAD to be coming from money expected from the new health care... Obozocare has nothing to do with health care, it's all about paying down on the $17,000,000,,000,000 national debt these a$$holes ran up. |
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 Expert
Posts: 1432
Location: Never in one place long | Wow, unbelievable! Sounds like the system is complete crap!!!!!!!! I would be livid. Definitely sounds like Obamacare is saving Americans!!!  sigh..... |
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 I Prefer to Live in Fantasy Land
Posts: 64864
Location: In the Hills of Texas | I no longer have healthcare that I pay $500.00 a month for...I now have catastrophic insurance. Sucks! My deductible is $6,000. I wish I had the money we have paid into healthcare just since the DickTator has taken office. |
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 Shelter Dog Lover
Posts: 10277
| First off, this isn’t a new law. Second, after cost sharing, an ER pays about 10K/year per individual enrolled. I’ve only seen one or two cases where the penalty exceeds what an ER is currently spending. Example: Enrolled Employees: 10 Cost of Current HC:$100,000 Eligible Employees: 20 Potential Penalty: $40,000 The law creates a HUGE incentive to drop coverage and send EEs to the exchange. Only the competitive disadvantage of no longer offering coverage is currently keeping ERs offering coverage. Whoever wrote this article is lying to convince the public that we’re not moving toward socialized HC.
She sees so much that is different then what was sold to the public.
There still will be pre- existing condition clauses. She has a client that is trying to figure out how to cover an employee who has an autistic child. It is a non-profit, does not have the $$ to afford the cost of covering an autistic child, the CEO makes 90K a year, avg salary is 60K. Cost to cover the child is estimated at 100K per year. Because of the ACA, the company has to offer an all or nothing plan. They are opting to not cover the child. One would think just get him covered under the ACA, no networks in their area offer plans to cover him.
She is seeing the trend of doctors not accepting ACA because when an indiviual is enrolled, they are considered covered for 60 days even if they have not paid their premiums. Dr. offices verifying enrollment will be told they are enrolled, however at the end of 60 days if premiums are not paid they get kicked off the exchange and the doctors will not be reimbursed for their expenses even though they were told they were covered. It is up to the doctors to collect payment from the indiviual.
I could write pages and pages on what she tells me about the ACA and the ridiculousness of it. There are formulas to calculate employee hours worked, seems like it should be simple right? She said she does not have one client who can do it in house, all have to hire it out and it is so complicated.
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 Accident Prone
Posts: 22277
Location: 100 miles from Nowhere, AR | rodeomom3 - 2014-05-28 1:30 PM
First off, this isn’t a new law. Second, after cost sharing, an ER pays about 10K/year per individual enrolled. I’ve only seen one or two cases where the penalty exceeds what an ER is currently spending.
Example:
Enrolled Employees: 10
Cost of Current HC:$100,000
Eligible Employees: 20
Potential Penalty: $40,000
The law creates a HUGE incentive to drop coverage and send EEs to the exchange. Only the competitive disadvantage of no longer offering coverage is currently keeping ERs offering coverage.
Whoever wrote this article is lying to convince the public that we’re not moving toward socialized HC.
She sees so much that is different then what was sold to the public.
There still will be pre- existing condition clauses. She has a client that is trying to figure out how to cover an employee who has an autistic child. It is a non-profit, does not have the $$ to afford the cost of covering an autistic child, the CEO makes 90K a year, avg salary is 60K. Cost to cover the child is estimated at 100K per year. Because of the ACA, the company has to offer an all or nothing plan. They are opting to not cover the child. One would think just get him covered under the ACA, no networks in their area offer plans to cover him.
She is seeing the trend of doctors not accepting ACA because when an indiviual is enrolled, they are considered covered for 60 days even if they have not paid their premiums. Dr. offices verifying enrollment will be told they are enrolled, however at the end of 60 days if premiums are not paid they get kicked off the exchange and the doctors will not be reimbursed for their expenses even though they were told they were covered. It is up to the doctors to collect payment from the indiviual.
I could write pages and pages on what she tells me about the ACA and the ridiculousness of it. There are formulas to calculate employee hours worked, seems like it should be simple right? She said she does not have one client who can do it in house, all have to hire it out and it is so complicated.
Re: the autistic child
my nephew has profound apraxia and is covered under TEFRA, a division of Medicaid. My sister and BIL pay a small portion that's set on a sliding scale per income. They couldn't afford his treatment or health coverage otherwise. |
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Hawty & Nawty
Posts: 20424
| I'm not trying to get the conservative base all ruffled up. I just truly would like to know where the fines, fees and other cost are actually going. If this is Goverment care then it is reasonable to expect some kind of Goverment report. Something that explains where the taxes are being used and the bodies of individuals in charge of making these important decisions for us. There are more than just "Death Panels" There must be some other panels of experts that are ensuring we are being financially prudent. Isn't that a reasonable expectation? Is it reasonable that unknown companies are being subsidized with our tax dollars yet are not funded to pay for a live person to operate the phone?
That sure is a ton of trust on the American people with thier money isn't it?
So, let me go on further to question this; all that private information you entered into your laptop...where did it go? To these unknown companies? Do they now know everything about you including in some cases your political affiliation?
Is this reasonable?
What if they are based out of caves in Afghanistan? I'm not kidding.
Who knows what's going on for sure? Why? Because your Senator, Congressman and maybe your best friend who talks a good game tells you to stop worrying everything will be alright?
It's not okay. It's not alright. Something is wrong. And guess what it's hitting ALL PARTIES. My friend is a die hard Obama supporter until this. She feels utterly let down because she remembers clearly...."If you like your insurance, you can keep your insurance."
Well guess what?
Edited by RidenFly 2014-05-28 1:51 PM
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Hawty & Nawty
Posts: 20424
| Is ObamaCare considred Non profit? |
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Hungarian Midget Woman
Location: Midwest | RidenFly - 2014-05-28 2:02 PM Is ObamaCare considred Non profit?
Obamacare is the nickname for the Affordable care act.
Plans offered over the exchange websites are all from private insurance companies. So those are not a non-profit.
Some insurance companies, like Aetna, are choosing to only offer insurance through group plans and not offer anything over the exchanges. |
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Hawty & Nawty
Posts: 20424
| barrelracr131 - 2014-05-29 12:09 PM RidenFly - 2014-05-28 2:02 PM Is ObamaCare considred Non profit? Obamacare is the nickname for the Affordable care act.
Plans offered over the exchange websites are all from private insurance companies. So those are not a non-profit.
Some insurance companies, like Aetna, are choosing to only offer insurance through group plans and not offer anything over the exchanges.
Cool. So who is awarded the fines and did were they clear where that money would be allocated? |
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 Ms. Poutability
Posts: 2362
Location: In my own world | I think what happened to your friend but it may not be just and Obamacare thing. My mother in law suffered a hemorrhagic stroke nearly 5 yrs ago and passed away. She was flown by the flight for life from a local hospital to a larger one equipped to handle her care. We paid the $15,000 bill for the helicopter ride because the company used was not covered by her insurance. We talked to the insurance company, a lawyer and the helicopter service because like your friend we didn't get to pick the service used. We didn't even know she was in flight until she made it to the bigger hospital. But we still had to pay the bill |
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Ms. Poutability
Posts: 2362
Location: In my own world | I think what happened to your friend but it may not be just and Obamacare thing. My mother in law suffered a hemorrhagic stroke nearly 5 yrs ago and passed away. She was flown by the flight for life from a local hospital to a larger one equipped to handle her care. We paid the $15,000 bill for the helicopter ride because the company used was not covered by her insurance. We talked to the insurance company, a lawyer and the helicopter service because like your friend we didn't get to pick the service used. We didn't even know she was in flight until she made it to the bigger hospital. But we still had to pay the bill |
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Hawty & Nawty
Posts: 20424
| livinonlove&horses - 2014-05-29 12:18 PM I think what happened to your friend but it may not be just and Obamacare thing. My mother in law suffered a hemorrhagic stroke nearly 5 yrs ago and passed away. She was flown by the flight for life from a local hospital to a larger one equipped to handle her care. We paid the $15,000 bill for the helicopter ride because the company used was not covered by her insurance. We talked to the insurance company, a lawyer and the helicopter service because like your friend we didn't get to pick the service used. We didn't even know she was in flight until she made it to the bigger hospital. But we still had to pay the bill
Understandable. Unfortunately, she was under the impression that she was safe. Is it her fault for being uninformed? Sure. However they really make you feel as though you are now covered for "whatever" may happen. |
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Cold hands and Warm Heart
Location: oklahoma | komet. - 2014-05-28 1:25 PM I'll tell you the same thing I told my dad when he saw the government buying bonds right after the SC gave the OK for this blasphemy we call obozocare.. He couldn't figure out where they were getting the money to do this and I told him it HAD to be coming from money expected from the new health care... Obozocare has nothing to do with health care, it's all about paying down on the $17,000,000,,000,000 national debt these a$$holes ran up.
That's what I figured it was going towards. Sickening that lives are being destroyed or will be for this.... We'll see more and more declaring bankruptcy, losing homes, jobs and their way of life. |
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Hawty & Nawty
Posts: 20424
| Here is the real time clock for our debt http://www.usdebtclock.org/
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Hungarian Midget Woman
Location: Midwest | RidenFly - 2014-05-28 2:17 PM barrelracr131 - 2014-05-29 12:09 PM RidenFly - 2014-05-28 2:02 PM Is ObamaCare considred Non profit? Obamacare is the nickname for the Affordable care act.
Plans offered over the exchange websites are all from private insurance companies. So those are not a non-profit.
Some insurance companies, like Aetna, are choosing to only offer insurance through group plans and not offer anything over the exchanges.
I have no idea where the fines go, if you are referring to the fines for employers not offering insurance and the fines for those who do not have health insurance.
I'm sure they will end up lining someone's pockets....
I am not sure what the law actually says though. Unfortunately I'm pretty sure what your friend experienced will become reality for many in the coming years. |
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  Warmblood with Wings
Posts: 27846
Location: Florida.. | livinonlove&horses - 2014-05-28 3:18 PM I think what happened to your friend but it may not be just and Obamacare thing. My mother in law suffered a hemorrhagic stroke nearly 5 yrs ago and passed away. She was flown by the flight for life from a local hospital to a larger one equipped to handle her care. We paid the $15,000 bill for the helicopter ride because the company used was not covered by her insurance. We talked to the insurance company, a lawyer and the helicopter service because like your friend we didn't get to pick the service used. We didn't even know she was in flight until she made it to the bigger hospital. But we still had to pay the bill
I was lifeflighted to and it was 26,000.. and they would not bargain .. had to pay it all.. or I could have paid 6,000 a month for 4 months.. nice huh.. |
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Expert
Posts: 4121
Location: SE Louisiana | CurlyQ - 2014-05-28 2:27 PM
komet. - 2014-05-28 1:25 PM I'll tell you the same thing I told my dad when he saw the government buying bonds right after the SC gave the OK for this blasphemy we call obozocare.. He couldn't figure out where they were getting the money to do this and I told him it HAD to be coming from money expected from the new health care... Obozocare has nothing to do with health care, it's all about paying down on the $17,000,000,,000,000 national debt these a$$holes ran up.
That's what I figured it was going towards. Sickening that lives are being destroyed or will be for this.... We'll see more and more declaring bankruptcy, losing homes, jobs and their way of life.
The worst part is I see the general public and the entire health care system being left out there flapping in the wind and going broke over this. |
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Shelter Dog Lover
Posts: 10277
| I sent your post to my daughter. Her response:
Could be true. There are several brand new carriers that entered the market b/c of obamacare and Lockton has told HR to warn EEs from these new companies for this reason. You don’t know anything about level of service, network coverage, etc. and there is no way for the consumer to know what they’re getting.
Under the affordable care act, ER services must be covered at the same level as in-network services so what that company is doing is illegal under HCR if it was truly an emergency and she was processed through the ER. They must have processed it as an in-patient stay and that would be out of network and the OOP maxes set under HCR don’t apply then.
It honestly sounds like this lady bought a plan that she really didn’t understand (narrow network) from a company that is turning out to be less-than reputable. That’s one of the major flaws with HCR. It assumes that consumers can make educated decisions on what kind of health insurance that they need but in reality, insurance is extremely complicated and the average consumer just hasn’t been educated enough on the intricacies of the legislation and insurance in general. Also, there is a lack of transparency on the part of insurance companies and this makes it difficult for consumers to make good choices even if they know exactly what they want/need.
From:
Sent: Wednesday, May 28, 2014 1:23 PM
To: Murphy, Ryan
Subject: your thoughts?/
a post on barrel horse world
My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer.
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 The Original Cyber Bartender
Location: Washington | RidenFly - 2014-05-28 11:01 AM My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer.
So before the emergency surgery there wasn't someone with her or herself signing paperwork? The hospital by allowing the surgery to take place had agree to her insurance plan, the medical team is also bound to this agreement. BUT they will charge her for her aftercare if they are out of network, they should be making her aware of that. Tell her to call the hospital, or better yet go down and talk to them. |
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 Famous for Not Complaining
Posts: 8848
Location: Broxton, Ga | Nevertooold - 2014-05-27 2:30 PM I no longer have healthcare that I pay $500.00 a month for...I now have catastrophic insurance. Sucks! My deductible is $6,000. I wish I had the money we have paid into healthcare just since the DickTator has taken office.
Same boat.........December our premium will increase to $1200.00 monthly..........$12,000.00 deductible..... |
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 Over Informed
Posts: 5372
Location: West Tennessee | fatchance - 2014-05-28 3:00 PM RidenFly - 2014-05-28 11:01 AM My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer. So before the emergency surgery there wasn't someone with her or herself signing paperwork? The hospital by allowing the surgery to take place had agree to her insurance plan, the medical team is also bound to this agreement. BUT they will charge her for her aftercare if they are out of network, they should be making her aware of that. Tell her to call the hospital, or better yet go down and talk to them.
In addition, the one thing I'm learning at my new job is that when a Dr's office verifies coverage the insurance companies also give themselves an out that on every EOB (estimate of benefits) -- that reads something to the effect of this doesn't gaurantee coverage it just shows that our system at the moment says the person has X insurance in place.
editied to attempt to make that clearer: When I verify coverage, I request a fax from the insurance company. In small print on every fax it states that this only verifies that coverage is in existence at the moment but does not guarantee coverage at the time a claim is filed.
The insurance portion of my new job is beyond scarey -- it is so incredibly confusing & I'm just dealing with orthodonic coverage only! I can't imagine medical or denistry!!!
Edited by dme0324 2014-05-28 6:46 PM
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"Heck's Coming With Me"
Posts: 10797
Location: Kansas | Riden, a month or so ago a fellow in 50's or 60's had something similar happen. He was forced onto Obamacare and had been paying his premiums as required. Then he had a heart attack. Turned out no "confirmation" that he was indeed on this specific policy was in place. Looked as if he was going to be stuck with all the hospital bills. |
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 Ima Fickle Fan
Posts: 3547
Location: Texas | I personally see cases like this becoming a lawsuit. We have friends in Wyoming who got dropped from their insurance. Before they could sign up for Obamacare, the wife had a stroke and was careflighted to Denver. She was in the nuero ICU for a week or so. Due to the astronomical hospital bills, they may lose their ranch and business.
The whole Obamacare thing to me is a huge scam and royal mess. |
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 Baby Blue's
Posts: 7306
Location: Texas | rodeomom3 - 2014-05-28 2:58 PM I sent your post to my daughter. Her response:
Could be true. There are several brand new carriers that entered the market b/c of obamacare and Lockton has told HR to warn EEs from these new companies for this reason. You don’t know anything about level of service, network coverage, etc. and there is no way for the consumer to know what they’re getting.
Under the affordable care act, ER services must be covered at the same level as in-network services so what that company is doing is illegal under HCR if it was truly an emergency and she was processed through the ER. They must have processed it as an in-patient stay and that would be out of network and the OOP maxes set under HCR don’t apply then.
It honestly sounds like this lady bought a plan that she really didn’t understand (narrow network) from a company that is turning out to be less-than reputable. That’s one of the major flaws with HCR. It assumes that consumers can make educated decisions on what kind of health insurance that they need but in reality, insurance is extremely complicated and the average consumer just hasn’t been educated enough on the intricacies of the legislation and insurance in general. Also, there is a lack of transparency on the part of insurance companies and this makes it difficult for consumers to make good choices even if they know exactly what they want/need.
From:
Sent: Wednesday, May 28, 2014 1:23 PM
To: Murphy, Ryan
Subject: your thoughts?/
a post on barrel horse world
My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer.
-----
~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~
Interesting! My daughter broke her arm last month and we took her to the ER where she was sent via ambulance to the childrens hospital (we had to start off in the ER there). My company goes through an insurance "broker" which is great because I just send them all my bills and they tell me what to pay and answer any of my questions instead of me having to deal directly with BCBS. Anyways, before I got my first bill I sent an email giving them a heads up about what happened and right off the bat she let me know that emergency services (ambulance, care flight, etc) hardly are EVER covered (meaning the fees are 100% the patients and don't go towards your normal deductable) because they don't have to be. People don't shop around for emergency services when there's an ACTUAL EMERGENCY. Wonder if the ACA lumps that in with "ER services?" |
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Hawty & Nawty
Posts: 20424
| Isn't that lovely?  Stupid law. |
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Hugs to You
Posts: 7551
Location: In The Land of Cotton | Here are some info numbers for anyone with insurance problems - Your individual State Insurance Department, the US Department of Labor, Employee Benefits Security Administration at 866-444-3272 or www.dol.gov/ebsa, the US Department of Health and Human Services - 877-267-2323x61565 or www.cciio.cms.gov
More and more people are going to find out that their insurance plans and coverages are only going to meet the minimum esstential coverage and the minimum value standard for benefits.
The reason for "most" but not all bankruptcies in America a few years ago was a health catastrophy. I see the numbers balloning because of the new health care laws and plans. Most people do not have the knowledge and time to research all of the "fine" print involved and are going to really get screwed. |
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Shelter Dog Lover
Posts: 10277
| bocephus's mama - 2014-05-29 9:29 AM rodeomom3 - 2014-05-28 2:58 PM I sent your post to my daughter. Her response:
Could be true. There are several brand new carriers that entered the market b/c of obamacare and Lockton has told HR to warn EEs from these new companies for this reason. You don’t know anything about level of service, network coverage, etc. and there is no way for the consumer to know what they’re getting.
Under the affordable care act, ER services must be covered at the same level as in-network services so what that company is doing is illegal under HCR if it was truly an emergency and she was processed through the ER. They must have processed it as an in-patient stay and that would be out of network and the OOP maxes set under HCR don’t apply then.
It honestly sounds like this lady bought a plan that she really didn’t understand (narrow network) from a company that is turning out to be less-than reputable. That’s one of the major flaws with HCR. It assumes that consumers can make educated decisions on what kind of health insurance that they need but in reality, insurance is extremely complicated and the average consumer just hasn’t been educated enough on the intricacies of the legislation and insurance in general. Also, there is a lack of transparency on the part of insurance companies and this makes it difficult for consumers to make good choices even if they know exactly what they want/need.
From:
Sent: Wednesday, May 28, 2014 1:23 PM
To: Murphy, Ryan
Subject: your thoughts?/
a post on barrel horse world
My "Friend" had to have emergency surgery just after she was dropped from United Health Care and forced onto Obamacare. She wansn't worried and hasn't seen a bill until two days ago. Nothing is covered. Why? Because the company providing coverage under the mandate nobody has heard of. When she contacts them all she gets is the reply that her surgeon is "out of network"
It was an emergency...she didn't have time to pick a surgeon or the anesthesiologist or any of the other charges.
She tries to get past the robot on the phone and there is NO live person to explain anything to.
Had she not been dropped all she would have had to pay is her deductible of 500.00 Now she is out for more than ten thousand thanks to this new federal mandate.
Question is; Where is the money going that is pouring into Obama care.
I really want to know. Signed, confirmed tin foil hat wearer.
-----
~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~~~~<>~
Interesting! My daughter broke her arm last month and we took her to the ER where she was sent via ambulance to the childrens hospital (we had to start off in the ER there). My company goes through an insurance "broker" which is great because I just send them all my bills and they tell me what to pay and answer any of my questions instead of me having to deal directly with BCBS. Anyways, before I got my first bill I sent an email giving them a heads up about what happened and right off the bat she let me know that emergency services (ambulance, care flight, etc) hardly are EVER covered (meaning the fees are 100% the patients and don't go towards your normal deductable) because they don't have to be. People don't shop around for emergency services when there's an ACTUAL EMERGENCY. Wonder if the ACA lumps that in with "ER services?"
My daughter's response:
The broker was 100% correct. Prior to 2014, there were no regulations around the cost share of out of network services. Beginning on Jan 2014 (or the plan’s ERISA contract date), all non-grandfathered plans have to cover out of network er services at the same level that they cover in-network services. The coverage of ambulances etc. does vary by plan but all EE out of pocket costs (except premium) must now accrue toward the OOP Max (where before most did not). As an aside, ER services are now considered an essential health benefit and thus cannot have any annual and lifetime limits. My understanding is that Ambulance, care flight, etc. now MUST be covered if it is considered a true emergency and if it is a non-emergency, it must be covered if taking another form of transportation would endanger the patient’s health.
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Shelter Dog Lover
Posts: 10277
| 3canstorun - 2014-05-29 10:14 AM Here are some info numbers for anyone with insurance problems - Your individual State Insurance Department, the US Department of Labor, Employee Benefits Security Administration at 866-444-3272 or www.dol.gov/ebsa, the US Department of Health and Human Services - 877-267-2323x61565 or www.cciio.cms.gov
More and more people are going to find out that their insurance plans and coverages are only going to meet the minimum esstential coverage and the minimum value standard for benefits.
The reason for "most" but not all bankruptcies in America a few years ago was a health catastrophy. I see the numbers balloning because of the new health care laws and plans. Most people do not have the knowledge and time to research all of the "fine" print involved and are going to really get screwed.
Exactly what my daughter is already seeing from the business side of it. |
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Hungarian Midget Woman
Location: Midwest | rodeomom3 - 2014-05-29 10:24 AM 3canstorun - 2014-05-29 10:14 AM Here are some info numbers for anyone with insurance problems - Your individual State Insurance Department, the US Department of Labor, Employee Benefits Security Administration at 866-444-3272 or www.dol.gov/ebsa, the US Department of Health and Human Services - 877-267-2323x61565 or www.cciio.cms.gov
More and more people are going to find out that their insurance plans and coverages are only going to meet the minimum esstential coverage and the minimum value standard for benefits.
The reason for "most" but not all bankruptcies in America a few years ago was a health catastrophy. I see the numbers balloning because of the new health care laws and plans. Most people do not have the knowledge and time to research all of the "fine" print involved and are going to really get screwed.
Just wait till the poop really hits the fan in coming years
it will be interesting to say the least.... I'm hoping specialized care doesn't go down the toilet enough for me to lose my job (I work in a genetics medical lab). If I look at what I know of other european countries with universal healthcare, I will likely be okay because I work in a private University hospital setting.
Countries like Poland, India, and others right now have two main tiers of care: the government care, which is basically where you go to die, or private care, which is paid out of pocket completely. There is no "insurance" to buy. If you can't afford the surgery/meds/whatever, you die. Plain and simple. And yes, you pay up front. No financing. |
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Hugs to You
Posts: 7551
Location: In The Land of Cotton | barrelracr131 - 2014-05-29 11:32 AM rodeomom3 - 2014-05-29 10:24 AM 3canstorun - 2014-05-29 10:14 AM Here are some info numbers for anyone with insurance problems - Your individual State Insurance Department, the US Department of Labor, Employee Benefits Security Administration at 866-444-3272 or www.dol.gov/ebsa, the US Department of Health and Human Services - 877-267-2323x61565 or www.cciio.cms.gov
More and more people are going to find out that their insurance plans and coverages are only going to meet the minimum esstential coverage and the minimum value standard for benefits.
The reason for "most" but not all bankruptcies in America a few years ago was a health catastrophy. I see the numbers balloning because of the new health care laws and plans. Most people do not have the knowledge and time to research all of the "fine" print involved and are going to really get screwed.
it will be interesting to say the least.... I'm hoping specialized care doesn't go down the toilet enough for me to lose my job (I work in a genetics medical lab). If I look at what I know of other european countries with universal healthcare, I will likely be okay because I work in a private University hospital setting.
Countries like Poland, India, and others right now have two main tiers of care: the government care, which is basically where you go to die, or private care, which is paid out of pocket completely. There is no "insurance" to buy. If you can't afford the surgery/meds/whatever, you die. Plain and simple. And yes, you pay up front. No financing.
Apparently though, the people in India must either: 1. Have lots of money to pay for medical care for child brith; or 2. Pop them out in their homes, because there sure are a lot of them. |
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Hungarian Midget Woman
Location: Midwest | OT but yes, A lot of people in India are very very poor. I believe midwives are common in their culture. They do a lot of things differently there. Many people live in village-type locales. I work with a lady from India- she told me it is still somewhat common for the shieks to come to India and buy poor young Indian women as second and third wives and move them to Dubai. The women then travel back and forth and can give some money to their poor families back in the villages. ETA: I'm pretty sure birth control is against their culture in some cases. But I'm not sure. Back in the day, lots of the babies wouldn't make it, so they had a lot.
I know some areas are more urbanized though, with more wealth than others.
I know some oncologists who are in the US (originally from India) that opened a clinic there, and travel back and forth between countries. The clinics in India are quite lucrative, so she says.
Edited by barrelracr131 2014-05-29 11:51 AM
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This is just one example