Obamacare: Our Current Hassle

I

imp

Senior Member
We feel as though our hands are tied. My wife was told her mammogram was completely covered cost-wise. For several months now she has been receiving a bill even though a letter received stated her cost was zero.

Today, on the phone again with HealthNet, another runaround. Asked for a supervisor, told the wait for that individual would be about 3 hours! Tell me the supervisor is sooooo busy? B.S.

She is at her wits' end, on her birthday, today, no less.

Thanks for allowing me to vent. imp
 

Hi Imp, I feel for your wife. We really haven't had too many problems at all with Obamacare, and Kaiser is our health provider. Sometimes we get paperwork that looks like a bill, but it's not.

It's true that getting things done over the phone is like pulling teeth sometimes with these people, you can only hope not to be disconnected after being on the phone for almost an hour and transferred back and forth from one clueless person to another. Now and then you get someone who's on top of things and you're taken care of right away.

I just noticed when I logged in that your name is at the bottom of the forum page, how cool that you and your wife get to celebrate your birthdays together! I hope you both have a very Happy Birthday, and enjoy a great day! :cheers:


Happy+Birthday+Balloons+19.jpg
 
Oh, boy! My wife sincerely thanks you for the birthday wishes! But, being the ever-suspicious guy I am, but also honest, I cannot accept the nice offer on my own behalf; it's not really my birthday. imp
 

imp said:
We feel as though our hands are tied. My wife was told her mammogram was completely covered cost-wise. For several months now she has been receiving a bill even though a letter received stated her cost was zero.

Today, on the phone again with HealthNet, another runaround. Asked for a supervisor, told the wait for that individual would be about 3 hours! Tell me the supervisor is sooooo busy? B.S.

She is at her wits' end, on her birthday, today, no less.

Thanks for allowing me to vent. imp
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Sometimes the billing company has no idea what is going on. Someone punched something into the computer system and a bill keeps generating automatically, and no one wants to take the time to fix it. Don't blame Obama care... because it is TRUE that preventative screenings are 100% covered. Its the law. Copy the letter and send it to them along with the bill..
 
These insurance companies are all Fouled up...as the "rules" seem to be changing every few weeks. Example....I changed dental plans for 2016, back in early November. We get our supplemental insurance from an exchange called Towers Watson, under contract to my old employer. TW was supposed to cancel the 2015 plan, and begin the new plan. I checked a couple of weeks later, and they had Both plans active, and billing me. I called again, and went through the same routine. A couple of weeks later, I found they had cancelled Both Plans. This time, I contacted the insurance companies directly, and hopefully got it straightened out. It seems like the "left hand" at this TW Exchange doesn't know what the "right hand" is doing.

Obamacare may not be Directly responsible for these kinds of messes, but it is screwing up the entire Health Care System. The Republicans won't have to kill Obamacare...it will implode all on its own. Just recently, Congress delayed the "Cadillac" tax which was supposed to help fund Obamacare and keep prices from going through the roof. This is just the latest move that will insure the failure of Obamacare. Whoever the next President is...Dem or Rep...they are going to have to deal with some major crisis issues that will begin probably no later than 2018.
 
Don.... I heartily disagree.. the ACA has been a Godsend for millions of people who have never had the luxury of being able to see a doctor. The ACA may need improvements over time as things pan out... Do you want to go back to when you could be denied insurance for pre-existing conditions? Do you like lifetime caps on benefits leaving you holding the bag for cancer treatments that exceed your limit? Do you like the fact that kids can stay on their parents insurance until their 26th birthday? Fix the problems if they exist, but to kill the whole thing is ridiculous.

 
QuickSilver said:
Sometimes the billing company has no idea what is going on. Someone punched something into the computer system and a bill keeps generating automatically, and no one wants to take the time to fix it. Don't blame Obama care... because it is TRUE that preventative screenings are 100% covered. Its the law. Copy the letter and send it to them along with the bill..
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I've seen that more times than I can count. Most recently I know someone in a car accident who had their Blue Cross billed yet they had their car insurance information by the next day. Problem was day of the accident they didn't have their insurance card with them, only their Blue information which what is put in "the system". Regardless that should've been an easy fix.
 
QuickSilver said:
Don.... I heartily disagree.. the ACA has been a Godsend for millions of people who have never had the luxury of being able to see a doctor. The ACA may need improvements over time as things pan out... Do you want to go back to when you could be denied insurance for pre-existing conditions? Do you like lifetime caps on benefits leaving you holding the bag for cancer treatments that exceed your limit? Do you like the fact that kids can stay on their parents insurance until their 26th birthday? Fix the problems if they exist, but to kill the whole thing is ridiculous.
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Yes, several million previously uninsured have signed up for the ACA...mostly those who require medical care. Meanwhile the millions of young healthy people who were supposedly going to offset these millions of ill, have resisted signing up. Several insurance companies who are involved in the ACA are threatening to back out of the program, or are raising their rates to ridiculous levels. And, as I pointed out, Congress...both sides of the aisle...set back the Cadillac tax, which was supposed to fund a large portion of this program. Bottom line....while the ACA might have looked good on paper, in reality it is headed for a brick wall. The ACA is just another step being taken by the government....at the request of our present Health Care Industry...to try to stave off going to a SP-UHC plan, like the rest of the world uses. The ACA was written by the Health Care Lobbyists, and it is showing the early signs of collapse. Whoever becomes the next President is going to have to devote much of his/her time to trying to unravel this looming mess....and Hopefully, we will Finally begin a serious move towards Universal Health Care. I figure 2020 as being the "tipping point", beyond which, our entire health care system...including Medicare...will be headed over the cliff, if this present situation continues.
 
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Don M. said:
Yes, several million previously uninsured have signed up for the ACA...mostly those who require medical care. Meanwhile the millions of young healthy people who were supposedly going to offset these millions of ill, have resisted signing up. Several insurance companies who are involved in the ACA are threatening to back out of the program, or are raising their rates to ridiculous levels. And, as I pointed out, Congress...both sides of the aisle...set back the Cadillac tax, which was supposed to fund a large portion of this program. Bottom line....while the ACA might have looked good on paper, in reality it is headed for a brick wall. The ACA is just another step being taken by the government....at the request of our present Health Care Industry...to try to stave off going to a SP-UHC plan, like the rest of the world uses. The ACA was written by the Health Care Lobbyists, and it is showing the early signs of collapse. Whoever becomes the next President is going to have to devote much of his/her time to trying to unravel this looming mess....and Hopefully, we will Finally begin a serious move towards Universal Health Care. I figure 2020 as being the "tipping point", beyond which, our entire health care system...including Medicare...will be headed over the cliff, if this present situation continues.
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I know some paying 75 a month getting 475$ a month in credits or subsidies. $550 regardless of how it's being paid for is not "affordable" health care COVERAGE. They were all happy getting it, supporters of the plan but don't or can't use it because of fees and deductibles. We have an urgent care clinic where the most expensive thing they do is $325 on their schedule or menu of fees. What they need is a government option and have an urgent or catastrophic care policy only, focusing on that would lower the actual cost of insuring more as much as subsidizing it.
 
Inserting the word "Affordable" into the ACA is truly a misnomer. The ACA just moves the financial burdens around, and places even more Unfunded Liabilities on governments. It does Nothing to address the root causes of why health care is so expensive in the U.S. Our Health Care Industry is based upon the Almighty Dollar, and thrives on things like needless surgery and overuse of prescription drugs, etc. While people and governments are going deeper in debt, the doctors and drug companies are getting richer. 7 or 8 of the top paying career fields in the US (depending upon which report you read) are in the medical fields, and investing in drug companies is a sure way to beat inflation. Most of the rest of the civilized world recognized the failures involved with Private Health Care long ago, but the people of the US haven't woken up to that reality yet.
 
QuickSilver said:
Don.... I heartily disagree.. the ACA has been a Godsend for millions of people who have never had the luxury of being able to see a doctor. The ACA may need improvements over time as things pan out... Do you want to go back to when you could be denied insurance for pre-existing conditions? Do you like lifetime caps on benefits leaving you holding the bag for cancer treatments that exceed your limit? Do you like the fact that kids can stay on their parents insurance until their 26th birthday? Fix the problems if they exist, but to kill the whole thing is ridiculous.
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For every new person covered under ObamaCare there's a person who lost her coverage and can't afford it now, it's only Godsend if you're getting extra help to help pay for your premiums in government subsidies and tax breaks.
The truth is many who were insured pre-ObamaCare are struggling with inflated premiums or no coverage now. We've just transferred to pain.
Many states pre-ObamaCare had a high-risk pool so people in those states didn't get denied coverage if they had a pre-existing condition. Many colleges had a pool to help pay for students healthcare at lower-cost pre-Obamacare. If we just lifted mandates where you could shop state to state for your plans rest of it would've worked itself out with increased competition. If Obamacare is killed in the future do you not think that whatever plan they come up with will have some of the protections you speak about. I would think that some of the good points of Obama's plan would be covered under whatever comes up in the future.

So I ask, what did we really fix?
 
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Dudewho said:
For every new person covered under ObamaCare there's a person who lost her coverage and can't afford it now, it's only Godsend if you're getting extra help to help pay for your premiums in government subsidies and tax breaks.
The truth is many who were insured pre-ObamaCare are struggling with inflated premiums or no coverage now. We've just transferred to pain.
Many states pre-ObamaCare had a high-risk pool so people in those states didn't get denied coverage if they had a pre-existing condition. Many colleges had a pool to help pay for students healthcare at lower-cost pre-Obamacare. If we just lifted mandates where you could shop state to state for your plans rest of it would've worked itself out with increased competition. If Obamacare is killed in the future do you not think that whatever plan they come up with will have some of the protections you speak about. I would think that some of the good points of Obama's plan would be covered under whatever comes up in the future.

So I ask, what did we really fix?
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So true in more ways than one. Cost of health care was a COST of INSURANCE issue which perpetuated the high cost of CARE. There were so many little things that could've been done rather than a massive 2000 page bill.

Setting that aside. The number of UNinsured is creeping back UP because Obama Care basically already helped those in dire need of care or financial assistance. In other words the increase in medicare/medicaid which many were already eligible for account for a nice chunk of ACA enrollees. Those in between the medicare/medicaid and the can afford it/get it zone is still where all the problems are. I still remember all the rhetoric of 40 million uninsured and the last number is around 12 Million ACA sign ups 6 years into the plan.

http://www.thefiscaltimes.com/2016/01/08/Despite-Obamacare-Uninsured-Rate-Ticks
 
Rather than respond to each post I may disagree with, I'll just say the only way, in my opinion, to make Affordable Health Care Act work well and truly be affordable is to get rid of the third parties, in other words, all the insurance companies. Let's get to single payer. Social Security and Medicare for all the bashing they get, do work.

As far as young people not signing up, "Times, they are a changing."
There was good news about uninsured people who came to Obamacare as new enrollees, too: 41 percent of them (980,000 people) were under 35. Last year, only 38 percent of new enrollees were that young.
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From an December 22nd article here: http://www.vox.com/2015/12/22/10653600/obamacare-young-adult-enrollment
 
QuickSilver said:
Don.... I heartily disagree.. the ACA has been a Godsend for millions of people who have never had the luxury of being able to see a doctor. The ACA may need improvements over time as things pan out... Do you want to go back to when you could be denied insurance for pre-existing conditions? Do you like lifetime caps on benefits leaving you holding the bag for cancer treatments that exceed your limit? Do you like the fact that kids can stay on their parents insurance until their 26th birthday? Fix the problems if they exist, but to kill the whole thing is ridiculous.
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I agree with QS, fix the problems don't scrap the whole thing...or go to Universal Health Care/Single Payer. It's not perfect (yet), but this is a good thing I can thank our President for.

I'm very happy with the Affordable Care Act, I was getting raked over the coals in monthly costs for coverage since I retired, paid Cobra and then was on my own. I'm pretty healthy, rarely visit doctors and am taking no prescription drugs. I don't always get preventative care, as I'm against taking excessive x-rays that may cause more problems than their worth.

But I see now that there are services I used to pay a co-pay on that are now free. The ACA guarantees the insurance companies can't deny you or kick you off of your plan for no reason, it's a godsend to many. It's crazy to try and get rid of it, the healthcare before the ACA was not working for middle and lower class citizens, that's for sure.
 
WhatInThe said:
So true in more ways than one. Cost of health care was a COST of INSURANCE issue which perpetuated the high cost of CARE. There were so many little things that could've been done rather than a massive 2000 page bill. http://www.thefiscaltimes.com/2016/01/08/Despite-Obamacare-Uninsured-Rate-Ticks
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Probably the most "telling" comment made when the ACA was being debated was when Nancy Pelosi said "We need to pass this bill so we can find out what's in it"...or words to that effect. Obama didn't write this bill, nor did Congress. The vast majority of whats in that bill came from the Health Care Industry Lobbyists, and Congress/Obama merely acted as their "conduit". It has Not lowered costs, and it is debatable about just how many people have Really been helped. It Has created situations where many doctors are refusing to accept new patients, or are retiring early because of all the government mandated hassles. It Has placed a major burden on many state governments whose exchanges are running major deficits. Now, major insurers such as United Health Care and even Humana are making noises about abandoning the ACA market. It appears that the Negatives are beginning to really outweigh the Positives.

IF our government was Really Serious about revising our health care system, they would be looking hard at the experiences of Canada, Europe, and Australia, etc., and working towards incorporating such provisions into our system. However, so long as our politics are dominated by the Big Money Interests, we probably shouldn't hold our breath. When this whole House of Cards collapses...and not that far into the future...maybe then, we will see a system that is Patient Driven, rather than Profit Driven.
 
Before I turned 65 and got the blessing of Medicare and my advantage plan (not sarcasm, it IS a blessing to me), I was paying $456 a month for 80/20 coverage for just myself (my employer did not offer health insurance), which I really could not afford to use much, but I was afraid to be without it, lest I get some catastrophic thing, or something that rendered me uninsurable. It was the best deal I could get, because the only other major insurer here denied me coverage because I had a "history of broken bones" (I had broken my arm 40 years ago, and that was considered a "history of broken bones"). During the time I was paying those awful premiums, I was a single, quite healthy woman (except for my arthritic hips, which hadn't been symptomatic when I signed up for the insurance), normal weight, normal blood pressure, etc., only one medication that wasn't really that expensive if I had paid for it myself.

That's ridiculous! It was a good sized chunk of my income, and most people I knew who were similarly situated just didn't have insurance because they couldn't afford it.

I've no personal experience with Obamacare, but I know people it has helped. What the US really needs to do is go to single payer universal health care like the US and Canada and take the huge profit motive out of health care.
 
imp said:
https://www.washingtonpost.com/blog...1eec914-bcf9-11e2-9b09-1638acc3942e_blog.html

33,000 pages of regulations in ACA, and that was before they completed it! No person in Washington or elsewhere could have written this in his or her remaining lifetime. What in the hell can possibly be included therein? Lots of hidden "pockets" being lined by the taxpayers? imp
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How did it get written if no one could have written it? And I don't believe the "pockets" are hidden at all -- they are the pockets of insurance carriers and big pharmaceutical companies.
 
If nothing else there should be a single payer option. If you want the government to pay for it this is what you are going to get take it or leave for both the patient and provider, a cut and dry plan not open to negotiation. I'd still let the insurance companies sell but this time there will be a much cheaper competition/alternative in all 50 states.
 
I was glad to get Obamacare. I retired with medical insurance but the employer went bankrupt and notified all the retirees their insurance was gone. Nobody wants to insure you at any cost at my age...and I have no big medical problems. I ended up in the hospital..first time in my life....6 months before Obamacare started. I was there three days and the cost of that and prescriptions helped empty our savings. Let's see...what government agency was there to help? You guessed it..none.

I learned first hand how bad it is to need medical care with no insurance. Covered California cost me nearly 1k a month. My husband is older and had Medicare..but couples who both were underage and retired from my bankrupt employer were devastated by the cost. I am sorry for people who get caught in this deathly quagmire like I was..through no fault of their own.

i would never have retired without medical coverage but hey sometimes we get caught up in things we can't control. I like to focus on the positive..I'm on Medicare now and can finally save some money again. I'm glad we managed to pay off the medical bills despite the setback to us.
 
Medical care costs are the Number One cause for individual Bankruptcy in this nation. That is Shameful. Even those in good health are often saddled with insurance costs that run into several hundred dollars a month...either Out of pocket, or as part of their employee compensation. If all this money that flows to our For Profit system were converted into a SP-UHC plan, we would quickly see our overall costs being reduced by 1/3rd or more, and become a much healthier nation, as a result. Dozens of other nations have created successful UHC plans, and it is only Greed that is stopping this nation from joining them.
 
Karen99 said:
I was glad to get Obamacare. I retired with medical insurance but the employer went bankrupt and notified all the retirees their insurance was gone. Nobody wants to insure you at any cost at my age...and I have no big medical problems. I ended up in the hospital..first time in my life....6 months before Obamacare started. I was there three days and the cost of that and prescriptions helped empty our savings. Let's see...what government agency was there to help? You guessed it..none.

I learned first hand how bad it is to need medical care with no insurance. Covered California cost me nearly 1k a month. My husband is older and had Medicare..but couples who both were underage and retired from my bankrupt employer were devastated by the cost. I am sorry for people who get caught in this deathly quagmire like I was..through no fault of their own.

i would never have retired without medical coverage but hey sometimes we get caught up in things we can't control. I like to focus on the positive..I'm on Medicare now and can finally save some money again. I'm glad we managed to pay off the medical bills despite the setback to us.
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Your experience parallels that of my wife & I. Neither had coverage when we quit working, no employer-contributed help at all. I got Medicare first, she must wait through this year yet. Last year, she became Obamacare-bound, and then the gov't. demanded $700 at the end of the year! Hard-pressed to suddenly pay up, having not expected anything like that. They even accept credit cards! What a nice system to force you to buy something and then charge you for not being able to pay for it! She got absolutely nothing during last year in personal help, excepting a mammogram, which is guaranteed "free" under Obamacare, but guess what? The bastards are still billing her for it! Free? Ha!

What does it take to become a Canadian Citizen, and how long a wait to become medically insured? imp
 
imp said:
Your experience parallels that of my wife & I. Neither had coverage when we quit working, no employer-contributed help at all. I got Medicare first, she must wait through this year yet. Last year, she became Obamacare-bound, and then the gov't. demanded $700 at the end of the year! Hard-pressed to suddenly pay up, having not expected anything like that. They even accept credit cards! What a nice system to force you to buy something and then charge you for not being able to pay for it! She got absolutely nothing during last year in personal help, excepting a mammogram, which is guaranteed "free" under Obamacare, but guess what? The bastards are still billing her for it! Free? Ha!

What does it take to become a Canadian Citizen, and how long a wait to become medically insured? imp
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Imp...Obamacare is better than nothing..it's expensive..not affordable with no subsidies..but even so, it's horrible to face the Medical Machine without any insurance. Whatever is wrong needs to be fixed. I see the problems on both sides. I'm surprised anyone wants to be a doctor with the costs for training..then malpractice insurance.

I am a supporter of universal Medicare or single payer. It has to happen.
 
Karen99 said:
I am a supporter of universal Medicare or single payer. It has to happen.
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I wish I understood this "single-payer" annotation, but have heard it mentioned often. Clue me in, if such is possible for an old reprobate! imp
 
imp said:
I wish I understood this "single-payer" annotation, but have heard it mentioned often. Clue me in, if such is possible for an old reprobate! imp
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Single-payer healthcare


Single-payer healthcare is a system in which the government, rather than private insurers, pays for all healthcare costs.[SUP][1][/SUP] Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). The term "single-payer" thus only describes the funding mechanism—referring to healthcare financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. In this sense, however, the UK Health Care system is technically not "single payer", as in reality it consists of a number of financially and legally autonomous Trusts, for example the Kent Community NHS Trust, which provides services in Kent, East Sussex and parts of London.[SUP][2][/SUP] The actual funding of a "single payer" system comes from all or a portion of the covered population. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system.

****from wiki :)



 

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