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Affordable Care Act price??
#8146804
01/28/21 04:05 PM
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Joined: Jul 2015
Posts: 18
texdave
OP
Light Foot
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OP
Light Foot
Joined: Jul 2015
Posts: 18 |
Has anyone here signed up for the Affordable Care Act? I’m a contractor with a wife and kids, and I need to find out if the cost/coverage is worth it, or if we should just continue as cash patients. Of course I’ll research online, but you have to jump through hoops to try and get a quote....just wondering if anyone can give a ballpark estimate of the price. Is/was the coverage sufficient? Any input you can offer is greatly appreciated.
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Re: Affordable Care Act price??
[Re: texdave]
#8146810
01/28/21 04:09 PM
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Joined: Apr 2007
Posts: 60,465
BOBO the Clown
kind of a big deal
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kind of a big deal
Joined: Apr 2007
Posts: 60,465 |
Problem is it’s income based quotes so nobody is the same. More you make the the more is costs you... exponentially
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Re: Affordable Care Act price??
[Re: texdave]
#8146847
01/28/21 04:35 PM
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Joined: Nov 2011
Posts: 11,013
Texas buckeye
THF Celebrity
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THF Celebrity
Joined: Nov 2011
Posts: 11,013 |
One other aspect is whether doctors will accept the coverage. I do not accept “exchange plans” because the rules state these plans can not he cancelled for a long time period (i want to say 3-6 months) after last payment is made so what ends up happening is a patient signs up and pays the first month payment to get the letter stating they have the insurance to suffice for tax purposes but then doesn’t pay anymore and then the doctors offices call to confirm if the patient is covered, the insurance company says yes, then the doctor provides services and the insurance company denies the covered services due to lack of premium payment by the patient. And then the doctors office is out time and money and they know sending someone like that to collections is a useless venture.
So i know lots of doctors offices don’t take exchange plans. Trumps EO making the “tax” void made this issue not as big a deal since people weren’t picking up plans just to suffice for tax purposes but it still applies for people who cant pay, decide to not pay, etc. and the rules of the exchange plans not being able to say a patient doesn’t have coverage for 3-6 months after they really don’t still applies.
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Re: Affordable Care Act price??
[Re: texdave]
#8146864
01/28/21 04:43 PM
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Joined: Nov 2014
Posts: 7,787
Mr. T.
THF Trophy Hunter
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Joined: Nov 2014
Posts: 7,787 |
Didn't know that. ^^^^^^ Thanks for the information.
Cabin rental in Pagosa Springs, Co. Sleeps 10, If interested please PM me.
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Re: Affordable Care Act price??
[Re: texdave]
#8146869
01/28/21 04:44 PM
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Joined: Nov 2008
Posts: 8,375
LoneStarSon
THF Trophy Hunter
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THF Trophy Hunter
Joined: Nov 2008
Posts: 8,375 |
I did just help a friend sign up for it back in December....I found it sad/funny that he made too little money at first to qualify (it's supposed to help the poor get insurance) but he had miscalculated his income and then qualified once I caught his mistake.
The plans seemed okay, but please note that a lot of doctors and hospitals don't take it, so look over the providers list.
Biden is supposed to allow Open Enrollment to have a special enrollment period from 2/15 to 5/15.
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Re: Affordable Care Act price??
[Re: texdave]
#8146880
01/28/21 04:49 PM
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Joined: Feb 2009
Posts: 1,985
talkturkey
Pro Tracker
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Pro Tracker
Joined: Feb 2009
Posts: 1,985 |
You can get estimates at healthcare.gov, just enter fake email, addy, name, etc and real estimate income. But as said above, premiums are based on income and the better the coverage, the more expensive the premium. Also have heard a lot of providers will not accept them...
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Re: Affordable Care Act price??
[Re: texdave]
#8146881
01/28/21 04:49 PM
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Joined: Jan 2007
Posts: 15,490
reeltexan
THF Celebrity
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THF Celebrity
Joined: Jan 2007
Posts: 15,490 |
I'm a Medicare guy from here on out.
Only took 53 years of workin'
"Give me an Army of West Point graduates and I'll win a battle... Give me a handful of Texas Aggies and I'll win a war." - General Patton
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Re: Affordable Care Act price??
[Re: texdave]
#8147017
01/28/21 06:17 PM
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Joined: Jul 2015
Posts: 18
texdave
OP
Light Foot
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OP
Light Foot
Joined: Jul 2015
Posts: 18 |
Thanks all. My fear is just what was mentioned above...that a lot of doctors won’t take it.
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Re: Affordable Care Act price??
[Re: texdave]
#8147050
01/28/21 06:45 PM
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Joined: Nov 2011
Posts: 9,928
unclebubba
THF Trophy Hunter
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THF Trophy Hunter
Joined: Nov 2011
Posts: 9,928 |
The Affordable Care Act is not affordable at all. You can get health coverage still on Non-Obama care plans. They do have pre-existing conditions and there are limitations, but they do exist still.
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Re: Affordable Care Act price??
[Re: texdave]
#8147057
01/28/21 06:50 PM
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Joined: Oct 2009
Posts: 10,496
Halfadozen
THF Celebrity
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THF Celebrity
Joined: Oct 2009
Posts: 10,496 |
There are quite a few Christian based medical co-ops that are a 1/4 of the cost of ACA. It's not insurance, all the members pay in monthly and the co-op pays the bills. All the staff at my church are on one of these. If interested, PM me and I can find out the name.
Freedom is a fragile thing ...Those who have known freedom, and then lost it, have never known it again. -- Ronald Reagan
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Re: Affordable Care Act price??
[Re: Texas buckeye]
#8147076
01/28/21 07:04 PM
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Joined: Aug 2005
Posts: 20,939
Sniper John
gumshoe
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gumshoe
Joined: Aug 2005
Posts: 20,939 |
One other aspect is whether doctors will accept the coverage. I do not accept “exchange plans” because the rules state these plans can not he cancelled for a long time period (i want to say 3-6 months) after last payment is made so what ends up happening is a patient signs up and pays the first month payment to get the letter stating they have the insurance to suffice for tax purposes but then doesn’t pay anymore and then the doctors offices call to confirm if the patient is covered, the insurance company says yes, then the doctor provides services and the insurance company denies the covered services due to lack of premium payment by the patient. And then the doctors office is out time and money and they know sending someone like that to collections is a useless venture.
So i know lots of doctors offices don’t take exchange plans. Trumps EO making the “tax” void made this issue not as big a deal since people weren’t picking up plans just to suffice for tax purposes but it still applies for people who cant pay, decide to not pay, etc. and the rules of the exchange plans not being able to say a patient doesn’t have coverage for 3-6 months after they really don’t still applies. Not exactly correct. The only reason to have it for tax purposes is to get the subsidies which can be quite substantial. The ACA has a three month premium nonpayment grace period. Go beyond that and those that get the subsidy will lose it and have to pay back any they have received for the year. And will be unable to receive subsidies again until they have held qualified insurance for a calendar year. So what one could do at least in theory is cancel their insurance after 9 months and still qualify for ACA insurance with subsidies the next enrollment period.
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Re: Affordable Care Act price??
[Re: texdave]
#8147085
01/28/21 07:11 PM
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Joined: Oct 2008
Posts: 16,781
68rustbucket
THF Celebrity
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Joined: Oct 2008
Posts: 16,781 |
My wife’s ob/gyn office lady said “ we don’t take that Obama crap”.
Last edited by 68rustbucket; 01/28/21 07:43 PM.
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Re: Affordable Care Act price??
[Re: texdave]
#8147088
01/28/21 07:19 PM
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Joined: Aug 2005
Posts: 20,939
Sniper John
gumshoe
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gumshoe
Joined: Aug 2005
Posts: 20,939 |
Has anyone here signed up for the Affordable Care Act? I’m a contractor with a wife and kids, and I need to find out if the cost/coverage is worth it, or if we should just continue as cash patients. Of course I’ll research online, but you have to jump through hoops to try and get a quote....just wondering if anyone can give a ballpark estimate of the price. Is/was the coverage sufficient? Any input you can offer is greatly appreciated. If your income qualifies for subsidies or if you can manipulate your income/maga score to qualify for subsidies, you can get it fairly cheap. Otherwise it is as or more expensive than non ACA plans. As others said, most doctors will not take it. Some you will be hard pressed to find any doctor to take it. But if you get the subsidies, it could be worth it to use as a catastrophic plan, for prescriptions, lab work, and free or inexpensive Teladoc use. Then pay cash for your regular in person visit dr and other services. I retired young and we pay cash on the lowest pay tier negotiated with our long time doctor. I have payed cash for other things like x-rays, an mri, cat scan in the last 3 years that was cheaper out of pocket than my part would have been when I had employer insurance. But I also have a catastrophic plan so we don't go bankrupt if something bad ever happens. Also as was also posted ACA plans will always cover preexisting conditions. Almost all non ACA individual plans will not cover preexisting conditions.
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Re: Affordable Care Act price??
[Re: unclebubba]
#8147103
01/28/21 07:26 PM
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Joined: Nov 2011
Posts: 11,013
Texas buckeye
THF Celebrity
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THF Celebrity
Joined: Nov 2011
Posts: 11,013 |
The Affordable Care Act is not affordable at all. You can get health coverage still on Non-Obama care plans. They do have pre-existing conditions and there are limitations, but they do exist still. Not in texas, the individual plan market went away, ask me how i know....the only way is through a group plan in texas. Or exchange plans as an individual. As a contractor, i dont think the OP would he eligible for a group plan unless through some guild or something else, but not likely through his business
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Re: Affordable Care Act price??
[Re: Sniper John]
#8147121
01/28/21 07:30 PM
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Joined: Nov 2011
Posts: 11,013
Texas buckeye
THF Celebrity
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THF Celebrity
Joined: Nov 2011
Posts: 11,013 |
One other aspect is whether doctors will accept the coverage. I do not accept “exchange plans” because the rules state these plans can not he cancelled for a long time period (i want to say 3-6 months) after last payment is made so what ends up happening is a patient signs up and pays the first month payment to get the letter stating they have the insurance to suffice for tax purposes but then doesn’t pay anymore and then the doctors offices call to confirm if the patient is covered, the insurance company says yes, then the doctor provides services and the insurance company denies the covered services due to lack of premium payment by the patient. And then the doctors office is out time and money and they know sending someone like that to collections is a useless venture.
So i know lots of doctors offices don’t take exchange plans. Trumps EO making the “tax” void made this issue not as big a deal since people weren’t picking up plans just to suffice for tax purposes but it still applies for people who cant pay, decide to not pay, etc. and the rules of the exchange plans not being able to say a patient doesn’t have coverage for 3-6 months after they really don’t still applies. Not exactly correct. The only reason to have it for tax purposes is to get the subsidies which can be quite substantial. The ACA has a three month premium nonpayment grace period. Go beyond that and those that get the subsidy will lose it and have to pay back any they have received for the year. And will be unable to receive subsidies again until they have held qualified insurance for a calendar year. So what one could do is cancel their insurance after 9 months and still qualify for ACA insurance with subsidies the next enrollment period. I was talking strictly from the doctors side of things and explaining why a lot of doctors don’t take exchange plans. You made my point though, someone stops paying in September but goes for a medical appt/procedure in November or December. Technically according to the plan the patient is still covered, so they verify the benefits as covered, but when billed the insurance company says “sorry that person hasn’t paid since September and so is not covered”. By that point the services are rendered so what’s the motivation for the patient to pay the doctor now? And we wonder why medicine is so expensive in the us...
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Re: Affordable Care Act price??
[Re: texdave]
#8147123
01/28/21 07:32 PM
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Joined: Jul 2008
Posts: 22,257
Texas Dan
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It works well for those like me who retired early, live a very modest lifestyle and need coverage until Medicare kicks in. While deductibles are high, all preventive care is paid 100%. I don't see it as something for a family that requires a higher income.
"Some people will never like you because your spirit irritates their demons."
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Re: Affordable Care Act price??
[Re: texdave]
#8147127
01/28/21 07:36 PM
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Joined: Nov 2011
Posts: 11,013
Texas buckeye
THF Celebrity
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THF Celebrity
Joined: Nov 2011
Posts: 11,013 |
Thanks all. My fear is just what was mentioned above...that a lot of doctors won’t take it. Unfortunately for you, the ACA would be not much more than a catastrophic plan that will cost a lot of Money to have. The exact thing ACA was enacted to get rid of... Your best het would be a heath share network (christian heath network if you qualify) or just go without and when a catastrophe hits, just tell the hospital you have no insurance. Reality is even with most ACA plans the deductible is so high the ability to do much within the medical System is still limited for most people in those plans. The plans do cover routine health stuff though, so if you aren’t sock you get at least a “free” physical” and stuff every year. Trust me When i say you can pay cash and make out like a bandit compared to the monthly fees for ACA (if you aren’t sick). But one big health bill and you will appreciate the insurance. Total catch 22.
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Re: Affordable Care Act price??
[Re: Halfadozen]
#8147152
01/28/21 08:03 PM
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Joined: Nov 2009
Posts: 4,604
chalet
Extreme Tracker
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Extreme Tracker
Joined: Nov 2009
Posts: 4,604 |
If you There are quite a few Christian based medical co-ops that are a 1/4 of the cost of ACA. It's not insurance, all the members pay in monthly and the co-op pays the bills. All the staff at my church are on one of these. If interested, PM me and I can find out the name. I am a member with Samaritan Ministries coop and have no complaints. Have only had to file a "need" once or twice but things were smooth. Runs about $150/mo for just me and there was a surplus this past year so my monthly share cost has actually gone down. Don't remember what the cost was when had the whole family on it but I think around $300.
Shoot. Eat. Repeat.
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Re: Affordable Care Act price??
[Re: Texas buckeye]
#8147167
01/28/21 08:12 PM
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Joined: Nov 2011
Posts: 9,928
unclebubba
THF Trophy Hunter
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THF Trophy Hunter
Joined: Nov 2011
Posts: 9,928 |
The Affordable Care Act is not affordable at all. You can get health coverage still on Non-Obama care plans. They do have pre-existing conditions and there are limitations, but they do exist still. Not in texas, the individual plan market went away, ask me how i know....the only way is through a group plan in texas. Or exchange plans as an individual. As a contractor, i dont think the OP would he eligible for a group plan unless through some guild or something else, but not likely through his business I have an individual plan...either that, or the agent that I use has put me in a group, but the point is, you have other options besides Obama care and the medishare faith based ones. I did the Medishare, and it was no good. Now I am on an individual plan. The cost is about 30% of what Obamacrap was going to cost.
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Re: Affordable Care Act price??
[Re: Texas buckeye]
#8147180
01/28/21 08:23 PM
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Joined: Aug 2005
Posts: 20,939
Sniper John
gumshoe
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gumshoe
Joined: Aug 2005
Posts: 20,939 |
One other aspect is whether doctors will accept the coverage. I do not accept “exchange plans” because the rules state these plans can not he cancelled for a long time period (i want to say 3-6 months) after last payment is made so what ends up happening is a patient signs up and pays the first month payment to get the letter stating they have the insurance to suffice for tax purposes but then doesn’t pay anymore and then the doctors offices call to confirm if the patient is covered, the insurance company says yes, then the doctor provides services and the insurance company denies the covered services due to lack of premium payment by the patient. And then the doctors office is out time and money and they know sending someone like that to collections is a useless venture.
So i know lots of doctors offices don’t take exchange plans. Trumps EO making the “tax” void made this issue not as big a deal since people weren’t picking up plans just to suffice for tax purposes but it still applies for people who cant pay, decide to not pay, etc. and the rules of the exchange plans not being able to say a patient doesn’t have coverage for 3-6 months after they really don’t still applies. Not exactly correct. The only reason to have it for tax purposes is to get the subsidies which can be quite substantial. The ACA has a three month premium nonpayment grace period. Go beyond that and those that get the subsidy will lose it and have to pay back any they have received for the year. And will be unable to receive subsidies again until they have held qualified insurance for a calendar year. So what one could do is cancel their insurance after 9 months and still qualify for ACA insurance with subsidies the next enrollment period. I was talking strictly from the doctors side of things and explaining why a lot of doctors don’t take exchange plans. You made my point though, someone stops paying in September but goes for a medical appt/procedure in November or December. Technically according to the plan the patient is still covered, so they verify the benefits as covered, but when billed the insurance company says “sorry that person hasn’t paid since September and so is not covered”. By that point the services are rendered so what’s the motivation for the patient to pay the doctor now? And we wonder why medicine is so expensive in the us... I should have started with "mostly correct" rather than "not exactly correct".
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Re: Affordable Care Act price??
[Re: Texas buckeye]
#8147190
01/28/21 08:27 PM
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Joined: Apr 2007
Posts: 60,465
BOBO the Clown
kind of a big deal
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kind of a big deal
Joined: Apr 2007
Posts: 60,465 |
I was talking strictly from the doctors side of things and explaining why a lot of doctors don’t take exchange plans. You made my point though, someone stops paying in September but goes for a medical appt/procedure in November or December. Technically according to the plan the patient is still covered, so they verify the benefits as covered, but when billed the insurance company says “sorry that person hasn’t paid since September and so is not covered”. By that point the services are rendered so what’s the motivation for the patient to pay the doctor now?
And we wonder why medicine is so expensive in the us...
Funny I argued this same thing a few years back and was told I was full of BS by a progressive “conservative”. Bad deal for Doctors. Huge roll of the dice.
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Re: Affordable Care Act price??
[Re: texdave]
#8147221
01/28/21 08:57 PM
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Joined: Nov 2020
Posts: 119
BooneCrockettBowieMartin
Woodsman
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Woodsman
Joined: Nov 2020
Posts: 119 |
Anytime you get doctors, insurance, lawyers ,hospitals agreeing on something by saying it sucks then you got a clue as to its worth , for they normally cant agree on anything and always suing one another, wife was with big insurance for 35 yrs. care act dam near made a mess of her trying to keep up, until she had enough and retired happily ever after.
You'll come to know, when the bullet hits the bone. I didn't come this far and get this old by Backing Up.
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Re: Affordable Care Act price??
[Re: unclebubba]
#8147477
01/29/21 12:48 AM
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Joined: Nov 2011
Posts: 11,013
Texas buckeye
THF Celebrity
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THF Celebrity
Joined: Nov 2011
Posts: 11,013 |
The Affordable Care Act is not affordable at all. You can get health coverage still on Non-Obama care plans. They do have pre-existing conditions and there are limitations, but they do exist still. Not in texas, the individual plan market went away, ask me how i know....the only way is through a group plan in texas. Or exchange plans as an individual. As a contractor, i dont think the OP would he eligible for a group plan unless through some guild or something else, but not likely through his business I have an individual plan...either that, or the agent that I use has put me in a group, but the point is, you have other options besides Obama care and the medishare faith based ones. I did the Medishare, and it was no good. Now I am on an individual plan. The cost is about 30% of what Obamacrap was going to cost. Thats interesting. I had individual insurance from 2009 to around 2014-15 timeframe. We had AETNA at first and when obamacare was signed a year or two later they pulled out of the market. We went to united. Then they pulled out of the market. There was no other individual non-exchange plan available for us then. Maybe things have changed back. I hope they have. But when united dropped us we were told there was no other option. It wasn’t because we weren’t paying an arm and a leg for our plans either, our price was initially 900/mo in 09 and was 1900/mo just a few years later and the only option we had for a comparable plan then was a 2500/mo exchange plan we knew hardly anyone would take. We went to christian medishare, never used it, paid cash for all our stuff. We are now in a group plan thru my practice, but it was simply put of desperation we were able to get my business partner to agree to pay for our employees. Caveat: we wouldn’t take an HMO plan. We wanted PPO only. So if you have a HMO then that might be the difference. We had no PPO option thru united, aetna, bcbs, or anyone else....
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Re: Affordable Care Act price??
[Re: texdave]
#8147656
01/29/21 03:31 AM
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Joined: Jul 2015
Posts: 18
texdave
OP
Light Foot
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OP
Light Foot
Joined: Jul 2015
Posts: 18 |
Sounds like these co-ops are worth researching. Ideally I’ll get back to a direct-hire job in the near future. Funny, since I started this thread I’ve had 2 companies follow up with me on job applications. Fingers crossed!
Thanks again boys and girls.
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Re: Affordable Care Act price??
[Re: BOBO the Clown]
#8147749
01/29/21 05:01 AM
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Joined: Dec 2010
Posts: 8,841
DocHorton
THF Trophy Hunter
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THF Trophy Hunter
Joined: Dec 2010
Posts: 8,841 |
I was talking strictly from the doctors side of things and explaining why a lot of doctors don’t take exchange plans. You made my point though, someone stops paying in September but goes for a medical appt/procedure in November or December. Technically according to the plan the patient is still covered, so they verify the benefits as covered, but when billed the insurance company says “sorry that person hasn’t paid since September and so is not covered”. By that point the services are rendered so what’s the motivation for the patient to pay the doctor now?
And we wonder why medicine is so expensive in the us...
Funny I argued this same thing a few years back and was told I was full of BS by a progressive “conservative”. Bad deal for Doctors. Huge roll of the dice. Very true. Our biggest "write-offs" for non-payment are people who say they have insurance but after filing a claim it gets denied. and only a tiny percentage of people ever pay their bills.
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