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Old 11-12-2013, 10:07 AM   #521
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Originally Posted by Texas Proud View Post
Thanks for the link...

The big problem I see with the plans offered are almost all are HMOs...

The first PPO is catastrophic and is more expensive... the first bronze PPO is $220 per month more than the HMO...

That is a big expense to keep out of an HMO.... and my experiences with HMOs have been bad...
I am signed up under an HMO and there are more providers listed with the HMO network then PPO offered through another insurer. I think everyone agrees that something is needed to curb the outrageous raising cost of health care and I am grateful that we are having this discussion and something is being done for a change.
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Old 11-12-2013, 01:04 PM   #522
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Originally Posted by Cedar View Post
I am signed up under an HMO and there are more providers listed with the HMO network then PPO offered through another insurer. I think everyone agrees that something is needed to curb the outrageous raising cost of health care and I am grateful that we are having this discussion and something is being done for a change.
Unfortunately, the ACA really does nothing to curb the rising cost of health care...it simply spreads that cost out among others and, has been widely reported, there will be some "winners" and some "losers" in the process.

Until individuals really start to bear some of the actual costs involved in the healthcare process, dealing in their own funds, it's going to be very difficult to see the cost curve bend downward. In the current process, and this continue under the ACA, there is little opportunity (due to limited networks) and even less incentive (since premiums can be maxed out at a percentage of income) to "shop around" for healthcare services.

For the purposes of ER though, many of us will be "winners" in the process, paying significantly less under the ACA than we would have otherwise under standard private care (particularly since many of us can "manage" our income levels to stay under the threshold for subsidies.
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Old 11-12-2013, 01:19 PM   #523
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Originally Posted by jflynn4 View Post
Unfortunately, the ACA really does nothing to curb the rising cost of health care...it simply spreads that cost out among others and, has been widely reported, there will be some "winners" and some "losers" in the process. Until individuals really start to bear some of the actual costs involved in the healthcare process, dealing in their own funds, it's going to be very difficult to see the cost curve bend downward. In the current process, and this continue under the ACA, there is little opportunity (due to limited networks) and even less incentive (since premiums can be maxed out at a percentage of income) to "shop around" for healthcare services. For the purposes of ER though, many of us will be "winners" in the process, paying significantly less under the ACA than we would have otherwise under standard private care (particularly since many of us can "manage" our income levels to stay under the threshold for subsidies.
I read an interesting article today that made a point with me and a chuckle since I am guilty as charged. The line was something to the effect of "to get a true control over healthcare costs, we need to switch from the current argument over who is paying for whose health insurance and get to the true problems that are causing the cost problems."
It appears that the bad economy over the recent years has slowed the rate increases due to higher deductibles and people just not having money to address medical needs if needed. But, this is only my opinion, I believe has only temporarily slowed the problem down. The cost issues are deeper than this. Cutting doctors pay isn't an answer to me, and we don't seem to have a desire to push granny over the cliff, so someone with more intelligence than me will have to solve it. But there sure seems to be answers out there based on other modernized countries whose per person cost for care is considerably cheaper.
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Old 11-12-2013, 02:24 PM   #524
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Originally Posted by jflynn4 View Post
Unfortunately, the ACA really does nothing to curb the rising cost of health care...it simply spreads that cost out among others and, has been widely reported, there will be some "winners" and some "losers" in the process.

Until individuals really start to bear some of the actual costs involved in the healthcare process, dealing in their own funds, it's going to be very difficult to see the cost curve bend downward. In the current process, and this continue under the ACA, there is little opportunity (due to limited networks) and even less incentive (since premiums can be maxed out at a percentage of income) to "shop around" for healthcare services.

I take a longer view. Yes, you are correct in that ACA spreads the cost around in terms of winners and losers. But shopping for insurance is not quite the same as shopping for healthcare.

CONSUMERS: As ACA has made the cost of insurance transparent and comparable, people are going to be jumping in (relatively speaking) a bit more onto lower cost, higher deductible plans. Well, that in turn makes them more aware of their usage of healthcare and it can only help to slow the rate of healthcare inflation.

HEALTH CARE INDUSTRY: Also, I think you are underestimating the effect of provider network shopping that is going on in choosing the insurance plan. It is well known that people are not very good at shopping for doctors when the need is immediate. If you are in pain and need to have an appendix removed, you are going to go to the best doctor you can find, cost be damned. But when you are shopping for insurance, the cost is a bigger factor and as long as the provider network passes some basic threshold you would be okay with it. This is going to put downward pressure on the cost such as lab cost, doctor salaries, hospital efficiency etc.

INSURANCE COMPANIES: The other leg of this three legged stool is the insurance companies themselves. They too will feel the pinch as they have to get adjusted to head to head comparison shopping. If one of the smaller companies get selected for the exchange and is reasonably price competitive, imagine what it would be equivalent to in marketing dollars for that smaller company. They could never have competed with the behemoths on equal footing in the pre-exchange era.

Also the ACA mandated limit on MLR (Medical loss Ratio) is already crimping the profits and skimming that used to go on in the insurance industry. As the industry improves, regulators can tighten up the ratio from 80/20 to 85/15 improving it even further. What service do the insurance companies provide any way? Their main reason to exist was to deny payments for services before. Now, they can't do that any more. So, they obviously don't need that many "claim adjusters". And the next logical question is what the function of the insurance company even is?!?!
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Old 11-12-2013, 02:33 PM   #525
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Originally Posted by pb4uski View Post
CBS had a feature on this website that provides easier access to health insurance exchange data. Note that some states that are not on the federal website are not included yet but it looks pretty user friendly to me. The feature indicates that a few young gurus put it together over a weekend.

HealthSherpa
I just tried it. Very cool. Health Care costs may help us decide where to live in the future. You can choose by zip code.
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Old 11-12-2013, 03:50 PM   #526
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I just tried it. Very cool. Health Care costs may help us decide where to live in the future. You can choose by zip code.
Just tried it also. I am not signing up for a couple of years until my wife retires but its good to know that we will get a 950 dollar subsidy per month.
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Old 11-12-2013, 03:58 PM   #527
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I just tried it [ HealthSherpa ]. Very cool. Health Care costs may help us decide where to live in the future. You can choose by zip code.
Huh. Hadn't thought of that. Interesting idea.

So a person with the raw data and little bit of programming skill could ...
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Old 11-12-2013, 05:47 PM   #528
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We got a letter from Humana telling us what we have to do concerning the ACA programs. Our options are to keep out current Humana package for 2014 at the current $514/month rate or jump up to the new (and lousy) ACA rate of $1,334. Obviously we will keep the current rate, but I have no idea what will happen in 2015.
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Old 11-13-2013, 02:26 PM   #529
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So after successfully completing the application process, reviewed plans and ventured into the actual enrollment process, I have a case which I'm curious if any others have experienced?

I got all the way to the enrollment finish line but it wouldn't complete as I couldn't select the button not requiring dental on that SET option. So I called the Help Center and the supervisor I spoke to indicated the typical response to just wait a few days due to technical issues.

At that point I was still able to review/change my healthcare plan selection, see and select any family members requiring a dental plan, and could fill in the enrollment screen info but could not compete the enrollment process because the dental option wasn't yet complete.

I initially tried just adding a dental policy for only one of us figuring I could always not send in any payment and was at the point of hitting confirm on the enrollment screen but figured I give it a few days to see if the techs resolve the dental screen bug as I still had time and was so close to the end.

Well then late last week I got on the site to see if any progress on the bug but now could no longer review / change our selected plan (blank screen) and also only get a blank dental selection screen with no names showing up. I also could get the first page of the enrollment screen with the T&C's on that option but that's it.

In speaking once again with a different CS rep/supervisor they don't know what to do but tell me don't submit a new application since I've already successfully navigated those treacherous waters and I only need to get through the final enrollment but have no idea on how to move forward. They apparently can confirm everything that I can see but have no means to do anything to help address.

They said they could escalate to an advanced resolution specialist but the track record for them getting back to individuals I hear is not so good. So here I wait and occasionally try site to see if any progress but nothing new over the past five days.
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Do premium assistance credit (subsidies) affect qualification for HSA contributions?
Old 11-13-2013, 03:03 PM   #530
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Do premium assistance credit (subsidies) affect qualification for HSA contributions?

Do premium assistance credit (subsidies) affect qualification for HSA contributions?

I recently was able to purchase a health plan through the Federal Exchange. The Plan is a Silver HSA and qualified under IRA guidelines for HDHP. My family deductible with the credit is only $1,000. After accepting the plan I called the customer assistance two different times to confirm that I will still qualify under HSA contributions. Both times they told me I am still eligible for HSA . I then called the insurance company that I purchased the plan from for further confirmation. The insurance agent told me that IRS qualifies the plan itself. The plan has a high deductible that confirms to IRS guidelines and my assistance credit, that is below the $1,250 does not change the plan’s qualifications or my qualifications form myself and spouse to be in the plan. I can still contribute to my HSA account in 2014 and use this deduction for my MAGI. I wanted to share my experience with the board. This affects a lot of people and I wanted to get other’s comments.
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Old 11-13-2013, 03:18 PM   #531
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Do premium assistance credit (subsidies) affect qualification for HSA contributions?
No. If you have an HSA-eligible policy you can open and fund an HSA bank account up to the amount allowed by the IRS. The only limitation I am aware of is if you don't have the policy for the entire year.
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Old 11-13-2013, 03:29 PM   #532
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Do premium assistance credit (subsidies) affect qualification for HSA contributions?

HSA eligibility restrictions only stipulate the deductibles, out of pocket maximums, and that no benefit (except as allowed under ACA preventative care) be paid until the deductible is paid.

It is meant to control unnecessary health care expenditures.

They don't care how the insurance premium is paid. The subsidy is for the premium.
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Old 11-13-2013, 07:38 PM   #533
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still can not "create an account" on healthcare.gov where I am, so can't get any plan details, as copays & deductables, etc
click on "create an account" & nothing happens
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Old 11-13-2013, 07:44 PM   #534
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still can not "create an account" on healthcare.gov where I am, so can't get any plan details, as copays & deductables, etc
click on "create an account" & nothing happens
Me too, I noticed last Friday. In my case I have an application 'in prosess'. So I'm wondering if it's because I have an existing account. Don't understand how we're supposed to use a system that doesn't allow for any data to be changed.

MRG
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Old 11-13-2013, 07:47 PM   #535
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Me too, I noticed last Friday. In my case I have an application 'in prosess'. So I'm wondering if it's because I have an existing account. Don't understand how we're supposed to use a system that doesn't allow for any data to be changed.

MRG
Just out of curiosity have you deleted your cookies from the browser? If you have there should be no record of your prior attempts, or is it after you start creating the account.
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Old 11-13-2013, 07:54 PM   #536
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Just out of curiosity have you deleted your cookies from the browser? If you have there should be no record of your prior attempts, or is it after you start creating the account.

That would also be my suggestion. Clear your browser, new email address, username and password. Create account early in morning when most are a sleep. Write down our personal information, income, and expenses so you are ready. Good luck
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Old 11-13-2013, 07:55 PM   #537
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Me too, I noticed last Friday. In my case I have an application 'in prosess'. So I'm wondering if it's because I have an existing account. Don't understand how we're supposed to use a system that doesn't allow for any data to be changed.

MRG
The status "In process/progress" is misleading. Click on the "2014 blurb" to the left of the status and you should see another screen appear
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Old 11-13-2013, 08:07 PM   #538
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Originally Posted by Time4brake View Post
still can not "create an account" on healthcare.gov where I am, so can't get any plan details, as copays & deductables, etc
click on "create an account" & nothing happens
What browser are you using? I just tried it and it seems to be working, it opened the page for the account creation.
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Old 11-13-2013, 09:01 PM   #539
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I got all the way to the enrollment finish line but it wouldn't complete as I couldn't select the button not requiring dental on that SET option. So I called the Help Center and the supervisor I spoke to indicated the typical response to just wait a few days due to technical issues.
I'm still looking but I was curious. I think you can just skip it ( it says "optional" on the dental box ). I went into the dental "set" and selected NO and it went back to the enrollment list screen. But both the dental selection and confirm selection have the "SET" option ( after selecting a health plan ), I clicked on the "SET" for the confirmation and the page opened to make confirmation. I didn't go any further as I am not ready to confirm. I think you can just skip the dental if you don't want it and go straight to the confirmation.
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Old 11-13-2013, 09:05 PM   #540
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You are correct on the dental. Just skip it. I am assuming you do not have any children. The dental for my enrollment came up for children only. I skipped the dental and it still allowed me to pick a plan.
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