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AZ 116% Increase in some cases, over 50% increase in most
Old 10-27-2016, 01:24 AM   #141
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AZ 116% Increase in some cases, over 50% increase in most

I live in AZ. Luckily I have a grandfathered private insurance plan (as long as it continues to exist). Once it is gone I will have to get Obamacare or a work around. But these facts are grim.

One county in AZ has only one choice -- so much for competition that could drive prices down. And even with more than 1 option, the strictures of an Obamacare policy mean all the policies offered have the same options, so no competition. Let's hope somebody fixes this b/c we have taken a system that 90% of people were happy with and turned it into a disaster. This thing is a rube golberg nightmare and it was more than foreseeable by anyone who could look at it objectively.

Also, when anyone is happy about how subsidies are increasing, let's remember that the taxpayers (we who are working) are paying for all of this. There is no free lunch. Let's hope our inept congress can somehow figure out how to interject competition into this pig and eventually make it affordable. But their usual answer (more taxpayer money for subsidies and insurance company bailouts) will only make the death spiral happen that much sooner.

My advice: If you need or can foresee any type of medical treatment, book your doctor now. In some cases, the wait in AZ is over 6 months to see a qualified doctor. If you are early retired, consider a part-time job at Starbucks or a similar company where you can get work-related healthcare that does not have the huge co-pay, narrow networks and limitations of Obamacare. This is only going to get alot worse before it gets better. Good luck all and God Bless!
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Old 10-27-2016, 03:12 AM   #142
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Just from the point of view of clarity, I wonder if at some point they'll memory-hole the moniker "Affordable Care Act".
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Old 10-27-2016, 04:07 AM   #143
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Originally Posted by NW-Bound View Post
Well, it's all about ACA plan availability and premium increases we talk about, yes?

It does not bother me that much that the healthcare cost is higher here than in Thailand. Heh, when working I got paid a lot more than a Thai engineer did in his country, so why should I ask an American doctor or nurse to be paid in Thai baht? Everybody gets paid more here than his counterpart in Thailand.

The question should not be whether it should be higher here in the US, but how much higher it should be.
The cost is also much higher then in Switzerland or France and on average very far from Swiss or French quality.

BTW you most likely got paid much less then you would if you did same job in Switzerland just as you are most likely collecting much smaller pension for that work then Swiss citizen.

It is meaningful to compare USA to France and not all that meaningful to compare it to Thailand or Zimbabwe.
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Old 10-27-2016, 05:43 AM   #144
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Our (MFJ, retired for a year) monthly Silver Plan premium will drop to under 33.

Nice!
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Old 10-27-2016, 05:49 AM   #145
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The cost is also much higher then in Switzerland or France and on average very far from Swiss or French quality.

BTW you most likely got paid much less then you would if you did same job in Switzerland just as you are most likely collecting much smaller pension for that work then Swiss citizen.

It is meaningful to compare USA to France and not all that meaningful to compare it to Thailand or Zimbabwe.
The cost of living varies between countries, so it is common to look at healthcare cost as a percentage of GNP. And indeed, the US is highest among developed countries.

For personal finance, where I am, when the premium for a Silver Plan along with the high deductible consume the entire median before-tax income of a couple, something is extremely wrong. See an earlier post of mine (#107).

Having the government picking up the tab is not the solution. This cannot go on forever. Are we becoming another Greece?
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Old 10-27-2016, 06:15 AM   #146
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I'm in eastern Pa. I have 3 Silver plans to choose from. Will probably go with Geisinger HMO which will be $0 (zero) per month premium after subsidy. $300 deductible. $2,350 max oop. Based on income of $16,500.
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Old 10-27-2016, 06:27 AM   #147
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With the premium so high, undoubtedly more people will qualify for a subsidy.
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The premium rate doesn't have anything to do with whether you get a subsidy, does it?
For young people with low SLCSP premiums, the sliding scale of subsidies often goes to zero well below 400% FPL. As their SLCSP premiums rise, more young people in the 300%-400% FPL range become eligible for subsidies.

On a different note, as SLCSP premiums rise 50 year olds will begin to experience "the cliff" currently seen by 60 year olds. The 60 year olds will see a bigger cliff.
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Old 10-27-2016, 06:31 AM   #148
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The cost of living varies between countries, so it is common to look at healthcare cost as a percentage of GNP. And indeed, the US is highest among developed countries.

For personal finance, where I am, when the premium for a Silver Plan along with the high deductible consume the entire median before-tax income of a couple, something is extremely wrong. See an earlier post of mine (#107).

Having the government picking up the tab is not the solution. This cannot go on forever. Are we becoming another Greece?
Well I am just mentioning it because immigration to place like Portugal is another option to bridge FIRE age to age 65 . I don't want to get into political discussion of broken Health System in US since that will be blocked by admins.

One can get 10 years tax free stay in Portugal. That is just an example.....
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Old 10-27-2016, 06:51 AM   #149
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For those who are getting the subsidy, it is still better than paying the full unsubsidized amount. At least I think so. It does pay to try and control your income. No SS for us till 66.

We do talk about the money a lot because that is also we are concerned about.

BUT Pre-Existing Condition Coverage, No Payout Caps, Women's Health, Wellness Health, and Diagnostic services are PRICELESS.
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Old 10-27-2016, 08:02 AM   #150
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the plan may have an employer cost cap
You are exactly correct. My former employer changed their retiree medical benefit rules some time ago and I missed being grandfathered by two years.
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Old 10-27-2016, 08:07 AM   #151
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In NY below 200% FPL the plan is still $20 a month or nothing. Amazed it is still $20.

http://info.nystateofhealth.ny.gov/s...eet%202017.pdf
is that a PPO plan?
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Old 10-27-2016, 08:08 AM   #152
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What is meant by "rack rate"?
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Old 10-27-2016, 08:12 AM   #153
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What is meant by "rack rate"?
Full price. In the hotel industry...the official or advertised price of a hotel room, on which a discount is usually negotiable.
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Old 10-27-2016, 10:07 AM   #154
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If it's any consolation... I recently had a procedure miscoded, and the hospital claimed I was responsible for the payment. I asked if there was any sort of reduction since I was paying out of pocket. I was told, if I was uninsured, they would reduce the charge by 80%. Since I was insured, they were only allowed by law or contract, I forget which one at the moment, to reduce the charge by 20%.

So, oddly enough, you may pay less for care without insurance, although the premiums aren't high enough yet for me to take that risk.
1) Not all hospitals may be so 'generous'.

2) You were talking to the hospital - there can be multiple additional providers, all of whom bill you independently (doctor, surgeon, anesthetist, radiologist, et. al.), each of which may take different angles on those who don't have insurance...and all of whom are more likely to not negotiate to that level, and instead go after you and/or sell it to a collections firm if you try and negotiate it after the fact, since the small individuals don't have billions in revenue to 'pay for' discounts like this.
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Old 10-27-2016, 10:58 AM   #155
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1) Not all hospitals may be so 'generous'.

2) You were talking to the hospital - there can be multiple additional providers, all of whom bill you independently (doctor, surgeon, anesthetist, radiologist, et. al.), each of which may take different angles on those who don't have insurance...and all of whom are more likely to not negotiate to that level, and instead go after you and/or sell it to a collections firm if you try and negotiate it after the fact, since the small individuals don't have billions in revenue to 'pay for' discounts like this.

Then just declare bankruptcy and they get nothing.
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Old 10-27-2016, 11:03 AM   #156
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For young people with low SLCSP premiums, the sliding scale of subsidies often goes to zero well below 400% FPL.
Yes, that's what I'm seeing when I preview plans for my 29 year old son. His income increased a lot this year (Yay!) as a free lance sound engineer but he won't be able to guesstimate his ACA MAGI until he gets closer to the end of the year. Unfortunately, he didn't inherit my love of detailed spreadsheets so he hasn't been tracking his deductible expenses all year, he just gathers them up at year end.

For his zip code and age the cliff is actually at about $31000 (261% of FPL). His SLCSP is $219/mo. The full cost of the lowest cost Bronze is $197/mo.
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Old 10-27-2016, 11:04 AM   #157
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What is meant by "rack rate"?
It can be a very big difference. A recent ER visit was 15k full price, insurance was 3k.
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Old 10-27-2016, 11:07 AM   #158
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When I used the term "rack rate" I meant the unsubsidized premium rate.
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Old 10-27-2016, 12:22 PM   #159
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I live in AZ. Luckily I have a grandfathered private insurance plan (as long as it continues to exist). Once it is gone I will have to get Obamacare or a work around. But these facts are grim.

One county in AZ has only one choice -- so much for competition that could drive prices down. And even with more than 1 option, the strictures of an Obamacare policy mean all the policies offered have the same options, so no competition. Let's hope somebody fixes this b/c we have taken a system that 90% of people were happy with and turned it into a disaster. This thing is a rube golberg nightmare and it was more than foreseeable by anyone who could look at it objectively.

Also, when anyone is happy about how subsidies are increasing, let's remember that the taxpayers (we who are working) are paying for all of this. There is no free lunch. Let's hope our inept congress can somehow figure out how to interject competition into this pig and eventually make it affordable. But their usual answer (more taxpayer money for subsidies and insurance company bailouts) will only make the death spiral happen that much sooner.

My advice: If you need or can foresee any type of medical treatment, book your doctor now. In some cases, the wait in AZ is over 6 months to see a qualified doctor. If you are early retired, consider a part-time job at Starbucks or a similar company where you can get work-related healthcare that does not have the huge co-pay, narrow networks and limitations of Obamacare. This is only going to get alot worse before it gets better. Good luck all and God Bless!
I'm not sure what you mean by all policies offered have the same options. Policies vary on premium and how much you can expect to co-pay for doctor visits, prescriptions, etc. and the total deductible and maximum out-of-pocket costs, not to mention what doctors and facilities are in the network. If you mean things like you can't be denied insurance, well I can't say I agree that's a bad thing.

90% were happy with the old system? Hardly - complaining about changes in our company health plan was an annual rite.

I'm sure anyone on pensions and/or social security, investments, etc. will be glad to know you've determined they aren't taxpayers anymore. I guess they can stop worrying about those pesky tax returns.
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Old 10-27-2016, 12:32 PM   #160
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1) Not all hospitals may be so 'generous'.

2) You were talking to the hospital - there can be multiple additional providers, all of whom bill you independently (doctor, surgeon, anesthetist, radiologist, et. al.), each of which may take different angles on those who don't have insurance...and all of whom are more likely to not negotiate to that level, and instead go after you and/or sell it to a collections firm if you try and negotiate it after the fact, since the small individuals don't have billions in revenue to 'pay for' discounts like this.
As more insurance companies switch to HMOS don't count on providers being generous. If and when uncollectibles start to pile up don't be surprised if you get turned away before you can rack up a big bill. If you are not in network you better have your checkbook with you if you want care. They might not let you bleed to death, but the rest is up in the air if they don't feel they are going to get paid.
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