PPACA (Obamacare) Draft Application Form -First Look

[heeyy_joe]

I need a job. Where I can put in the application to become a government worker who process those applications, figure out and hand out the subsidy and implement the Act?

Try the Department of Labor. www.DOL.GOV

 

[gerrym51]

I hope you're right on this one. As someone noted above, here in Mass, the current'exchange' plans are viewed as a middle ground between Medicaid and a "full freight" provider. Not all Drs accept exchange plans.

i find that most doctors accept full pay exchange plans-i bought one. it's the subsidized they don't

 

[scrabbler1]

Do we count tax-exempt interest from muni bonds or muni bond funds as "other icome" in the application? Under deductions from income, we include home mortgage interest and state+local taxes?

For a single person with no kids, most of the pages do not apply to me which is good.

 

[Peter]

That's not the way Obamacare is going to work.

I don't see any choice of participation or non participation by a doctor based on whether a plan is subsidized. Subsidies are tax credits that go directly to the taxpayer/individual paying the premiums for health insurance. There will be no difference in the type of policies an individual can buy as everyone will be buying from the same group of policies offered by their state through the state or federal exchange.

If that's the case, there is no such thing as a subsidized vs non-subsidized plan, only subsidized vs. non subsidized individuals.

My understanding was that subsidized plans would only be available through the exchanges, and that you could still buy insurance outside the exchange system if you wish.

But I could very easily have this wrong!

 

[REWahoo]

My understanding was that subsidized plans would only be available through the exchanges, and that you could still buy insurance outside the exchange system if you wish.

Looks like the ability to buy insurance outside the exchange will continue, but this article expresses some concern that could change:

Life Outside the PPACA's Public Health Insurance Exchanges

Clearly PPACA intends to make the public exchanges a key offering for consumers, who need more accessible and affordable healthcare options at their disposal.... However, as Levitt and Claxton point out, options outside of the public exchange domain will remain an important part of America’s healthcare system:


"(A)s central as exchanges will likely be, it’s important to remember that there are other key provisions that help shape the reformed marketplace. Insurers will still be able to sell insurance to individuals and small businesses outside of the exchanges, and the health reform law applies new consumer protections to plans sold in that outside market, too."

 

[ERhoosier]

My understanding was that subsidized plans would only be available through the exchanges, and that you could still buy insurance outside the exchange system if you wish.

But I could very easily have this wrong!

Techncally I believe you're right that it might be possible to buy plans outside the Exchange. However private insurers may decide not to offer such individual plans. Plans that are too expensive would trigger the "Cadillac Plan" tax. Plans that are too inexpensive (e.g. less coverage, more deductibles/co-pays, etc) would not be "qualified", so buyer would still be subject to IRS penalty (er- "tax" per SCOTUS) since they did not have a "qualified" HI plan.
Theoretically it is also possible insurers might decide to not even offer any plans under the Exchange, although this seems highly unlikely to me. Even if the profit margis shrink, there's too much marketshare to ignore.

 

[MichaelB]

i find that most doctors accept full pay exchange plans-i bought one. it's the subsidized they don't

My understanding is the insurance company designs lower cost plans that exclude some doctors and other providers, not the other way around. We were in plans like this when we lived in NY and only had access to the guaranteed issue plans mandated by the state. The way the insurer builds a lower cost plan is by limiting the number of doctors, providers and service options available, and then maximizing the number of subscribers to that plan.

 

[MichaelB]

My understanding was that subsidized plans would only be available through the exchanges, and that you could still buy insurance outside the exchange system if you wish.

But I could very easily have this wrong!

Most healthcare insurance in the US is large group, and that will not be sold thought the exchanges. At least for now they are only providing policies to individuals and small groups. It is correct that subsidies will only be available for policies acquired in the state exchanges.

 

[Throwdownmyaceinthehole]

How will the docs know?

So, if I have high earner income in 2012, 2013, and no income due to retirement in 2014, then how will the docs know what kind of subsidy I have as I won't even get the credit until tax time? So its just between the plans and medicare And then no income, so I'd be on medicare, can I keep saying I'll have income, stay on the plans, pay monthly, then get credit at tax time??

 

[gerrym51]

My understanding is the insurance company designs lower cost plans that exclude some doctors and other providers, not the other way around. We were in plans like this when we lived in NY and only had access to the guaranteed issue plans mandated by the state. The way the insurer builds a lower cost plan is by limiting the number of doctors, providers and service options available, and then maximizing the number of subscribers to that plan.

We can't get enough doctors for the rates were paying so well tell the buyers of the insurance that were restricting number of providers so we can offer a lower cost.

 

[M Paquette]

We can't get enough doctors for the rates were paying so well tell the buyers of the insurance that were restricting number of providers so we can offer a lower cost.

LOL! Our medical insurer offers a dental plan from another company. The literature is full of glowing statements about how it reduces the out of pocket costs when we go to an in-network dentist. "Cleanings - $15.00; Simple Filling - $28.00;" and so on. Wow! Sign me up!

Now, which dentist in town is in the network? Ah, here we go. Search for providers in the network for our Super Economy Plan:

Within 5 miles; <SEARCH>

... 0 providers found

OK... Within 25 miles; <SEARCH>

... 0 providers found

Eh? Lemme try this again...

Within 100 miles; <SEARCH>

... 0 providers found

Um. It turns out that the economy and cheap plans don't actually have any in-network providers in driving distance. Flying distance, yeah. Now, if I kick up to the Deluxe Extravaganza Plan, I can pay about twice what I actually pay dentists every year, and have local dentists in-network.

There ain't no such thing as a free lunch...