Big_Hitter
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
If he drops coverage and goes to a state exchange doesn't the employer have to pay a penalty?
That's the right choice for us too. I looked at Silver w/cost sharing, but even if doctor visits were free, that wouldn't save enough to make up the premium difference. Of course the math doesn't work that way if you have a lot of doctor visits, but we don't. The catastrophic policy would probably be better, since what I'm buying is the negotiated rates and the max out of pocket. The process to get the over 30 catastrophic put me off the last couple of open enrollments. Maybe I'll look into it again.I only read half the thread.... but I would just buy the lowest cost bronze plan and call it a day....
Can insurers deny coverage if you have a hotel’s address as your home address on your policy but aren’t living in the hotel at the time of the claim?
Let’s say you’re an RV’er or permanent traveler. You find the most inexpensive policy in a particular state. You enroll for coverage and list a hotel address in that zip code as your home address and your virtual mail service address (in the same state, but with a different zip code) as your mailing address (the ACA application has separate home address and mailing address sections). At the time of the application, you may or may not actually stay at the hotel.
Enrollment complete, your paper mail from ACA and your insurer should go to the virtual mailbox where you can have it scanned or forwarded to yourself, which you could do to get your insurance cards. You keep the hotel address as the home address on your policy.
Then you incur medical costs. Would the insurance company try to deny you coverage for gaming the system like this? I understand they have entire departments that seek out ways to deny claims.
Or say someone like the OP applies for a cheaper policy on the other side of his state using a hotel as his home address and his physical home as his mailing address. Would the insurance company try to deny coverage in that case? How would they even know about the scheme in either case?
They can deny coverage if they can show that any part of the application process was misrepresented. Residency is pretty easy to challenge if your driver's license, voting registration and banking records show a different domicile than the one used for health care.Can insurers deny coverage if you have a hotel’s address as your home address on your policy but aren’t living in the hotel at the time of the claim?
+1I would think you would need to have a PPO plan if you are a perpetual traveler so imo the address you use on your tax return would be the valid address to use, but in any case if you have a PPO plan what does it matter where you have treatment as long as you are in network.
I don't know the answer, just speculating as I am someone who travels 6 months a year so need to have a PPO for decent coverage.
Most Blue Cross Blue Shield plans participate in the BlueCard Program which extends the provider network nationwide.Or say someone like the OP applies for a cheaper policy on the other side of his state using a hotel as his home address and his physical home as his mailing address. Would the insurance company try to deny coverage in that case? How would they even know about the scheme in either case?
Most Blue Cross Blue Shield plans participate in the BlueCard Program which extends the provider network nationwide.
When you apply on an exchange the submitted information, including address, is 'pinged' against various government agencies (IRS, SSA, DMV, etc.) and any inconsistencies suspend the application process. If you apply off the exchange, I can only speak to the dominant insurer in my state. They 'ping' one of the three major credit reporting agencies and any inconsistencies suspend the application process.
I've heard that my retiree HI is doubling in 2016 and doubling again for 2017 so last week I enrolled in healthcare.gov to make an initial application to see what is on offer. As I have a credit freeze in place they could not verify my identity on-line so the website provided a reference number and an Experian phone number to call in order to verify the details of my application. After a series of questions over the phone the Experian rep said that my identity had been verified and when I logged back in to Healthcare.gov I was able to proceed with the application.
BCBS Florida offers 27 plans for independent insurance, 20 of which are PPO. Half are called BlueSelect and the other half are called BlueOptions. The language BCBS uses to describes them never mentions Blue Card, and the network checking tool on their website is clumsy. The only way to verify that the BlueSelect network is not BlueCard and that a user of that policy has limited coverage outside the home state is by speaking with an agent and asking specific questions about the coverage. The terms they use on the website would easily lead an unsuspecting user to a different conclusion and an unfortunate surprise down the road.Most Blue Cross Blue Shield plans participate in the BlueCard Program which extends the provider network nationwide.
My state's health website never managed to verify my identity so I applied on paper. I did this to see if I could save money with an ACA plan rather than paying the full $450 premium for my ex-employer's plan. I didn't qualify for ACA because my income was too low so I got put on Medicaid and given a choice of paying nothing to go on Medicaid or take a $430/month subsidy check to stay on my ex-employer's Cadillac plan. I took the check. The ironic thing is my ex-employer is the state so with one hand they charge me and with the other they pay me.
A prime example of how screwed up our healthcare system is.
I remember getting a job (was it the 70s) and given the choices of which insurance I wanted, full coverage, for free.
In the near future $2000-$4000/month premiums will become the norm.
It just doesn't make sense. There's got to be some kind of low cost alternative that will come about.
I agree. As Buffett says, trees don't grow to the sky. Nor can health care costs eventually eat the whole pie.Regardless of what party is in office or what the fix is, there has to be some fix at some point. There is just no way possible we can continue to have 10-30%+ increases every year. We will literally have $5000 / month premiums 10 years from now at that rate.
There will be a revolution in this country if that happens. 90% of the population will have no insurance. What's the government going to do? Change the max annual income level for subsidy eligibility to $250,000?
Regardless of what party is in office or what the fix is, there has to be some fix at some point. There is just no way possible we can continue to have 10-30%+ increases every year. We will literally have $5000 / month premiums 10 years from now at that rate.
There will be a revolution in this country if that happens. 90% of the population will have no insurance. What's the government going to do? Change the max annual income level for subsidy eligibility to $250,000?
There are a lot of new treatments that are very expensive, and I'm sure there will be many more. At some point there will have to be a limit that excludes the most expensive procedures from "normal" health insurance just to keep the cost reasonable. Not because they are "unproven", but simply because they cost too much.
So, as a course of business, they are going to let people die because a treatment costs too much? I doubt that.
Society will have to decide as some countries in europe do how much an extra year of life is worth and not pay for treatments that do not demonstrate that cost effectiveness. For example $10 million for a year for one person might be out of bounds.So, as a course of business, they are going to let people die because a treatment costs too much? I doubt that.
I don't think that insurance companies determine what medical procedures and drugs cost (at least not the initial bargaining price). In fact, without insurance you will pay more for the same procedure........... If insurance companies were non profits, healthcare would cost many multiples less than it does. The same treatments and medicines cost many many multiples less in other countries than it does in the US and it doesn't have to.
I hate to say this but I think eventually the government will take over healthcare in some form. If insurance companies were non profits, healthcare would cost many multiples less than it does...