Mama Carol

Yeah, it kinda is. Might not be the Kool Aid shooters but it is the rose colored glasses for sure. If I want better insurance, I don't need the government to mandate it. If it were truly better insurance, I might feel different about it. My bank account is down a bit over 12 grand as opposed to this time last year so you'll understand if I don't share your enthusiasm for the ACA. Under my old plan, my bank account would have been down a bit over a thousand. If you want something screwed up, get the government involved, especially at the federal level. I just today got a

That's due to the grandfathering. If a plan was in place but didn't offer coverage for something either a procedure or a condition, there is nothing that says it must cover it now. This from the tax course I took: The provisions concerning the prohibition of pre-existing condition exclusions. These provisions are inapplicable to grandfathered individual health insurance. It also goes on to say group plans that didn't offer coverage for certain things don't have to. It's not just the individual plans. Not only that, if the plan didn't offer coverage to dependents up to the age o

You have to remember TP is drinking the Kool-Aid (shooters). I, too, paid more for less. I couldn't keep the doctor I wanted who is affiliated with one of the finest orthopaedic practices in the entire nation. No primary care doctors nearby would accept the insurance I had last year (fortunately there is better choice this year but it's a different plan). For my surgeries, I had a choice of two hospitals, both located in another county and 20+ miles away. I could go to the hospital around the corner but there was no orthopaedist on my plan who does surgery at that hospital. That's

I hear you! I got so tired of the local hospital business office somewhere up north sending me a bill for a co-pay I'd already paid and then ignoring my attempts to get it straightened out that I just sent them another payment for it. It was $25 and it just simply wasn't worth my time or effort to fight them on it. I had proof I had paid it but they didn't have it credited to my account. Best $25 I ever spent. It shut them up. I know at some point they will probably find it and refund it to me. We had that happen not long ago with my husband's pain management doctor who he saw for the l

I'm 60 years old and a female who had a complete hysterectomy 11 years ago. It is pointless for there to be coverage in my policy for maternity care. Nor do I need to have prostate exams to be covered. Insurance should not be a one policy for everyone deal. You should be able to choose what you want covered. Need maternity care? That should be offered. Need prostate exams? That should be offered. Have no need for either one? No reason for you to pay for it. Auto insurers don't require you get full coverage, why should health insurers.

In that case, Frank needs to be tested. And soon!! So sorry to hear of his passing. You and Frank have my prayers.

According to people I am in contact with you don't get a knee replacement unless you're a certain age regardless of how bad the arthritis is. According to people I am in contact with you don't get a choice in which "consultant" you are sent to and the consultant may not be the type of doctor you need. According to the people I am in contact with you may wait months, or even years, to see a consultant who, as I stated above may not be the type of doctor you need but instead is the one assigned to you. Depending on which Canadian province in which you live, treatment for the same c

Fortunately, we're north of I-10 and insurance is a bit cheaper here for homeowners than it is south of I-10, plus we aren't in a flood zone so that helps. And we're not even in an evac zone. We pay roughly $100 a year in city property taxes which is the best deal I've ever seen. For that $100 a year we get police and fire protection (fire chief lives two doors down even), we have a very responsive city council, amazing parks (as you know since you've seen some of the pictures I post) and some of the friendliest people you would ever want to meet. In fact, I just got back from the dentist a

Actually, where we live is cheaper than Powder Springs. Our taxes are lower, we have no personal income tax (which meant I brought home 6% more of my income than I would have in Georgia). The weather is better. And the people are awesome. I've not had any complaints about the cost of health care. In fact, prior to my surgery I did a cost comparison for the hospital where I was going to have surgery and what it would have cost to have it done at Cobb Hospital, where I would have been had I stayed in Powder Springs. It was considerably less expensive to have it in Pensacola. You coul

What injury are you referring to? The diagnostic procedure I may need has nothing to do with an injury and neither did my knee replacements. The knee replacements were due to osteoarthritis. The diagnostic procedure is due to iron overload, which has a genetic cause and has been taken care of for over 20 years. These were not "bad choices". These are health issues that essentially were out of my control. I have done whatever was necessary to take care of them through the years, to the point of living with a bad knee and constant pain. The total submitted charges for both knee repla

The problem with that last part is the insurance company has to make a profit as well. And every additional entity involved in the process--from the doctor to the billing service to the insurance company--has to make money or else they wouldn't be there. Nobody and I mean NOBODY should have to provide a service for free unless they are set up to do just that, as a non-profit. And even non-profits have paid staff (at least I sure hope one of them does).

How do you think Obamacare got passed? Insurance lobby is pretty darn strong. What better thing for them than to have mandated health insurance for everyone, a guaranteed payment for it from the government and to pay pennies on the dollar on the charges for medical care? If I remember my figures correctly, my insurance company paid about 40% of the charges submitted last year for my surgeries and PT. Maybe 40%. Some charges, like for PT they were paying around 20% of the charge. They paid nothing on two charges and the hospital had to write them off. Those two charges were roughly

This year I'm getting a subsidy and I despise Obamacare. My choices are a bit better than they were last year but I have to have my PCP do a referral for everything including that blood work I had last week ordered by another doctor. Next time you pay 30 grand in federal taxes in one year, you can tell me how I'm one of the same ones that get breaks on things that WE subsidize.

It took a lot of research but last year I found a policy that has a deductible AND maximum out of pocket of $6250. That's for in-network. Deductible and max out of pocket for out of network was $12,500. One thing a lot of people don't realize is the premiums are higher if you're older than say 26 or if you've ever smoked. My orthopaedist, who is basically 3 miles from my house and part of one of the south's most prominent orthopaedic groups, was not in-network. In fact, NONE of their physicians were in-network. Nor was the primary hospital where they perform surgery. I had to

I'm pretty sure I'll have to have a diagnostic procedure here in a week or so. I'll be sure to let you know how much of that cost my insurance pays. I'm betting it will be zero as I haven't met my deductible yet. But I'll keep in mind that EVERYONE'S insurance pays 100% of the cost.

What you said was another way of saying what I said--the reason they were closing was because they couldn't afford to stay in business BECAUSE THEY AREN'T MAKING A PROFIT because they aren't getting paid. Unless you are a non-profit, if you're running a business whether it is a retail store, a website, a newspaper or a hospital you must have profit in order to stay in business. Expanding Medicaid would only make the problem worse for medical providers who aren't getting paid already. It would mean they are providing more free service to more people. That's completely against good business

Has NOTHING to do with profit, right? Absolutely nothing to do with the fact that on a $50,000 charge, the hospital may only get $6,000-$8,000 in reimbursement, right? Medicare is administered through Social Security. The state has nothing to do with it. You're thinking MedicAID. But then again, that goes back to profit for the corporation that owns the hospital. But that has nothing to do with why hospitals are closing.

In 2011 I was told I needed to have my right knee replaced. I had just gotten new insurance which was around $500 a month. When they got my medical records and saw the knee arthritis was pre-existing (well duh), they dumped me in spite of the fact that I had not seen a doctor for my knee since 1977 when I injured it. That's right, I had not seen a doctor for it in all those years. It hurt, it got better, it hurt, it got better. I existed on Aleve and aspirin, which I might take for a week or so until the pain went away and then I'd stop taking it. I'd run the gamut of conservative tre

Preventive medicine is the key. Unfortunately, a lot of the time even the "preventive" medicine that is currently in place misses things that should have been caught. I'm now part of a foundation working to get one particular preventive/screening test on routine lab work. The $40 or so the test costs could save thousands of lives and millions of dollars. We also are working to educate doctors. Does no good to have prevention without knowledge of how to work with a patient to head off potential problems.

Nope. My out of pocket last year was about 55% of our income. And of my personal income, what I earned in my job, thanks in part to having two surgeries and not being able to work for more than half the year, JUST my insurance was about 2 1/2 times what I earned. Kick in my deductible, the total was about 5 times what I earned. Even when we do eventually get our refund, the majority of which is a refund for insurance premiums I paid, we will be back to the total being about 2 1/2 times what I earned. And don't even get me started on the tax returns for people who purchased health ins

Actually, I wouldn't have regardless of where I lived. Even in states that expanded Medicaid, they didn't change eligibility requirements except income. Having my husband's pension buyout in the bank would have knocked me out regardless even though he is covered by Medicare and I was the one needing insurance. I suspect this was an issue with a lot of people, too. They don't make enough money to qualify for a subsidy but they have some money in the bank which knocked them out of getting Medicaid, even in states that expanded it. You're mistaken about the deductibility of medical expens

He missed the enrollment period and wouldn’t have qualified for subsidies because, since he’s not working, he makes too little money. Am I the only one who thinks this is totally wrong. You make TOO little money to qualify for a subsidy? Wasn't the point of the ACA to help those who couldn't afford insurance be able to buy insurance??? BTW, this was my situation in 2014. I made too little money to qualify for a subsidy so I had to pay 100% of my premium which took almost 1/3 of our total monthly income. If we had had just a bit more income, and therefore been in a better fina

If you don't have insurance, talk with the hospital. They have special rates for people without insurance.

does it matter?

You're far from alone in that.