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It’s possible for many ordinary people to pay off a $6000 bill *eventually* with the aid of crowdfunding and penny-pinching. Not so much a $100k bill.
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Jan 6, 2018 15:46
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BarbarianElephant posted:It’s possible for many ordinary people to pay off a $6000 bill *eventually* with the aid of crowdfunding and penny-pinching. Not so much a $100k bill. Progress! 
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Jan 6, 2018 17:30
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Twerk from Home posted:Isn't there benefit to having insurance at all, even if you can't pay the deductible because you'll get better access to care with insurance? Somewhat, although hospitals have been known to deny care for non-emergency services if it doesn't look like you can pay the full deductible amount, since if you're unable to pay they would only be reimbursed 80% of the cost past your deductible -- and at the rates the insurer has negotiated with the provider, which are generally rather low. The big benefit of having bronze tier if you're poor is, at least, the ACA out of pocket maximum. Assuming you don't get hosed with out-of-network costs. Because a bill for $7.3k is survivable especially if you get help from family members or community organizations, whereas a bill for $60k would be time to declare bankruptcy. The downside of bronze tier plans for poor people from a public health standpoint is that few people will ever hit the deductible amount with routine healthcare expenses, making it essentially equivalent to not having insurance at all. You get free preventative care but we generally don't see people on the bronze tier utilizing it since you pay out-of-pocket if you are actually diagnosed with something as a result of a screening. It's basically catastrophic coverage and doesn't offer a whole lot else. CSR plans on the other hand are insanely good and people should really get in on those if they can rather than purchasing bronze plans.
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Jan 7, 2018 18:38
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So just how far does that "can't be denied insurance for pre-existing conditions" thing go because a spouse of a co-worker was just diagnosed with leukemia and neither of them have any insurance.
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Jan 7, 2018 22:59
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He or she would have to qualify for a special enrollment period and the easiest way to do that is marriage or having a kid, neither of which would be applicable. But...there is a way
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Jan 7, 2018 23:26
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The Phlegmatist posted:He or she would have to qualify for a special enrollment period and the easiest way to do that is marriage or having a kid, neither of which would be applicable. What about divorce?
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Jan 7, 2018 23:32
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PerniciousKnid posted:What about divorce? Doesn't count unless you lose health insurance as a result of the divorce. I'm mostly kidding about the jail time thing but this is the United States of America TYOOL 2018 and you can get a special enrollment period if you somehow managed to get locked up in the county jail for a misdemeanor for, say, ten days.
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Jan 7, 2018 23:42
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The Phlegmatist posted:Doesn't count unless you lose health insurance as a result of the divorce. I don't know that I would recommend it, but last I knew, the health exchanges allowed you to self certify a QLE to enroll. It's probably fraud though.
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Jan 8, 2018 03:10
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Republicans posted:So just how far does that "can't be denied insurance for pre-existing conditions" thing go because a spouse of a co-worker was just diagnosed with leukemia and neither of them have any insurance. It goes 100% of the way for plans sold on exchanges. What state are they in? Different states can have different open enrollment periods and I know of at least one that is going until 1/15. If their state is our of open enrollment, moving across state lines can trigger a special enrollment period if I'm not mistaken.
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Jan 8, 2018 15:56
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Reik posted:It goes 100% of the way for plans sold on exchanges. What state are they in? Different states can have different open enrollment periods and I know of at least one that is going until 1/15. If their state is our of open enrollment, moving across state lines can trigger a special enrollment period if I'm not mistaken. WA State is one of those states.
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Jan 8, 2018 18:33
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Reik posted:It goes 100% of the way for plans sold on exchanges. What state are they in? Different states can have different open enrollment periods and I know of at least one that is going until 1/15. If their state is our of open enrollment, moving across state lines can trigger a special enrollment period if I'm not mistaken. You don't have to move across state lines to trigger a special enrollment period -- to a different ZIP code or different county within a ZIP code is sufficient -- but that doesn't work if you're uninsured: you must have been covered by insurance for at least one day of the 60 prior to the move to qualify.
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Jan 8, 2018 18:49
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Republicans posted:So just how far does that "can't be denied insurance for pre-existing conditions" thing go because a spouse of a co-worker was just diagnosed with leukemia and neither of them have any insurance. Does this spouse work? Quitting their job might count for a QLE. Edit: After doing some more research, I'm pretty sure the law expects you to just die if this happens. I'm not joking. Double edit: I would have the person with leukemia quit their job and tell the other person's company that they had insurance through the first job to force a QLE. Someone will probably look into that later and it's totally fraud, but I would commit fraud to get cancer treatments every day of the week and twice on Sundays. I guess if someone manages to get a NEW job, that should count either way, but... good luck. As a bonus, if you go to jail for fraud you get healthcare! KillHour fucked around with this message at 19:11 on Jan 8, 2018 |
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Jan 8, 2018 18:54
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Also, it varies state by state, but they should see if their state Medicaid plan has a "medically needy" determination they could qualify for. This is for when your income is higher than the Medicaid thresholds but you have substantial/catastrophic medical costs.
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Jan 8, 2018 19:47
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We're in Washington state so yeah they have until the 15th to enroll. I told a friend of theirs about it so hopefully they can start getting coverage next month but oooooo I don't even wanna think about what its gonna cost in the meantime.
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Jan 9, 2018 06:55
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Republicans posted:We're in Washington state so yeah they have until the 15th to enroll. I told a friend of theirs about it so hopefully they can start getting coverage next month but oooooo I don't even wanna think about what its gonna cost in the meantime. Why the gently caress are they even waiting? Why aren't they signing up literally the minute they found out? On a different note. I've seen people jumping through quite a bit of hoops with this enrollment period on income verification if they had big changes in their income. Apparently Healthcare.gov doesn't actually have a clear process for how the income verification is supposed to work. So, for example, if you're self-employed you should be able to just submit a spreadsheet of how you more-or-less predicted your income for 2018. I've heard from people that they've turned that spreadsheet in and received a notification that they needed further documentation. They would get 4+ emails, each saying the same thing about additional documentation, all within a 48hr period. They'd get a phone call for each email, and a letter would be mailed to them as well. What was needed? They were never told. Try to call Healthcare.gov and apparently no one knows and has no way of knowing. It basically boils down to "just keep sending things." That spreadsheet is apparently not enough. They basically want the spreadsheet, last year's 1040 / schedule C / and all calculation worksheets, 1099s, proof of deposits...the works. Basically the same level of documentation you'd need to prove income for a mortgage.
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Jan 11, 2018 11:31
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Can I ask a question about how you physically access healthcare in the US? I live in the UK but the work I manage takes place in the US and I'm over every month. While I was over in October I thought about seeing a doctor while I was there. I called up and they all had 3-month waiting lists.. I had thought that because it's for-profit and especially paying cash it would be really quick. It's a big contrast to here, as a privately insured patient you typically get seen next day or that week, in my experience.
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Jan 11, 2018 13:04
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Basically you make that appointment for months out, and if you have something that needs to be seen ASAP, you're stuck footing the bill for an ER or Urgent Care type place.
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Jan 11, 2018 13:05
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Well-visits have longer wait times than sick visits. If you're sick you can usually see your doctor same-day. Edit: vvv Yes, emphasis on your doctor. PerniciousKnid fucked around with this message at 14:30 on Jan 11, 2018 |
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Jan 11, 2018 13:36
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Assuming you have a GP that you're under. Getting a new physician can take a while since most seem to have waiting lists.
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Jan 11, 2018 14:13
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knox_harrington posted:Can I ask a question about how you physically access healthcare in the US? I live in the UK but the work I manage takes place in the US and I'm over every month. If you are just in the USA for a couple of days a month for work and you get sick, what you want is a non-hospital “Urgent Care.” They can treat things like sniffles and sprains and they shouldn’t be too expensive out of pocket (probably about $100.) You walk in and wait, usually about an hour. But be sure it is not an “Emergency room” at a hospital because those charge an arm and a leg.
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Jan 11, 2018 14:47
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BarbarianElephant posted:If you are just in the USA for a couple of days a month for work and you get sick, what you want is a non-hospital “Urgent Care.” They can treat things like sniffles and sprains and they shouldn’t be too expensive out of pocket (probably about $100.) You walk in and wait, usually about an hour. I like using the local urgent care places, but apparently those are easy to confuse with freestanding emergency rooms. quote:... US healthcare is a financial minefield between stuff like this or getting referred to an out-of-network doctor (I lost ~$3000 on this just recently). I could easily see myself confusing a "freestanding emergency room" with an urgent care center, especially if distracted by a sick child.
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Jan 11, 2018 15:11
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Seems silly but at our Walmart there is an outreach clinic that is part of the local hospital that charges decent rates for simple things. Some Insurance covers it and you can get stuff like antibiotics pretty fast. Keep that in mind too.
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Jan 11, 2018 15:38
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Invalid Validation posted:Seems silly but at our Walmart there is an outreach clinic that is part of the local hospital that charges decent rates for simple things. Some Insurance covers it and you can get stuff like antibiotics pretty fast. Keep that in mind too. There's also drugstore clinics like the CVS Minute Clinic. Some of them take appointments, but walk-in waits are usually reasonable. https://m.cvs.com/minuteclinic/services/price-lists Nocturtle posted:US healthcare is a financial minefield between stuff like this or getting referred to an out-of-network doctor (I lost ~$3000 on this just recently). I could easily see myself confusing a "freestanding emergency room" with an urgent care center, especially if distracted by a sick child. PerniciousKnid fucked around with this message at 15:57 on Jan 11, 2018 |
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Jan 11, 2018 15:55
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https://www.washingtonpost.com/nati...436a_print.htmlquote:Trump administration opens door to let states impose Medicaid work requirements
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Jan 11, 2018 16:00
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knox_harrington posted:Can I ask a question about how you physically access healthcare in the US? I live in the UK but the work I manage takes place in the US and I'm over every month. Depends on your region and your doctor. I've had same-day or same-week appointments with a new doctor, I've had 8 week waits. Psychiatrists and dentists tend to be particularly busy in my experience.
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Jan 11, 2018 16:02
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Crashrat posted:Why the gently caress are they even waiting? Why aren't they signing up literally the minute they found out? I wonder if that's related to the fact that under the prior administration Equifax Workforce Solutions won a $330 million, multiyear contract to provide income verification. Maybe Equifax was cut off from their contract after the data theft and hasn't been replaced? On the other hand, healthcare.gov (as well as many of the state-based exchanges) has always been a clusterfuck when it comes to tracking verification documents.
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Jan 11, 2018 19:13
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No Equifax still provides the workforce stuff, it’s state dependent but unless you don’t file taxes or started self employment recently they use tax return to verify income. Some states want to verify if you have money stashed away in an account but a state like Kentucky does not care.
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Jan 11, 2018 19:44
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Invalid Validation posted:No Equifax still provides the workforce stuff, it’s state dependent but unless you don’t file taxes or started self employment recently they use tax return to verify income. Some states want to verify if you have money stashed away in an account but a state like Kentucky does not care. If this is their first time, it shouldn't matter (in theory) because the state can just tax them to make up for income verification, at least that's what I was told when this started.
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Jan 11, 2018 19:49
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Invalid Validation posted:Some states want to verify if you have money stashed away in an account but a state like Kentucky does not care. For the purpose of the ACA, do you mean? Because I don't recall any part of the Act's being asset-based (except for longterm care under Medicaid, which had always been the case).
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Jan 11, 2018 19:50
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Yea it shouldn’t matter either way since you would get the money back or have to pay the fine when you file taxes. I’ll speak for Kentucky as I know what they need, they want your tax return and only take personal records when you can’t provide it or your income changes enough to warrant personal records. In theory that is. States like to put in certain requirements to make it hard for people so they don’t have to spend as much money on it.
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Jan 11, 2018 19:56
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Willa Rogers posted:I wonder if that's related to the fact that under the prior administration Equifax Workforce Solutions won a $330 million, multiyear contract to provide income verification. Maybe Equifax was cut off from their contract after the data theft and hasn't been replaced? Honestly I'm kind of wondering if there is an automated system involved with it. The file names I've seen for the messages delivered to Healthcare.gov people who submit "insufficient documentation" or "sufficient documentation" all have the "AI" somewhere in the filename. Every time a file is generated it always has "AI" in it. So I wonder if the reason no one know what you need to send in is precisely because a human isn't even involved.
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Jan 15, 2018 08:53
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"Additional Information" is a slightly less exotic possible interpretation.
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Jan 15, 2018 13:40
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Nocturtle posted:I like using the local urgent care places, but apparently those are easy to confuse with freestanding emergency rooms. Our local urgent care will quote out-of-pocket prices, so you can just ask that. If they um and haw and say "It depends" they are probably a freestanding emergency room. A real urgent care will say something like "Our uninsured rate is $120 not including tests." And then say "no" to tests except those that are truly necessary because they can be $TEXAS.
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Jan 15, 2018 18:24
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hailthefish posted:"Additional Information" is a slightly less exotic possible interpretation. I'm just trying to find out the reason for why they can't explain to anyone what information they need to send in. You'd think if there were humans reviewing it there'd be a note or something someone at the call center could look at and let the applicant know. Because literally no one has any idea; it's like a black box.
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Jan 15, 2018 23:08
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Crashrat posted:Why the gently caress are they even waiting? Why aren't they signing up literally the minute they found out? I'm actually running into that right now as well on healthcare.gov. There's a tiny bit of overlap where I can actually get all my various w-2s and whatnot in early Feb and then submit those. I'm not sure what else to do - my household income has changed wildly from two years ago and again this year and I guess healthcare.gov is determining that letting everyone just type in 30 grand for expected income & get max CSR is not working? It'll be cool when I lose health insurance due to no documentation or feedback on their end. I submitted a bunch of paystubs from last year as examples of how my income varies, I guess I need to get on the phone with some random worker and find out what else they need. It's not like last year is in any way predictive of this year for people who do contract work, so it doesn't make sense to even do this in the first place.
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Jan 16, 2018 16:20
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BarbarianElephant posted:And then say "no" to tests except those that are truly necessary because they can be $TEXAS. Anyway, my point mainly is: gently caress this system, if I'm not sure whether a test ultimately will be helpful or not, the patient sure as hell shouldn't have to try to figure it out. Unfortunately, I'm also in a situation where patient follow up can be abysmal, and where missed or delayed diagnoses have a high litigation rate, so over-testing is the norm. Honestly, I get way more patients demanding, "I want everything checked out," and getting angry when I refuse completely unnecessary or irrelevant tests. Every once in a while someone will voice concern about healthcare costs (almost always someone in his or her early twenties, just out of one of the local colleges, trying to find full-time work); they're a lot more receptive to skipping plain films for probable sprains, skipping labwork for probable vomiting and cramping that could be but probably isn't an early appy, etc. I generally "forget" to click some boxes on those charts so they get billed at a lower level, too.
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Jan 16, 2018 18:03
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mastershakeman posted:I'm actually running into that right now as well on healthcare.gov. There's a tiny bit of overlap where I can actually get all my various w-2s and whatnot in early Feb and then submit those. I'm not sure what else to do - my household income has changed wildly from two years ago and again this year and I guess healthcare.gov is determining that letting everyone just type in 30 grand for expected income & get max CSR is not working? It'll be cool when I lose health insurance due to no documentation or feedback on their end. Healthcare.gov - despite ostensibly being a system for people who cannot get health insurance through work...seems really only built for people who work multiple part-time jobs. Don't get me wrong here - I am fully cognizant of how poo poo our economy is for people and that employers drastically cut full-time employment to avoid paying for healthcare resulting in the growth of the part-time sector; however, that doesn't suddenly make all of the independent contractors and disappear. Indeed if anything the shift to independent contractors, rather than part-time employees, seems to be the new trend. The Dept of Labor has seemingly gone completely toothless in protecting workers in this arena. But that doesn't comport with the kind of means testing that Healthcare.gov is seemingly being asked to do. ICs are being asked to prove the impossible, effectively, in that Healthcare.gov seemingly wants them to show proof of income they haven't even received yet. Honestly it seems like if you're an IC then your only hope is to submit your full 1040, Schedule C, all 1099s received, and then any proof you have of direct deposits. Because at that point you've sent literally everything that could even exist. But since this is all historical I can only presume they're wanting to see proof that you are actually an independent contractor.
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Jan 17, 2018 00:48
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Crashrat posted:But that doesn't comport with the kind of means testing that Healthcare.gov is seemingly being asked to do. ICs are being asked to prove the impossible, effectively, in that Healthcare.gov seemingly wants them to show proof of income they haven't even received yet. It's certainly made me really busy these past few weeks trying to help our navigators figure out WTF is going on. There's something really hosed up in the system this year and nobody from healthcare.gov seems to be able to give a coherent explanation.
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Jan 17, 2018 06:21
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The Phlegmatist posted:It's certainly made me really busy these past few weeks trying to help our navigators figure out WTF is going on. I honestly believe it's just barriers being put in someone's way. The letters are all automatically generated. In fact the *filenames* are more descriptive than the letters. The letters just say you have provided insufficient documentation to prove income. But if you look at the file names as they're being sent from Healthcare.gov the file names will include things like "low side fail" or "high side fail". And that "high/low side fail" in the file name is more information than the letters have, than anyone at Healthcare.gov can give you, and certainly any Navigator. When I pointed it out for a colleague they had no idea what I was talking about because they just had the printed letter. When they opened the file Adobe has its own Title of "ESD Custom Notice" But the actual file name for the PDF has the information itself. Like so many people that was just something in their Downloads folder that they never looked at - their browser or Adobe Reader just opened the file automatically once it was downloaded. They had no idea it was even there. I earnestly believe there were some management changes at CMS with the Trump administration who just decided to not break the law, but walk a tight rope on it, to make getting the tax credit more difficult for the shear purpose of "gently caress poor people." Crashrat fucked around with this message at 12:17 on Jan 17, 2018 |
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Jan 17, 2018 08:57
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Crashrat posted:I earnestly believe there were some management changes at CMS with the Trump administration who just decided to not break the law, but walk a tight rope on it, to make getting the tax credit more difficult for the shear purpose of "gently caress poor people." I wouldn't be surprised if this was the case. We also ran into a bunch of problems with people failing identity verification because they had a security freeze on their Experian credit report. And getting past that requires submitting documents to the black hole known as healthcare.gov which can take a while. How the hell was anyone supposed to know the two systems were linked?
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Jan 17, 2018 19:05
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