|
Crashrat posted: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. Have you tried taking this to a news outlet or senator yet? It sounds like if there's no reasonable way to get answers through the system, blowing it up through the news might get some action before people start getting dropped.
|
#
?
Jan 17, 2018 21:58
|
|
|
|
| # ? May 15, 2024 02:50 |
|
|
If this isn't the best thread for this question I hope that you will refer me and preferably not probate me, but I didn't see a more appropriate link in the OP. In short, I was too poor last year to afford health insurance for over half the year after losing a government job with disappointing pay but excellent benefits, and I'm wondering if there is any way that I can avoid paying the ludicrous ACA penalty on my tax this year as I am dirt loving poor this year as well and presently live in a lovely Red StateTM with no Medicaid for the destitute. I lost my job in mid-May of '17 and my benefits ended at the end of that month. Cobra was, of course, an option, but it was $600 a month and far out of my price range. I had to pay over $6000 for a life-or-death surgery and had to relocate, which forced me to cash in my meagre 401k. The moving company I hired screwed me blue as Peter and further destroyed my cash reserves. I only received a few hundred dollars a week in unemployment for a measly 14 weeks despite working full time for a year because I had the poor judgement to work in an Even Shitter Red Statealso TM. I was unemployed for months afterwards as I was taking care of my crippled mother who was recovering from major surgery, and I only started working again six months after losing my first job. I am technically full-time at this waste of time "job" and am benefits eligible, but I only get about 28 hours per week, the pay is poverty-level and the benefits are Utter Shitealso also TM so I can't really afford them. Both my mother and I being unemployed so long means my modest savings are gone, and I do not savour the idea of having to pay hundreds of dollars in tax because I had the unmitigated gall to be too poor to buy lovely, Overpriced Insurancevery TM indeed. I do not want to come across as some government-hating MY FREEDOM!!!! Ted Cruz-worshipping neocon prick, but I really don't relish the idea of paying nearly $1000 in penalties for the heinous crime of being broke. At this point that would be twisting a very large knife in a gaping, suppurating wound full of salt, lemon juice and hedgehogs. Any hope? Fake Edit: Merciful Moses on the Mountain, but I do miss the NHS. 
|
|
#
?
Jan 18, 2018 04:19
|
|
|
Even before this administration there were numerous ways to get an exemption from the penalty: https://www.healthcare.gov/health-coverage-exemptions/hardship-exemptions/ Sounds like you'd qualify for at least a couple of them, especially having medical debt. But be sure to fill out the exemption form and submit it well in advance of April 15. When I moved cross-country twice a few years ago I filed for and received an exemption, even though I didn't neatly fit into one of the exemption categories. I just added a couple paragraphs of a typed narrative describing My Hell Year and enclosed it with the form. Please don't feel bad about asking for an exemption; there are lots of people who can't afford even minimal coverage, especially in non-expansion states.
|
|
#
?
Jan 18, 2018 04:32
|
|
|
Willa Rogers posted:Even before this administration there were numerous ways to get an exemption from the penalty: https://www.healthcare.gov/health-coverage-exemptions/hardship-exemptions/ Thank you so much; I bookmarked that link. I also moved cross country twice in the space of two years, moving 1800 miles west in the summer of 2012 and then 2500 miles back east in 2014 to change from one poorly-paying job to another. Both had excellent benefits as they were for state governments, but the moving expenses wiped out my savings every time. You have both my gratitude and my empathy.
|
|
#
?
Jan 18, 2018 05:00
|
|
|
I was just directed to a site for "Dental Savings Plans" from my dental care provider, since my health plan doesn't cover dental. These things seem much, much too good to be true, and I note that they're going out of the way to not characterize themselves as insurance. What's going on here that I'm missing?
|
|
#
?
Jan 25, 2018 18:22
|
|
|
Discendo Vox posted:I was just directed to a site for "Dental Savings Plans" from my dental care provider, since my health plan doesn't cover dental. It's probably just negotiated network pricing. They're not going to cover cost of your treatment, but they're going to negotiate low rates so that you don't have to do it yourself.
|
|
#
?
Jan 25, 2018 18:25
|
|
|
Dental insurance is barely insurance anyway. It's like prepaying for your cleanings every year and getting a discounted rate on stuff like fillings.
|
|
#
?
Jan 25, 2018 18:34
|
|
|
Twerk from Home posted:It's probably just negotiated network pricing. They're not going to cover cost of your treatment, but they're going to negotiate low rates so that you don't have to do it yourself. This usually the case. They are typically surrounded by marketing material that says something like "no deductibles!" or "no annual limits!" because they don't actually pay you any benefits. It could be a reasonable purchase if you don't otherwise have insurance, if it only costs a few bucks a month, and if the dentist you usually go to is in the network. Or you could just ask your dentist for a discount and they might give you one.
|
|
#
?
Jan 25, 2018 18:45
|
|
|
My current dentist has a discount if you pay out of pocket.
|
|
#
?
Jan 26, 2018 00:52
|
|
|
Stickman posted:Have you tried taking this to a news outlet or senator yet? It sounds like if there's no reasonable way to get answers through the system, blowing it up through the news might get some action before people start getting dropped. I'm in the camp that there's a sincere hope within the Trump administration that their decisions will blow up, and let them bring back "Obamacare is a Failure!" despite the fact that the only reason this system is causing so many problems is because of Republican attempts to kill it with a thousand cuts. Hell I've talked to CMS people on the phone who've flat out asked if they're being recorded, and upon saying no, just start explaining how to get around barriers and issues. They're fully aware of how utterly hosed the whole system is. Almost everyone I've met from CMS seems genuinely dedicated to the task of improving the healthcare of everyone they have to work with and they have absolutely no stomach for this poo poo Republicans are pulling. So with the fuckery that's going on - combined with most career civil servants in CMS being pissed at it - I imagine this sort of fuckery will get resolved internally. There's a lot to be said for bureaucratic autonomy, and when it comes to healthcare CMS absolutely knows how to clean their own house from the fallout of political shenanigans. Like I have no doubt that it seriously pisses off the Trump administration that the Healthcare.gov landing page opens with asking you if you need health insurance and a photo of a pretty chill looking black guy looking like he's in the midst of moving to greener pastures; that landing page has to push *so* many Trump administration buttons. Virtue posted:Dental insurance is barely insurance anyway. It's like prepaying for your cleanings every year and getting a discounted rate on stuff like fillings. It's usually only discounted after you've paid premiums for a year, and then there's a yearly limit to boot. But for kids it can be a *huge* cost saver for orthodontics; BCBS doesn't have yearly limits on kids up to 19 for orthodontics, and it usually covers 50% of the cost, which can make it an outright nobrainer. Qu Appelle posted:My current dentist has a discount if you pay out of pocket. I've seen dentists who will discount the amount the patient has to pay for their portion after insurance as well. Their contract with the insurer almost certainly prohibits it, but it seems like a commonplace practice - and obviously there's no way for the insurer to find out since neither the provider or the PT has any incentive to let the insurer know. Kinda like how some independent pharmacists will cut down the amount the amount the PT has to pay to help the PT out, and because hit means the PT will it their OOP max sooner so their finances can be helped out. Same pharamcists that will work to schedule patients with expensive brand drugs to make sure their first refills of the year are all refills that have co-pay discount cards from the manufacturer so when it runs through the primary insurance - and the PT has hundreds of dollars owed - the discount cards knock it down to $10-30 per script putting the PT well on their way to hitting their deductible without actually incurring a vast majority of the cost. This is especially true with insurers like BCBS hitting PTs with a loving 50 PERCENT coinsurance from an in-network pharmacy if you dare to be prescribed a non-preferred brand name drug. I don't really see a problem with this at all considering the patient was responsible for that portion and just managed to "negotiate" to get their costs reduced - but I'm sure there's some contract rules that prohibit all of these things. So loving glad I don't work in billing. Just learning about it constantly underscores the absurdity of healthcare in America. Crashrat fucked around with this message at 11:19 on Jan 26, 2018 |
|
#
?
Jan 26, 2018 11:07
|
|
|
Why are physical therapists being hit with pharmacy copays? Drug companies have programs to offset those coinsurance fees in most cases.
|
|
#
?
Jan 26, 2018 13:15
|
|
|
Crashrat posted:So loving glad I don't work in billing. Just learning about it constantly underscores the absurdity of healthcare in America. We have billing software that estimates how much you'd be able to pay on a payment plan based on stuff like how much your house is worth and where you work. Technically that decides how much of a discount self-pay patients should be offered. But the people we have working in patient business services are dumb and their bonuses are based on month-to-month goals so they offer everyone the maximum discount anyway (which varies from 50% to 75% if you can pay it all at once) so they can get paid immediately. There's some mismanagement going on in the billing side but the patient wins out overall so whatever.
|
|
#
?
Jan 26, 2018 13:50
|
|
|
Good morning everyone https://twitter.com/sarahkliff/status/956540184165867520
|
|
#
?
Jan 26, 2018 14:15
|
|
|
skull mask mcgee posted:Good morning everyone The other insurance companies are the ones who stand to lose, when the cheap healthy patients get stolen. Expect fast lawsuits from people with deep pockets.
|
|
#
?
Jan 26, 2018 17:01
|
|
|
The big insurers are already selling non-ACA term medical in several markets this year though? Not sure why Idaho got singled out.
|
|
#
?
Jan 26, 2018 19:21
|
|
|
Devor posted:The other insurance companies are the ones who stand to lose, when the cheap healthy patients get stolen. Expect fast lawsuits from people with deep pockets. Wouldn't it make more financial sense for them to just start doing it themselves?
|
|
#
?
Jan 26, 2018 21:58
|
|
|
Without the mandate you should expect all insurers to be selling non-renewing 12 month "temporary" policies that they can medically underwrite if their state department of insurance lets them. People that can't pass underwriting will have to stay on the exchange but those premiums will skyrocket, so anyone not receiving subsidies that can't pass underwriting will lose coverage due to prohibitive costs.
|
|
#
?
Jan 26, 2018 22:35
|
|
|
Yeah, this year is just a trial balloon since you'd have to pay the penalty if you had non-ACA term medical "insurance" (which as Reik said is 1 to 3 month renewable insurance so it doesn't trip any flags of being federally illegal.) It depends on how much marketing it actually gets, but next year it will start to be an attractive option for healthy people, pulling them away from the exchanges. Current pricing looks like it's targeted to be cheaper than ACA plans even if you're receiving a gigantic APTC. In my market it's about 10% of the cost of an ACA plan. e: Imagine if you bought term life insurance month-to-month to get a good idea of how well this term medical insurance would protect you. The Phlegmatist fucked around with this message at 23:20 on Jan 26, 2018 |
|
#
?
Jan 26, 2018 23:09
|
|
|
Zauper posted:Why are physical therapists being hit with pharmacy copays? PT is just shorthand for patient.
|
|
#
?
Jan 27, 2018 07:48
|
|
|
Crashrat posted:PT is just shorthand for patient. Medical billing shortcodes are their own language. A glossary would be helpful if you would be so willing.
|
|
#
?
Jan 27, 2018 07:58
|
|
|
BlueBlazer posted:Medical billing shortcodes are their own language. A glossary would be helpful if you would be so willing. Just a quick Google search. I didn't look through all of it. Basically if someone writes "P.T." that means physical therapy, but "PT" means patient. Here's an example PDF. Again I didn't look over it too much, but it should be pretty close - http://www.jdmd.com/pdf/jdmd_glossary.pdf It's not like you have a class where you sit down and rote memorize this stuff. Well...there may be some community college type classes that do it, but mostly it's just something you become used to over time. The Phlegmatist posted:Yeah, this year is just a trial balloon since you'd have to pay the penalty if you had non-ACA term medical "insurance" (which as Reik said is 1 to 3 month renewable insurance so it doesn't trip any flags of being federally illegal.) Honestly I'm not buying into the all of the doom & gloom of collapsing ACA-level insurance or at least not yet. The people posting and reading here are most likely in the top quintile of informed people in health care policy. Even if you don't think you are it's pretty probable you are because the overall level of education and knowledge about health insurance and costs is outright abysmal. The average person doesn't even check to see if a provider is in network before showing up for urgent care or a non-referral specialist visit. The average person, upon being told a medication isn't covered by their insurance prescription list, will just choose not to entirely forgo that prescription. For example BCBS drastically cut down the available prescribed cough medicines this year. The standard codeine/promethazine syrup that's pretty much ubiquitously prescribed is flat out not covered, but it's not terribly expensive as a cash price and an independent pharmacist might even cut that price some because the stuff is honestly really cheap for them to stock. BCBS started pushing Tuzistra XR this year, which is codeine & chlorpheniramine in a time-release form, but it's stupidly expensive because of course it is - and of course there's a copay assistance card to probably make it just as cheap as the codeine/prometh would have been last year...but PTs don't know, and don't bother to try, so they just go buy some OTC "cough syrup" (dextromethorphan + a bunch of acetaminophen). The end result being a shitload of PTs who take W-A-Y too much acetaminophen combined with their preferred whisky & honey in tea cough medicine leaving their liver feeling like even being Archer Sterlin's liver would be a vacation. Point being - people don't bother to look things up, people don't bother to research, people don't bother to find alternatives. So unless there's just some kind of *MASSIVE* marketing push to sell the "12 month temporary" non-ACA compliant plans I don't see them being bought up in en masse.
|
|
#
?
Jan 27, 2018 08:11
|
|
|
Most people will buy whatever is the cheapest thing their employer offers. Employers are going to start offering these "plans" because of course they will.
|
|
#
?
Jan 27, 2018 12:14
|
|
|
KillHour posted:Most people will buy whatever is the cheapest thing their employer offers. Employers are going to start offering these "plans" because of course they will. They've already been able to do this through an ACA loophole. You can offer a cheap and lovely non-ACA plan to employees and you're okay and don't pay any penalties as long as you offer them the ability to buy into an (expensive) ACA-compliant plan. Then your low-wage employees buy into the lovely plan that doesn't cover anything. One of the reasons why this is uncommon is that UHG is basically the only carrier that will work with businesses to do this. Nobody else is really chomping at the bit to be known as "the really lovely health insurance company that killed your family."
|
|
#
?
Jan 27, 2018 17:58
|
|
|
I'm looking at the in-process bills for my son's birth (via section after two days of attempted induction), and holy loving poo poo thank God our insurance is good.
|
|
#
?
Jan 27, 2018 19:51
|
|
|
KillHour posted:Most people will buy whatever is the cheapest thing their employer offers. Employers are going to start offering these "plans" because of course they will. Nah it's usually a pretty complex choice environment and employees tend to choose the plan that offers the best value for their health. In 3 plan environments you'll often only get 10% enrollment in the cheapest plan
|
|
#
?
Jan 27, 2018 21:41
|
|
|
esquilax posted:Nah it's usually a pretty complex choice environment and employees tend to choose the plan that offers the best value for their health. In 3 plan environments you'll often only get 10% enrollment in the cheapest plan Stores sell a lot more gato negro than night train, therefore people are making perfectly efficient wine choices.
|
|
#
?
Jan 27, 2018 21:52
|
|
|
esquilax posted:Nah it's usually a pretty complex choice environment and employees tend to choose the plan that offers the best value for their health. In 3 plan environments you'll often only get 10% enrollment in the cheapest plan Depends on the industry and what employees are being paid. I worked for a company that had something like 27 different options for insurance in 2007. 9 choices for deductible, 9 for prescription coverage, 9 for something else I can't remember. These plans ranged in cost from $0 for something about the equivalent of a bronze exchange plan, to $60 a paycheck for platinum level coverage. It was about half of people paying for the best, 20% of people on the free plan, and the rest somewhere in between. I think I did something with low deductibles, moderate co-pays, and basic prescription coverage, paid about $25 per paycheck. But we were paid decently, and, as auto insurance company workers, had to hear a lot of sob stories about accidents that make you want to take care of yourself. Contrast that with my retail jobs before that, where everyone below management was either uninsured or on the most bare bones plan offered. When you make $9.00 an hour, you REALLY don't want to spend more than $9.00 a week on insurance -- so cheapest plan it is, if any at all.
|
|
#
?
Jan 28, 2018 19:46
|
|
|
tetrapyloctomy posted:I'm looking at the in-process bills for my son's birth (via section after two days of attempted induction), and holy loving poo poo thank God our insurance is good. Our completely uncomplicated vaginal delivery of our daughter, with good insurance and deductible fully paid was still 6k out of pocket at the end of the day. loving stunning how expensive healthcare is here.
|
|
#
?
Jan 28, 2018 20:21
|
|
|
I finally realized the secret to getting my mom to vote democrat. "You're not getting a grand kid until we have socialized medicine."
|
|
#
?
Jan 28, 2018 20:24
|
|
|
LeeMajors posted:loving stunning how expensive healthcare is here. It's like a mechanism for transferring wealth from middle class boomers to the upper class --  -- which, I don't know, could that be part of what's driving market-beating sector performance? (BTW, that's Vanguard's healthcare ETF compared to the S&P over 20 years) Boomers are all hitting end-of-life and that's the expensive care. Those nest-eggs they'll be spending total up to quite a lot. I can't help but wonder if our reticence to pursue UHC is in large due to our societal betters' desires for great returns any way and anywhere they can get it. How much would 'Medicare-for-All' (or something) dampen investor returns? Accretionist fucked around with this message at 23:04 on Jan 28, 2018 |
|
#
?
Jan 28, 2018 21:48
|
|
|
tetrapyloctomy posted:I'm looking at the in-process bills for my son's birth (via section after two days of attempted induction), and holy loving poo poo thank God our insurance is good.
|
|
#
?
Jan 28, 2018 22:03
|
|
|
"You were the budget baby" is the new "You were adopted."
|
|
#
?
Jan 28, 2018 22:56
|
|
|
LeeMajors posted:Our completely uncomplicated vaginal delivery of our daughter, with good insurance and deductible fully paid was still 6k out of pocket at the end of the day. The billed total for my wife and our son appears to be in the $60k range (induction, c-section, discharge three days after delivery), the bulk of it hers. Our cost was ... $300. Literally 0.5%.
|
|
#
?
Jan 29, 2018 01:44
|
|
|
tetrapyloctomy posted:The billed total for my wife and our son appears to be in the $60k range (induction, c-section, discharge three days after delivery), the bulk of it hers. Our cost was ... $300. Literally 0.5%. You just know Republicans are pissed that the PP-ACA included child birth, but knew there was no way they could spin the optics for "the plan covers everything but having children" to their base.
|
|
#
?
Jan 29, 2018 08:33
|
|
|
Crashrat posted:You just know Republicans are pissed that the PP-ACA included child birth, but knew there was no way they could spin the optics for "the plan covers everything but having children" to their base. I'm sure they had extensive meetings and really, really tried regardless.
|
|
#
?
Jan 29, 2018 13:01
|
|
|
Accretionist posted:It's like a mechanism for transferring wealth from middle class boomers to the upper class -- Significantly, but only because healthcare returns are insanely inflated by the nonsensically opaque and exorbitantly expensive for-profit system. Also, our politicians fight UHC because they are literally being bribed for vociferous representation by the healthcare and pharma industry. Our politicians are no longer our politicians--they do not represent us. tetrapyloctomy posted:The billed total for my wife and our son appears to be in the $60k range (induction, c-section, discharge three days after delivery), the bulk of it hers. Our cost was ... $300. Literally 0.5%. I think the billed total was something in the 30-35k range (I couldn't bear to total it up) - but we somehow still ended up paying around 5800-6000k. It felt like every person who walked near the room billed separately.
|
|
#
?
Jan 29, 2018 15:14
|
|
|
I know it's too late now, but before you have a kid I always recommend seeing if you have an HMO available. They usually have a per diem copay for Inpatient Admissions instead of a deductible/coinsurance arrangement and it can shave thousands off.
|
|
#
?
Jan 29, 2018 18:43
|
|
|
https://twitter.com/aaronlinde/status/958004158161854465 Can't see any disastrous consequences from this, no sir
|
|
#
?
Jan 29, 2018 20:05
|
|
|
Yeah, it basically requires people to somehow diagnose the severity of their own conditions before calling an ambulance. For some reason I can't imagine it's a good idea to put people in a situation where they have a distinct disincentive to seek urgent care.
|
|
#
?
Jan 29, 2018 20:42
|
|
|
|
| # ? May 15, 2024 02:50 |
|
|
Rhesus Pieces posted:https://twitter.com/aaronlinde/status/958004158161854465 This is despicable. Wouldn't it make more sense to work with hospitals so that ERs could invest more resources in screening patients and send non-emergencies to an adjacent urgent care? The cost discrepancy between ERs and urgent care is horrifying.
|
|
#
?
Jan 29, 2018 21:17
|
|