Thursday, October 31, 2013

If you lost your insurance because of Obamacare...

By Carl

Blame your insurer for selling you crappy insurance:
The controversy mainly surrounds the minority of Americans who shop individually for insurance – not for people insured through an employer-based plan or a government program such as Medicare.

The White House has said that, technically, the law allows insurance plans that individuals had in 2009 to be grandfathered in under the law, whether or not their coverage meets ACA conditions.

In practice, though, it’s common for insurance companies to change their policies frequently. Once they change, the policies need to comply with ACA standards of acceptable coverage.

So, as Obama argued, many Americans will now be offered stronger insurance coverage. And in a shift from prior law, a policy can’t be denied or jacked up in price based on an individual’s health.

“Junk insurance,” Like this idiot:
On CBS This Morning, Crawford reported that 56-year-old Dianne Barrette received a letter last month “from Blue Cross Blue Shield, informing her that as of January 2014, she would lose her current plan. She pays $54 a month. The new plan she’s being offered would run $591 a month, ten times more than what she currently pays.”

[…]First of all, the plan that Barrette paid $54 a month for is barely health insurance at all. It’s part of a subset of insurance that Consumer Reports calls “junk health insurance” (and which even the company that sells it recommends that customers not rely solely upon) and it pays only $50 towards most of the services it covers. That’s it. If Dianne went to the doctor every week for a year, her plan would pay, at most, $2600. Meanwhile, based on average office visit charges, Diane would pay about $5,600.00. She probably doesn’t go to the doctor every week, of course, which means her plan pays a lot less, while her premium buys her a lot less. If she goes to the doctor, say, six times in a year, she’s paid a $648 premium for the privilege of spending another $600 on office visits. The plan also pays up to $15 per prescription, which will get you a few milligrams of most prescription drugs. The one decent deal on her plan is that it covers 100% of in-network lab services.

But many people just want the peace of mind to know that if something really bad happens, they won’t have to worry about being billed into the poorhouse. What if the worst happens, and Dianne needs to be hospitalized due to sudden illness or injury? Well, unless Dianne is suffering complications due to pregnancy, her plan covers nothing. If she’s having complications from pregnancy, it covers fifty bucks. It’s entirely possible that now-healthy Dianne is “happy” with this plan, but the whole idea behind the Affordable Care Act is that the rest of us are not happy having to pick up the tab if Dianne gets a disease, has an accident, or otherwise needs to go to the hospital. Frankly, though, Dianne would be better off saving that $648 and negotiating her office visits on her own.

Ironically, it took FOX News(!) to get the other side of the story out:
Greta [van Susteren] teed up the interview using the same setup as Crawford’s piece, that Barrette is “finding out she will have to pay 10 times as much for health insurance” because “she is losing her current plan to Obamacare.”

“I have a copy of your Florida Blue insurance and it’s about $54 a month,” Greta continued, “and now I understand that under Obamacare, it’s going to go up, at least they said that the policy they would offer you under Florida Blue, would be $591; is that correct?”

Actually, the plan BCBSFL was only one of many plans Dianne has to choose from, 10 of which are cheaper than that $591, and based on her income, she’d only pay around $209 a month, but Greta did cut right to the chase about the quality of her old plan.

“Your $54 a month policy is a pretty, you know, bare bones policy, “Greta said. “Why do you want to keep that one, except for the price? Maybe you can get something better with a subsidy?”

“Well, I know it doesn’t cover lengthy hospital stays,” Barrette replied, adding “It’s perfect for what I want. I get co-pays for doctor visits and prescriptions. So it suffices what I need. Also, the price isn’t too bad either.”

Her $54 plan actually doesn’t have copays for doctor visits and prescriptions. It pays $50 toward covered doctor’s visits, Dianne pays the rest, and $15 toward prescriptions, Dianne pays the rest. As for hospitalization, Greta again went where CBS did not, and actually asked about it.

“Well, does it pay for any hospitalization, the current policy you have?” Greta asked.

“Again, I’m a little confused about it,” Barrette answered. “I have been reading over and over the policies, and it appears that it does cover some outpatient, but when you go through the booklet they sent, it would say refer to this, refer to it but then refer back to… it was very confusing.”

Keep all this in mind when your idiot conservative friends start getting all “But he promissssssssssssssssssed!” about Obamacare. Yes, you can keep your plan if you’re happy with it AND if it meets the criteria established for minimum healthcare coverage under the ACA. But if it doesn’t, the insurance company has to kick you off, just like a bar has to kick you out if its closing time. There’s a law, you see…
(Cross-posted to Simply Left Behind.)

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