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  #1  
Old 11-02-2016, 10:48 AM
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MissAnn MissAnn is offline
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Default Curious....Medical Insurance

Who has to buy it through Obamacare? How much has it increased?

Who has it with their husbands?

Who is using Medishare or anything similar?

Who is doing Bizplan?

OK....here's me....

Obamacare....increasing from $999 with $6330 deductible for each person to $1600 with family deductible of $10,000. Paying this much and we still can't afford to go to the doctor unless we absolutely have to. A total $15,000 in medical expenses not counting premiums the past 2 years.

Can't do Medishare because my husband has cancer....won't cover it for 84 months.

Just signed up for Bizplan (Section 105)https://www.tasconline.com/products/bizplan/ . Hiring my husband to help with preschool and will give him medical insurance.....I can deduct 100% of medical expenses.

I'm trying to find out if we qualify for group insurance through the business....but I don't know. Would LOVE to hear your solutions!
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Old 11-02-2016, 11:14 AM
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Quote:
Originally Posted by MissAnn View Post
Who has to buy it through Obamacare? How much has it increased?

Who has it with their husbands?

Who is using Medishare or anything similar?

Who is doing Bizplan?

OK....here's me....

Obamacare....increasing from $999 with $6330 deductible for each person to $1600 with family deductible of $10,000. Paying this much and we still can't afford to go to the doctor unless we absolutely have to. A total $15,000 in medical expenses not counting premiums the past 2 years.

Can't do Medishare because my husband has cancer....won't cover it for 84 months.

Just signed up for Bizplan (Section 105)https://www.tasconline.com/products/bizplan/ . Hiring my husband to help with preschool and will give him medical insurance.....I can deduct 100% of medical expenses.

I'm trying to find out if we qualify for group insurance through the business....but I don't know. Would LOVE to hear your solutions!
I have insurance through dh employer. Some of my friends have it through obamacare and were complaining about the increase in price.
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  #3  
Old 11-02-2016, 11:18 AM
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Quote:
Originally Posted by MissAnn View Post
Who has to buy it through Obamacare? How much has it increased?

Who has it with their husbands?

Who is using Medishare or anything similar?

Who is doing Bizplan?

OK....here's me....

Obamacare....increasing from $999 with $6330 deductible for each person to $1600 with family deductible of $10,000. Paying this much and we still can't afford to go to the doctor unless we absolutely have to. A total $15,000 in medical expenses not counting premiums the past 2 years.

Can't do Medishare because my husband has cancer....won't cover it for 84 months.

Just signed up for Bizplan (Section 105)https://www.tasconline.com/products/bizplan/ . Hiring my husband to help with preschool and will give him medical insurance.....I can deduct 100% of medical expenses.

I'm trying to find out if we qualify for group insurance through the business....but I don't know. Would LOVE to hear your solutions!
I'm no help... I'm one of the people who gets the IRS waiver due to my income after deductions. Single (widowed 17 yrs ago) working childcare provider whose state DID NOT expand Obamacare thru medical assistance (my kids are grown an gone). I won't qualify for Medicaid for several years, so I'm SOL. I pay cash for minor stuff & use a credit card if it's something more than $100.
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Old 11-02-2016, 11:26 AM
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OP I'm so sorry Sometimes I wish the hug guy didn't have a smile, because that is nothing to smile about. That is stressful and ridiculous.

I won't get on my rant about insurance here, but what about a Health Savings Account? Is that plausible for you? I'm not sure because of your husband's cancer, if that is wise.

What about purchasing a policy through a carrier on your own? Around here we could purchase a policy through Blue Cross Blue Shield or others if we wanted to. It would be expensive, but cheaper than Obamacare.

Can your husband work? Can he get a job anywhere, doing anything that offers insurance?
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  #5  
Old 11-02-2016, 11:29 AM
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I heard it was +$2,000 a month for my area for the cheapest plan....

Thankfully DH has medical with his employer, the kids and I have Alaska native benefits, And my son also qualifies for Medicaid with his disabilities so that helps with all his extra medical (without having to fight for it with his native benefits...)

If we didn't have the benefits/Medicaid for my son we'd have to file bankruptcy, lose the house, car and such... as we can't afford even the cheapest 'affordable' plan if the $2,000 a months is correct....
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  #6  
Old 11-02-2016, 12:20 PM
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Because I am under 26 I am still on my dad's insurance. His plan would cost him the same to insure him and my 2 siblings as it does to insure me, so I stay on his plan. My Step-Mom also has an insurance plan through work that I am on until 26, as that was part of the child support agreement for me from years back.

When I was pregnant, because of my income I qualified for Medicaid. I used that to help offset the costs of a unplanned pregnancy after getting pregnant while using birth control.

Next November, DF and I will be married and then I will be on his insurance plan, as he insures our DS. We will have a family plan then, as right now he has a parent-child plan.
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  #7  
Old 11-02-2016, 01:06 PM
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Controlled Chaos Controlled Chaos is offline
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My family of 5 is on Obomacare. We currently pay $200 a month + $80 for dental. Our deductible is $1000. Our state didn't expand medicare either which was super rough a few year ago, but we are making a little more money now so its not too bad. I haven't checked how much ours is going up yet...I'm nervous.
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  #8  
Old 11-02-2016, 01:21 PM
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Originally Posted by Controlled Chaos View Post
My family of 5 is on Obomacare. We currently pay $200 a month + $80 for dental. Our deductible is $1000. Our state didn't expand medicare either which was super rough a few year ago, but we are making a little more money now so its not too bad. I haven't checked how much ours is going up yet...I'm nervous.
I wish we paid that! Family of 4, insured through my husbands employer and we pay $400 premimum with a $6000 dedictible. We use our HSA for almost everything. Considering paying the fine and going with a "catastrophic" plan or investing in our HSA more. Between our insurance and out of pocket expense, we are averaging $8000 a year in Healthcare, yet we go to the doc/dentist about 2-4 times a year.
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Old 11-02-2016, 01:31 PM
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Originally Posted by Miss A View Post
Because I am under 26 I am still on my dad's insurance. His plan would cost him the same to insure him and my 2 siblings as it does to insure me, so I stay on his plan. My Step-Mom also has an insurance plan through work that I am on until 26, as that was part of the child support agreement for me from years back.

When I was pregnant, because of my income I qualified for Medicaid. I used that to help offset the costs of a unplanned pregnancy after getting pregnant while using birth control.

Next November, DF and I will be married and then I will be on his insurance plan, as he insures our DS. We will have a family plan then, as right now he has a parent-child plan.
Did your state not count your fiance's income? Here they count the income of whoever lives with you whether you are married or not.

ETA: I looked up the options for insurance in my state. There are NO private options (meaning you can't go to ehealthinsurance . com or another broker and purchase an individual plan directly through the insurance company) and there is one plan on the marketplace. Our county is in big trouble
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  #10  
Old 11-03-2016, 06:28 AM
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Our family has insurance through dh . It will be going up again next year . We currently pay $600 per month and have a $2500. deductible per person . We do have a HSA and pay most of the deductibles through that but like the year my dd got hit with a rock and needed stitches the HSA was not enough to cover the cost .
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  #11  
Old 11-03-2016, 08:58 AM
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Annalee Annalee is offline
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Quote:
Originally Posted by Second Home View Post
Our family has insurance through dh . It will be going up again next year . We currently pay $600 per month and have a $2500. deductible per person . We do have a HSA and pay most of the deductibles through that but like the year my dd got hit with a rock and needed stitches the HSA was not enough to cover the cost .
Our's is similar to this...

I really am thankful how much it pays.....rarely do we owe that much on visits and dh has been thru some surgeries over the years....rotater cuff/spurs removed, etc....simple but costly.
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Old 11-03-2016, 09:09 AM
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Our last two plans (this year) have been through my husbands company. For the first half of this year, we had an "Obamacare" type plan through my husbands company in California. The company only offered bronze, silver, gold, or platinum plans. (Like the exchanges). All were outrageously expensive and we could only afford the silver plan. I am still paying off huge medical bills from the beginning of this year.

My husbands new insurance is through Kaiser; however, the benefits are amazing. $20 copayment for doctors, specialists, and tests. So much better! (Especially when you have someone in the family who needs to use it frequently)
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Old 11-03-2016, 09:54 AM
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Originally Posted by spedmommy4 View Post
Our last two plans (this year) have been through my husbands company. For the first half of this year, we had an "Obamacare" type plan through my husbands company in California. The company only offered bronze, silver, gold, or platinum plans. (Like the exchanges). All were outrageously expensive and we could only afford the silver plan. I am still paying off huge medical bills from the beginning of this year.

My husbands new insurance is through Kaiser; however, the benefits are amazing. $20 copayment for doctors, specialists, and tests. So much better! (Especially when you have someone in the family who needs to use it frequently)
Oh How I miss Kaiser!!
Dh was on his work plan and DS and I were on a private plan. We were paying almost $600 and have insane deductibles.
We decided to try Semaritian Ministries instead. We will pay $495 a month but only have a $900 deductible per yer and then we pay nothing over that. We do have to pay for anything under $300 though. We like what it stands for though and love knowing exactly who our money is going to. You even send a note to the family with your monthly "share".
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  #14  
Old 11-03-2016, 10:30 AM
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284878 284878 is online now
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Dh work insurance and we choose the bronze family plan because we rarely have medical expenses. It cost us about $125 a month. (double that if choose the most expensive plan) There is a discount as long as dh gets a annual check up.
I also use the HSA and put aside enough for our copays and glasses.
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  #15  
Old 11-03-2016, 10:40 AM
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My husbands new insurance is through Kaiser; however, the benefits are amazing. $20 copayment for doctors, specialists, and tests. So much better! (Especially when you have someone in the family who needs to use it frequently)

We had Kaiser a few years back while I like the doctor everything else was horrible . We had to travel an hour to get to the urgent care ( could only use kaiser) , my dd was under a specialists care and we were told that kaiser was not going to continue to allow him to be a covered provider , we would have to travel into D.C to find a new Dr. , the customer service was horrible and most times we never had any questions answered .We also had to pay 100% until we reached our deductible limit . I have heard good things about them in other states where they have more facilities but for us and others I know who had them here in MD it was a bad experience.

I just want the good old days where they paid their % of all visits , tests, etc... right away and you paid your co-pay until you reached the deductible .
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Old 11-03-2016, 10:50 AM
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MissAnn MissAnn is offline
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Quote:
Originally Posted by spedmommy4 View Post
Our last two plans (this year) have been through my husbands company. For the first half of this year, we had an "Obamacare" type plan through my husbands company in California. The company only offered bronze, silver, gold, or platinum plans. (Like the exchanges). All were outrageously expensive and we could only afford the silver plan. I am still paying off huge medical bills from the beginning of this year.

My husbands new insurance is through Kaiser; however, the benefits are amazing. $20 copayment for doctors, specialists, and tests. So much better! (Especially when you have someone in the family who needs to use it frequently)
We paid $1 to have our son.....48 hour labor and C section with Kaiser! 24 years ago. We don't have Kaiser here. I miss it.
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Old 11-03-2016, 11:02 AM
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Quote:
Originally Posted by Second Home View Post
My husbands new insurance is through Kaiser; however, the benefits are amazing. $20 copayment for doctors, specialists, and tests. So much better! (Especially when you have someone in the family who needs to use it frequently)

We had Kaiser a few years back while I like the doctor everything else was horrible . We had to travel an hour to get to the urgent care ( could only use kaiser) , my dd was under a specialists care and we were told that kaiser was not going to continue to allow him to be a covered provider , we would have to travel into D.C to find a new Dr. , the customer service was horrible and most times we never had any questions answered .We also had to pay 100% until we reached our deductible limit . I have heard good things about them in other states where they have more facilities but for us and others I know who had them here in MD it was a bad experience.

I just want the good old days where they paid their % of all visits , tests, etc... right away and you paid your co-pay until you reached the deductible .
Yes!

I had my first trimester blood tests done in August. Per my insurance book the tests were supposed to be covered and my cost share was waived as preventative care if they were a) done at my first OB visit and b) with an in-network lab. I fulfilled both of those requirements and they covered NOTHING. I called the insurance company and they said the OB coded it as maternity instead of preventive. I said that make sense because it was maternity and the insurance booklet specifically says "these services are covered for pregnant women and cost shares are waived if xyz criteria are met." Insurance said it still needed to be coded as preventative.

Insurance company suggested I speak to the OB. I spoke to OB and she referred me to the billing department. Called billing and gal said she would re-code and resubmit for me. She resubmitted with the exact same codes as the first time. I called the lab and even the rep questioned why it wasn't covered because she said these are covered services under ACA. The lab re-coded, resubmitted and insurance finally covered it....in late October. It was a mess.

And the frustrating thing is if I wasn't educated about my insurance plan (and I happen to have a sister in law who works for Aetna and can help navigate insurance red tape) I would have just paid the bill and not given it two thoughts.
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Old 11-03-2016, 11:13 AM
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Just curious for those with Kaiser. Does that operate more like a co-op? It almost sounds like it is not insurance, but more of a "membership" to go to certain hospitals for care. Is that correct? If so, do these exist in other states?
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Old 11-03-2016, 11:22 AM
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Just curious for those with Kaiser. Does that operate more like a co-op? It almost sounds like it is not insurance, but more of a "membership" to go to certain hospitals for care. Is that correct? If so, do these exist in other states?
I think so. I can only go to Kaiser facilities, unless there is no Kaiser facility in the area. I have traveled out of state and had an emergency with Kaiser; they covered most of it.

I agree with a previous poster that it is extremely annoying to have to travel for any specialized care. I live in a large city, by Oregon standards. Its a two hour round trip for my sons neurologist, spine specialist, opthamologist, and neurosurgeon. (Each) The travel is getting to me.
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Old 11-03-2016, 11:38 AM
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Originally Posted by mommyneedsadayoff View Post
Just curious for those with Kaiser. Does that operate more like a co-op? It almost sounds like it is not insurance, but more of a "membership" to go to certain hospitals for care. Is that correct? If so, do these exist in other states?
Kaiser is a hospital group that provides insurance for their facilities only.
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Old 11-03-2016, 12:11 PM
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I think so. I can only go to Kaiser facilities, unless there is no Kaiser facility in the area. I have traveled out of state and had an emergency with Kaiser; they covered most of it.

I agree with a previous poster that it is extremely annoying to have to travel for any specialized care. I live in a large city, by Oregon standards. Its a two hour round trip for my sons neurologist, spine specialist, opthamologist, and neurosurgeon. (Each) The travel is getting to me.
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Originally Posted by jenboo View Post
Kaiser is a hospital group that provides insurance for their facilities only.
Thank you both for the info! Do other hospitals do this? Seems like it would be a good idea as it provides local care (no traveling), yet also gives hospitals (and the employees) more control of healthcare pricing, as well as consumers collectively pay for the community health, versus on a national level. Am I missing something or does this exist everywhere and I am just now hearing about it?
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Old 11-03-2016, 01:02 PM
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I've had "Obamacare" for 2 years. I qualify for the subsidy and am the only one on the policy (my adult kids live at home but get Medicaid because they are disabled) so my premiums have been around $250/month. This year I have to change my plan because the company that offered it is no longer doing it. Since my daycare income is way, way down (only have 1 part-time dck; haven't been able to get any more for over a year!) my subsidy is quite a bit higher so my premium will be a lot lower.
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Old 11-03-2016, 02:44 PM
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Originally Posted by mommyneedsadayoff View Post
Thank you both for the info! Do other hospitals do this? Seems like it would be a good idea as it provides local care (no traveling), yet also gives hospitals (and the employees) more control of healthcare pricing, as well as consumers collectively pay for the community health, versus on a national level. Am I missing something or does this exist everywhere and I am just now hearing about it?
Kaiser is a hospital, group of medical facilities, and also an insurance company all in one. I only know of one other that is similar, and that's Sutter Gould.

I had it through a non profit I worked for in California. The insurance was far less expensive. (Controlled costs) But . . . I experienced the same issues with Sutter. Even though I lived in a large city, all specialized care was a minimum 2 hour round trip. (Sometimes 3 in CA)
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Old 11-03-2016, 02:48 PM
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We just got the info on the health insurance policies for next year . Kaiser is the same exact cost as Blue cross , same premium and deductible - there is no cost difference at all . I guess there is a big difference in cost regionally .
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