Rant about un-Affordable Care Act - I am being forced to give up my insurance

a reply to: Metallicus

It was written by the progressive think tanks too. The health care lobby needed to be paid off so that they wouldn't fight it because what it really is designed to do is destroy the system by doing exactly what it's doing to people like you. When enough of us are priced out of the system, then we are supposed to scream at the government to fix the problem they created by demanding single payer because we are supposed to be too stupid to remember that they "fixed" us all good to begin with.

originally posted by: ketsuko
a reply to: Metallicus

It was written by the progressive think tanks too. The health care lobby needed to be paid off so that they wouldn't fight it because what it really is designed to do is destroy the system by doing exactly what it's doing to people like you. When enough of us are priced out of the system, then we are supposed to scream at the government to fix the problem they created by demanding single payer because we are supposed to be too stupid to remember that they "fixed" us all good to begin with.

Sad thing is that is what will probably happen.

Then we will get the "Sorry sir. You too old for us to invest in with our limited money. NEXT!"

originally posted by: ketsuko
a reply to: Metallicus

It was written by the progressive think tanks too. The health care lobby needed to be paid off so that they wouldn't fight it because what it really is designed to do is destroy the system by doing exactly what it's doing to people like you. When enough of us are priced out of the system, then we are supposed to scream at the government to fix the problem they created by demanding single payer because we are supposed to be too stupid to remember that they "fixed" us all good to begin with.

Sad thing is that is what will probably happen.

Then we will get the "Sorry sir. You too old for us to invest in with our limited money. NEXT!"

Let's start a support group. I'm a single mother on disability. I'm covered by Medicare, but it doesn't cover my medications or dependents, which means my 7 yo and 2 yo are not covered. I make $200 more than their bracket says I should make to get any assistance. My taxable income is ZERO. They want me to pay $200 per month for NOTHING, for a plan with a deductible so high that it will never be reached. I'm already paying out of pocket for my medications, plus everything in relation to the kids: doc visits- including vaccinations, and I'm still making payments on an ER visit my daughter had a year and a half ago.

Joke's on them, I'm pregnant right now. As soon as I pop this puppy out my kids will qualify for Medicaid. (for the record that's not WHY I got pregnant) And if anyone thinks I'm a crappy person for this, hey, don't hate the playa, hate the game!

As far as advice, is it possible for you to take yourself OFF one of your forms of disability? You may want to crunch the math to see if that would work. A lower income would put you within the bracket for help. You need to weigh the cost of keeping both forms of income and paying out of pocket for all your medical stuff.....or dropping your income and have them pay for it.
-shrug-
I wish I had a better answer for you, but you're right, these folks are dicks. I've spent HOURS on the phone with them, the last time I even had a case worker sitting there trying to help me. Part of my disability is a severe anxiety disorder and I end up in hysterical tears every time I try to deal with these jerks. It's cruel and unusual.


EDIT: As I was doing chores around the house, I thought of this too- maybe instead of dropping altogether you could contact one of your forms of disability and see if they could REDUCE your payments by $150. Thereby putting you into the bracket for help. It's worth a shot. I mean, who is going to refuse to pay you LESS money?

originally posted by: Domo1
Here's a fun example. You don't have health insurance, and have a medical emergency that requires an ambulance pickup and an emergency room visit. You don't have health insurance because you can't afford it. Now you're in debt for probably $3,000+ (5 minutes in an ambulance here is $1,200 + alone) for something incredibly basic and simple. So health insurance is even harder to obtain because you now have a substantial amount of debt to pay off.

A year and a half ago my perfectly healthy daughter was struck by some mysterious respiratory illness. I took her to the doctor, they said she's too sick take her to the ER. So I took her to the ER across the street. They took blood, did an x-ray and gave her a breathing treatment. Then they told me they weren't equipped for pediatrics and were going to ship her to Children's Hospital. I asked if I could drive her. They said that wasn't an option and FORCED us to go by ambulance. We got to Children's and they gave her 2 more breathing treatments. She didn't have pneumonia, or a bacterial infection, in fact the illness was never diagnosed or treated beyond the 3 breathing treatments.
Total: $10,000
Not kidding. Not exaggerating.
I could buy FIVE decent used cars for that amount.
Of course her health is most important, and I'm glad she's fine, but still....

not directed at the OP, just a general observation: Why do people reference health insurance deductibles like they are the same as auto insurance deductibles? They aren't.

I have health insurance deductibles. Never reached the limit once, and still received the same $25 co=pay office visits, free vaccinations, $35 minor emergency clinic visits, etc. Hell, my daughter who is still on my plan just go tout of the hospital after giving birth. Total out of pocket expenses to me... $150.00, which was my specific deductible for the stay. Went to my total, which I won't put $300 towards the entire year.

Health insurance deductibles, by and large, DO NOT mean you have to pay out of pocket whatever amount before the insurance covers anything. It simply doesn't.

a reply to: dianajune



Sadly, for politicians We The People are seen as if sand on a beach... Since they and theirs (those they care about) are guaranteed to be well taken care of, it would never occur to them to examine a few individual grains of sand.

I personally know too many that "technically" have insurance. These are individuals and families that previously had been responsible and worked hard to have what would probably be described as mostly "lower middle class". My wife and I don't know anyone who isn't struggling.

Far too little MSM coverage has been given to Americans that "technically" have insurance. If you are paying twice as much (or more) for coverage that has a deductible that you could never possibly afford to meet, that is, imo, the same thing as having NO coverage.

I will keep you in my prayers and check this thread for any updates you post.

a reply to: usernameconspiracy

Well congratulations on having insurance that actually does what it's supposed to.

For the rest of us a deductible means you have to pay out of pocket for everything until you get to that threshold...THEN they will pay whatever percentage (80% etc). Even when I had decent insurance- before I was disabled- I was still out of pocket about $5000 when I had my baby.

And don't assume I don't understand their system. I've been on the phone with Obamacare for literally HOURS over the past year trying to figure out how to get insurance for my kids. First, they couldn't even figure out how to give me a tax credit when I don't file taxes ($400 per month without the credit, still $200 with the credit). After about 3 phone calls and 2 supervisors and a case worker on my side trying to help we finally sorted that out...only to learn that I would have to pay out of pocket for everything until the deductible was met ($12,000- even the year my baby had to go to the ER I wouldn't have gotten up to that amount) THEN they would pay 80%. This is directly from a Obamacare supervisor with my case worker as a witness. I make $200 too much per month to qualify for even Chips assistance.

Medicare doesn't cover my medications (about $300 per month) and I'm still paying $200 a month toward that one ER visit. If they didn't count that money toward my income I would be in the right bracket to actually get a little help. And like I said before, my TAXABLE income is ZERO. Their own wording asks for taxable income. But then all of the sudden they turn around and count all my income even though by their own wording it shouldn't be counted.

Shady.

Again, congratulations on having insurance that actually works like it's supposed to. Some of us aren't so lucky.

Sorry to bombard your thread, but I had another thought....their stupid brackets also go by household size. Is there any way you could get a family member to live with? Or invite a whole family of migrant farm workers to live with you? They always ask about those guys, I'm assuming they're more likely to get assistance.

But seriously, decrease your income or increase your household size so you can fall into the right bracket for help.

a reply to: ladyvalkyrie

How odd. I still have all my late grandmother's Medicare insurance paperwork, and your experience doesn't seem to mirror her insurance & billing paperwork at all. She had a laundry list of medications, and only paid a co-pay on 3 (all total, less than $30 a month) According to her own records, she never had a co-pay on her appointments or for her hospital stays (she fell & broke a few things more than once in her last years) Her Part B ran her about $100, that's about it -- her Part A was premium-free.

I'm going to assume you don't qualify for Medicaid? I'm going to be honest here, it doesn't sound like, compared to my grandmother's experience, that your caseworkers are truly going to bat for you on this one. You should be eligible for Part B, and your Medicare, as someone on disability, should have no premium. Maybe she qualified for less (in cost) due to age or income (I doubt it, turns out she wasn't living on peanuts like she let everyone believe) but it sure seems like you should be able to get more than you say you are here.

a reply to: Nyiah

I am covered by Medicare because I am receiving SSI disability. They cover most of my doctor appointments but none of my medications. Maybe they would cover my medications too if I applied for Part B, but honestly it's easier just to pay for them out of pocket. I'm sure it wouldn't save me that much money in the long run to deal with Plan B.

I'm talking about my kids. Medicare doesn't cover dependents, so my 7 yo and 2 yo are left hanging in the wind. My 2 yo was covered by Medicaid when he was born and then they kicked him off the minute he turned 1. "Get a f**king job ya little mooch." -Republicans
Obamacare says they should qualify for Medicaid, but I live in Texas- which refused the expansion- so they don't. Insurance for 2 healthy kids (according to Obamacare) costs $400/month. Their tax credit brings that down to $200....but even paying $200/month would put them in the Silver plan, which has a $12,000 deductible- which I would never meet unless (God forbid) they get cancer or something. And straight from an Obamacare supervisor's mouth even paying the $200/month I would STILL be responsible for the full price of doctor visits and everything (which I'm doing anyway) until the deductible was met. So...to sum it up....pay $200 for jack sh*t.

I'm covered, I'm bitching about the complete lack of help for 2 little babies.

Again, OP, I'm sorry to jack your thread. But hopefully I've given you some ideas and hopefully it makes you feel a little better to know you're not alone. *hugs*

a reply to: dianajune

Not a good time to be sick in America unless your are a multi-millionaire then you can get the very best fastest health care, very sad it's system for profit over taking care of peoples health needs.

Canada system is slower but better.
It's a wash with taxes in and and health care costs out.
Unless you and all your family are perfectly healthy for your whole life until death, even having a baby is costly.

a reply to: 1funnychick

Sorry, but I DID call them. All I got was the run-around. Oh, and to call Social services in my area to see about medicaid.

Even though I already told them I did this a few years ago and found that I was eligible for Medicaid but with a HUGE spend-down. I just can't afford it. I just can't.

With all due respect, I disagree with what you said. Obamacare is affordable only for big pharma and the insurance industries. It was never meant to be affordable for people like me. As of January 1st I will be officially uninsured.

Being a diabetic, with a hx of other serious conditions including cancer, it will be interesting to see how long I can go without a trip to the ER because I won't even be able to get my medicine.

originally posted by: usernameconspiracy
I'm a fellow FEHB'er and my rates have raised very little pre or post ACA. Which plan do you have? Last year mine (BCBS family option) went up about $6 a pay period. And it's outstanding insurance. I looked at the 2016 rates, and they don't seem to have "skyrocketed".

I do recognize that you are a former Fed, so I'm guessing a medical disability retirement? I don't know how much the total rates changed without the gov kicking in a good portion of the payment.

I'm on Federal employee disability retirement. I stuck with the FEHB instead of getting Part B because I couldn't afford to carry both. I had no clue that I would be forced to pay a penalty for Part B should I choose to sign up for it after the fact. No one took the time to explain that to me.

At the moment I have GHI, aka Emblem Health. Their premium will climb by $48 as of January 1st. Not only that, their copays are going up as well. Can't afford it any longer.

The only other alternative for me is MVP, but I gave them up because of their sky-high deductible for prescriptions.

I can't believe that OPM and Social Security have unbelievably cruel rules. They are pricing me out of my healthcare. I know I am not alone.

I googled health emergencies/no insurance and came up with a ton of frightening stories about people like me who died because they were unable to get health care. It's just too high.

originally posted by: horseplay
I am also in the same boat. sort of.
I work, but seasonal and plugged in 18k into the website . it said 'no available plans'.

BUT it offered me insurance at a whopping $400 a month, maximum out of picket $13000.

WTH? seriously ?

I put in an application for medicaid but I think I make too much.
So I fall into the middle category of sorry about your luck.
bastards.
I have no choice but to fly by the seat of my pants uninsured. apply for county/state benefits/help if I need it.
and I can always file bankruptcy if the shtf to keep my farm I guess.

what really pisses me off is the penalty. damned if I do. damned if I don't.

I've been told in the past that I have fallen "between the cracks." In other words, I make too much to qualify for regular medicaid and too little to afford what I already have.

We can't win, can we? I never thought I'd see the day where I would have to depend on the emergency room for primary care. I have no idea how long I will be able to go without taking my medicine, being a diabetic. Or how long I can go w/o my thyroid medicine.

I too may have to file for bankruptcy if this keeps up. I heard that medical bills are the number one reason why people file.

originally posted by: DARKJEDIG
This is such a sad state of affairs and my heart truly goes out to you. As a British American, I can sympathize with you as I have recently moved back to the UK (again!) , mainly due to the difficult living conditions including healthcare costs which we were subjected to back in the U.S. Our family plan rose from $465 per month to $1137.

You know, it really pains me to see all the smear stories regarding universal healthcare, and the pundits including Alex Jones slam them as the worst thing ever. Im not saying it's perfect but all systems have problems... I tell everyone back in FLorida to think about it.....if you guys were told that 'the free at the point of use' healthcare system like the UK's were actually very good, you'd all be furious and refuse to keep paying. My wife recently suffered a miscarriage and the level of care she was given here was exceptional. Similar care in the U.S was costly and didn't have the caring touch as we've found here. If there is a way you could get to the UK or if you have family here or in Canada i would recommend trying to sort some kind of treatment out to get the help you need.

I wish you all the best and hope you can find some alternative care...

I like listening to Alex Jones, but this is one of the things I disagree with him about. Universal healthcare is an absolute necessity. Last night I did some online research and found many stories about people who died because they had to go without seeing a doctor. They just couldn't afford insurance.

I wish I could travel to the UK or Canada. But at this time it is out of the question. I don't have family there at all, except I do have British ancestry. One of my cousins, who did alot of research on Dad's side of the family, believes we are distant relatives of HM the Queen. I don't know if he is correct, but it would be interesting to find out. :

Do you read the Daily Mail? I've seen stories about NHS horror stories. I don't know how reliable that source is, but I would be willing to give the NHS a try if I could do so.

I'm sorry to hear about what you and your wife went through.

originally posted by: network dude
a reply to: dianajune

I am right there with you. Self employed and can't afford the $500 a month for what used to be $175. But check this out.
www.health.com...

Maybe some help with your meds. Stopping isn't an option for what you described. Perhaps one day, we can get an administration that considers real life, and not "fantasy land".

I will check out that link. Thank you!

Imo the United States should be re-named "Fantasy Island," where reality is determined by Obama.

a reply to: ketsuko

I couldn't have said it better myself. This system was designed to fail - for us, that is.

originally posted by: ladyvalkyrie
Let's start a support group. I'm a single mother on disability. I'm covered by Medicare, but it doesn't cover my medications or dependents, which means my 7 yo and 2 yo are not covered. I make $200 more than their bracket says I should make to get any assistance. My taxable income is ZERO. They want me to pay $200 per month for NOTHING, for a plan with a deductible so high that it will never be reached. I'm already paying out of pocket for my medications, plus everything in relation to the kids: doc visits- including vaccinations, and I'm still making payments on an ER visit my daughter had a year and a half ago.

Joke's on them, I'm pregnant right now. As soon as I pop this puppy out my kids will qualify for Medicaid. (for the record that's not WHY I got pregnant) And if anyone thinks I'm a crappy person for this, hey, don't hate the playa, hate the game!

What you said about deductibles reminds me of MVP, an insurance I gave up because I could never reach their prescription deductible. I can't afford to keep GHI as their premium has skyrocketed, right along with their copays.

I'm sorry you are having to jump through so many hoops to get healthcare for you and your family. No one should have to go through this. I am all for a support group. Can we form one here at ATS?