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Old 04-11-2013, 12:39   #121
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by CatInHand View Post
Especially since WHO ranks Canadian healthcare above the US.

World Health Organization ranking of health systems - Wikipedia, the free encyclopedia

In fact, many countries rank above the US which suggests that you should consider your destination and the quality of the available care before considering the need for catastrophic, US based insurance.
You should also consider that the link to the WHO rankings is from 2000 and the blurb at the bottom of the rankings about criticism of how the rankings were done.

The fact is that lots of claims on the lines of 'my dog is bigger than your dog' are not really apples to apples claims. As others have pointed out medical care is not an undifferentiated commodity.

Just as some folks have better (and often more expensive) boats some folks have better health care.

The most important thing to remember is health care coverage/insurance is not the same thing as health care. Many doctors/hospitals in the US will not accept Medicare/Medicaid patients even if they have coverage. Many of the plans under Obamacare have what is called in network coverage and out of network health care is not covered.

Sad to say you almost need to be a lawyer to understand the fine print in lots of health care insurance policies.
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Old 04-11-2013, 12:40   #122
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Re: Affordable Care Act - catastrophic plans cancelled

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It's very hard to get definitive information. I have been hearing that many doctors and hospitals will be dropping out of B. O. Care or that some policies will be very restrictive of which doctors or hospitals they will cover. If I am cruising, how do I decide if the policy I'm looking at will provide care where I am or where I can get to? If I sign up now and make a mistake, how long do I have to wait before I can make a change? It seems that "coverage" does not equate to "care".
This is a general problem with insurance. A person needs to consider all factors before buying insurance regardless of where they buy it.
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Old 04-11-2013, 12:46   #123
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Re: Affordable Care Act - catastrophic plans cancelled

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You should also consider that the link to the WHO rankings is from 2000 and the blurb at the bottom of the rankings about criticism of how the rankings were done.
Since my point was that the US is not the only place in the world to get quality health care, I don't think the date of the link is relevant. I doubt there's been much change.

Really, none of this is hard to understand, if you just do a little research.
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Old 04-11-2013, 12:52   #124
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Re: Affordable Care Act - catastrophic plans cancelled

SVMARIANE

"Without an actual SSN she can't / won't be enrolled under ACA should I myself actually enroll. At least the Washington state website refuses to recognize her TIN."


I have seen this a few times already. The "non-citizen legal resident" needs passport ID to apply for coverage or TIN on a paper application. I can send you the paper application for Washington State if you need it. PM me with a email and I will send over ASAP.
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Old 04-11-2013, 12:55   #125
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Re: Affordable Care Act - catastrophic plans cancelled

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Since my point was that the US is not the only place in the world to get quality health care,

Absolutely!
Cruisers in planning have this fear that if something happens to them out cruising it will mean a helecopter ride back to their home Country for quality care. Speaking from what I know rather than guess, the quality of the Private Health Care system in Mexico is excellant and I would trust the Docs there with my life any day. Now the Socialized free for everyone care is a disaster and we brought down boxes of medical supplies for the local town on almost every trip we made up/down from the States. (my wife is a PA and has access to medical stuff)

The Colonoscopy I had yearly in Mexico in Mazatlan cost $385 cash and the equipment was better than my Doc at UCLA where the procedure cost $7500. In my personal opinion I wouldn't need health insurance while cruising Mexico at least, but my wife didn't agree, thus we compromised and had insurance...which the love letter informed me was being canceled due to the ACA. The "If you like your insurance you can keep it" Lie will rank historically up there with "No New Taxes", "They Hate us for our Freedoms" and "I did not have sex with that woman".
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Old 04-11-2013, 12:57   #126
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Re: Affordable Care Act - catastrophic plans cancelled

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This is a general problem with insurance. A person needs to consider all factors before buying insurance regardless of where they buy it.
CatInHand, where did you do your research? I'm new at this...always just took my employer's package before. Maybe I'm just spoiled.
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Old 04-11-2013, 13:00   #127
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by CatInHand View Post
Since my point was that the US is not the only place in the world to get quality health care, I don't think the date of the link is relevant. I doubt there's been much change.

Really, none of this is hard to understand, if you just do a little research.
Lots of things can change in a decade. But one thing that has not changed is the difference in the way infant mortality is determined in the US as compared to the rest of the world. In the a US a live birth is one where a baby shows signs of life at birth, even if it dies less an hour after birth. On the other hand in most of the rest of the world, including Europe, a baby has to live for a week before it is considered a live birth; otherwise it is consider still born.



These are just some of the reasons the wiki article contains the blurb about critics of the WHO rankings.
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Old 04-11-2013, 13:02   #128
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Re: Affordable Care Act - catastrophic plans cancelled

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HBWT:

What line on the IRS 1040 form
is the "less than 30,000" to be
eligible for the exchange?
It was a cost benefit point I was trying to make. If you make less than $30,000 your tax credit is typically high and the benefit of health coverage is fairly inexpensive. It was in reference to an earlier post where someone makes $30,000 a year and was going to pay the fine and enroll if and when they got sick.

FYI: Your income and tax credit is calculated by a MAGI (Modified Adjusted Gross Income). If you want the link or more information, I will be happy to send over.
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Old 04-11-2013, 13:04   #129
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Re: Affordable Care Act - catastrophic plans cancelled

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Oh it was discussed all right...and glossed over.

But all you have to do it use emergency care until the open enrollment and BINGO...you are in Baby. If you don't think people will do that...ha ha ha ..then you also could believe the Government cost estimates...ha ha ha . Just drive the damaged car and buy your new car insurance policy at open enrollment and Bingo then get your car fixed. There are cottage industies out there exploiting every loop pole under the tax code and anyone that doesn't think this will be the same is dreaming.
Legally, I suppose you could do that, but it's completely irresponsible. Emergency care isn't free for the uninsured so I'm not sure why anyone would want to go the route you mentioned.

Also, what happens if you get cancer or have a heart attack? Your plan is entirely misguided and uninformed. By the way, that was a rhetorical question so don't bother answering... you appear to be in a fog and guided only by your dislike of the ACA. This thread is intended to help people develop practical approaches to navigating this new legislation... and I can tell you your approach is anything but.
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Old 04-11-2013, 13:10   #130
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Must be NC day!!!! Wake Forest here. btw..I have a $5000 deductible, BCBS plan, love it, get to keep it and it only went up $25/mth...to $175...and I get not one cent of help/subsidy from anyone. The plans seem to be out there...for some of us anyhow. Being a UK expat...often wonder if I'd still qualify for free NHS treatment in an emergency.
Where and how did you get this ???
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Old 04-11-2013, 13:32   #131
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Re: Affordable Care Act - catastrophic plans cancelled

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CatInHand, where did you do your research? I'm new at this...always just took my employer's package before. Maybe I'm just spoiled.
I'm sorry, I don't have a good answer for you.

A couple years ago when I lost my job I spent a lot of time researching health insurance (and came to the conclusion that I wasn't able to get sick for a few years).

The insurance exchange (which is just one part of the ACA) is nothing more than a way to buy insurance and take advantage of subsidies. All the annoying bits that people complain about like deductibles and caps are a function of the insurance system, not the ACA.

Things like open enrollment, networks and preferred providers are the same issue whether your plan is from an employer, through a third party broker or though the exchange.
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Old 04-11-2013, 13:36   #132
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Lot of people here talk about the subsidies, but there are 36 states that do not offer a state market place. As I understand it no state market place no subsidy.
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Old 04-11-2013, 13:39   #133
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Re: Affordable Care Act - catastrophic plans cancelled

No, you understand that incorrectly. The subsidies come from the federal government for all states.

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Old 04-11-2013, 13:56   #134
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by Stugots View Post
Legally, I suppose you could do that, but it's completely irresponsible. Emergency care isn't free for the uninsured so I'm not sure why anyone would want to go the route you mentioned.

Also, what happens if you get cancer or have a heart attack? Your plan is entirely misguided and uninformed. By the way, that was a rhetorical question so don't bother answering... you appear to be in a fog and guided only by your dislike of the ACA. This thread is intended to help people develop practical approaches to navigating this new legislation... and I can tell you your approach is anything but.
Who said it WAS MY PLAN?
This is where people get so emotional to seeing oposing views that they take it personal and slip into a Fog of attack the messanger mode, unfortunate, but not surprising in the days where attack trumps discussion of ideas.

As was posted by another cruiser, Mark I believe, HIS plan was laid out and there are thousands of people planning to pay the fine just like Mark and then buy insurance after their "car gets hit".

Why is understanding this reality important to us cruisers...easy...because living in a self imposed ideological bubble is dangerous. From our experiences of cruising in Mexico, I would choose not to pay for ACA insurance and stick with local care because the private heath system in Mexcio is of good quality. Others who have not been to Mexico and only imagine what they see on the news about Mexico need to know that there are other options than the ACA for quaity health care. The "What if Heart Attack" you ask about, no problems in Mexico as I've known cruisers that have played that unfortunate game and came out fine.

If my negative view of the ACA should somehow exempt me from sharing my POV, then wouldn't someone with a positive view of the ACA also be exempted from discussing the law, yes in a fair world it would. I would rather have a discussion with 9 people that disagree with me than 9 that agree or what is there to learn?

The facts as I see them and most agree is that there are WINNERS and LOSERS due to the ACA. I'm a loser, as our upper middle class earners. There are winners on the other hand, reality again isn't black and white outside of the ideological bubble some constuct to protect themselves from having their ideas challanged.
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Old 04-11-2013, 14:02   #135
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Re: Affordable Care Act - catastrophic plans cancelled

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No, you understand that incorrectly. The subsidies come from the federal government for all states.

Mark
There are two ongoing cases on point. Both have cert. Obamacare was written to use the subsidies as a carrot to encourage states to set up exchanges. No such carrot was written into the bill for the federal exchange since no one saw a need to encourage the federal govt to set up an exchange. The monkey in the wrench was that if HHS was in charge they could make the rules at the agency level.

Problem was the SC found Obamacare constitutional, but only as a tax so the subsidies are basically a tax exemption. DOJ has historically been very strict about the need for tax exemptions to be explicit in a bills language. A couple of links if you want to research more

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