Quote:
Originally Posted by zookester
Hello JimKing,
The subsidy is determined in part by household size, income, the state you live in, the county you live in and your age. In my case I live in WA which is considered a higher income state, our children are all grown and having children on their own so it is just my husband and I or a 2 person household. The ACA exchanges are geared more for single mom's and families of 4 and so our subsidies are much lower. In a two person home if either one makes 65K or more the subsidy is between $0-$20 and with higher out-of-pocket deductibles and co-insurance payments (mine came up with 35% after insurance paid its portion and after the $7K-$12K deductible was met). But, as I have said it isn't just about cost it was that through the exchange or medicaid I would have to switch every single one of my doctors. The switching itself would be costly for me since it would be managed through a new PCP costing me at that appointment and then every appt after while getting the new team up to speed on my current condition(s). Additional driving to and from these new physicians, time away from work for my husband and still with a high cost attached on what was supposed to be less expensive and better coverage.. so far this is not the case at least for me. If I was a bit older, had children and lived in a different state then maybe that would be different.
I know paying out of pocket is not for everyone. For me it might be better only because there really is no other treatment available for me (unless medical advances offer one) with the exception of medication or the need for my SCS to be replaced which hopefully won't happen for many years. I have additional policies in place for accidents, cancer and critical care that would cover much of the out of pocket expenses. At least for now while I am still healthy other than the horrid affects of CRPS II and issues resulting from the TBI I don't need any care. Prior to my accident I hadn't been to a doctor in over 5 years and wouldn't go now if it weren't for the need for medications to help manage symptoms of CRPS.
Sadly.. I am not scared of the risk of other diseases afflicting me since it would likely relieve me of the daily pain from CRPS.. I want to live don't get me wrong but if something else takes me then that would be a blessing. Sorry that was a little off track.
I just think it is more important for anyone to choose their own physicians especially if they have already established a good relationship.
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I agree. When my wife became eligible for medicare, her doctor told us she does not except medicare, so I continued to pay out of pocket. But not for the meds-my wife used medicare p-D for that because of the large expense. Because of this her doctor still dumped her because even though we paid out of pocket for visits the using of medicare for the scripts was something the doctor would not except. The advantage plan my wife uses through medicare has only 6 doctors to choose from throughout the DC area. That to my wife was not acceptable. Those doctors treated her like a drug seeker. So she now suffers, but without the stress, she's not doing bad at all compared to 5 years ago. So your choice of doctors is extremely important.