I'm not offended. I just feel bad for what you are all going through and am frustrated that I can't help offer any solutions to you. That's all. I hope things will eventually work out for all of you. Take care and hope you have a better day today. It's about four in the morning here and I still can't sleep. I have to go to the root canal dentist this morning and I have a terrible headache. Well at least I'll get to see the sun come up. Bye for now.

I have changed the title of this thread as that sets a tone that can lead to political argument, which we do not allow here.

Discussing the pros and cons of the new healthcare law is ok and relevant here....but if the discussion takes a negative political turn we will have to close it.

Hi Finz,

No, what I was saying was that I didn't want to go on medicaid because, I wanted to stay with my current doctors who have been treating me during the last 2 years. A head on collision caused multiple injuries throughout my body, I endured 12 major surgeries and though I am somewhat healed from the orthopedic side of things I am still suffering (and will continue to) from a TBI and CRPS II/Causalgia. The plans offered through the exchange as well as the private plans will cost me way more than what I pay for my current COBRA plan. With Medicaid much of my care will not be covered but more importantly I won't be able to keep my doctors that know my medical history. That is also true if I were to enroll through the exchange. In my opinion medical care is the best when the patient and the medical professionals treating them have a good relationship and trusting both ways. Switching now would be harmful to me in many ways both physically and financially and that is my concern. The financial burden is secondary.. that is why though I qualify for medicaid I have not gone on it.

There is much more to it than just that a doctor doesn't want to accept this lower fee. But, that isn't my gripe so I will forgo commenting any further on that.

I realize that there are many posters who don't have a PM within a 4 hour radius who understands CRPS and I am extremely grateful that there is one in my area but, that goes back to my point.. I would NOT be able to see this doctor if I chose the health care plans offered through the exchanges for ACA or on medicaid. That fact alone tells me that this whole system is still flawed.

I wish it didn't cost so dang much also.. but I would rather pay a higher amount for the doctors I have, than pay $5 for a doctor who is forced to see me and doesn't have the slightest clue what my diagnosis is or what it means for my future.

I haven't looked through the website yet. Mostly because of all the news saying there are problems, as well as the pre existing clause isn't in effect until January 1st.

The main thing at this point I an say is I am SO excited that I would will actually be able to get insurance with preexisting conditions!! I'm still waiting on a hearing for SSDI ( so no Medicare) Because of my income from my long term disability the only Medicaid I can get is for catastrophic basically my deductible is nearly my entire income so I'd I'm hospitalized they may pay for it.

I paid $820 for my COBRA until I could no longer afford it. My insurance was amazing then. Low copay, cheap RX coverage. Just amazing coverage. When I was working my insurance was paid 100% by the city whose Police department I worked for.

I can say paying cash for months now it is very stressful. I haven't seen my Rheumatologist for 6 months or more. I have to figure out a way to afford it this month. My PMD would like me to be in every 4 weeks, but when I lost my insurance he agreed I could do every 8 weeks. I can't afford the injections I was getting on top of the $75 office visit (which is only $75 if you pay cash, no credit, check,etc.). He would like to try medication I simply can't afford. I had my primary doctor switch my blood pressure to a medication on my pharmacy savings plan. I'm paying over $200 a month for prescriptions. But I did get approved for Cymbalta assistance ( no way I could afford it. I'm waiting to see if I can get assistance for my migraine medicine which generic is still nearly $300 for 6 doses! When I had insurance I was on a medication ( name escaping me right now) That was $800 a month.

Basically this long ramble is paying cash is quite difficult and in my experience you miss out on medications and treatment you need.

I think there are some obvious growing pains with the affordable health care act. Its unfortunate that we ended up with this instead of what was originally wanted by the president, but its what we have. I think there is all kinds of issues with costs of care and prescriptions. The prices are incredibly inflated comparatively speaking.

My take home point of the original post. Something that I believe many of us overlook simply because the idea of having healthcare when one might have not been able to in the past regardless of pre-existing conditions can cloud our vision to the fine print.

Healthcare coverage does not equal access to healthcare. Physicians have to be willing to see patients. If medicaid or healthcare coverage through the exchange does not pay well enough to give incentive to the physicians to see patients, or if some other barrier stands in the way of helping the patients on these plans - then it is of no use to obtain healthcare coverage that doesn't get you healthcare!

For me- a no cost preventative visit does me no good. I need a specialist who is so dedicated to his/her patients that they keep up on the latest medical advances and treatment options for numerous diseases and the effects that chronic illness has on the body.

zookester, If you qualify for medicaid, why is your subsidy so low through the exchange? Are you in a state that does not support the ACA? When you were plugging in the numbers on the exchange site, did it indicate to you what the subsidy will be and if so did you feel it was low?

The reason I ask this is I've found sometimes it seems folks are not seeing the subsidy for some reason. The other is a state issue, where the state is not going along with the ACA. This, I believe will change because at this time it does not cost the state to participate, or as I understand it the state's contribution is minimal. Its more of a political issue with some states.

My experience paying out of pocket for my wife's care, because we lost our coverage after the company I worked for during the economic downturn went out of business, we did not qualify for COBRA because there was no company to draw from. I paid out of pocket for nearly three years that cost us well over $100,000.

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.

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.

Your wife is very lucky to have you on her side and I applaud your efforts in doing whatever you can to help her!! Be blessed :)

Yes, changing doctors is scary and will cause a trickle down effect only to add to peoples suffering. For instance - when you see a new doctor they don't generally 'accept' another doctors diagnosis but take that into consideration as they put you through there own diagnostic process mainly for liability reasons. So.. they will recommend testing, treatments etc., in order for them to take on the diagnosis for themselves and then treat accordingly. Medications may change because often government funded programs don't allow for 'preferred or off label medications' and cutting edge treatments will also likely be hard to come by as advances in medicine are made.

When a specialist is needed to treat a more complex disease/condition having any type of "managed plan" (ie., medicaid, medicare, HMO, L&I, etc.,) makes for less treatment options and much more time spent suffering than for those on a PPO or a plan gives freedom to choose providers themselves.

I fully understand that there were many so called 'junk' policies out there but those that chose them chose them willingly. Even now.. what looks pretty at first glance with a low or no monthly premium might still be junk if it doesn't provide you with the care you need but, the choice was still there. Now.. where it irks me is when I'm spending my money I can choose the plan but.. when I am spending the money after it went into there pockets (after the bill was paid) suddenly, I lose the right to choose what is best for me.. and only I know my body! Call me suspicious but that does seem a little backwards; doesn't it?

Would you be able to keep the drs you have now by going "out of network"?
Is that still an option in the ACA plans?