Before anyone gets upset or offended at the title "I'm not slamming the president or inciting a political debate" but wanted to share my recent experience with this new plan.

A little history: I've been on my employers insurance plan or COBRA for the last year. I am so extremely grateful for this plan and for the kindness of my employer! However, my COBRA benefits will run out in in August and it is very expensive so I thought possibly with the new healthcare plan that I could save some money and switch over. OMG was I shocked.. not only are the prices higher than what I am paying, the deductibles are 7K-12K and out of pocket more than quadruples what I currently pay per year AND not one plan will allow me to stay with my current doctors and that ****** me off more than anything. I consulted with every single PM doctor who has an understanding of CRPS II/Causalgia within a 4 hour radius of where I live who I felt would work well with the rest of my medical team. My team involves doctors from several different big hospitals including one at our states University and NOT ONE of the 8 physicians are covered under any of the plans. I am so angry.. then I decided to see what medicaid offered because I would qualify for that but wanted to stay with private insurance for better options in care.. again NOT ONE doctor is accepting medicaid patients and if I sign up I would have to go to whomever 'they' decide I should see. Utterly stupid!

Have you looked at the gold and platinum plans? I have found that they have no deductible and the plan is actually better then what I get from work, and cheaper too. The companies were all the same ones work places offer (Anthem, Blue Shield, Kaiser, etc).

My DH was complaining about it. The plans he was looking at were the catastropic plans. You don't need that.

Maybe it's the difference in our state or something. I'm in CA.

It is different in every state and county and then it also depends on age I am only 45 and we don't have children living at home. There weren't any plans with a zero deductible .. and I need a PPO to keep my current doctors. My plan from work is incredible so I doubt I would find that anywhere but something close.. without huge out of pocket charges. After doing the math and calling my doctors for amounts of cash payments it would be cheaper to pay cash and add catastrophic insurance just in case cancer raises its ugly head again.

Hi,

Catastrophic Health plans are more expensive than the Bronze plans because they are not eligible for tax subsidies. .
When the site starts working, check on the Bronze plans.
https://www.healthcare.gov/can-i-buy...strophic-plan/

BTW, COBRA is a law from 1984 -- signed by Pres President Ronald Reagan

The gov web site is supposed to be in better shape by the end of the November. Wait until the site has clear information about whether you are eligible for a tax credit and how much.

http://www.irs.gov/uac/The-Premium-Tax-Credit



M

Hello Mari and thank you.

Yes, I understand that catastophic plans don't allow for subsidies that wasn't what my primary concern was. My main concern was being able to keep my team of doctors and going through the market place that isn't an option for me. Also, with the bronze, gold etc., even though the monthly premium amount may seem low there is still a high deductible and a minimum of 35% coinsurance amount so doing the math only by the monthly premium doesn't calculate the entire cost. Even on these plans if I can't keep my doctors then it does me no good, so that is why I would consider the catastrophic plan through a non-exchange insurer unless things change over the next few months. ** the low rates of $141-150 are not what is being quoted in Washington state, at least in my county, with a household of 2 (only one seeking coverage).

Regarding COBRA - I understand what COBRA is and am thankful everyday for this plan!

I will continue to look at what is being offered through the exchanges. Again the subsidies or tax credits aren't the issue (anyone who files taxes can deduct medical expenses) my concern is for my health and my ability to continue to see the physicians that have been caring for me.

.. would you sign up for a free/low cost cell phone plan if the service provided only gave you 1 bar, 100 miles away, with a 1 mile radius and even then it was choppy?

Be careful when choosing plans (this text was copied directly from the Kaiser Subsidy Calculator from the link provided above):

For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.

A Silver plan has an actuarial value of 70%. This means that for all enrollees in a typical population, the plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required.

The premium amounts above are based on a Silver plan. You could purchase other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).

.. End quoted text .. LinkOut: http://kff.org/interactive/subsidy-c...hild-tobacco=0

In the example above my premiums given on the Silver plan came out to be $307.00/month + 30% + deductible + co-pays etc., this adds up to over 12K year and still doesn't cover Vision, Dental or my current doctors. To me that math doesn't make sense. A cheaper plan (like the Bronze) would still cost 40% after the insurance pays its portion and the premiums weren't much less than that of the silver plan. None of them offered vision or dental and looking at the preferred drug list I can only assume my medications will be switches as well if I were to choose one of these plans.

It just doesn't make sense on how the premiums are calculated for people living in what some would call a higher income state/county, not to mention 2 person homes. Just because I live in a higher income state doesn't mean I am one of the higher earners and I whether or not we have children living at home shouldn't matter.. we shouldn't pay more just because we don't. That is just my opinion and it isn't about politics it is merely about he plans being offered so far.

So sorry this happened to you. I am just waiting for the shoe to drop on me too as I have had an individual policy for nearly 40 years. I am just hoping to hang on for the next two years. I have said many many times, it does not matter how great the coverage if your doc and hospital do not accept it or vice versa.

I know what you mean about waiting for the shoe to drop.. I actually heard through our company grapevine that BCBSIL may cancel our policies.. the thing is many of them also don't show (except in the fine print) the many things they don't cover. Like vision and dental for adults, off label prescriptions and even chiropractic care. I know many people don't believe in chiro.. but mine has been helping me and knows more about CRPS II than many of the PM's I consulted with.. I had it with my old plan I should have it with my new plan.

I actually made several calls today to find out how much it would cost on a cash basis.. and now I am thinking about going that route with a catastrophic plan for major issues if one arises. Here is an example of what one doctor would cost me with cash vs. billing an insurance company.

Currently I pay a $25 co-pay to my PM.
He bills BCBSIL $356.00 for a 20 min. basic visit
BCBSIL pays him $156.00 after the contract discount

If I pay cash I would only be charged $82.50.. SHOCKING.. really!! Think I'm going cash.. my reasoning.. being that there is no cure or real treatment other than medications and I won't be having surgery unless it is life/death situation due to the CRPS II and I can't have MRI's because of my SCS.. unless I cancer raises its ugly head again or something else catastrophic I am better off paying cash in the long run I would be about $400+ dollars ahead every month.

Ugh.. it is just another stress to our already stressful lives.

I so understand what you are saying. CASH may be the only thing that will be accepted soon and in many cases will be the cheaper way to go. No one seems to know or feel secure about all the chaos with health care and health insurance at the moment. A lot of people that are currently covered under their employers, are healthy, and think none of the current turmoil affects them may soon find themselves in a similar boat. We here with health issues are more aware as we are affected first.

I only hope that when all the dust settles, everyone comes out of all this without too much harm but I fear that will not be the case.

Wishing you the best and hope we can keep our docs. Nothing is more important to me than being able to choose who I trust with my life and health. I don't just want a doctor, .... I want MY doctors. It IS MY life that is in their hands.

Well said Hopeless! That is exactly how I feel. Unfortunately being that we suffer from a disease that not many are aware of and it is also a 'chronic pain' condition I fear that we will be under cared for or brushed off if we aren't able to choose or stay with qualified physicians.

Like you.. I hope when the dust settles the picture I see currently has a whole different look. Praying for those who are already being affected by this mess. They really should have waited and researched the medical/treatment maze through people who it affects on a daily basis!

Wishing you well,
Tessa