Affordable Health Care Act

[TCI]

Morning all. We are fulltimers and rarely stay in one state more than 6 months in the winter and 1 month in the summer. We have our domicile at South Dakota. We do not qualify for medicare or medicade. Our current insurance which we pay, is set up that we can visit any doctor in any state. My concern is, if we register in SD, can we get care in say SC, FL, AZ, TX, etc. I was reading about the marketplaces and it didn't seem clear. It sortof read in emergency situations. So I thought I would put this out on the forum and see what your opinons are for fulltimers. Thanks for the info.

[RVUSA]

orfsotr wrote:
If you are happy with your current insurance plan why not just keep it? I got a letter from my insurance co stating that since I already had coverage I did not need to change it unless I elect to do so.

I read a news article the other day that was interesting. It looked at the other side of that coin. If you have a work policy and find a better deal on the exchange, can you drop the work one. Answer: No.

I thought the whole premise was to lower costs. Apparently not.

[BarbaraOK]

sdianel wrote:
So far the state exchanges don't seem to be cheaper than purchasing insurance on the open market. You might consider getting a quote from Blue Cross Blue Shield or any national insurance company that will cover out of state costs. As long as the plan you purchase meets the new ACA requirements. Then you can compare the plans offered on the state exchange. It's my understanding that you must purchase on your home state exchange as most can't sell across state lines. Plan to pay high rates and high deductibles. Saw one ACA example, male, pre-existing Diabetes, income $45-55K, premiums $597 per month with $13,998 in deductibles before the "insurance" paid one cent.

First of all pre-existing conditions are no longer considered. And what type of tax credits will this person get. There are credits for families up to 400% of poverty level.

Barb

[rexlion]

The plans can have different copays, deductibles, and max out of pocket numbers depending on if you're in network or out of network. The key is to get their list of in-network providers, look to see if there's a decent selection in all the areas you like to frequent, and try to go to the in-network providers if you need care in whatever geographic area you're in. I think nearly any plan will have providers throughout the country, but some companies may have more or better selections than other companies.

My health insurance co. says I can sign up in December for 1 more year of a non-ACA-compliant plan, and I may do that. The rate is almost half that of their most comparable ACA plan. But I still want to look at the federal incentives before I decide.

[orfsotr]

If you are happy with your current insurance plan why not just keep it? I got a letter from my insurance co stating that since I already had coverage I did not need to change it unless I elect to do so.

[TechWriter]

fla-gypsy wrote:

earlvillestu wrote:
"Total out of pocket" is not the same as "deductible." There is no ACA compliant plan that doesn't "pay a dime" until the policy holder has spent $13,000.

Never say never!

Never

[fla-gypsy]

earlvillestu wrote:
"Total out of pocket" is not the same as "deductible." There is no ACA compliant plan that doesn't "pay a dime" until the policy holder has spent $13,000.

Never say never!

[Gale_Hawkins]

The debugging phase will be three years I expect before we will see the real ACA options. I am looking and reading but even our agent of many years does not know what tomorrow may bring.

The private options are leaving fast from what I read in all of the confusion.

Something has to give. For a family of four with Blue Cross plan we pay $12,000 annually in premiums and the first $5000 of services but do get some 'wellness' services.

I read the young and healthy with ACA are getting soaked but I am not in that group.

[earlvillestu]

"Total out of pocket" is not the same as "deductible." There is no ACA compliant plan that doesn't "pay a dime" until the policy holder has spent $13,000.

[hitchup]

sdianel wrote:
I got my info from a friend on Facebook who tried to sign up for the family plan. His out of pocket would be $13,000 plus $597 per month.

I've seen something similar, also on FB.

It really depends on if you have a State Exchange or the State you're in has defaulted to the Federal Exchange. Some even have a combo of both. They aren't all the same.

[eubank]

The deductible on our plan refers to individual treatments. When cancer treatments are calculated, however, it's by the visit to the hospital. Many, many visits to the cancer center, daily for months. Suddenly, your stuck with a mountain of payments.
😞
Lynn

[sdianel_-acct_c]

I got my info from a friend on Facebook who tried to sign up for the family plan. His out of pocket would be $13,000 plus $597 per month.

[earlvillestu]

Don't know where the previous poster is getting his information on an "ACA plan," but under the ACA the maximum allowable deductible is $6250 for an individual or $12,500 for a family. Lower deductible plans are available. The plan we just signed up for has a family deductible of $3000

[TechWriter]

TCI wrote:
We have our domicile at South Dakota. We do not qualify for medicare or medicade. Our current insurance which we pay, is set up that we can visit any doctor in any state. My concern is, if we register in SD, can we get care in say SC, FL, AZ, TX, etc. I was reading about the marketplaces and it didn't seem clear.

You use your domicile state when signing up for a ACA plan.

"Where" you get care, like network or out-of-network, depends on the plan you sign up for. However, you could get emergency room treatment anywhere regardless of your plan.

[sdianel_-acct_c]

So far the state exchanges don't seem to be cheaper than purchasing insurance on the open market. You might consider getting a quote from Blue Cross Blue Shield or any national insurance company that will cover out of state costs. As long as the plan you purchase meets the new ACA requirements. Then you can compare the plans offered on the state exchange. It's my understanding that you must purchase on your home state exchange as most can't sell across state lines. Plan to pay high rates and high deductibles. Saw one ACA example, male, pre-existing Diabetes, income $45-55K, premiums $597 per month with $13,998 in deductibles before the "insurance" paid one cent.

[PapPappy]

Being as I believe you can choose your coverage, I'd make that a priority when looking for the one you will need.
The whole thing is pretty confusing, and probably more so for Full-Timers.

Good Luck