Healthcare - A Vent

[Bounty's Wife]

I am generally not one to complain out loud about things, but this is just making my life grumpy, and there is really nothing I can do.

I work for a very small company, and this year, due to the costs of health insurance premiums, my employer had to make a change, and the small number of us had to get our insurance plans from the marketplace. For example, the insurance plans that would have been available through company offerings would have ranged between $1400-$1900 per month for me and my husband. I asked if that came with an economy, standard, or luxury cardboard box to live in.

Okay, not really happy about having to go to the marketplace, but it is what it is. I pick a couple plans to review, look at the list of available doctors (not our current ones, but enough to choose from), and I pick a plan (not too cheap, but not where I have to sell my house to have insurance), and I choose my PCP.

I'm good. Or, so I thought. I call yesterday to make an appointment for me and my husband. The PCP I chose no longer accepts that insurance and has been attempting to get off of their list for over a year. Okay...I think...there are about 15 doctors on the list within 25 miles of my house. Out of all 15 of those doctors, I found ONE, yes ONE, that still accepts that insurance. ONE and ONE where I could barely even understand the receptionist as her native language was not English and her English was broken and heavily accented. I am all for people working where they can, but, personally, I prefer going to a doctor where I can be understood and the staff and doctor can be understood by me.

Seriously, I am paying a pretty penny to be able to see ONE doctor in a 25 mile radius of my house. One said if I had chosen a different insurance company they would accept it. Ummm, yeah, I make too much money to qualify for any financial assistance, and those plans would cost me my car or my home because they are completely out of financial range.

Just super aggravated at this whole thing...Vent over...

[kaialeena]

I work for a national health insurance broker and the whole healthcare industry is a mess, whether it be insurance or just the cost alone for any medical need.

And this probably doesn't help your situation, I apologize in advance. I'll try to help you out the best I can. If your income is over the threshold to receive a subsidy, you do not necessarily have to apply for a plan on the marketplace. You can apply for coverage (what is considered Off Exchange) and the cost isn't necessarily higher. I forgot which area it was, but there was a particular region in the US where Off Exchange plans were found to be cheaper than On Exchange. You still may want to try to check it out once you find out which health insurance companies your doctor will accept.

Unfortunately though, we just entered SEP (Special Enrollment Period) as the last day for OEP (Open Enrollment Period) was yesterday. So you will need a qualifying event in order to be approved for coverage. If your group coverage ended in the past 60 days, that might qualify you, but I am unsure if getting other coverage in between the time would change that. Sorry, I don't work in the sales, but you can ask a licensed sales rep.

At the company that I work for, we stopped offering quite a few health insurance companies because they stopped paying commission or changed their own business and even stopped selling individual insurance, but you may want to take a look at the health insurance company directly since there might be quite a few that cut broker commissions and brokers are not willing to sell these if they aren't getting paid.

Summary in case my message is too long and confusing: You may want to still look into other coverage off the marketplace as it might not necessarily be a lot higher than the marketplace and check to see if you have a qualifying event that would allow you to apply for coverage right now.

Let me know if you have any questions through PM. Do you know which health insurance companies your doctor's office will accept?

[annkie]

This is gonna get political quickly. heh... First off, I find that the list of doctor's the insurance provides are outdated. I used it a couple times before and I had to call a few just to find one still in the network or accepting new patients. It's annoying. Second, I cannot wait until our healthcare system is off this horrible track. I'm lucky enough that I'm minimally effected. But my mom's premiums went up like 30% or something. I've heard others go up as much as 100-300%!!! That's insanity!

[Bounty's Wife]

I work for a national health insurance broker and the whole healthcare industry is a mess, whether it be insurance or just the cost alone for any medical need.

And this probably doesn't help your situation, I apologize in advance. I'll try to help you out the best I can. If your income is over the threshold to receive a subsidy, you do not necessarily have to apply for a plan on the marketplace. You can apply for coverage (what is considered Off Exchange) and the cost isn't necessarily higher. I forgot which area it was, but there was a particular region in the US where Off Exchange plans were found to be cheaper than On Exchange. You still may want to try to check it out once you find out which health insurance companies your doctor will accept.

Unfortunately though, we just entered SEP (Special Enrollment Period) as the last day for OEP (Open Enrollment Period) was yesterday. So you will need a qualifying event in order to be approved for coverage. If your group coverage ended in the past 60 days, that might qualify you, but I am unsure if getting other coverage in between the time would change that. Sorry, I don't work in the sales, but you can ask a licensed sales rep.

At the company that I work for, we stopped offering quite a few health insurance companies because they stopped paying commission or changed their own business and even stopped selling individual insurance, but you may want to take a look at the health insurance company directly since there might be quite a few that cut broker commissions and brokers are not willing to sell these if they aren't getting paid.

Summary in case my message is too long and confusing: You may want to still look into other coverage off the marketplace as it might not necessarily be a lot higher than the marketplace and check to see if you have a qualifying event that would allow you to apply for coverage right now.

Let me know if you have any questions through PM. Do you know which health insurance companies your doctor's office will accept?

I looked into off plan insurance options, and the companies that I found only seemed to offer catastrophic plans. Maybe I didn't look correctly. My company did have a qualifying event (ie: discontinuing medical coverage). This is all such a pain in the rear end, I hate to have to start looking again in the next 14 days. But if you are willing to help...

[Bamps]

Insurance is a scam, healthcare is overpriced and sub par performering!! Its like the credit rating system, changes daily, they feed you some BS score thats not even the score thats used to determine your interest rate. Its all a rip off scam and a bunch of BS. They feed the polititions cash and WE end up paying up the rear end!!

[Pogie]

I can get ins from where I work, cost are out of this world. So I tried the market place but seeing that I can get it through work I do not qualify to get the discount. My husband is retired and I work so he can't get it either with out it costing a lot. So for the last several years we pay the fine for not having it. I did wind up getting it on my because I have a health issue but for the two of us it ain't gonna happen.

That's all I know, so if you can get it through your work place and you dropped it because of the expense they won't give you the discount ins. Hope that helped some what.

[Jollymolly]

Oh don't even get me started. Ughhhhhhhhhhhhhhh

[Bounty's Wife]

I can get ins from where I work, cost are out of this world. So I tried the market place but seeing that I can get it through work I do not qualify to get the discount. My husband is retired and I work so he can't get it either with out it costing a lot. So for the last several years we pay the fine for not having it. I did wind up getting it on my because I have a health issue but for the two of us it ain't gonna happen.

That's all I know, so if you can get it through your work place and you dropped it because of the expense they won't give you the discount ins. Hope that helped some what.

I can no longer get it through work, and discounts through the marketplace are based on your income, so, if you actually have a decent paying job there is no subsidy (discount), and they make you pay through the wazoo for insurance. I'm not willing to take the penalty hit as I have been told that it can be quite a large dollar amount depending on your income and what you "could" have paid. Plus, I am getting older, and I have monthly medical needs.

[Bounty's Wife]

Oh don't even get me started. Ughhhhhhhhhhhhhhh

Agreed!

[Meeps83]

I am thankful that I have insurance. I'm diabetic and also have an autoimmune disorder. Without insurance my total monthly prescription costs would be approaching 15k. With insurance it's around 150 per month. Plus I'm allowed to see a specialist that's head of the hematology/oncology department at the UW Madison hospital. Even though many people have it rough, I would be dead without insurance.


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