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ProSense

(116,464 posts)
Thu Dec 27, 2012, 11:23 AM Dec 2012

Five ways your health care will change in 2013

Five ways your health care will change in 2013

Posted by Sarah Kliff

1. Health-care cost growth will slow to a new low. <...>

2. Your Medicare taxes will increase. Some people mark the turning of the new year with champagne and kisses. The Affordable Care Act has something slightly different in mind: Two new taxes to finance Medicare. Both are meant to bring in additional revenue to continue funding the health-care program for seniors.

Employers already take out 7.65 percent of workers’ wages to support the elderly and disabled. Of that, 1.45 percent goes toward paying Medicare’s hospital bills. Obamacare increases the Medicare hospital tax by 0.9 percent, beginning in 2013, for anyone who earns more than $200,000 ($250,000 for joint filers). It also creates a new, 3.8 percent tax on investment income, setting income thresholds at the same $200,000 and $250,000 levels mentioned above. Taken together, those two provisions are expected to generate $210.2 billion over the next decade.

3. Your insurance plan will be explained in plain English. Say goodbye to insurance forms with 8-point font that stretch on for dozens of pages. Starting in 2013, the Affordable Care Act requires insurance companies to send their subscribers a standardized, four-page summary of benefits and coverage that runs through the health plan in easy-to-understand terms. Think of this as a nutrition label for health insurance. Here’s what one page of the sample summary looks like.

<...>

4. Primary care providers in Medicaid will get a 73 percent raise.<...>

5. The Obamacare exchanges will open for business. We often talk about January 1, 2014 as the date that states need to be ready for the health reform law. But when you talk to the states actually working to roll out the law, they often talk about October 1, 2013 as a much more significant deadline. That’s the day when the health exchanges open for business, when any American can go online, compare plans and, if they want, purchase health insurance. This is true for state-operated health exchanges as well as those being run by the federal government.

http://www.washingtonpost.com/blogs/wonkblog/wp/2012/12/26/five-ways-your-health-care-will-change-in-2013/


Increasing Medicaid Primary Care Fees for Certain Physicians in 2013 and 2014...
http://www.democraticunderground.com/10022047642

Having failed to repeal Obamacare, Republicans refuse to implement it
http://www.democraticunderground.com/10021978966

5 replies = new reply since forum marked as read
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Five ways your health care will change in 2013 (Original Post) ProSense Dec 2012 OP
A question about implementation in 2012 csziggy Dec 2012 #1
I don't know ProSense Dec 2012 #2
Once the exchanges are going, my husband may retire csziggy Dec 2012 #5
CIGNA is in business to generate profits, not provide health care nt msongs Dec 2012 #3
True, and they are one of the worst companies about denying claims csziggy Dec 2012 #4

csziggy

(34,137 posts)
1. A question about implementation in 2012
Thu Dec 27, 2012, 11:30 AM
Dec 2012

According to what I read, as of August this year, 'wellness exams' or routine checkups are supposed to be free. So my husband and I waited until this fall to get our checkups.

According to our insurance company, CIGNA, they only provide free checkups if we use their in-network doctors. So we got bills totaling about $1200 for the two checkups (plus some other things, like my shingles vaccination).

Are insurance companies allowed to do this? I've been willing to pay some extra for using the doctor we had long before my husband's employer switched to CIGNA. But we can't afford to pay that much for routine preventative care. I hadn't budgeted for this amount since I thought it was covered by the ACA requirement and it was a shock to get the bills for those checkups!

Are we being screwed by CIGNA? Or are they allowed to exclude our choice of doctor from the free 'wellness exam' provision?

ProSense

(116,464 posts)
2. I don't know
Thu Dec 27, 2012, 12:41 PM
Dec 2012

"According to our insurance company, CIGNA, they only provide free checkups if we use their in-network doctors. "

...what the rule is for going out of network. Remember, this was implemented before the exchanges are up and running.



csziggy

(34,137 posts)
5. Once the exchanges are going, my husband may retire
Thu Dec 27, 2012, 01:54 PM
Dec 2012

He's working to have insurance for us, mostly for me. But once the feds set up the exchange for Florida we will run numbers to see if he can retire.

He hates his job, he hates the corporation he's working for, and we're starting to hate the insurance we have. I hope we can afford for him to retire next year!

csziggy

(34,137 posts)
4. True, and they are one of the worst companies about denying claims
Thu Dec 27, 2012, 01:51 PM
Dec 2012

I was surprised this year with all the stuff I've had done. I expected CIGNA to give me trouble about some of it. Instead they paid for two total knee replacements, carpal tunnel and nerve translocation surgery, and a colonscopy, and I only had to pay 30% of the first knee replacement.

I guess I shouldn't complain too much about what I have had to pay out of pocket - it was less than I feared.

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