Minnesota
Related: About this forumMy Health Insurance Company bcBS just informed me my rates are going up due
to the implementation of Obamacare. Why again is our state working with this rat infested Company??????? We use our living money to pay for this and I already had to raise the deductible again!!!!!!!!! Soon I will be asked to pay more for less again!!!!! Not a happy camper at the moment. Talk me down!
Niceguy1
(2,467 posts)But they had no choice...the expanded coverage mandated by the aca cost more and the company is a non profit trust....
glinda
(14,807 posts)I may have to drop my insurance and hope for the best. They are killing us. We have one retiree income. That is it. And I am too young for Medicare and too old and sick to work if I even could find work.
Non-profit my ass.
Niceguy1
(2,467 posts)It is a union plan. I can't afford nor do I want the extra coverage that is required by the new law.......
Wish we could opt out.
Response to glinda (Reply #2)
Roselma This message was self-deleted by its author.
msongs
(67,193 posts)glinda
(14,807 posts)JayhawkSD
(3,163 posts)If you have eligibility for employer coverage you are not eligible for the exchanges.
The verification of this has been waived for a year by executive order, so he could do it for one year and probably get away with it, but he would have to lie on the form about his employer not offering coverage, and it would be illegal.
scooter rider
(80 posts)$1500 a month for him and his wife for 6 more months. His wife has early stages of MS and they have to have coverage plus he bought a semi-truck to go back on the road and has to have health insurance or the freight brokers can't give him loads to haul.
He's been checking the exchanges and so far it looks like his premium will go up to about $2500 a month but they do have to provide coverage for pre-existing conditions.
They also tell him that he makes too much for the subsidies so he's just shit out of luck.
Is this how it was supposed to work?
Hoyt
(54,770 posts)level.
the_sly_pig
(740 posts)Cancer patients can't carry the whole load you know. Seniors need to do their part; accountants and actuaries need income too!!!
(syrupy, syrupy sarcasm)
JayhawkSD
(3,163 posts)The rising costs are not some idle whim of the insurance companies. They are caused because the insurance companies are having to pay higher costs. They are being billed higher prices by hospitals, cllinics, doctors and drug companies.
When they pay out more money because hospitals, cllinics, doctors and drug companies charge higher prices, they have to raise the amount they charge for the health insurance that pays for that health care.
glinda
(14,807 posts)helping me so far. Just the opposite. I hope I am wrong.
JayhawkSD
(3,163 posts)The cost of your health insurance is not the fault of any health insurance company. It is caused by the doctors. hospitals, clinics, laboratories and drug companies that charge higher and higher prices for the health care that they render to you and that health insurance pays for.
A more reasonable complaint than "I cannot afford the increased cost of insurance" would be "I cannot afford the increased cost of health care." That would put the fault where it belongs. The insurance companies also do not like the increased cost of health care.
dflprincess
(28,057 posts)The obscene salaries paid to the corporate officers the commissions to the insurance agents the concern for the shareholders (at some companies) and all the other overhead has nothing to do with the cost of insurance.
hermetic
(8,258 posts)That one poor guy there, only made 39 thousand a day!
ms. dflp.
JayhawkSD
(3,163 posts)Just pay cash out of poicket for every medical procedure you need to have.
That MRI will only cost you $1800. Fuck the insurance company. Just pay it yourself. And when the radiology lab raises the price to $2100, don't complain, just pay the bill.
I know, if it weren't for insurance companies it would only cost $1.93 and the radiology lab would never raise the price. Dream on.
"I want to hate insurance companies. Don't confuse me with any facts."
dflprincess
(28,057 posts)Per PNHP Medicare's admin costs are between 1.4% and 6% depending on which measure is used. Even with the "Affordable Care" Act the insurance companies get to waste 20% of your premium dollar on expenses other than healthcare.
And don't you kid yourself that the for profit insurance companies won't find a way around the 20%, especially if the fines for not adhering to it are low enough that it will be written off as a business cost - assuming anyone bothers to enforce the MLR.
JayhawkSD
(3,163 posts)An expense that is twice what other developed countries pay, and three times most countries. Not 20% more, 100% to 200% more.
It doesn't explain why a hospital bills $1800 for a colonoscopy that costs $600 anywhere else. The insurance company doesn't bill that, the hospital bills it. The extra $1200 is, in any case, a lot more than 20%.
If health insurance is so hateful, why did the great Democratic Congress decide to make every single citizen of this nation pay money to buy it? Why did the great Democratic president who is adored with such fervor by Democrats support such legislation? Why is the legislation that required every citizen to buy health insurance hailed as "the greatest liberal legislation since FDR" by Democrats?
You can continue this "let's hate health insurance" rant if you all want to, but it is too devoid of sense for me to do so.
dflprincess
(28,057 posts)single citizen of this nation pay money to buy it? Why did the great Democratic president who is adored with such fervor by Democrats support such legislation?"
Because they're corporate whores and don't represent us. And I don't know many people who are hailing this as "the greatest liberal legislation since FDR" - and you'll find a lot of people on this board who are less than impressed with having the Heritage Foundation's plan shoved off on us.
The hospital may bill $1800 for a colonoscopy but that's not what the insurance company pays. I know with my broken wrist and surgery last winter the doctors/hospital and therapists billed nearly $26,000 - my insurer paid about $14,000 (of which I paid about $600, mostly in copays for therapy). I imagine, when rates are negotiated, the doctors come in asking for way more than they know they'll get - just like in any negotiation. And, at least the medical personal are providing a service, the insurance company is nothing but a middle man who, in the case of the for profits, looks for ways not to pay anything if they can weasel out of it.
BTW - are you a wheel at UnitedHealth Group (or other for profit insurer) or just a stockholder?
glinda
(14,807 posts)azurnoir
(45,850 posts)most of them these days work for HMO's and it's them the corporate HMO's that are raking in the bucks, now don't get me wrong some MD's ain't hurting financially but others are making a more modest income than you might think, add to that the costs of student loans these days they come out of med school nearly $1,000,000 in debt and malpractice insurance and a good deal of them are not exactly rich, it all depends on what specialty they're in
madrchsod
(58,162 posts)i went to a very good rehab center after my heart attack. i was there two weeks and medicare paid 100%. why? because the center adjusted their costs to match medicare`s payments. most of my doctors bills are far less than they were under private insurance.
dflprincess
(28,057 posts)I went out to another of the large nonprofit website and they're not quoting anything after December 31 yet because they haven't finished figuring out what the "Affordable Care" Act will do to rates... No mention of whether they expect them to go up or down.
Strange that BCBS (how appropriate the last 2 initials are) knows already.
BCBSMN has always been a stinking company to deal with despite it's nonprofit status.
glinda
(14,807 posts)If they raise it again like they say they are going to, I will be back scraping to pay that amount and having higher co-pays. Much higher. I always address my checks "bcBS" to them. I cannot afford to go higher!!!!!! That is why I dropped my last Plan!
They said the rates are going up because of three or four new things they have to cover which is stupid really. Mental health which they "cut" prior on my rate I could pay and "prevention" BSBSBSBSBSBS!!!!!!!!!!!!!!!
I am livid.
Liars all. Crooks all!
drm604
(16,230 posts)It's possible that a lot of companies are just using it as an excuse. I'm not saying that it absolutely is never ever the cause of rate increases or layoffs or whatever, but I need more than the word of some company that's already biased against the ACA.
We need to see the overall effects before reaching any conclusions.
That said, I feel for glinda. I've been in a similar position.
madrchsod
(58,162 posts)the hospital set me notices of non payment so i called the hospital. the woman said because bcbs was`t paying them with-in the usual 30 days. she said they decided to pay maybe after two or three months. she said throw away the notices and they will notify me if bcbs paid.
dflprincess
(28,057 posts)Bear with me, I never get tired of this story.
Many years ago I worked for a small company that had BCBSMN insurance one of my coworkers developed lung cancer and, as his bills mounted, BCBS wasn't paying and it was really stressing him out.
This was pre-HIPPA and, as he had asked me to help, I started calling BCBS on his behalf. One of my brother's friends worked for them, not in claims, but he gave me a number to try calling rather than the usual "customer service" line listed on the bills.
First, the person at BC wigged out because I had that number and got nasty when I wouldn't tell her how I got it. Then she told me the coworker must have had experimental treatment. So I asked if BC really considered the surgical removal of a cancerous lung "experimental" - because that's what they weren't paying for. It was also at that point I asked to speak to her supervisor.
I pretty much got the same attitude from the supervisor. At the time Mike Hatch was the Commerce Commissioner (yeah, a long time ago) when I told her I would be calling his office she told me to go ahead. So, I go dramatic. I told her that I had known Mike well (an exagerration) when he was chair of the DFL and I was not just calling his office, but I would be speaking directly to him (a real exagerration but I did know people who would make that call for me). I told her she had until noon the next day to let me know when those bills would be paid.
Swear to God, I got a call back within the hour with the amounts, payees and check numbers - though she claimed it was just a coincidence and all those checks had been scheduled to go out anyway. And my coworker had no more trouble with BCBS.
Several years later when Hatch was AG I got the chance to tell him this story. He liked it.
glinda
(14,807 posts)BFD
dflprincess
(28,057 posts)I wonder if they're getting close to having too much in reserve (or whatever it's called) and risking violating the MLR Minnesota has had for years for the nonprofits. The AG's office does check on that.
glinda
(14,807 posts)They raise their rates anytime they want. Obviously by lowering them maybe they are hoping I will not be surprised when they raise it even higher sticking to their original letter. lol!
chillfactor
(7,566 posts)we have the option of staying with the health insurance the school offers OR going on the exchange and see if we can find a better deal.....great option......
dflprincess
(28,057 posts)The law requires that they notify you about the exchange and your option for using it. However, we were also told that people who have access to employer insurance may not be able to get subsidies even if their income is low enough.
Also, you can't deduct the premium from your taxes and many employers do take you share of the premium out of your paycheck as pretax dollars.
The amount I pay for single coverage is way, way lower than what a plan from the exchange would cost me - if I were still doing contract work the exchange might be a better deal, but I'd be nuts not to stick with what my employer offers (and who also said nothing is changing for next year.)
chillfactor
(7,566 posts)but people who buy into that BS believe it.....good god
RC
(25,592 posts)The criminals are still figuring out their new cons under the ACA law.
chillfactor
(7,566 posts)this is the first step to single-payer whether they like it or not!
RC
(25,592 posts)Before we can have Single payer, we need to get rid of the 3rd Way, DINO's, and the rest of the Right of Center, that are masquerading as Democrats.
SheilaT
(23,156 posts)Without knowing a lot of details (and even if you tell me, I'm not knowledgeable to parse your specific situation) it's hard to know what to say. One thing is that the insurance companies now must spend 80% of the premiums on actual health care claims. They can only use 20% for overhead.
I recently got a letter from my company, one apparently required by the ACA, explaining under what circumstances a person can opt out of their company's plan and go to the exchanges.
My plan does not allow me to do that, and I'm not surprised. It's very good. I'm lucky. It's actually a self-insurance, and United Health Care simply acts as an administrator. I only work part time, but I still get benefits. Personally, I'm annoyingly healthy, rarely need to use my health care. But I do opt to pay a little more for the highest level of coverage. A co-worker who has various health issues is likewise pleased with the plan.
I do keep on reading over and over that most people going into the exchanges will be vastly better off than they had been.
progree
(10,864 posts)Thanks to the ACA. Odd that nobody has mentioned this until now. Thank you for bringing it up.
(I suppose though that the insurance companies will get better and better at creative accounting and coming up with some kind of arrangements with providers to game the system as much as possible).
dflprincess
(28,057 posts)(BCBS, Medica, Health Partners to name a few) have had that restriction for years though I thought it was 15% .
It's one of the things Medica got in trouble for a number of years ago.