Congratulate Me! Got my best insurance plan ever, starting January.

[freshwest]

First:

Already had Medicare Parts A & B.

Had no RX coverage for years, couldn't afford any.

Really committed to a set of doctors, providers, etc. Did not want to change.

Now:

I get to see all my doctors, no additional premium.

Get very low cost RX benefits, no premium.

Will get services that only Medicaid covers, which I am not eligible to get. Some of these were ones that I really needed.

There are no deductibles for almost anything.

The co-payment for my providers is $15, which is less than the amount that Medicare was not paying.

Am stuck, however with a small monthly penalty for not having prescription coverage for some years.

That penalty is no matter compared to what I'm getting. I am so relieved.

And because of the ACA, there are no limits nor are there any conditions that can be denied.

I found the people that worked on seeing that I got the right policy to be honest and concerned about my costs, and they made sure that all my questions were answered.




Obamacare In Action.

http://theobamadiary.com/2013/10/01/obamacare-in-action-3/

Thanks, Obama!

[napi21]

1. That's GREAT! I registered, but couldn't access the site.

Of course I live in RW Georgia! From everything I've seen & read, the people who are having the problems with the site all live in the states with Pub Governors. I'll keep trying though. I'm sure it will work soon.

aI was only looking, but didn't realize that you could get RX coverage through the exchange. I thought once you had Medicare, you didn't qualify. I've been paying for RX coverage, but it's sure not cheap, neither is the supplement. Maybe I'll get lucky like you did.

[freshwest]

8. I didn't even go to the website, but live in a blue state. We have a good state website for info.

The various companies have been advertising to get us to pick them in the exchanges. So there is more information out there thanks to the exchanges being set up. You might want to check out private insurers, as they are now having to compete with exchanges.

I'd been quoted various supplementals, medigap, etc. policies over the years. There was no way I could afford them!

A friend who just retired and signed onto to the company of their choice, and few other people made recommedations for a company that covers most of my state.

They advertised meetings at community centers and a friend and I went to see what it was. I did not expect something I could afford. The brochures said $0 premium, deductibles, etc and I just could not believe it.

Then after an overview, we looked at the books they had, and everything I wanted did not have a premium. I told them I had certain providers that were a deal breaker for me, and that I needed to have any other things in my zipcode.

And the results after a few days were worth it all. I had my doubts up to the very last minute when I asked a representative to come to my place today.

She made sure I got all I needed, went on the websites, and all the different provider lists as I could not get anything to come up on my computer (not the ACA's fault, my computer) and was about to give up.

I did mention that for me, even if it didn't work, I wanted to see it work for the most vulnerable and poorest Americans that were and are getting help through the ACA.

As she left I said I hoped this would lead to a more humane America, and that she was part of that.

I just don't know what the situation is in the red states. I didn't qualify for Medicaid, but ended up I got as a good of help, for no more than what I've paif for basic Medicare.
Not sure how this works with a red governor at all. Our past governor and our most recently elected one ran on the ACA.

If this doesn't work out, it's all the more reason to GOTV in your area and see it makes a difference.

Good luck!

[enough]

43. Freshwest, I'm not clear on whether you were working through Medicare or not?

Are you still paying for Medicare part A and B? What is the additional coverage you have found?

Sorry to be so dense. I am also on Medicare and it never occurred to me that the ACA would have anything relevant to my personal situation.

[mimi85]

49. I didn't either

I'm on Medicare because of disability though I'm getting pretty damn close to "that age." I had no idea we could shop through the ACA. Damn, learn something every day around here!

[freshwest]

53. I'm on Medicare A & B. It was all I could afford. I could not the Part D.

That was the prescription plan, and I have not had an RX for years. Or any medical supervision. Doctors expect you to 'get with the program' but if all your income goes to a place to live, etc., and you don't qualify for RX plans, some refuse to be bothered.

I will get RX just at the same rates I had when I was working, the same plans. There are tiers for non-generic and more costly drugs, but they will waive the higher cost if the doctor says one must have that brand. Costs at a pharmacy range from $2 to $10 for month's supply; only a dollar or two more for a three month supply by mail. That comes from bulk purchasing, but it's nothing new.

Since I don't qualify for Medicaid, SNAP, or any other kind of assistance, I have to pay everything out of my pension. And although I am considered by at least one utility to be in poverty, it's the only break I get. There seems to be no 'senior discount' for true living expenses, just optional things, which I couldn't afford, anyway. Unless one is in an income level that matches Medicaid, which helps with living expenses.

I have needed management or home health services for a long time, but they are not available through MC, only through Medicaid. This company will give me that free of charge to make sure I am doing all right, even come to my home and call to see if I need any help. No charge, like Medicaid. So it makes me think they are getting something from the ACA or something?

That's my way of putting it but as far as working with Medicare, it is only working with Medicare in that they are paying the premium for me. But I get much more.

As far as the ACA help, I found the names of providers via the state healthcare exchange set up to enroll people in the ACA. I was discouraged at first, as all queries went to the Medicaid eligibility page. Once again, I was not going to be able to participate, at least that's what I thought.

But the same companies that were handling the Medicaid expansion, handled others. Just not on that website. It was the most helpful site I could access, whereas I've been unable to get into the ACA or other sites, or get anyone on the phone.

I called SSA and they had a three hour waiting time, no doubt they are getting more calls than ever and we are still in the first phase of the GOP sequester.

Friends were helpful too, who had just signed up onto plans. They were in the same position I am, no extra money. They have their Medicare A & B payments diverted to these firms. So I went and checked them out.

I am getting the benefit of the ACA directly or indirectly; but I can't explain details for others, since I have a private plan now - except it's funded publicly through my Medicare premium.

I suspect they are being subsidized, but we didn't talk about it. The people offering the plans, offered to retired and non-retired and disabled as well, and used all the buzz words we've heard from SSA, such as entitlements, benefits earned over the years paying FICA, etc. They said it was our right to have these benefits. Too bad the GOP hasn't heard that one yet.

I'm not sure if that will answer you question, but this is going through the Medicare administration, because they are being paid by them. With the money Medicare takes from my SS for Medicare premiums.

Hope that helps. I'd advise NOT calling SSA or Medicare, because they are only paying the insurers. Call the insurers or visit a community meeting.

Since September, they are all over the place, to educate people on their choices under the ACA and Medicare. Or for choices under Medicaid, too, but I didn't go that route, even though they were willing to help me through that, too.

If you are eligible for Medicaid, your state exchange will have the eligiblity page for you to sign up much faster.

[silverweb]

2. Way to go!

[freshwest]

9. Thanks!

[sheshe2]

3. Oh my dear freshwest,

Tears.

I am so happy for you, such relief from worry. The President is making a huge difference in so many peoples lives, you are one of them. He is saving lives and that is simply beautiful.

Thank's Obama, you care~







Obamacare upheld!



For the people, we the people.

freshwest

[freshwest]

10. Thanks, sweet. My heart feels at ease!

[sheshe2]

12. I cried when I saw your thread, freshwest.

You are someone that I care about, there are so many more out there that are getting these benefits.

I can not say it more forcefully, these are our rights. Affordable health care for all, is it perfect? No it is not. Yet this a huge step. We will get stronger everyday.

Thanks Obama. You care.

[freshwest]

17. Thanks! The representative kept stressing the words 'affordable care.' You know what that is...

[sheshe2]

18. "The representative kept stressing the words affordable care"

Yes. I know what that is, it is the most important lifeline that we have.

It's care, freshwest, affordable for so many for the first time in a long time.

I cannot thank Obama and all that supported this enough. It is the start, and it's beautiful!

[freshwest]

35. Makes me cry, too! So many will be helped.

[Indykatie]

4. As an Enrolled Medicare Beneficiary Did You Simply Add a Part D Prescription Drug Plan or Move to

a new medical plan other then Medicare. I was not aware of the ACA plans or Medicaid expansion applying to folks already Medicare eligible either due to age or disability. The Part D Prescription drug plans have been around for a few years and available at little or no cost for low income seniors. Congrats to you for obtaining better coverage!!!!

[freshwest]

11. I went to a new plan that will accept my basic Medicare A & B premium to cover D without a premium.

They stressed that what was being offered, was NOT supplemental or Medigap or other things I couldn't afford.

It is HMO but the insurers here are now scrambling because the exchange has been set up and 35K people have signed up is less than a few weeks. Many of those were close to eligibility for Medicaid, but did not qualify nor did I.

While I don't think my plan is subsidized, it was almost seamless the way it goes. I'm not an expert. But it appeared they were eager to get more clients, and they are very large.

As I said, they have all that I wanted, and for a separate payment I can get dental, almost literally on a month by month basis. Feel that something is going wrong, pay and take advantage. When done, quit and wait until the next time. I never heard of anything like that but they said some of their more cash strapped customers were doing it and they didn't care. My dentist is also in their group of providers.

All in all, it was just what I needed for next to no cost and actually ends up cheaper than my bare bones Medicare.

[The Wielding Truth]

5. That's great! I think of Nancy Pelosi, too, and how hard she worked to help pass this.

[freshwest]

13. Keeping hard at the goal, she was, all of them were. Despite death threats, etc.

[Lefta Dissenter]

6. Congratulations!

I'm stuck at the "there-are-a-lot-of-great-options-so-it's-hard-to-make-a-decision" stage. It looks like I'll be able to pay about $100 less a month than I am now, adding dental coverage, and reducing my copay and out of pocket. And this is in Wisconsin, where Walker was doing his best to make sure we all just up and die.

[freshwest]

14. The Wanker refused the expansion? I knew he was bad news, but that's simply deranged. At least a few

of his criminal notions are being overturned in court there...

Hope you get what you need!

[Lefta Dissenter]

42. Thanks, freshwest

Hey, on the bright side, John Doe II is heating up. I'm still holding out hope that I'll see him in an orange jumpsuit one day.

[Cha]

7. Sounds really good, fresh.. so

you just got all that accomplished very recently?

Thanks Obama in Action.. ah yes, I remember I did an OP on that back on October 1, 2013.. Obamacare's Birthday

Thank You, Mr President

http://www.democraticunderground.com/110217448#post22

So glad you're getting the help you need without costing so much money.. I love these anecdotal stories from people who have been helped.

[freshwest]

16. As soon as the default demons were pushed back, I decided to take PBO at his word when asked about

another threat of default - NO.

So I went to work on it as folks I knew realized I really did need the help. Just about every day I worked on it.

And it will cost me no extra money. I made it clear to everyone, that I did not qualify for Medicaid and had no budget cushion for this.

And thanks for the good wishes, link and video, Cha! You and Sheshe bring the some of the best content to DU!

[Cha]

21. "The default demons" damn

good description, fresh. And, I'm taking the President at his word, too.

"And it will cost me no extra money. I made it clear to everyone, that I did not qualify for Medicaid and had no budget cushion for this." Excellent!


Thanks to you for what you bring to DU, also, fresh~

[freshwest]

23. TY and YW. I had to make the income matter clear, as I said, to not waste their time or mine...

Because no amount of salesmanship or wishful thinking changes the harsh facts of economic life for some of us.

I wanted to spend my and their time productively, and was most definite on that point, telling them all the various methods I had tried in the past to get such coverage, and why it had not happened.

Feeling cautiously optimistic that all will go smoothly, not luxuriously, but just as most of us have planned our lives to be. That one does not get to escape certain limits just because one wants them to be so - such as a sales pitch that is unrealistic.

They were down to earth, plain talking. For those with more money to spend other things were offered. For the rest of us watching our pennies, they were ready to help and didn't thumb their noses at it.

So all in all, my foray was successful.

[Cha]

31. I would expect this.. but so nice to have it confirmed from a

DU buddy.. especially one whom has gone through the Default Demons battle with us.. And, every other freaking battle!


"They were down to earth, plain talking. For those with more money to spend other things were offered. For the rest of us watching our pennies, they were ready to help and didn't thumb their noses at it."

[sheshe2]

15. Kick!

Because this is so very important.

[applegrove]

19. That is so great FreshWest. Yes prescriptions

do add up. Way to go Obama.

[freshwest]

20. Thanks, Applegrove!

[SoapBox]

22. freshwest, congratulations!

Every success story is good to hear.

Ya know I've got say that I feel lucky to have great coverage through my employer.

The other thing is that I moved my Mom (92!) in with me about 4 years ago...moved her from Oregon to SoCal. Sheesh...she was actually WAY over paying in OR compared to the plans in SoCal. There is good competition (or at least there has been) here. I've had her in Advantage plans and they have worked great, especially for her meds.

I can hardly wait to see what the Pukes and Baggers do/say, as the enrollment hits a million plus!

Again, congrats.

[freshwest]

25. TY, and good with your Mom, there! I once had great coverage with my company.

This is comparable and affordable for me. I'm thinking America is going to be leaving the health care nightmare in time, not exactly as we might have wanted, but we will.

One thought I had was, ah, with single payer I wouldn't have to think! But this still gets the job done. I'm letting others know who are in the same place in life that there really a road back to getting healthcare.

And getting the kind of healthcare you want and need, not what is simply profitable for some other entity.

And many kudos to you for helping your Mom!

[Hulk]

24. CALL IN if you can't log in!

I live in Washington state. I called in the end of the week for my wife, and her new policy, beginning January 1, will cost $50 less a month, have a "out of pocket annual expense" of $3250, and include prescriptions and all the ACA features. Her current policy has ZERO prescription coverage, an annual "out of pocket annual expense" WELL ABOVE $6000, and is so inferior to her new coverage in so many ways, it's WONDEFUL!

CALL, don't waste any more time trying to log in. I had to spend 20 minutes on the phone, but the lady was helpful, patient and we got it all done with the first month's premium set to be paid on December 1, 2013.

Now, all the BS you hear on the fox-nonsense network is simply nonsense, and nothing more.

[freshwest]

28. Luckily, I didn't have to call or log in, and don't do Faux. But that's good advice for some. Thanks

[freshwest]

30. First, I didn't go to the website or call. I sought out insurers who were seeking to expand.

I'm under 65 on Medicare but not Medicaid eligible. I'm no expert. My state's ACA exchange website referred people of all ages to various firms.

I found there were several companies very interested in signing up people of all ages, conditions and also economic circumstances. I did not quality for the Medicaid exchange, but they gave me leads.

Friends helped me find the right insurer or me. The companies that are getting the Medicaid eligible, are also ready to insure others.

I did not go to the ACA website or call anyone. My age did not affect the coverage I was seeking.

Some people who are not Medicare or Medicaid eligible are going with the same companies. Most of the people I know who were attending the open enrollment meetings were seniors, but some were not. That's all I know.

Perhaps someone you know has a good lead for you to use. ACA seems to be subsidized to bring the rates down. There was no talk of subsidy in the meetings I attended.

They stated repeatedly to those on Medicare who would not be paying an additional premium to sign on, was they were not getting a 'freebie.'

Because we paid FICA taxes and pay a monthly premium for Medicare. (That will go to the insurer.) They said that it was an 'entitlement' we had earned because of the tax dollars we paid in for many years.

The ACA itself was not mentioned specifically, but the policies stated up front that there was no lifetime cap nor any denial for any pre-existing health problem. That was enacted by the ACA prior to the exchanges coming online in October.

There is a lot in the ACA that people don't know about - such as the cap being lifted off FICA to fund Social Security. There has been little or no coverage of what good PBO has done with many things. But they are law. And the GOP is still trying to fight progress.

But they lost in the tiny corner of life that is mine, and those I care about.

Don't know if that answers your questions.

[Tx4obama]

27. From the DCCC - Stand With OBAMACARE

[SoapBox]

47. Ooooooo...nice!

[pnwmom]

29. freshwest, could you please tell me

how you figured out that your doctors were covered?

I have a couple family members I want to help through this, and that's the big question. I haven't been on the website since the first week, but at that point I couldn't see lists of providers, which is the big question remaining.

[freshwest]

33. I went personally to see my doctors and asked if they were 'providers' to that network. They were.

There is a website, but it didn't show any of them in the lists I found. I have had no success with any of these website. I suspect it iseither my OS or my browser that won't work with them.

It was hard to catch them on the phone. So I visited their offices to ask them personally. Then when I spoke to the sales rep for whom I'd given my phone number in a community meeting they looked them up and did not find them all; then kept on looking, as their initial searches didn't find them.

Fortunately all of them, from foot doctor, chiro, dentist, urgent care and internal medicine doctor - were in the plan. So were all the hospitals and clinic, as well as the pharmacies I wanted to use when not using the mail order option.

I didn't find my providers on their website, nor was I able to make use of the ACA or state website, save for the barest suggestions. I did not call the ACA, SOW, or any of that.

I drove in person to see all the people I hoped would be in a network, and they listed who they were paid by. That helped me make a choice and I talked to that one firm.

And that's how I did it. Not online, not on the phone. Hope that helps.

[pnwmom]

34. Thanks, Freshwest! I'm so glad everything worked out so well for you! n/t

[freshwest]

36. Hope you can find what your family members need, as well!

[Tx4obama]

32. UPDATE from the White House

-snip-

We’ve updated HealthCare.gov to offer more information about enrolling over the phone, by mail, or in person with a specially-trained navigator who can help answer your questions. Just call 1-800-318-2596 or visit https://LocalHelp.Healthcare.gov/

-snip-

http://www.whitehouse.gov/the-press-office/2013/10/26/weekly-address-enrolling-affordable-care-act-marketplace

[freshwest]

37. Thanks, Tx4obama! All the tech saavy folks can have at. I did it the low-tech way, no other choice.

But grantcart and others have had great success.

[Tx4obama]

38. The link I posted takes folks to a list of 'local' places to go to get help to sign up in person

This one: https://localhelp.healthcare.gov/

Folks just have to put in their zip code and a list comes up with LOCAL places for 'application assistance'

[freshwest]

39. Terrific! That is going to reach a lot of people who really need the help. How about you make an OP?

[Tx4obama]

40. I did earlier today, link below

Here: http://www.democraticunderground.com/10023927670

I'll make another one.

[freshwest]

41. Great! Just bumped it. Hadn't seen it.

[ucrdem]

44. Wow.

Molti congrats, freshwest!

[Whisp]

45. very happy for you

and the less stress you will have to live under.

[sheshe2]

46. Kick! n/t

[IrishAyes]

48. Hooray!

That picture says it all.

[freshwest]

50. Yup, I feel like that's me in that pic, getting the Obama hug I always wanted!

I've wondered at times...

If I met him and he shook my hand, would I ever wash it again...

Because I've heard that from people who shook hands with someone they admired greatly...



hehehe!

[Tarheel_Dem]

51. Congrats Fresh!

[giftedgirl77]

52. Congrats Freshwest!

It's always a relief when we know our health is in good hands.