Yay, they just lowered the rates again on the federal pre-existing condition plans

[Juche]

I've read in this economy the main kind of job being created is part time, temp, pays 20k a year, has no benefits, seniority or security. That describes where I am at right now. Luckily I have no kids, no debt, etc.

I can't get private health insurance due to pre-existing conditions, obviously my employers don't cover it (the company I really work for has me as a contractor to avoid paying benefits, the temp agency doesn't offer any either). The rates for someone my age for the federal plan created under the PPACA were about $330 a month at first. I passed since I couldn't afford that and as a relatively young person I figured I'd do fine (I've never had more than 1-2k a year in medical expenses). Then they were lowered to about $250/month. That isn't terrible, but that is with a 2k deductible. So if you are making 20k a year gross income, spending 5k a year net income on premiums and deductibles before the insurance even kicks in can't be justified.

But they just lowered the rates again starting July 1st, now they are only $180 for a 2k deductible plan. I can afford that. It will still eat a lot of my savings, but that is 1k a year less in premiums.

http://www.pciplan.com/index.html

I realize health care in America is an unrelable joke so I figure if I go on the plan I can get some issues I've had taken care of, and maybe the next 10-15 years I will be fairly healthy. I don't know what'll happen with insurance rates jumping 20% a year while wages stagnate, but I figure this may be the only period for a long time that I can get insurance. I hope the bill isn't overturned before 2014, but even if it isn't I don't know if the tax credits for private insurance for those making less than 400% of the poverty level will be reliable (I've heard in MA the tax credits aren't keeping up with the cost of insurance).

Maybe I can get my hernia repaired and have those moles removed that a dermatologist told me to have removed. I've been able to get primary care w/o insurance w/o problem, and generic drugs are affordable. But I've got some issues that require minor surgery that I can't afford w/o insurance.

[W_HAMILTON]

1. Could you please explain to me...

...how prescription drugs work on this program?

[Juche]

5. This is what I can tell

My impression is there is a $250 or $500 deductible based on which plan you use (standard vs extended) (the ded. goes up to $750 if you use drugs not on the list).

After you hit that your copay is $10 for generics, $100 for brands that are on the rx list and $200 for brands not on the list. For the extended plan it is $75 and $150, not 100/200 for 3 month mail order supplies.

A $100 copay on a 3 month supply of an orphan drug would be a pretty good deal. But I don't know if that is how it works. There is a category called 'speciality' that may be orphan drugs, that is 25% or $350 every 3 months.

The only meds I use are on the $4 list, so I haven't looked into it much.

http://www.pciplan.com/forms/pdfs/2011BenefitsSummary.pdf

http://www.pciplan.com/enrollees/prescriptions.html

[Horse with no Name]

2. Insurance is a joke

A big ugly joke.

My insurance rates went up moderately this year but what I thought was still affordable. Until I went to use it.

I found that this year, I have to pay a copay at the visit like always. However, NOW I have to pay for my labwork AND XRays separately--I've never had to do that--they used to be included in the office visit. So, going in for an office visit is a huge expense and pretty much makes going to the doctor a luxury I can't afford.

[Ishoutandscream2]

3. Exact same thing happened to me

Exactly! Got my lab bill (which I have never received before, everything was with the co-pay) and about fainted.

[Juche]

4. I know

That is why I'm happy with this, I'm hoping I can get some issues I have taken care of so over the next 10-15 years I won't have very many major medical expenses to worry about. I have no faith in the US health care system, so I want to get my issues taken care of now and hopefully avoid needing it for more than primary care for a while.

Our system deserves to collapse. But who knows what'll happen. Something like 1/3 of the public put off medical care due to costs now, soon it'll be 1/2.