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View Diary: Laid off workers will have alternative to expensive COBRA coverage (46 comments)

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  •  Great information (0+ / 0-)

    Question

    Married friend with three kids just lost job.  Is taking a construction job until he can find a better job.

    The job pays $600 a week which, after income taxes (30% total), barely covers expenses and food.

    How in the heck is this family going to afford to pay for health ins premiums?

    Using New York Silver Leaf as an example for the Silver Plan the family has to pay

    The premiums plus

    DEDUCTIBLE: $1,750 individual/$3,500 Family for In-Network Providers
    Does not apply to Prescription Drugs, or preventative care visits or services

    Once deductible is met, co-pays kick in (so family pays 100% of health care costs up to the $3,500 deductible

    Plus co-pays

    30% Co-insurance.

    With a total out-of-pocket cap of $8,000 (do I have this right?)

    What is not included in the out–of–pocket limit?

    Premium, Balance Billing charges and the cost of health care services this plan does not cover.
    In short the maximum annual cost for this family, if there is a major event, will be Insurance Premium + $3,500 deductible + Co-Pays with an annual cap of out-of-pocket of $8,000.  

    This is not doable.

    Well, excuse me.  I can see this family avoiding health care.

    Exceptionalism my buttocks.

    I'm sorry, but unless I'm missing something, Obamacare is looking like the Great American Heist albeit it better than before.  Just another Third Way boondoggle.  

    I am afraid for my friend's family.  Kids are always presenting health care challenges.

    So, what's the fine?

    It's difficult to be happy knowing so many suffer. We must unite.

    by War on Error on Tue Sep 17, 2013 at 04:04:57 PM PDT

    •  One word: subsidies. (3+ / 0-)
      Recommended by:
      War on Error, elwior, jck

      Yes, if there is a medical need, they will be out money--but that would have been the case if your friend was employed, too. The cost of insurance will be subsidized pretty much to the extent that you'd have had from your employer, most likely.

      "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

      by bryduck on Tue Sep 17, 2013 at 04:12:47 PM PDT

      [ Parent ]

      •  OK I found this (2+ / 0-)
        Recommended by:
        elwior, bryduck

        For a family of four the premium would be $118 a month, the rest paid by subsidy

        Plus the $3,500 deductible etc.

        So, each month the cost is $118 plus 100% of health care costs up to $3,500 plus billing fees, co-pays, co-insurance etc

        All approximately, as it varies from state to state.

        There are no subsidies for the cost of health care, just the premium, right?

        It's difficult to be happy knowing so many suffer. We must unite.

        by War on Error on Tue Sep 17, 2013 at 04:42:31 PM PDT

        [ Parent ]

        •  Correct. (1+ / 0-)
          Recommended by:
          War on Error

          Cost of actual healthcare depends on the insurance plan paid for.

          "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

          by bryduck on Tue Sep 17, 2013 at 04:47:16 PM PDT

          [ Parent ]

          •  The affordable Silver plans (1+ / 0-)
            Recommended by:
            bryduck

            require an addition 30% co-insurance payment.

            I am hoping that the cap is $8,000 out of pocket per year.

            If this family has a major event, it will still bankrupt them.

            It's difficult to be happy knowing so many suffer. We must unite.

            by War on Error on Tue Sep 17, 2013 at 04:57:22 PM PDT

            [ Parent ]

            •  Oh, don't get me wrong, (2+ / 0-)
              Recommended by:
              War on Error, Kickemout

              I still realize this comes far from being anywhere close to wonderful. $8K (which is probably high for a silver cap, I think, but I have not checked) and a cure, though, ain't $80K or $800K, neither of which are entirely out of the range of the possible for the uninsured who "choose" to get medical help for something major.

              "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

              by bryduck on Tue Sep 17, 2013 at 05:03:47 PM PDT

              [ Parent ]

              •  It's non sustainable for a family on the Exchange (1+ / 0-)
                Recommended by:
                bryduck

                that has chronic medical conditions.

                They would be better off getting a low paying job, living like paupers, maybe divorcing, so the sick one could get Medicaid.

                I so ashamed of this country for it's horrible for profit health care system, with too few doctors, and laughable billing rates for service.

                America is a laughing stock in the eyes of the world on this issue.

                It's difficult to be happy knowing so many suffer. We must unite.

                by War on Error on Tue Sep 17, 2013 at 05:13:56 PM PDT

                [ Parent ]

                •  Absolutely correct yet again. (0+ / 0-)

                  When I got cancer, my net salary was immediately reduced by my annual cap for 3 straight years. Nothing about that was fun, speaking strictly from the fiscal POV.
                  USA! USA! USA!
                  A family facing this, though, would probably want to invest in a Gold or Platinum Plan--obviously, if offered, and whichever plan runs the cheapest if one assumes the cap will be hit every year . . .

                  "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

                  by bryduck on Wed Sep 18, 2013 at 08:00:39 AM PDT

                  [ Parent ]

    •  This is completely normal for self-insured people (1+ / 0-)
      Recommended by:
      annakerie

      I paid for my own health insurance for 20 years and this is completely normal, not a new thing. Self-employed people have always lived with this situation. You learn to put aside money for healthcare emergencies and, if anybody needs elective procedures, try to get them all in a single calendar year. That's been our reality.

      The changes brought by the ACA, however, make a huge difference. In the past, we had to pay for annual check ups, all tests, and many other things that will now be included at no co-pay with ACA. We also lived in fear that our insurance coverage could be terminated at any time, a $1 million cap on total output, and no coverage for pre-existing conditions.

      The plans available through ACA are not perfect and may not compare to the best plans offered by some employers, but they are a hell of a lot better than what we have had to live with up until now.

      Never interrupt your enemy when he is making a mistake.

      by Libertina on Fri Sep 20, 2013 at 07:37:13 AM PDT

      [ Parent ]

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