Only 15% of Uninsured Know Deadline is Sunday

[TN_agent]

Had one call this morning wanting to switch plans on the exchange.

Gave her the number to the exchange and said "good luck".

They will probably let her anyway.

 

[cadylou]

I agree, we've reached a tipping point with budgets and premiums. Only the very low income, very high income, and unhealthy will continue to buy.

I was disgusted myself last night with the whole "system".
I pay $760/mo for my 6450 HSA Humana PPO policy.
Son diagnosed with flu.
Late night urgent care = $150 + 2 swab tests (unknown cost)
Tamiflu = $276 (Didn't buy, kid doesn't take meds well, he'll suffer an extra day)

Total = $450+ potentially

Have you heard this before? "I pay all this money each month, and then I get no benefit when I use it". You can only sell "insurance is for catastrophic reasons" for so long before clients just give up.

Exactly. It's even worse than that - It was recommended I have a PET scan this fall after a high number on a blood test that was alarming - as someone who had cancer with a high recurrence rate, this would be the only type of scan that would pick up "pre-cancer" cellular activity, so . . . .

The insurance discounted rate for that test would have been $2500 - all coming out of my pocket. The insurance company denied the scan. I asked the hospital if I could simply pay the insurance co rate and just not have it count toward my deductible, since I do "comply" with the law and am spending over $6000 a year on premiums.

I was told "no" - they'd have to charge me full retail ($8000). I asked what would have happened if I had no insurance at all - they said they'd charge the full retail & then if I was a cash payer, knock off about 2/3 - which gets us back down to the insurance co. discounted rate. Obviously I didn't have the scan . . . .

If you're going to force me to buy insurance, I should pay the same price as the insurance company whether they approve it or not, if I choose to foot the bill. . . . .it's all terrible!

 

[RayNY]

1/3 of $8000 is pretty much what you'd spend under insurance...

Go back in a week (or just to a different place) and inform them you dropped insurance because you were told it would save over $5000 on this procedure alone. Play stupid.

Don't actually drop it, just tell them you did so they'll process it as cash.

 

[MW Agent]

I agree, we've reached a tipping point with budgets and premiums. Only the very low income, very high income, and unhealthy will continue to buy.

I was disgusted myself last night with the whole "system".
I pay $760/mo for my 6450 HSA Humana PPO policy.
Son diagnosed with flu.
Late night urgent care = $150 + 2 swab tests (unknown cost)
Tamiflu = $276 (Didn't buy, kid doesn't take meds well, he'll suffer an extra day)

Total = $450+ potentially

Have you heard this before? "I pay all this money each month, and then I get no benefit when I use it". You can only sell "insurance is for catastrophic reasons" for so long before clients just give up.

That's just it. One of my long time clients has a family of five, not subsidy eligible. "You mean I am going to pay $18,000 in premiums this year, but I have to pay another $13,000 out of pocket before we reach our family deductible? That's....(pauses in unbelief) $31,000 just in case something big happens." Yes. I respond "blah blah blah, network discounted pricing, blah blah blah, preventive care covered, blah blah blah, embededd deductible." It doesn't change the fact she is right and we will reach a breaking point.

 

[cadylou]

Health Care Policy and Marketplace Review: Why the Obamacare 2016 Open Enrollment Stalled: The Big Unwritten Story About Obamacare––How Unaffordable It Is For the Working and Middle Class

Finally someone else is writing about it . . . .

 

[houcoogster]

I agree, we've reached a tipping point with budgets and premiums. Only the very low income, very high income, and unhealthy will continue to buy.

I was disgusted myself last night with the whole "system".
I pay $760/mo for my 6450 HSA Humana PPO policy.
Son diagnosed with flu.
Late night urgent care = $150 + 2 swab tests (unknown cost)
Tamiflu = $276 (Didn't buy, kid doesn't take meds well, he'll suffer an extra day)

Total = $450+ potentially

Have you heard this before? "I pay all this money each month, and then I get no benefit when I use it". You can only sell "insurance is for catastrophic reasons" for so long before clients just give up.

So let me make sure I understand this. You are clearly getting ripped off. The Insurance Company is losing money. The providers are all complaining about low reimbursements. Is somebody lying??? Or do we find ourselves in some parallel universe where everybody loses??? WTF???

 

[GreenSky]

I find it funny that 2 years ago one of the posters on this thread was thrilled with Obamacrap.

I guess the predictions from EVERYONE came true.

Rick

 

[TN_agent]

So let me make sure I understand this. You are clearly getting ripped off. The Insurance Company is losing money. The providers are all complaining about low reimbursements. Is somebody lying??? Or do we find ourselves in some parallel universe where everybody loses??? WTF???

There are some winners. The person at 101% of FPL gets both knees replaced, 20 psychologist visits and all the xanax they want for $500 MOOP for the year.

 

[AllenChicago]

There are some winners. The person at 101% of FPL gets both knees replaced, 20 psychologist visits and all the xanax they want for $500 MOOP for the year.

these clients have the fewest complaints and generate the least amount of service work.

 

[Yagents]

A word from our sponsor. I guess only 15% of agents know OEP is closed:

As a reminder, the plan year 2016 Open Enrollment period is now closed. The Centers for Medicare & Medicaid Services thanks you for your hard work enrolling consumers in coverage over the past three months.