Want to see the healthcare rates for my mom, who is 55 years old and works 2 jobs?

[Firebrand Gary]

Yes, this is going to help her and many other women who share her story. I'm literally dumbfounded the Republicans are cheering in the hallways, celebrating the pain that they are inflicting on the people. Yosemite celebrates it's 123 anniversary today... Closed. The Statue of Liberty lifts her lamp beside a door, that is locked... Nearly 1 million people will be directly affected by furloughs and they celebrate? NASA celebrates is 55th birthday, but the rover on Mars is parked because 18,000 Nasa employes are not at work.

Did I mention that my mother makes 13k a year and they want to her raise her healthcare costs?

Edited to add detail: Her monthly plans range from $1 a month to $245 a month, depending on her selection. She is choosing a pretty big plan that is $103 a month. We've already run the calculations, she is going to save nearly $2900 a year in addition to all of the other goodies like, inclusive preventative care, no lifetime caps, VERY LOW co-pays, etc.


<a href="http://imgur.com/jR5CcLh"><img src="" title="Hosted by imgur.com"/></a>

<a href="http://imgur.com/gOYxBPj"><img src="" title="Hosted by imgur.com"/></a>

[napi21]

1. That's GREAT. 90% of all the copays are less than what I pay and I'm on medicare

and pay $165/mo. for supplemental insurance.

[Firebrand Gary]

4. God bless, Medicare!

Yes, she is over the moon with her new rates. This is a huge blessing to our family!

[Art_from_Ark]

38. I'm really confused here

I went to an Obamacare site that Yui-san provided to see how it would affect some relatives and it said that people on Medicare would not be covered by Obamacare? Or does it depend on the state?

[truebluegreen]

53. Medicare patients will not be covered by Obamacare, in any state.

The expansion of Medicaid is part of Obamacare, but that depends on whether or not you live in a state with an a**hole Republican governor

[Art_from_Ark]

87. Thanks for the clarification

[brer cat]

59. Something seems wrong, napi21.

I am on medicare and also pay about 165 for supplemental however my deductible and copay is 0. I have had surgery, MRIs and other tests, visits with specialists, etc. and haven't paid a dime. Have you checked all of your options? There may be something about your situation that is different, but it seems you are not getting the best deal available.

Off topic, but I like to see people get the best value for their money.

[DURHAM D]

60. My guess is that

Napi has a Medicare Advantage policy instead of regular Medicare and Medigap Supplemental. More than likely Napi's policy includes drugs (which you and I would pay through a separate insurance policy - $29.20 a month for me) and perhaps dental and eye care in her Advantage plan.

[brer cat]

61. ah. I don't know about all the plans.

Dental and eye care would be nice, although my eye check-ups are covered by medicare because I have very early cataracts.

[napi21]

89. It depends on what state you're in and the ins. rates there.

I could have gotten a diff. supplemental with no deductibles, BUT it would have cost another $80/mo. and I couldn't justify paying an added $960/yr. to eliminate all the deductibles. I've been fortunate for the last 2 years that I have only had to pay about $70 in copays, but still have the peace of mind that IF I should have to go to the hosp. for any reason and have ti stay, AI wouldn't end up paying more $$ than I have in this world.

[Tigress DEM]

2. So how much does she have to pay to get the silver plan?

[Firebrand Gary]

3. I'm not sure as of yet, but I will find out shortly.

No matter what, it will beat what she is already paying.

[joshcryer]

27. If you X out that thing that pops up you can see the rates.

The little X is at the top of the square part showing the breakdown. It's a little unintuitive.

[freshwest]

5. Thanks for the sentiments in the OP, some truth and those screenshots! Best wishes to your mom.

[Firebrand Gary]

6. Thank you, Freshwest!

Best wishes to you and your family.

[steve2470]

7. I'm glad this will help her !

Just for fun, despite the fact I'm a FL resident, I plugged my info into a CA zip code near LA. My premiums even for a platinum plan would be DRAMATICALLY lower in California, which shocked me. I thought they would be the same or even a tad higher. It must be because of more competition in CA than FL ?

[Firebrand Gary]

10. Thanks Steve2470

I'm keeping my fingers crossed that this will prompt more competition in your state. Best wishes to you!

[Tarheel_Dem]

8. Thanks for that.

[Firebrand Gary]

11. You're most welcome Tarheel!

Congratulations on the great news out of the Justice Dept. Forward.

[grantcart]

9. kick

[Cha]

12. Gary, this is awesome for your Mom! thanks for letting us know!

And, thank you for the reality on what's being Shut Down because the Koch bros are pulling the strings of the teabagger fascist pos.

[Firebrand Gary]

14. Thanks Cha!

I'm literally on cloud 9! Not only for my own mother, but for people all over our great country! You know what, the Koch brothers are scared and it looks like they should be. Hugs to you!

[Cha]

16. Backatcha!

[Bolo Boffin]

13. Am I seeing that right? The Enhanced Silver plan has a monthly payment of $8????

The Bronze plan doesn't look so great, but that ES plan had great copays, etc. In fact, it sort of looks like my employer plan in the copay arena. Good for your mom!

[joshcryer]

17. Insane if so, but the first picture has $662 and $245.

So it's unclear which numbers go where.

[Bolo Boffin]

23. Those may be before any subsidies are applied.

And I see this are California plans, too. I've been "discussing" the Alabama plans with a couple of Alabama cousins on Facebook, and they posted their numbers from a Kaiser tool linked in the NYT. It seems they weren't posting everything.... How about that?

One of them (I'll call her Paula) said her income was 80% of the Federal poverty line and her payments after the subsidy was really high. But she should be eligible for Medicaid with that number. However, Paula was clearly quoting the family out of pocket expense (around $12,000) instead of the individual number. So if she's figuring with a family involved, her husband's income is probably knocking them up into that range of monthly payments. But Paula was only telling us what her individual salary was.

So sad when you have to lie and misrepresent to slam something like this...

[joshcryer]

25. Yeah, looks like we replied at the same time.

It'd definitely with the tax credit (which is in effect a subsidy). But everyone is going to use that tax credit.

[Ms. Toad]

69. I believe Alabama is one of the states which did not expand Medicaid

So she may not be eligible for Medicaid - and may have to pay full price (without subsidies).

People in those states who are poor, but not eligible for traditional Medicaid, are really going to be hurting - since the entire rate structure and subsidies were premised on those in the lower income range being covered under Medicaid, so subsidies don't start until >100%xpoverty.

[Bolo Boffin]

73. Yes, it is likely she doesn't.

I knew Alabama had not extended Medicaid eligibility, but I thought that she would qualify at 80% poverty. Nope. None of the Alabama programs will accept her. Effing BS, but that's on Alabama, not Obama.

[Firebrand Gary]

19. Yes, she could choose that plan if she wanted. I'm going to edited the above for more detail.

[joshcryer]

21. Wow! I just paid with the calculator, and yes, with the tax credit, it's around that.

Holy fucking shit! Note: that's the bronze plan you're looking at, but even the Silver 94 plan ranges from $13-$50! Incredible!

The calculator is here: https://www.coveredca.com/shopandcompare/#calculator

I put in a random LA zip code though so I am getting slightly different numbers. If we knew that OP's zip code we could get the same page.

[Firebrand Gary]

26. It's AMAZING...... No wonder the GOP wants to run us off the cliff, they are in soooo much trouble.

People are finally going to be able to afford quality healthcare!

[B Calm]

15. What state is your mom in?

[Firebrand Gary]

22. California

[AngryOldDem]

48. That explains it.

I'd like to know the cost for something comparable here in Indiana.

[joshcryer]

52. Check your exchange if you have one.

Please post back here if it's better than the plan you have now or don't have.

[SunSeeker]

18. K & R

[SoCalDem]

20. She should take the BEST one she can afford, because that 10 year gap

is a very dangerous decade..even if her kids chip in so she can get the diamond-studded plan, it will pay off if she ever has a big illness or needs surgery..

[joshcryer]

24. Agreed, with the tax credit it's like $50 tops.

That's amazing.

[Firebrand Gary]

28. We are going to step up and help her for whatever she needs. Suzy Orman is right, people first...

[sheshe2]

29. Kick it!

And keep the stories flying!

So very happy for your mom!

Excellent news Firebrand!

[Firebrand Gary]

30. Thank you so much! We're thrilled! I think I also read that today is your birthday?

Happy Birthday Sheshe! I hope that you have a fabulous day and spend it doing lot's of happiness, laughter and love!

[sheshe2]

33. That is so sweet~

Thank you, Firebrand. I need nothing more for my birthday than to celebrate the birth of Obamacare sign up. It will be the gift that keeps on giving.

Who could ask for anything more. to you and your mom!

[dorkzilla]

77. Happy Birthday, sheshe!

Hope you're doing something fun to celebrate!

[sheshe2]

81. Nope, just got back from work in fact.

However on the 13th we will have our families quarterly birthday bash. There will be several of us celebrating our birthdays. It will be fun~

Thanks dorkzilla!

[Wounded Bear]

31. Our website (WA) isn't up quite yet...

But the estimator calculated about $108/mo after subsidies and tax credits for a Silver plan for my situation.

I'm currently working, and the company will pay my insurance after I make 90 days (around Dec 1). So I don't really need this, but that number is less than I was paying when I was working at the temp agency, and it's probably better coverage.

[JustAnotherGen]

32. I'm up with a nasty

Head and chest cold - but it makes me feel "good" to know that another person has access to a GP if they get one of these that doesn't go away. It's never been an issue for me other than the inconvenience of sitting in the waiting room for an hour. That should be the only inconvenience or worry for anyone. Not an emergency room visit for a systemic sinus infection or pneumonia.

[Drunken Irishman]

34. So happy for your mom!

[LostinRed]

35. $13000 a year

Doesn't she qualify for Medicare? Isn't that below poverty?

[steve2470]

37. I believe you must be either 65 and/or disabled to qualify for Medicare nt

[Humanist_Activist]

42. I think they meant medicaid, and I would think 13k is poverty level and she would qualify. n/t

[joshcryer]

45. Depends on the zip code I THINK.

I couldn't get the calculator to return similar returns without bumping up annual pay to 15k (OP says 13k). But I picked a zip code at random. I think it's dependent on where you live. Otherwise it says that 13k qualifies for Medi-Cal which is California's Medicaid. Still, we're looking at a very low cost health care for those on the bottom.

[Humanist_Activist]

47. I don't see why it would matter, 13k is pretty much poverty level nationwide. n/t

[joshcryer]

49. The plans in Colorado are county-based.

I agree it shouldn't matter but for efficiency I can see why it might. Some districts may have a lower cost of living than others. Some may have more people on insurance than others or Medicare / Medicaid. I would prefer it be a general demographic based approach, but from what I've seen in Colorado it's county-based.

Otherwise I'd have to assume the OP was lying. In all randomly selected zip codes I couldn't reproduce the OP's result with a $13,000 income (I even bumped it to $14,000, to no avail).

It's possible the OP was talking about an after-tax income of $13,000 and used the higher, pre-tax, figure on the exchange. Which isn't clear but it gives you an idea. Not sure of CA's current state or Federal taxes so I didn't bother to reverse engineer the "$13k" figure. Still cheap. I just assumed $15k and the numbers were similar.

Regardless the results are very good for the working poor.

[Humanist_Activist]

50. I guess I make around 13-15k after taxes, my pre-tax income is a little over 19k...

too much to qualify for MO Healthnet, Missouri's medicaid program.

[joshcryer]

51. Sorry to hear that.

But is your exchange going on pre or post tax income and what sort of results are you getting? For California I think it's promising. I can't say for other states. Still waiting for Colorado's exchange to go "live." I've been wanting to pay the $95 penalty for the first year (I admit I've been wanted to see how this thing plays out and have been cynical, but CA's rates are really amazingly promising to me) but if these rates are indicative of Colorado's rates, then I might sign up (say, up to $250 for a single, white, male with no pre-existing conditions). Just can't get the exchange to work from here.

[Humanist_Activist]

54. Missouri's is being set up by the Federal Government, our State Government is split politically...

so, they didn't do shit, even though we have a Democrat as governor, he can't do much without the legislature initiating it.

[joshcryer]

56. Is the exchange working then?

[Ms. Toad]

62. Missouri has not expanded Medicaid

so it is still available only to the traditional groups Medicaid is available to (children and mothers, essentially). That puts you in the worst situation possible. You were intended to have access to Medicaid, so the statute doesn't provide subsidies for you. You can shop in the marketplace - but it will be at full price.

Press your state legislature/governor to expand Medicaid - they are acting like the folks in Congress who shut the government down rather than fund Obamacare - and rejecting the money available to expand Medicaid in order to make it look like a failed program.

As of September 17, States which are not expanding:
Alabama, Alaska, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Texas, Utah, Virginia, Wisconsin, Wyoming

New Hampshire, Ohio, and Tennessee haven't decided yet.

In these states, the poorest citizens (whose health care was intended to come through an expanded medicaid program) can buy insurance on the exchanges - but without subsidies (unless they meed traditional Medicaid standards). So they will be paying more both in premiums and shared costs than folks making more.

The money to pay for expanded Medicaid is available for a period of time (I believe 2 years) from the Federal Government - so it will not cost these states anything. If you live in these states, get busy working on your state legislature and governor.

(And - sorry!)

[Ms. Toad]

70. But traditionalMedicaid -

it is often not available to single adults - and there are more than a dozen states which have refused to expand Medicaid to cover all in poverty. In that case, those in poverty, but not eligible for Medicaid are also shut out of subsidies.

[winter is coming]

82. But the cutoff percentage of FPL for Medicaid eligibility varies state by state.

http://kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/

[Drunken Irishman]

63. Depends on the state. If they don't live in a state that has expanded coverage, then no.

[SharonAnn]

86. Depends on the state. If the state didn't expand Medicaid, many of the poor are

not covered by Medicaid (like here in Tennessee). Also, they are not eligible for subsidies.

Sucks that this loophole exists, but it's the fault of the state. It's a state decision to leave their poor people without coverage.

Sucks.

[Bluenorthwest]

58. Medicare Premiums are also much higher than what the OP is saying his Mom's are

so Medicare would be a shitty, crappy deal compared to what the OP is speaking of. It is age or disability associated, but no one would want it at any age or status if one could have great insurance at a fraction of the cost.

[joshcryer]

46. Of the ZIP codes I tried on the caculator, 13k qualified for Medi-Cal.

But the OP's mom may live in a zip code that doesn't qualify (a lower cost of living, more impoverished area). I played around with the calculator a bit and the zip code does appear to play a part in it. In any event once you hit around 15k you no longer qualify for Medi-Cal using that calculator (just, again, me playing with the calculator).

[steve2470]

36. ok I just applied in my state, but I have to use the federal website which is fine

Despite some trivial errors on some pages and having to wait a minute or so for the application to get sent, I was very impressed. I may not be able to save any money or get better coverage, but I want to see my options.

[ellisonz]

39. OBAMA! OBAMA! OBAMA! OBAMA!

[whttevrr]

40. Grown man... kinda weepy thinking about the reality of health insurance for $100 or less for the

working poor.

I consider myself lucky. I am not making a lot of money but that is totally my fault. I thought I was too cool for school. But, I still lucked into a low level supervisory position that is ... meh... good enough to keep me fed. I'm going back to school as an adult and I really don't qualify for any assistance.

That being said:

I am very grateful for what little help is available for those who need it. I believe there should be more. I think The ACA is a good step forward. I am glad that so many people will be helped by this.

Thank you for posting this. I hope more stories like this come out.

[joshcryer]

44. The OP is a case example of working poor (wage slaves).

They are getting the most out of it. It's wonderful.

[Beartracks]

41. Wow, those Maximum Out-of-Pocket costs!

Those look really good. Is that maximum for one year?

================

[joshcryer]

43. Yeah, it's per year, so you could have cancer, and that's all you pay.

For hundreds of thousands of dollars of medical care. It's amazing.

[progressoid]

67. $6350 out of pocket?

That's half of her annual income.

[Ms. Toad]

71. If that is half of her income -

and she lives in a state with expanded Medicaid, her costs (both for premiums and out of pocket) would be zero.

Unfortunately, there are more than a dozen states which refused to implement expanded medicaid - which forces the poorest in those states to pay more than the working poor (who are eligible for subsidies - which start above the expanded Medicaid income limit)

[IronLionZion]

75. Those states are going to have surprises in the next elections

people want health insurance. If their neighboring states have better plans due to properly implementing the law, there may be some election time revolts.

[Ms. Toad]

80. That's what I'm thinking as well.

Perhaps those tea party folks holding the country hostage won't look quite so attractive when it is their political siblings who have refused to implement expanded Medicaid.

[Beartracks]

84. Let's hope you're right. But I'm sure they'll be blasted with propoganda...

... that tells them that Obamacare doesn't work and it obviously raised prices and mandated impossible premiums, etc., just like in their own home state. Never mind that it didn't have to be that way, but rather was sabotaged by the state so that indeed something less than effective was the only result.

Never underestimate the desire of the GOP to sabotage good laws and policies so that they can then claim that "government doesn't work."

=====================

[IronLionZion]

85. I'm hoping the fact that the prices are available online will help

There was so much bullshit flying around speculating about prices but now its up for all to see. Its important to get people looking for themselves to see what is available rather than listening to anyone tell them different.

And I'm sure the GOP will continue to try to convince young people not to sign up. But I hope enough will simply look online and do it like they do so many other things that it will work out. Parents and schools can be influential here.

[Mopar151]

55. IMHO, the economic stimulus will be huge!

More nursing and medtech hours, more prescriptions filled. Productivity up incrementally, due to healthier workers and less lost time. Medically driven bankruptcies down, collection agencies sucking wind - beautiful.

[gollygee]

57. That Enhanced Silver is better than my insurance

and I have good insurance from a Fortune 500 company.

[Safetykitten]

64. On that Bronze plan. Three doctor visits per year. What happens after that?

[Ms. Toad]

72. There are no limits on doctor's visits on ANY of the plans.

Last edited Tue Oct 1, 2013, 04:45 PM - Edit history (1)

But this structure is a modified high deductible plan - which is not really intended to cover day-to-day medical expenses. In traditional high deductible plans you pay 100% for everything until you reach the deductible, then the co-pays kick in until you hit the out of pocket maximum (and often they are merged; my current plan has a $6000 deductible and a $6000 out of pocket max - I pay 100% of everything until I hit $6000, then I pay nothing).

In order to make sure you visit the doctor when needed, the plan exempts some visits entirely from the deductible (the preventative care ones) and allows you to visit the doctor a few times at a lower out of pocket cost even before you meet the higher deductible, and at least one time without charge.

The normal structure for that kind plan (generally referred to as catastrophic coverage), though, is you pay 100% of everything until you reach the deductible. As modified in the exchanges (or at least the CA one), you are entitled to at least 3 visits even though you have not met your deductible for $60 each, plus the preventative. Beyond that additional visits either have a $0 co-pay or it reverts to catastrophic coverage (you pay everything until you hit the annual cap, then you pay nothing - I haven't found enough detail to know which).

It is not a plan for everyone - but it is better than my current coverage and the coverage which I purchased when I was not eligible for any other coverage because of pre-existing conditions. Younger individuals, who are healthy and just want to make sure they are not completely wiped out by a catastrophe might find this cheap plan attractive because they generally have low premiums in exchange for accepting more of the risk. If you expect to need more than 4 visits (preventative + 3), you might want to confirm who pays for the 4th visit if you have not had a medical catastrophe - or look at a more traditional plan.

It is explained slightly differently here:

http://www.medicoverage.com/health-insurance-blog/news/comparing-exchange-plans-bronze-silver-gold-platinum

What is listed in the chart is what you pay. It looks to me as if you pay $60 for each of the first three visits. There is no additional payment listed for the 4th - Nth visit - so it looks to me as if there are no additional charges for those. But, as I said, it isn't entirely clear.

[BlueCheese]

65. What are the premiums?

That Bronze plan looks awful-- $5000 deductible? Ouch. The Silver plan looks a lot more reasonable.

[roamer65]

66. This shows the importance of getting Medicaid expansion passed...

...in all states. You will never be without coverage if you live in a Medicaid expansion state.

[duffyduff]

83. Just forget about finding a doctor who will treat you or leaving anything to your heirs

if you have any assets when you die and are 55 and older. Many poor DO have assets, which will be seized upon their deaths by the government until the liens are paid.

Medicaid for older people is nothing but a loan with your estate as collateral. Not a good deal at all.

[Hekate]

68. A DUer last week demanded to know if I could look myself in the mirror for supporting ACA...

... since it provides "levels" of options (Gold, Silver, Bronze) rather than one thing for the entire country including those who can afford to buy their own hospital wing.

I still say: Yes, yes I can. I am so happy for you and your Mom, because you both have a load of worry lifted from your shoulders.

Cheers.

[pnwmom]

74. Wouldn't she qualify for free Medicaid at that income level?

When I ran the numbers for a friend that's how it came out.

[darkangel218]

76. K&R!

[tabasco]

78. Exactly why the pukes are making a last ditch kamikaze attack

They really don't want people to find out about the ACA.

[Link Speed]

79. I hope it's good because I don't understand any of those tables

Heck, I don't have any idea of what 'Copay' is, but I hear the word quite often.

There is no way in the world that I could personally navigate my way through all of that.

[Dark n Stormy Knight]

88. Is the payment at the bottom the premium? If so why are there 3 columns?

So what are the premiums?