I cannot afford insurance

[FrodosPet]

I am in that no-man's land around 18K a year...above the poverty level, but still poor (for now, anyhow...health conditions may soon drop that to zero).

If I could afford health insurance, I would GET health insurance. As for getting a new job, people tend to not want to hire a middle aged man with a bad back and a heart condition.

Will any of this help me without huge deductibles and waiting for some tax credit at the end of the year? And are their people (other than employees of the insurance companies) that can help walk through this process?

[LiberalFighter]

1. You need to discuss this with someone responsible for your state's plan for ACA.

[FrodosPet]

4. Thank you for the advice

I'm not going to lie...I am glad pre-existing conditions are now covered, because I mos def have them (along with over $20,000 in past-due hospital bills).

Blood from a turnip, I suppose.

It's just that even with the ACA, I am worried that the combination of premiums and deductibles is still more than I can afford and still live indoors without burdening my friends by crashing their couch.

[Electro]

42. Me too

I too have a heart problem, so the pre existing condition thing seems to be good.

What, exactly, does this mean now? That no insurance company can reject me for my heart condition and they have to cover any heart related problems without raising my rates?

[bhikkhu]

45. I just checked with my state about expected deductibles and copays -

and it looks like I'd be well covered based on the calculator they have up now http://www.orhix.org/calculator/index.php

I make 24K+ a year, for a family of four. Based on other calculations I've seen on wiki I was expecting $60-100 a month in premiums, which would be manageable too...so overall I'm very much looking forward to the change.

Definitely check with your state. I checked to make sure mine was on track, and it seems they are (but then Oregon's always been good about those things).

[dkf]

48. You'll land up using all your money buying insurance with none left for actual services.

This system is a joke.

[Nuclear Unicorn]

6. What if a state refuses to set-up an exchange?

Honest question. The enforcement provision (withholding Medicaid funds) was struck down.

[cbdo2007]

12. If a state refuses to set up an exchange, the federal govt will do it for them.....

it is a completely separate issue from the Medicaid funds issue. That is strictly related to them not being able to punish states who do not want to expand Medicaid by refusing them all of their Medicaid funds.

[Nuclear Unicorn]

13. OK, I think I'm following

But why are there 2 separate exchanges? One state, one federal. If the feds have one why even bother with state exchanges?

[cbdo2007]

16. I may be wrong....but I don't think there is a federal exchange....

the Feds would create one for the state if the state refused to do it. It wouldn't be a "federal" exchange, it would just be created by the feds and forced on the state.

Part of the Repube plan is a Federal Exchange, so that plans could sell across state lines, but I'm pretty sure that's different than what's being discussed here.

[Nuclear Unicorn]

18. Hmmm -- I'll guess we'll have to see what shakes out the next few days.

[ellenfl]

23. aren't federal employees in the federal exchange?

having the states renege on the exchanges might put us one step closer to single payer.

ellen fl

[1StrongBlackMan]

27. I suspect ...

Having the States renege on the exchanges WILL put us SEVERAL steps to single payer.

I, further, suspect this ... and mass employers' dropping of employee insurance plans ... was contemplated when the law was originally drafted. I think I remember reading about this in an industry consultant's advisory report to businesses. I seem to recall they advised one strategy where employers would drop (or limit) it's providing of insurance benefits for their employees, as a cost-saving measure since paying the fine (tax) would be far cheaper than providing the insurance. The report listed as a negative, the partisan point, that if enough employers do this, the insurance companies would take a hit, as the Federal government would then provide the insurance.

I'm gonna have to find that advisory report.

[ellenfl]

29. i'm surprised employers aren't whole-heartedly in favor of single payer. eom

[1StrongBlackMan]

35. I have worked in HR ...

for the better part of 25 years, in both the public and private sectors, and I ask myself that every year as I am guiding employees through "open enrollment."

If we are able to sever the employer-based insurance model, that money (minus any increase in taxes) goes directly to the corporate bottom-line. And any increase in taxes is bound to be less than the employer's premium share and the employer's cost in staffing a Benefits Person/Department.

But I guess the "NO TAX" thing blinds many to what is clearly in the best interest of their business.

But then again, many employers enjoy the "Golden Handcuffs" that an employer-based system offers.

[RainDog]

36. ^^this^^

thank you.

[progressivebydesign]

2. So if you get sick, and everyone does get sick, who pays for your care?

I mean if you have health conditions, who is paying for it now? But people who don't have insurance.. how do they pay for care when they need it? Do they wait until they're really sick and then apply while in the hospital? Or wait for acute care and then deal with bill collectors later?

From what I've heard the provisions include pools to offer affordable catastrophic care at a lower price. Even Walmart offers health insurance, as does Barnes and Noble, and other companies. Call centers where you can work from home, often offer health insurance, too.

[FrodosPet]

7. Right now, I just avoid getting treatment

I don't want to be a burden on people, so I do have the terrible habit of waiting until I am so sick it requires an E.R. visit.

As far as call center jobs, that is pretty much what I am already doing. But it is getting to the point between the stress of dealing with angry spoiled impatient drunks every weekend and the pain of sitting upright for 8 hours a day is causing me to lose prime shifts and lose hours. Stacking books or standing at a register is an impossibility for me.

I'm trying to avoid the "Woe is me!" trap, but DAMN, I am scared!

[girl gone mad]

17. Can you please stop?

This is so hateful.

[HiPointDem]

20. +1.

[leftstreet]

21. +1

[Starry Messenger]

30. Thank you.

And bigoted.

[lunasun]

39. SOoooooooo true -it really is !!!

[pnwmom]

46. Are you talking about #2 post? What is hateful in there? n/t

[gkhouston]

22. For the most part, I no longer receive care.

I have to go occasionally to get prescriptions renewed, and I can still pay for that. Other than that, I don't seek medical care.

[ellenfl]

24. i haven't had employer based insurance since the middle 90s and i work in the legal field.

after my cobra ran out, united hc raised my rates so high that i could not afford it. not everyone has employer-based insurance.

i would think the employers would welcome single payer.

ellen fl

[SammyWinstonJack]

28. ugh.

[enough]

3. This thread has some relevant info and a useful link:

http://www.democraticunderground.com/1002869863

[progree]

34. +1000 nt

[Tanuki]

5. Until the rest of ACA kicks in,

you could try this website, which includes a clickable map of the US to identify free or sliding scale health clinics in your area and other resources that may help you afford health care:

www.needymeds.org

[FrodosPet]

9. Thank you

I am such an idiot for letting things go this far. It's just that I have had such profound obstacles in the past in trying to take care of my grandma (Alzheimer's) and dad (paralyzed stroke victim) that doing anything in the "help system" gives me anxiety.

It seems like most people in that field are better at buck passing than helping ("we don't have the funding this year" or "try calling these people" or ...).

[sabrina 1]

19. You're not an idiot. If you lived in a country that cared about people rather than profits, you

would not be having this problem. But a doctor told me a few years ago when I told him that my friend, like you, didn't want to go to the ER to get care because he knew he could not afford it, AND the bills would be so high he would never be finished paying them off, that doctor YELLED AT ME. He said 'we are talking a human being here, you get your friend to the ER and do not give a second thought to the money.'

He was a South American doctor and he had given up his job at the hospital where he earned quite a high salary, to set up a practice for people without coverage. He despised the system here and had no sympathy for those who cared about money at all. Plus he put his beliefs into practice by only charging people what they could afford, very little generally, and nothing at all if they had no money. He has probably saved many lives. He is an Angel and Hero, imho.

But his lecture to me was needed and I did make my friend go to the ER, not that I didn't agree with the doctor, but I understood my friend's reasons, until the Doctor made things clear, 'life is way more valuable than money'. I needed to hear someone say it out loud I guess.

[Denninmi]

8. Well, I don't make a lot more than you do.

I have health insurance. It's crap. $5k deductible before it covers anything. It's basically only good for a major traumatic event like getting hit by a bus and spending weeks in the ICU. I haven't been back to my PCP for over 3 years because I can't afford to go. Like so many other people, I just have to ride it out and pray I don't get really sick.

[FarCenter]

14. If you are young, healthy, and only have colds, flu, etc occasionally, you don't need to visit PCP

What would the PCP do?

The PCP will ask you for a medical history, ask whether you have any symptoms, might draw and send blood for analysis, take your blood pressure, listen to your chest with a stethoscope, peer into your ears, and lecture you about losing weight (most likely).

If you have something like strep throat, the PCP will do all that stuff as part of a necessary visit for an illness.

[coalition_unwilling]

10. I'm right with you. I posted a similar thread and it sank like a stone, so

I have no idea what I'm supposed to do, not being able to afford insurance for myself or my wife. (Right now, cheapest policies would be about $1,000/month, an amount which would make me homeless in very short order).

[mzteris]

32. You need to find a better agent

there are plenty of insurance policies lower than that.

Originally, insurance was designed for catastrophic care, over the years it morphed into people thinking it should pay for every visit, every pill, every test. (Not saying that's wrong, but that is what drove up the cost.)

Seriously, call an independent agent and have them find you a cheap policy that will at least cover the catastrophic care.

[coalition_unwilling]

40. Thanks. I will check into it. I'm relying on preliminary research I

did with Kaiser Permanente and United Healthcare here in Los Angeles and I believe $1,000 a month was about what it was going to cost to cover my wife and me. Blue Cross may have been somewhat less expensive. But I think now that these were HMO-type plans I looked into after I lost my job and not the 'catastrophic coverage' you allude to.

Again, thanks for the tip.

[bananas]

11. k&r nt

[Zalatix]

15. You're supposed to "stop raining on people's parade" and celebrate your new financial burden.

That's sarcasm, by the way. I'm sorry that you and so many others are taking this very ugly and financially damaging hit.

[davekriss]

25. Your subsidized premium will be about $64/month

I don't mean to suggest $65 a month is trivial when you're only bringing in $1500 per month before taxes, but I just want to be sure you're aware of how little you'll have to pay.

If you do get seriously sick, you'll be out another $2000 in copays and deductible (this for $10,000+ in medical bills).

I made some assumptions: you're single, 35. If you're older, the premium goes up a bit. If you're buying for a family, at this income you'll be covered by the expanded Medicaid provisions and pay nothing (depending on your state's decisions, as Roberts gave them some wiggle room on the Medicaid provisions of the aca).

Note: my figures are from the Kasier-Permante health insurance subsidy calculator (google it up).

[Digit]

26. I make a few thousand less than you do, and I am probably older

I understand where you are coming from since I am unable to afford health insurance as well.

I have been trying to find a better paying job and of course would be thrilled if it offered health insurance.

Of course I am happy for the people who benefit from this, but I fear a few of us are slipping through the cracks.

Unfortunately, I cannot offer any advice to you and only wanted to say that you are not alone. I hope you get the answers you seek...

[FrodosPet]

47. Middle aged and crazy!

Just hit 50, and it hit back.

Again, I thank you all for the advice and support. I am challenged by my health, occupational setbacks, and years of caring for my family which cranked the stress up to 11 for over 15 years.

But I don't see candles or smell flowers, so I'm not ready to surrender.

[sinkingfeeling]

31. Then read what is available to you. ACA financially assists anybody

up to 400% of the federal poverty level. For a single person the FPL is $9,350. So you're about 200% of FPL, and your premium would be limited to 3-5% of your income with the affordability credit picking up 93% and capping your out-of-pocket expenses to $1000.

[Electro]

43. I don't know if I'm too happy about

this "Federal" poverty level thing.

I live in northern NJ, the cost of living here is literally twice as high as when I lived in Florida and Montana. What can be considered a decent salary in those two states can very well be far below the poverty level here in NJ.

The end result is that altho someone here might make X amount more than the Federal poverty level, they still may be pretty "poor" and barely getting by.

[FarLeftFist]

33. The bill raises the poverty level. You will most likely qualify for medicaid.

[sad sally]

37. Here's a link to the Affordable Care Act - might help answer some of your questions.

http://www.healthcare.gov/law/index.html

[yardwork]

38. Our healthcare system is very unfair.

Your situation is a good example of that. People who work for large corporations or the government get subsidized health insurance, either for free or at an extremely reduced cost to what we would pay on the market. Our employers get tax breaks from the government in return to buying negotiated package deals from the health insurance industry. This is the way it's been for decades. In the U.S., many of us have socialized medicine. That's why we fear losing our jobs.

Self-employed people, people who work for small businesses or organizations, and the many people who are contractors or part-time employees, get very little help. They get no access to the big package deals negotiated by large companies or the government.

"Obamacare" is an effort to help this situation somewhat. People will now be offered some assistance, some subsidies to help them buy health insurance.

I firmly believe that the better approach would be to extend Medicare to everybody in the U.S. and get rid of the health insurance industry, but it's a multi-billion dollar profit-making industry that is also in bed with Big Pharma and the AMA, so that ain't going to happen. This is the best we can do for now. I hope that it continues to improve.

[Hell Hath No Fury]

41. I have insurance. I cannot afford CARE.

Last year I went in for a physical -- I have been struggling with iron deficiency for several years now and the doctor recommended another colonoscopy. It wasn't until the night before the procedure I found out my employer had changed our plan and my copay was doubled - $200. Well, I had $100, I didn't have $200. In fact, it's not often I have $200 these days. I rarely have $$$ left over at the end of the month that doesn't go to take care of my elderly Mom.

So, no colonoscopy the next day. Not one to this day.

Access to health insurance isn't always the answer (*cough*, ACA). I have insurance. I wish to hell I could use it.

[unapatriciated]

44. My husband had a simple hernia repair this month.

It was a quick out-patient surgery, he was home by noon. We have decent health insurance and our share of cost was $3,000.00.
not to mention all the different deductibles we paid for doctors and test before the surgery.


In the early 90's my son was diagnosed with Dermatoymyositis. I had what some would call Cadillac Coverage plus a Catastrophic Plan (they refused coverage, didn't pay a dime because I had an HMO) and I still had to sell my home to insure he received needed medical treatment.

I'm a firm believer that having health insurance does not mean access to health care. In fact I believe that the for profit Insurance Industry does nothing but add to the raising cost of our medical care.

[Recursion]

49. Find a local FQHC

They don't require insurance, and charge fees on an income-based sliding scale.

http://findahealthcenter.hrsa.gov/Search_HCC.aspx

Edit: wrong link