I'm so confused, upset, whatever about our new insurance

[biblionerd]

NOT a political debate, it is what it is... but I'm so lost about insurance/obamacare right now. Basically, as of Oct 1st I'm going to be uninsured, at least until I can figure something else out. Is there anyone that actually understands all of this right now? Our insurance sucked before, but it was doable. We had decent/kind of high premiums with a $4,000 deductible/OOP limit. For having a baby it was ok because everything was covered 100% after that. NOW the premiums are astronomical. DH is reasonable, adding the kids is a sting, and it's basically a joke to have me covered. Our family plan would be well over the 9.5% "affordable" cutoff or whatever it's called. We just plain can't afford for me to be covered through his work. If it were just premiums it would be one thing, but our plan now changed to a $6,000 deductible (yes, we would pay everything but well visits 100% until we reach $6,000 and then there's a 20% copay until $12,000). 

There is another local hospital that has waived all of our bills until April '14 because of how many bills we've gotten there. So technically, (I guess?) I could switch to that system and be covered until April, but I'm just terrified there's SOMETHING we're missing and we'll get stuck with a $25,000 bill or something. I don't WANT to leave my OB. I hate having c/s and with my thin uterus stuff I really feel comfortable with her. But I don't want to spend $12,000 to have this baby. 

If you have to renew company plans Oct. 1st and this new affordable health marketplace whatever doesn't open until Oct. 1st, how are you supposed to figure anything out ahead of time? Can we switch as a family because as a family our insurance premiums would be over 9.5%? Or since DH's is less does he have to stay on work insurance? What about the kids? Are the new plans going to suck as bad as this one now? How am I supposed to figure any of this out when we have to renew his work insurance on the 1st and you can't cancel without a life-changing event?? GRRRRRRR. I HATE THIS.

[kkfeb04]

Why are you losing enrollment on Oct 1st? Is that when his open enrollment is or does that actually start the benefit year?

Our open enrollment is Oct 1st for Jan 1st start date.

No one has a clue what the marketplace will have or cost. It does sound like your current plan is what the ACA should be changing to make it more affordable.

I do know that our employer is getting taxed for offering great insurance but they will not take a lesser insurance.

[katfco]

We have to wait until November to find out how catastrophic our new plan is going to be. DH's boss doesn't know much (or can't say) but he has hinted that some people may use it as another impetus to leave. Not good.

This is the gov. website that explains it and if you put in your demographic information, it can tell you what your options will be. www.healthcare.gov/families/

[puppylove64]

Wow that sounds awful! I thought employers couldn't offer insurance with a deductible higher than $2,000. That is what my boss said. Surely you can find better insurance elsewhere!

[teamhayes]

Sept 27, 2013 19:58:04 GMT -5 puppylove64 said:

Wow that sounds awful! I thought employers couldn't offer insurance with a deductible higher than $2,000. That is what my boss said. Surely you can find better insurance elsewhere!

we have a $3K deductible (luckily my employer pays it for us to keep the monthly payments down)

That sucks Biblio. Sorry I can't offer more advise.

[biblionerd]

Sept 27, 2013 19:43:49 GMT -5 kkfeb04 said:

Why are you losing enrollment on Oct 1st? Is that when his open enrollment is or does that actually start the benefit year?

Our open enrollment is Oct 1st for Jan 1st start date.

No one has a clue what the marketplace will have or cost. It does sound like your current plan is what the ACA should be changing to make it more affordable.

I do know that our employer is getting taxed for offering great insurance but they will not take a lesser insurance.

Oh, you know what, I think DH misunderstood that, and I was so upset it didn't dawn on me. I bet Oct. 1st is when his open enrollment STARTS and he was just calling that the new insurance start date or whatever he said. He made it sound like that's when the insurance would change, but I don't understand how that could be. That he should at least be able to figure out from work. According to him the plan literally changed Oct. 1st (i.e. our 4,000 deductible we already met was changing to 6,000 then, etc.). But I don't think that can be. Who knows... 

[TrudyCampbell]

Sept 27, 2013 20:04:24 GMT -5 teamhayes said:

Sept 27, 2013 19:58:04 GMT -5 puppylove64 said:

Wow that sounds awful! I thought employers couldn't offer insurance with a deductible higher than $2,000. That is what my boss said. Surely you can find better insurance elsewhere!

we have a $3K deductible (luckily my employer pays it for us to keep the monthly payments down)

That sucks Biblio. Sorry I can't offer more advise.

Same here, I think ours is 3 or 4000 but my H's company pays it.

[biblionerd]

Sept 27, 2013 19:45:56 GMT -5 katfco said:

We have to wait until November to find out how catastrophic our new plan is going to be. DH's boss doesn't know much (or can't say) but he has hinted that some people may use it as another impetus to leave. Not good.

This is the gov. website that explains it and if you put in your demographic information, it can tell you what your options will be. www.healthcare.gov/families/

The problem with all of the calculators and everything I've found is that they don't give any info about family coverage offered by employers. When they ask if you have employer insurance they don't offer any more info other than "you may be able to switch if it's not affordable or offers minimum coverage whatever", but there's no way to find out any more specifics that I can find (like employee coverage vs. family coverage). 

[Deleted]

I wish I could help you but this all confuses me too! We have private insurance as DHs company doesn't provide any. All I know is our plan will get worse but our monthly payment is going to go up $350 a month, to $850, and our deductible will be $8,000

I know I'm going to look into state options because I was reading online and they looked better and cheaper. I wish I could help you more but health insurance is so confusing. I wonder if your state will have a number to call to ask questions about their plans?

[Deleted]

Sept 27, 2013 20:28:37 GMT -5 @pcloadletter said:

I'm not gonna lie I wish that they would just get rid of the current Obamacare and start over. There has to be a better way. This shit is just way too confusing. Can't we just do it like the Canadians?

Yes please! Healthcare is easiest through a nationalized system. I know treatment takes longer and you don't get all the extra fluff stuff we take for granted but idk I just want non confusing and not so damn expensive!

[jfh]

Have you googled "ACA navigators" for your area? They're supposedly trained to help with these kinds of questions. I don't know much about them, only that they exist.

[katfco]

Sept 27, 2013 20:07:01 GMT -5 biblionerd said:

Sept 27, 2013 19:45:56 GMT -5 katfco said:

We have to wait until November to find out how catastrophic our new plan is going to be. DH's boss doesn't know much (or can't say) but he has hinted that some people may use it as another impetus to leave. Not good.

This is the gov. website that explains it and if you put in your demographic information, it can tell you what your options will be. www.healthcare.gov/families/

The problem with all of the calculators and everything I've found is that they don't give any info about family coverage offered by employers. When they ask if you have employer insurance they don't offer any more info other than "you may be able to switch if it's not affordable or offers minimum coverage whatever", but there's no way to find out any more specifics that I can find (like employee coverage vs. family coverage). 

You might be able to ask questions on their live chat, but I think a lot of those things will be answerable on Oct. 1.

[browneyedhunni85]

This makes me extremely nervous.

[biblionerd]

Sept 27, 2013 20:07:01 GMT -5 biblionerd said:

Sept 27, 2013 19:45:56 GMT -5 katfco said:

We have to wait until November to find out how catastrophic our new plan is going to be. DH's boss doesn't know much (or can't say) but he has hinted that some people may use it as another impetus to leave. Not good.

This is the gov. website that explains it and if you put in your demographic information, it can tell you what your options will be. www.healthcare.gov/families/

The problem with all of the calculators and everything I've found is that they don't give any info about family coverage offered by employers. When they ask if you have employer insurance they don't offer any more info other than "you may be able to switch if it's not affordable or offers minimum coverage whatever", but there's no way to find out any more specifics that I can find (like employee coverage vs. family coverage). 

Well, DH insists that the "open enrollment period" ends Oct. 1st (basically there wasn't one) and they apologized to them that they only gave them a few days notice and that they could not get the directors to decide blah blah blah. 

[biblionerd]

Sept 27, 2013 20:43:08 GMT -5 katfco said:

Sept 27, 2013 20:07:01 GMT -5 biblionerd said:

The problem with all of the calculators and everything I've found is that they don't give any info about family coverage offered by employers. When they ask if you have employer insurance they don't offer any more info other than "you may be able to switch if it's not affordable or offers minimum coverage whatever", but there's no way to find out any more specifics that I can find (like employee coverage vs. family coverage). 

You might be able to ask questions on their live chat, but I think a lot of those things will be answerable on Oct. 1.

I guess my problem is that if his insurance really needs the paperwork turned in by oct. 1 I don't know how I'm supposed to get my questions answered on the same day and figure it all out. So stressful!

[biblionerd]

The "family glitch" is disturbing if you read news articles. Basically, from what I can find, coverage is deemed affordable if it is less than 9.5% of the employee's income for coverage of the EMPLOYEE, not including children and family. There are no provisions for being affordable for just an employee vs family. So you can't afford workplace insurance for your wife and children, but they are apparently not eligible to buy into the marketplace because the employee's coverage is affordable. What a joke.

[DesertMoon]

Sorry to hear about your problems with it, my mom has been upsets bout her insurance too, although I don't understand it. I live in Canada now so everyone has insurance. I hope everything gets figured out and it's not as bad as you're anticipating.

[EnchantedSoul]

I don't know any specifics but I've understood it the same as KKFeb.  Enrollment opens on Oct 1st but the insurance changes take effect Jan 1.  There will be kiosks all over your area where you can enroll and ask questions.  Our regional office is going to have a kiosk and many of us have to be trained to answer client questions.  The problem is, we don't have a kiosk and haven't been trained and all of this begins on Oct 1.  I've heard that Walmart is one of the places that will have the kiosks as many people with lower income (that will likely need to change Medicaid providers) frequent Walmart.

The Affordable Care Act doesn't scare me.  I don't like the unknown but any major move for an entire country is bound to have its glitches and uncertainties.  I'm glad that my client's who were being denied services before, will now be covered.  I am paying for our family plan and it SUCKS.  I'm a social worker and paying $900/month for health insurance.  The ACA will likely not help my situation much, if at all but I'm cool if it helps the greater good.

[jfh]

Sept 28, 2013 8:08:04 GMT -5 EnchantedSoul said:

I don't know any specifics but I've understood it the same as KKFeb.  Enrollment opens on Oct 1st but the insurance changes take effect Jan 1.  There will be kiosks all over your area where you can enroll and ask questions.  Our regional office is going to have a kiosk and many of us have to be trained to answer client questions.  The problem is, we don't have a kiosk and haven't been trained and all of this begins on Oct 1.  I've heard that Walmart is one of the places that will have the kiosks as many people with lower income (that will likely need to change Medicaid providers) frequent Walmart.

The Affordable Care Act doesn't scare me.  I don't like the unknown but any major move for an entire country is bound to have its glitches and uncertainties.  I'm glad that my client's who were being denied services before, will now be covered.  I am paying for our family plan and it SUCKS.  I'm a social worker and paying $900/month for health insurance.  The AFA will likely not help my situation much, if at all but I'm cool if it helps the greater good.

(heart)

[biblionerd]

Sept 28, 2013 8:08:04 GMT -5 EnchantedSoul said:

I don't know any specifics but I've understood it the same as KKFeb.  Enrollment opens on Oct 1st but the insurance changes take effect Jan 1.  There will be kiosks all over your area where you can enroll and ask questions.  Our regional office is going to have a kiosk and many of us have to be trained to answer client questions.  The problem is, we don't have a kiosk and haven't been trained and all of this begins on Oct 1.  I've heard that Walmart is one of the places that will have the kiosks as many people with lower income (that will likely need to change Medicaid providers) frequent Walmart.

The Affordable Care Act doesn't scare me.  I don't like the unknown but any major move for an entire country is bound to have its glitches and uncertainties.  I'm glad that my client's who were being denied services before, will now be covered.  I am paying for our family plan and it SUCKS.  I'm a social worker and paying $900/month for health insurance.  The ACA will likely not help my situation much, if at all but I'm cool if it helps the greater good.

Yes, I understand all of the logistics about when it rolls out, questions, etc., but that does not change my situation. I'm trying not to read too much into this, but am I not allowed to be upset because my family is basically now getting screwed? Greater good, yeah yeah. I never said I was against the ACA in general, and I'm not "scared" of it. But the fact of the matter is that while your clients and other people will be able to get insurance, people like me and my family are going to be screwed and lose ours. Yes, every new thing has their kinks, but the "family glitch" is disturbing, not just for me but many others. Many work premiums have shot SKY HIGH and because of the wording of the ACA, there are no provisions to allow family (aside from the employee) to get affordable insurance. Yes, it's a glitch, but you know what? It directly affects my family and I'm pissed about it. I will be pg and uninsured. Uninsured for the first time in my life because of a fucking glitch. So yeah, I'm mad. At this point, I'm glad Suzy who's never been able to get insurance now can, but I'm not glad to be a martyr and lose mine. My children both have health conditions and now we won't be able to afford their medications. We're not poor. We're an average middle class family who planned adequately and never imagined that our insurance premiums/coverage would do this. We make too much for any state assistance and not enough to cover astronomical premiums. I'm not into sharing finances online, but our insurance and rx costs would easily be a mortgage payment, much better than the one we're getting now. On top of that, it's shit insurance. Who seriously pays that much for insurance and has to pay 6,000 before they can get a penny covered? So yeah, greater good is wonderful and all, but I want my family covered with affordable insurance also. 

[Deleted]

I would talk to someone once the places are set up October 1st. I could be wrong but my understanding is that all premiums for the entire family can't go over 9.5% of the family income so you should have another option if your DHs company doesn't provide something that is under that. He may have to stay with his company but you and the kids should be able to look into other insurance.

[biblionerd]

Sept 28, 2013 12:41:05 GMT -5 @lindy said:

I would talk to someone once the places are set up October 1st. I could be wrong but my understanding is that all premiums for the entire family can't go over 9.5% of the family income so you should have another option if your DHs company doesn't provide something that is under that. He may have to stay with his company but you and the kids should be able to look into other insurance.

Yes, thank you, we will. The catch though from what I understand is that the 9.5% of income cap only applies to the employees coverage, not the cost of family coverage. I think we still may be eligible to get separate private insurance, but it will not include any of the benefits of the subsidies (which are supposed to be what makes it so affordable) because DH is still offered employer insurance. So who knows how much separate new private insurance will be. We will look though.

[EnchantedSoul]

Sept 28, 2013 12:35:51 GMT -5 biblionerd said:

Sept 28, 2013 8:08:04 GMT -5 EnchantedSoul said:

I don't know any specifics but I've understood it the same as KKFeb.  Enrollment opens on Oct 1st but the insurance changes take effect Jan 1.  There will be kiosks all over your area where you can enroll and ask questions.  Our regional office is going to have a kiosk and many of us have to be trained to answer client questions.  The problem is, we don't have a kiosk and haven't been trained and all of this begins on Oct 1.  I've heard that Walmart is one of the places that will have the kiosks as many people with lower income (that will likely need to change Medicaid providers) frequent Walmart.

The Affordable Care Act doesn't scare me.  I don't like the unknown but any major move for an entire country is bound to have its glitches and uncertainties.  I'm glad that my client's who were being denied services before, will now be covered.  I am paying for our family plan and it SUCKS.  I'm a social worker and paying $900/month for health insurance.  The ACA will likely not help my situation much, if at all but I'm cool if it helps the greater good.

Yes, I understand all of the logistics about when it rolls out, questions, etc., but that does not change my situation. I'm trying not to read too much into this, but am I not allowed to be upset because my family is basically now getting screwed? Greater good, yeah yeah. I never said I was against the ACA in general, and I'm not "scared" of it. But the fact of the matter is that while your clients and other people will be able to get insurance, people like me and my family are going to be screwed and lose ours. Yes, every new thing has their kinks, but the "family glitch" is disturbing, not just for me but many others. Many work premiums have shot SKY HIGH and because of the wording of the ACA, there are no provisions to allow family (aside from the employee) to get affordable insurance. Yes, it's a glitch, but you know what? It directly affects my family and I'm pissed about it. I will be pg and uninsured. Uninsured for the first time in my life because of a fucking glitch. So yeah, I'm mad. At this point, I'm glad Suzy who's never been able to get insurance now can, but I'm not glad to be a martyr and lose mine. My children both have health conditions and now we won't be able to afford their medications. We're not poor. We're an average middle class family who planned adequately and never imagined that our insurance premiums/coverage would do this. We make too much for any state assistance and not enough to cover astronomical premiums. I'm not into sharing finances online, but our insurance and rx costs would easily be a mortgage payment, much better than the one we're getting now. On top of that, it's shit insurance. Who seriously pays that much for insurance and has to pay 6,000 before they can get a penny covered? So yeah, greater good is wonderful and all, but I want my family covered with affordable insurance also. 

Holy cow! I was trying to let you know that there are supposed to be people out in the field to help answer your questions. Excuse me for attempting to help.

My greater good comment wasn't directed specifically at you. At was talking about from a global perspective. I may very well be in the same boat you're in. But good luck, jeez.

Sent from my SGH-T999 using proboards

[skwcm80]

Sept 28, 2013 12:35:51 GMT -5 biblionerd said:

Yes, I understand all of the logistics about when it rolls out, questions, etc., but that does not change my situation. I'm trying not to read too much into this, but am I not allowed to be upset because my family is basically now getting screwed? Greater good, yeah yeah. I never said I was against the ACA in general, and I'm not "scared" of it. But the fact of the matter is that while your clients and other people will be able to get insurance, people like me and my family are going to be screwed and lose ours. Yes, every new thing has their kinks, but the "family glitch" is disturbing, not just for me but many others. Many work premiums have shot SKY HIGH and because of the wording of the ACA, there are no provisions to allow family (aside from the employee) to get affordable insurance. Yes, it's a glitch, but you know what? It directly affects my family and I'm pissed about it. I will be pg and uninsured. Uninsured for the first time in my life because of a fucking glitch. So yeah, I'm mad. At this point, I'm glad Suzy who's never been able to get insurance now can, but I'm not glad to be a martyr and lose mine. My children both have health conditions and now we won't be able to afford their medications. We're not poor. We're an average middle class family who planned adequately and never imagined that our insurance premiums/coverage would do this. We make too much for any state assistance and not enough to cover astronomical premiums. I'm not into sharing finances online, but our insurance and rx costs would easily be a mortgage payment, much better than the one we're getting now. On top of that, it's shit insurance. Who seriously pays that much for insurance and has to pay 6,000 before they can get a penny covered? So yeah, greater good is wonderful and all, but I want my family covered with affordable insurance also. 

Late to this, but I'm pretty sure EnchantedSoul was just trying to explain why you may not have the answers you want right now. I'm also sure she didn't imply that you didn't plan adequately, or that you and your family should be martyrs. I'm fairly positive she was just trying to help.

Also do you have a source for the statement about family premiums going sky high? I remember reading in passing that premiums have/ will come down, but I haven't read anything about that either.

[kkfeb04]

It is 9.5% of HOUSEHOLD income not just personal. Please go to this website: www.healthcare.gov/how-can-i-get-an-estimate-of-costs-and-savings-on-marketplace-health-insurance/

If you want to be pissed, be pissed at your husband's employer. No one is causing them to increase their deductibles and premiums. Hell my insurance premium hasn't changed in 8.5 years, and it will not change in 2014. The amount they pay does, but it is never passed down to us and we have had the same great coverage.

Why would you be uninsured, you still will be offered coverage by your husband's employer? Yes, you will have to pay more for that coverage OR you can find coverage in the Marketplace. No one knows exactly how much it will be.

I would be extremely wary of a company that didn't offer open enrollment but for a few days. BE PISSED AT THEM.

[skwcm80]

Sept 28, 2013 14:06:21 GMT -5 @therealmc said:

Ok, I'm glad to see I didn't imagine that since our premiums only went up $12/month. 

[Deleted]

Sept 28, 2013 13:48:36 GMT -5 skwcm80 said:

Sept 28, 2013 12:35:51 GMT -5 biblionerd said:

Yes, I understand all of the logistics about when it rolls out, questions, etc., but that does not change my situation. I'm trying not to read too much into this, but am I not allowed to be upset because my family is basically now getting screwed? Greater good, yeah yeah. I never said I was against the ACA in general, and I'm not "scared" of it. But the fact of the matter is that while your clients and other people will be able to get insurance, people like me and my family are going to be screwed and lose ours. Yes, every new thing has their kinks, but the "family glitch" is disturbing, not just for me but many others. Many work premiums have shot SKY HIGH and because of the wording of the ACA, there are no provisions to allow family (aside from the employee) to get affordable insurance. Yes, it's a glitch, but you know what? It directly affects my family and I'm pissed about it. I will be pg and uninsured. Uninsured for the first time in my life because of a fucking glitch. So yeah, I'm mad. At this point, I'm glad Suzy who's never been able to get insurance now can, but I'm not glad to be a martyr and lose mine. My children both have health conditions and now we won't be able to afford their medications. We're not poor. We're an average middle class family who planned adequately and never imagined that our insurance premiums/coverage would do this. We make too much for any state assistance and not enough to cover astronomical premiums. I'm not into sharing finances online, but our insurance and rx costs would easily be a mortgage payment, much better than the one we're getting now. On top of that, it's shit insurance. Who seriously pays that much for insurance and has to pay 6,000 before they can get a penny covered? So yeah, greater good is wonderful and all, but I want my family covered with affordable insurance also. 

Late to this, but I'm pretty sure EnchantedSoul was just trying to explain why you may not have the answers you want right now. I'm also sure she didn't imply that you didn't plan adequately, or that you and your family should be martyrs. I'm fairly positive she was just trying to help.

Also do you have a source for the statement about family premiums going sky high? I remember reading in passing that premiums have/ will come down, but I haven't read anything about that either.

We have private insurance. Our premium is going up from $520 to $850 and our deductible is going from $7000 to $8000. I don't know if that is normal but private insurance sucks before and it will still suck after.

We will be going into the state insurance pool as it appears it will be better coverage and cheaper.

[skwcm80]

Sept 28, 2013 14:22:48 GMT -5 @lindy said:

We have private insurance. Our premium is going up from $520 to $850 and our deductible is going from $7000 to $8000. I don't know if that is normal but private insurance sucks before and it will still suck after.

We will be going into the state insurance pool as it appears it will be better coverage and cheaper.

Oh I don't doubt that costs will rise for some people, but Biblio said many work premiums are rising when I thought I'd heard the opposite.

[biblionerd]

Sept 28, 2013 12:50:17 GMT -5 EnchantedSoul said:

Sept 28, 2013 12:35:51 GMT -5 biblionerd said:

Holy cow! I was trying to let you know that there are supposed to be people out in the field to help answer your questions. Excuse me for attempting to help.

My greater good comment wasn't directed specifically at you. At was talking about from a global perspective. I may very well be in the same boat you're in. But good luck, jeez.

Sent from my SGH-T999 using proboards

I'm sorry, I haven't read anyone else's responses. I'm in a hurry, but just wanted to apologize. I guess I'm exhausted, depressed, overwhelmed, defensive, whatever, about everything going on in life right now. I must have read your message incorrectly. I just took it as more like "well my insurance sucks too, but it's for the greater good so suck it up". I feel like shit that my insurance in in the air so I'm sorry that I read your message incorrectly. I guess me bitching about everything does no good, so sorry to vent. Hope your insurance situation works out better as well.  

[EnchantedSoul]

Sept 28, 2013 17:18:56 GMT -5 biblionerd said:

Sept 28, 2013 12:50:17 GMT -5 EnchantedSoul said:

Holy cow! I was trying to let you know that there are supposed to be people out in the field to help answer your questions. Excuse me for attempting to help.

My greater good comment wasn't directed specifically at you. At was talking about from a global perspective. I may very well be in the same boat you're in. But good luck, jeez.

Sent from my SGH-T999 using proboards

I'm sorry, I haven't read anyone else's responses. I'm in a hurry, but just wanted to apologize. I guess I'm exhausted, depressed, overwhelmed, defensive, whatever, about everything going on in life right now. I must have read your message incorrectly. I just took it as more like "well my insurance sucks too, but it's for the greater good so suck it up". I feel like shit that my insurance in in the air so I'm sorry that I read your message incorrectly. I guess me bitching about everything does no good, so sorry to vent. Hope your insurance situation works out better as well.  

No worries, I understand. Hope you get some answers soon. Feel better.

Sent from my SGH-T999 using proboards