Saturday, January 11, 2014

I Have My Obamacare, I Think!

As of January 1, I have health insurance. Sounds great, right? Here I am at the age of 64 with the ability to have needed tests and procedures to diagnose a problem I have and get it taken care of. Except for a couple of small details. Or maybe details which turn out to be not so small.

The insurance company has sent me a card, and a booklet explaining my responsibilities under the plan. What they haven't sent me is the booklet which lists plan providers that I am limited to. Also? Doctors I know who accept this plan, aren't taking any new patients. Those who are accepting new patients are ones I wouldn't let touch me with a 10 foot pole. Trust me, I know which doctors are good here and which aren't. You find that out in my line of business.

So, for the next 9 months I won't be doing anything except seeing the doctor I've been seeing who tries her best to help me without sending me for the expensive tests I can't afford. She was hoping I'd get ahead of the curve with the ACA so that her suspicions can be confirmed. At this point we're guessing, but the treatment she started has helped so she may be on target. I won't die from it if she's wrong. In 9 months I'm Medicare eligible which may be the step needed to put me ahead. We'll see.

Another thing. With the $1.65 per hour raise I got, I may find myself over income limit and no longer qualify for medicaid. Yes, I qualified for medicaid at 109% of poverty level. According to statistics 40% of the working population make less than $20,000 a year, 53% make less than $30,000, and 73% make less than $50,000 a year. It's nice to know we weren't as unsuccessful as we thought we were. While I may be in the 40% right now, we used to be in the 73%, 14 years ago. Those were 2012 statistics, I imagine the 2013 stats will be worse.

If I can keep the physical condition I'm in now and grab 6 more hours a week, I'll at least be able to retire after reaching the 53% category. I can't retire at full benefit until I'm 66 so that does give me time. Now I just need my joints to hold out. Always something, right?




10 comments:

  1. Medicare is not too far away at least. I was pleasantly surprised that it as good as my insurance from work was.

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    Replies
    1. The policy I have isn't bad, we have a lack of doctors here. Closest city to me is 30,000 and there's only 20 to 30 primary care docs here. I may have to travel to find a doc.

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  2. Sherry,
    The ACA needs what is broken fixed jsut like the Congress did with GW's Part D Medicare plan. The problem is that the repealicans are set on granting Obama no success and ObamaCare is being successful - Especially across the river in Kentucky (and that is not good news for Mitch McConnell). No, the law is far from perfect but the status quo was just unacceptable! I actually had a clients daughter get a rider on a health policy because she had acne and Blue Cross and No Shield tried their best to cancel a woman in Indy who had ovarian cancer.

    Once you get close to 65 - take a hard look at the Advantage plans out there vs a traditional Med Supp. I recommend United Health Care.

    Bests,

    Sarge

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    1. Sarge, the problem isn't the insurance, we have too few doctors with more people now able to see one. We have specialists, and are lacking primary care. Our local hospital saw to that.

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  3. Oh,
    In October I went on TriCare for Life...

    Ron

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    Replies
    1. Why TriCare? Will it pay if you have access to a VA facility? It won't here, and closest VA hospital is 50 miles away. I've got clients with refusal to pay notices from TriCare including on an ER basis. Letters state they could have gone to the VA emergency room. Which is 50 miles away.

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  4. I like original Medicare since it pays for everything and I don't need referrals. I don't understand why people go with the Advantage plans. Maybe original Medicare isn't so good when it comes to IP or serious disease. I've yet to see.
    Why do you all like the Advantage plans better?

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    Replies
    1. I can't speak for others, but I know how much hospital bills amount to. Original Medicare only pays 80% of those and despite Medicare claims to the contrary you are responsible for the other 20%.

      My SIL fell and shattered her shoulder requiring a shoulder replacement surgery. Her bill for it was $90,000. Without her Advantage plan she would have come out owing almost $20,000. Some doctors and hospitals will settle for the 20%. Far too many won't and they take legal action to recover it, even when you have next to nothing in income.

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