Under the current Healthcare law can anybody answer this question. I am retiring on November 1st. I am currently covered by my employer with Keystone Healthcare East and I will be going onto my wife's Blue Cross Anthem plan at that time. During the last two weeks I have had some unusual chest pain that I have seen my family doctor and cardiologist about. The cardio guy said I did not have a heart attack and sent me do a stress test on Tuesday. The family doctor also has seen me and both men have had me give blood for testing. My question is about pre existing conditions. Should that be a concern of mine?
Healthcare question.
- Thread starter SEPATOPTEN
- Start date
Make sure that your wife's plan offers full coverage on Nov. 1, but it probably does. In that case, Blue Cross will cover procedures done before Nov. 1, after Nov. 1 it goes to the new insurance. (Keep in mind procedure billing often takes months, so chances are you will still be working with Blue Cross in 2019 to make sure stuff gets paid from this year)
Now if the new insurance offers really crappy coverage or drastically limits your choice of doctors/hospitals, you may want to consider using COBRA to extend your current insurance. COBRA is very expensive but, say you need a catheterization that costs $70,000, and the new insurance only covers 80% or has a huge deductible, it might be worth it to pay for extending the old coverage at least a couple months.
The other thing that's really cool about COBRA is that you can elect it retroactively. I think you have 30 or 45 days from your date of separation from your employer to elect it but the insurance is effective from your separation date. I'm not positive you can do the retroactive election if you're being covered by your wife's plan -- definitely double check that. But retroactivity is at least something to be aware of.
Now if the new insurance offers really crappy coverage or drastically limits your choice of doctors/hospitals, you may want to consider using COBRA to extend your current insurance. COBRA is very expensive but, say you need a catheterization that costs $70,000, and the new insurance only covers 80% or has a huge deductible, it might be worth it to pay for extending the old coverage at least a couple months.
The other thing that's really cool about COBRA is that you can elect it retroactively. I think you have 30 or 45 days from your date of separation from your employer to elect it but the insurance is effective from your separation date. I'm not positive you can do the retroactive election if you're being covered by your wife's plan -- definitely double check that. But retroactivity is at least something to be aware of.
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And more specifically to your question, you shouldn't have to worry about pre-existing conditions. Now if the party-who-shall-not-be-named succeeds in repealing the health care law like they promise to do, then pre-existing condition will become a major thing everybody has to plan for (and it will also be a major source of bankruptcies). Elections have consequences.
Seriously. For anybody self-employed but still a few years from Medicare you have to be thinking about this. ACA repeal would mean annual health care costs for a healthy couple in their late 50s-early 60s would get to $40k-$50k-$60k. People have no idea what is coming down the pike. If you're not wealthy, that is a pretty big nut.
The options, if you can't afford American health insurance, include going abroad (hard to get residency permits, plus you're a long way from your loved ones) or just going bare and plan for bankruptcy (move to Fla and put all your assets in a house). Or just plan for suicide if you come down with a bad cancer, because you don't want to leave your spouse impoverished. I believe in planning for contingencies, but this is not fun planning.
I know people say, just quit being self employed and get a wage job with benefits, but you can't count on that. If ACA goes, there will 30 million people desperate to get on employer health plans at the very time employers will be dropping millions of people from health plans. The math is not good.
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my daughter broke her arm, requiring surgery, and we were shocked to find out our deductible was $12,000. That was a bigger ouch than her arm.
Just make sure you sign up for coverage under your wife’s plan as of 11/1, not 1/1.
Good luck with your medical issue!
Good luck with your medical issue!
Yeah - I have a “Cadillac” health care plan and pay a ton of money for it with an $8K deductible and it goes up every year and people who are self employed have it worse - yeah they must have forgotten about the first “A” in the ACA. Was poorly conceived from the get go.
$40-60K sounds pretty high. A 60 year old male can get a Keystone Gold HMO from Independence Blue Cross for about $1K per month with low deductibles, office visits, and scripts. Its not cheap, but manageable until Medicare.
You need to check into things, but many companies will cover through the end of the month, so you may be covered until 11/30 (BE SURE TO CONFIRM).
Also many/most plans allow 60 days to retroactively select COBRA. I would advise against this for two reasons. If you wait out to near the end of the 60 days, and something happens to you where you need the coverage from COBRA, and are incapacitated/unable to complete the forms/etc., you could be SOL. Also if you decide to wait that could interfere with the ability to join your wife's coverage as a life changing event.
If you’re going from a group plan to another group plan, they will cover your chest pains (as well as any other preexisting conditions) whether it be a heart attack or indigestion. If you chose Cobra, it would be the same plan you had while you were working, only you are fitting the full bill instead of your employer picking up part of the tab. If you go for an individual private insurance plan, they usually do a 12 month look back on anything you’ve been treated for, and 5 year look back on prior events (heart attack, cancer, etc.). If you go the individual route, make sure you wait until after October 2nd, because the law will change so you can get a plan for up to twelve months instead of just three months.
Wow that is high. I was on a $7k deductible last year - and naturally that was the year I needed a $6,000 procedure.
I have looked into Europe for scheduled procedures. Even with insurance, a colonoscopy can get to thousands of dollars here -- whereas in France or Belgium, there are excellent clinics that do them for around $400. But you can't schedule a broken arm.
Wow 30 million desperate for coverage. Where did the extra 21 million come from since there are only 9 million enrolled in ACA in 2018.
Yes we pay about that now, but it's only that low because ACA limits the premium insurance companies can charge for age risk. If it weren't for ACA, individual premiums for people in their 50s and 60s would be double or triple what they are now. So for a couple, maybe $4000 a month for minimal coverage/high deductible. With chronic conditions or cancer/heart conditions, much higher because pre-existing conditions would factor in.
It’s income redistribution - older people have more health care costs and they shift that cost to younger people who pay for coverage they won’t use - hence the Obama mandate.
Are you talking about screening colonoscopies? In most cases they are supposed to be covered 100% by law unless you're in a grandfathered plan from before 2010.
He only makes political posts, and even then just makes most of the shit up as he goes anyway.
Yes but here's the catch. The colonoscopy itself is fee by law but the anesthesology ($1200-$1500) is not free, it's billed. Often there is a hospital "facility fee" which is also billed separately. And if they find polyps, which is fairly common, generally the doctor and hospital will bill a full surgery fee ($500-$1200) for each polyp they snip. So a routine colonoscopy can get to be thousands of dollars if you have high-deductible insurance. Your doctor won't warn you about that when they're trying to talk you into a colonoscopy.
There's a lot of individual insurance that isn't marketplace plans, no? And millions more people covered by employer plans that would be dropped if ACA is abolished. Whatever the number, my point is, when they abolish ACA, self-employed people are going to have some painful decisions. Just getting on employer plan may not be a viable option.
For the record, screening colonoscopies are covered. Diagnostic colonoscopies are not.
I don't know why you think millions under employer insurance will be dropped if ACA is abolished. In a tight labor market employers need to offer more to keep or hire good employees not lower their benefits or salary.
With more people working in better jobs should mean more are covered under employer plans not less
If this is your experience, you're being screwed. I didn't pay a penny in that same scenario.
https://www.cancer.org/cancer/colon...iagnosis-staging/screening-coverage-laws.html
Yes it's true. It's cost shifting from the old to the young. And ACA is definitely cost-shifting from the healthy to the sick.
But really you could say that about almost anything. Social Security is just income redistribution to poor old people. Public schools are a total ripoff of property owners in order to subsidize families with kids. And there are people on this list who would abolish all of it.
People can debate health care and what's wrong, I'm just saying that if you're middle-aged and self-employed, I don't know what the answer will be if ACA goes away. It will be interesting trying to stay financially afloat.
It's just something people should be aware of. Pricing is not transparent. It always pays to talk with the billing department beforehand and then double check with your insurance. The big hospitals are always pushing the boundaries to enhance their revenue. You can't assume anything.
Another one of these which isn't a big deal but is kind of funny is the "free" physical. It's becoming very common for doctors to double bill the "free" physical with a "sick patient" appointment if they actually discuss health issues. I.e. if you're at your physical and the doc asks you how you're feeling, and you answer "I have the sniffles," the doc will check something on his chart so it becomes a sick patient visit which isn't free. Not a big deal but I wish they would at least warn you. You would expect that from a car mechanic or the cable company if there was an extra $50 charge.
Bottom line. If the ACA was remotely positive, it wouldn't have to be mandatory. Think about that.
Then stop inserting politics into a non political post.
Well rape isn’t positive but some people think if it happened a while ago, it’s fine. Mandatory healthcare works everywhere else it’s instituted and nobody ever tries to get rid of it after they enjoy it. Some people just like to vote against their own interests.
Typical - so now people like you think you know what’s best for us all - Thank God we get to decide for ourself at the Voting booth and not through some dictatorship of one political party or the other who has the arrogance to think we need somebody to think for us - what condescending horsesh&t
yeah, probably every other advanced country is wrong and we are right
Universal healthcare is coming. As soon as enough dumb people either wise up or die off. Over the next 20 years, boomers will start to die off like the greatest generation started their die off in 1996. They went from 61 million to 28 million in 20 years. There are 70 million boomers vs 62 million millennials of voting age. Expect a big shift by 2024.
Perhaps Sproul's dumbest post ever, but it's a close call with many of his other dumb posts. Sproul needs to stick to State College weather and traffic updates. He's pretty good with that.
There's no easy answer to health care, because we Americans want everything, we want it now, and we want it cheap. Not possible.
Single payer healthcare is right around the corner. Obamacare was constructed to be imperfect, to act as a stepping stone to the unavoidable change to single payer. The people who wrote Obamacare knew this when they did it, and it was fully planned this way.
And I'm a physician who is a Republican who thinks Obamacare is actually OK, mostly.
Single payer healthcare is right around the corner. Obamacare was constructed to be imperfect, to act as a stepping stone to the unavoidable change to single payer. The people who wrote Obamacare knew this when they did it, and it was fully planned this way.
And I'm a physician who is a Republican who thinks Obamacare is actually OK, mostly.
I'm not sure that it works everywhere and that everyone who has it enjoys it. I've lived in countries with government run - read free, mandatory healthcare- and a lot of people don't like it. In fact, often those with resourses have separate private, retainer based doctors. Waits for surgeries if ridiculous and end of life treatments , in some instances are significantly less than in US ( which is ok if you're young but not so good if you are old). Plus, doctor shortages are normal...can make more money in finance than medicine.
