jeudi 31 octobre 2013

Examples of insurance plans that are being cancelled because of the ACA

This thread is not about whether Obama lied, there's already for that, but about the actual contents of the insurance plans that are being discontinued because they don't meet the new requirements under the ACA.



As a first example, Jan Crawford of CBS News reported on the case of a woman named Dianne Barrette:




Quote:








That includes 56-year-old Dianne Barrette. Last month, she received a letter from Blue Cross Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she's being offered would run $591 a month -- 10 times more than what she currently pays.



Barrette said, "What I have right now is what I am happy with and I just want to know why I can't keep what I have. Why do I have to be forced into something else?"



Sounds pretty bad, doesn't it? Her insurance premium is going up by 10 times!



But what exactly did she get for $54 a month? CBS News didn't bother to find out. The point it that she was happy with it, and now her premiums are going up 10-fold.



Well, it turns out that -- Surprise! -- $54 a month doesn't buy a whole lot of coverage. Greta Van Susteren of Fox News (!) and Mediaite dug a little deeper and found out:






Quote:








56 year-old Dianne Barrette’s old insurance plan barely even qualifies as insurance, paying only $50 toward most of the small list of covered services (Dianne pays the rest), and offering exactly zero coverage for hospitalization.



Van Susteren also found out that Barrette didn't understand what her plan actually covered:


Quote:








“Your $54 a month policy is a pretty, you know, bare bones policy, “Greta said. “Why do you want to keep that one, except for the price? Maybe you can get something better with a subsidy?”



“Well, I know it doesn’t cover lengthy hospital stays,” Barrette replied, adding “It’s perfect for what I want. I get co-pays for doctor visits and prescriptions. So it suffices what I need. Also, the price isn’t too bad either.”



Her $54 plan actually doesn’t have copays for doctor visits and prescriptions. It pays $50 toward covered doctor’s visits, Dianne pays the rest, and $15 toward prescriptions, Dianne pays the rest. As for hospitalization, Greta again went where CBS did not, and actually asked about it.



“Well, does it pay for any hospitalization, the current policy you have?” Greta asked.



“Again, I’m a little confused about it,” Barrette answered. “I have been reading over and over the policies, and it appears that it does cover some outpatient, but when you go through the booklet they sent, it would say refer to this, refer to it but then refer back to… it was very confusing.”



Actually, it doesn’t cover any hospital stays, unless Dianne suffers complications from pregnancy. Then, it pays fifty bucks. It doesn’t cover any outpatient care, except for mammography, osteoporosis screening, diabetes self-management, and complications from pregnancy. For that handful of services, the plan pays $50, and Dianne pays the rest.



So let's see, for $54/month they pay $50 toward covered doctor’s visits, with the individual paying the rest, $15 for prescription medication, with the individual paying the rest, nothing at all if you have to be hospitalized except for complications from pregnancy, in which case it only pays $50 (Dianne is 56 anyway).



If she got breast cancer, for example, it would be almost no help at all. If she had any serious disease or injury it would be almost no help at all.



Another thing CBS didn't mention:


Quote:








Actually, the plan BCBSFL was only one of many plans Dianne has to choose from, 10 of which are cheaper than that $591, and based on her income, she’d only pay around $209 a month



This is for a plan that would actually help if you get a disease like cancer or serious injury.



Here's another example from Consumer Reports. This report is from last year, but it's about what happened to a person who had an insurance plan somewhat like this who was then diagnosed with breast cancer. Her plan had annual limits of $1,000 a year for outpatient treatment and $2,000 for hospitalization, which is actually more than Dianne Barrette's plan covered, but not nearly adequate to pay for the course of treatment she needed:




Quote:








Facing a $30,000 hospital bill, she delayed treatment. “Finally my surgeon said, ‘Judy, you can’t wait anymore.’ While I was waiting my tumor became larger. It was 3 centimeters when they found it and 9 centimeters when they took it out.” After a double mastectomy, radiation treatments, and reconstructive surgery, Goss is taking the drug tamoxifen to prevent recurrence.



Any other concrete examples of plans that are being cancelled? I'm looking not just for premiums, but what they actually cover. When your health insurance only covers a tiny fraction of a major medical expense, what is it really worth? Not much IMHO. If people Like Dianne say they are satisfied with their coverage, but don't even understand what their coverage really covers, are they really getting a good deal?





via JREF Forum http://forums.randi.org/showthread.php?t=267824&goto=newpost

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