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Affordable Health Care

Has the new Affordable Health Care Act affected anyone's insurance yet. I am so scared it is going to affect my insurance and I will not be able to continue to see my Pain Management Dr.


  • I'm curious about this too. I have pretty bad coverage right now and could use some good insurance, but from what I'm reading, hubby and I won't be able to afford it.

    I'll keep checking on this thread - I was wondering if anyone was talking about it on here. Maybe Spine-Health should address this issue?

    Thanks for asking, Ice man. Insurance in pretty danged important to us all.
  • The affordable healthcare act changed my husbands insurance. Its not a drastic change. It went from paying 70/30 to paying 60/40. Our copays have went to 40 dollars for a PCP and 55 for a specialist. The deductable went up to from 750 to 1000. I know it doesn't seem like much of a change, but when you are living paycheck to paycheck the increase in premiums can hurt. Plus I don't get medicare until July of next year.

    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
  • I carry a secondary policy on top of Medicare, The rate on the secondary policy went up over 20% this year plus the deductible went from 0 to 500 dollars. Other services went up a few dollars and some went down a buck or two, but it certainly didn't even out. My question is how much is medicare going up this year? Nobody seems to want to put that number out and that worries me alot.
  • I've done quite a bit of research since yesterday(early, early morning) the only numbers I could find on medicare premiums for next year were an increase of about $20 a month. These numbers all came with a caveat that these were only preliminary numbers and the actual increase could be more or less. This tells me it will probably be about the same amount as the cost of living increase in social security. This is just my opinion as we have seen the same thing in the past.

    To those living on just social security it ends up that they live on the same amount of money even though we all know that the cost of living has gone up drastically in the last year, at least in my neck of the woods.
  • golfjunkieggolfjunkie Posts: 1
    edited 11/02/2013 - 10:04 AM
    First one must accept the fact that the ACA isnot designed to make insurance affirdsble or health c a re better or cheaper. The main goal is to control one sixth of the economy and eventually force this country into a single payer system like Canada and europe.

    Post edited for political content by Liz (moderator)
  • My husband has insurance on just the 2 of us and we pay 600 a month and our deductible is 5400.00 then it pays 100%. Only time we have met deductible is past 3 yrs. When either he or I had surgery....but we owe 13000 in deductibles from last 3 yrs. Dont know what will happen if I need another surgery or on Jan. 1. Very scary!!!!!!!!

  • I brought this subject up because there are many unknowns. I really feel Spine Health can not accurately address the issue because of the unknowns. It is just like the chronic pain we all suffer from, we have it and are going to have to learn to deal with it. It is not a discussion about our political views or opinions. I have formed personal relationships with many of my Doctors just like all of you have and it absolutely scares me to death to check the mail box every day knowing I could get a letter from my insurance provider saying due to the AHA your rates are going to increase 10 times. I live payday to payday and simply can't start the entire process over with new doctors. Do my fellow spiney's feel the same way or am I just thinking the wrong way? I was told, just like everyone else that if I had health insurance I would not be affected. That simply wasn't true.
  • grammaof9ggrammaof9 Posts: 263
    edited 11/03/2013 - 2:27 PM
    Just received a letter starting on Jan. 1. 3.1 percent. Just renewed in Oct. 1874.00 per month. Went up 350.00 in Oct. each of us have a 2500.00 deductible . I meet mine every year and can never catch up with the payments.. Now wondering how going to keep up. Just received letter for denial of SSD so now on to seeking an attorney. Who knows.
  • Get a disability atty ASAP
    Someone ir a practice that is ONLY disability attorneys
    Most get DENIED three times, then court date, that gets adjourned once or twice, but YOU NEED AN ATTY.
    For court...

    You will get there, but it takes time. The govt. Gives three denials to weed out tbe chaff from the wheat.
    The chaff (phonies) dont have patience for the long process.

  • cynmarccynmar Texas, USAPosts: 65
    edited 11/11/2013 - 5:55 AM
    My husband and I received our cancellation letter in October. First we were told that we would no longer be insured effective Jan 1, then they came back after weeks of trying to navigate the marketplace website, and offered us a different plan. The insurance we now have has a $5,000 deductible, no co-pays, etc. and costs us $800 per month. The new plan offered will cost us $1,300 per month with more out of pocket expenses. I'm frantically going back and forth to Dr's (without pay)trying to figure out what to do before we lose our coverage. I have a cervical herniated disc with spinal stenosis and a lumbar herniated disc, both compressing a nerve. I think I can deal with the lumbar conservatively (I hope). Looks like surgery for the cervical as I have exhausted all avenues of treatment unsuccessfully. The clock is ticking. Going back to Dr. tomorrow. Decision time and I'm scared. It's hard enough dealing with all the pain and reprocusions that surround us with work and family. I can't believe this is happening, too. I have a friend that is an independent insurance broker and she can't even quote us because she can't get in either. We are hard working middle class people, too young for Medicare and too old for good rates. I am sitting at my office desk wearing a tens unit. Something's not right.
    Cervical foraminotomy 12/20/13 (herniated disc) C5-C6
    Lumbar microdisectomy 02/28/14 (herniated disc) L4-L5
    Mild Disc Bulge L5-S1
    Moderate Facet Arthrosis L4-L-5 w/gr1 Anterlolisthesis
    Spondylosis w/gr 1 Retrolisthesis L3-L-4
    Failed Back Surgery
  • RickilalasRRickilalas Posts: 559
    edited 11/17/2013 - 7:22 PM
    I find it interesting.
    My insurance which I had for twenty or more years went up each and every year.
    Started at $220 and is now $708 a month.
    My deductibles went from $500 to $2500 and my out of pocket went from $2500 to $9500
    A year. So if I get it now every raise in premium is because of the AHCA.
    Ok if that is true why did I pay more every year before we had a health care program.
    My insurance was one of the major carriers in the US. There profits are outrageous.
    With or with out a health care program our rates would have gone up and our share of cost would go up also. History is proof of this.

    It may not be a perfect program but it's a start that can be adjusted has we go along.
    We use to get sick and they would cancel us now they can't do that. That one law alone is worth it. I do not see many people from the state of Massachusetts complaining.
    Most there now have insurance and the national program is very similar to that.
    When running for president their Governor that signed it in would not talk about it.
    His program did work. Just maybe in time this will work.

    Over the years of six spine surgeries my insurance went up and what they paid to the doctors and hospitals went down. One surgery I was embarrassed at how little the surgeon was paid for twelve hours of surgery. The insurance company still made money on me.
    We have to look past the negative news that is not always correct anymore and give this time.

    I was surprised that one person was telling me this will never work because it will just give the insurance companies all the profit they want. Well interesting enough if anyone would read parts of the health care act it limits the profits of these greedy people.
    It's not perfect but it's a start. YES IT LIMITS THEIR INCOME. This is why so much negative and wrong information is spread out has to what is happening. Congress is protecting big companies not us little guys. Follow the money and see who gets insurance money to show how bad this is. Yes it has some problems getting started, give it time.
    I was able to start my medicare which has been great. Even though many of my relatives told me keep your insurance don't take the medicare because doctors are going to stop taking it.
    I dont know where that rumor came from but so far my doctors are doing more for me now then ever and we don't have to get some non medical persons OK to do things.
    Medicare is paying doctors better then my big blue.company did. Interesting. To me anyway.

    I was able to get into my states program the first day and had no problem getting quotes.
    One thing that did bother me was I could get a new policy through the health care act that was slightly better then what I had and it was $200 a month cheaper and to top it off it was from my insurance company that I had. Plus I would be able to.get tax credits to help me pay it which would save me more money yet..

    I wish we all had good medical and get the help we need without a insurance company saying what we do and don't need. I wish we could have somebody making a list of fair reimbursement prices for health care treatment and quit giving so much money to insurance companies. Yes they have a place but let's make it fair to everyone.

    If you don't believe me or don't want to just look over the profits and stock prices of the major companies. People make money just owning the stock.

    When getting a price on a new health care policy also check to see how much tax credit you will get to help pay for it. Again it's not perfect but it is a start that will have growing pains
    Let's give it a chance and then make.changes.
  • But I quoted just my premium increases for this year. My premium on my supplimental actulally went down $40 last year. Over the last 5 years my supplemental went up about $45 and my co-pays stayed the same till this year. I shop around every year and got a hold of a facilitator for the aca and even though my wife and I do not make much money, we did not qualify for any help from the government. I hope more people have better luck and would really like to see this work, but it seems to be off to a rocky start. Good luck to all.
  • dilaurodilauro ConnecticutPosts: 9,835
    I retired from IBM in 2009, but am covered under my wife's Aetna Medical plan through the Hospital she works out. She will either be working PRN or Retiring in February 2014, so, we are looking at insurance costs.
      - If she stayed as a full time employee, benefit costs $700 / month- If she goes PRN or Retires, Cobra costs (same coverage) costs $1,300/ month- I can pick up IBM Medical benefits for Retirees through a FHA program (much less coverage) at about $1,600/monthCompany medical benefits seem to stay pretty much the same, perhaps increasing by $10-$30 a year. But getting things OUTSIDE the company, but still within the SAME insurance company, those prices go way up.We need the coverage, so we just have to bite the bullet and pay itBut as was said before, no one at Spine-Health is going to solve this issue. We can bring out some figures and facts. As long as we keep it in that tone, fine. But, please do not bring in anything about government and/or political changes.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • RickilalasRRickilalas Posts: 559
    edited 11/18/2013 - 8:48 AM
    OK I guess that closed the discussion we can talk about facts and figures but cannot bring in Government or political changes. That really limits the discussion It's a government program isn't it.
    People on Spine Health in my Opinion can help solve this issue by using the numbers and facts then get in contact with your political reps and start discussions and always remember we have a vote and that can help solve problems when used in numbers.
    Sorry I thought this was a forum covering all aspects of spine issues and medical care has to be the most important one there is.
    I take the warning and will stay away from this thread in the future.
    Maybe I am wrong and Rons message isn't being sent to me but nobody said anything about the post putting down the health care act. All I was saying is give it a chance.
    If it did not go into effect this year your insurance would still be going up anyway.

    Just disappointed that we can not have a adult conversation on here anymore.

  • dilaurodilauro ConnecticutPosts: 9,835
    edited 11/18/2013 - 10:54 AM
    Nothing about we cant have an adult discussion. As long as it stays that way, I am 100% fine with it. I always have been and will continue that.
    I only put a stop to things when they get out of hand.
    This thread is fine, but based on my experience, I just wanted to lay the boundaries.

    Also, for the future, we have an entire forum category devote do Insurance situations that cover this and many many more items. There you would find people that pay more attention to insurance related items. Here on Chronic pain forums, you may reach some, but not as many.

    Continue to say what you want, but its best said in the category where others are talking about the same thing
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • There's lots I do not like about the ACA... however I'm compelled to say that for the last two years my OOM for just ME was 8k per year and I hit it two years running. This year its 6k for just me. The insurance company was forced to reduce it because an 8K OOM for an individual didn't meet the new ACA guidelines (or at least that is what I was told). Of course my monthly cost did go up, but still nice to see the drop in the OOM... of course I'm hoping not to reap that benefit :)
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • dilaurodilauro ConnecticutPosts: 9,835
    a difficult time when it comes to the different coverages. I can understand the differences between the amount of monthly payments you need to make, depending on deductibles, different types of co-pays, etc. But when you are talking about the same insurance company, but coming into it from different avenues (Cobra, Company, Retirees, etc) the cost is so much different. I fully understand that companies have contracts with insurance companies that can result in lower monthly payments, but the differences are so great. That I have a hard time with.

    I wish I knew more about how all of this medical coverage and insurance companies work. But I will get a better understanding, I have to.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Ron
    Keep in mind I did not start this thread or I would have done it under another forum.
    I was responding to what was posted here.
    There is so much bad and untrue information out there today I just wanted to point a few things out. I was not and do not want any argument started.
    I left the Pain Medications forum just because of that.
    Our medical is a mess I don't agree with everything that has been done but somebody finally got something started. It will take time and it will take changes to work.
    My policy's were canceled before over the years and I was moved into a new plan.
    My rates went up each and every year.
    I just wanted to point out that this has been happening for many years and was not because of any health care act.
    This was one of our business areas that had very little regulation or supervision and now they are very unhappy and trying to make it go away. I feel we just need to give it a chance.
    That's all.

    In closing this out tonight I want to point out that the letter and rumor that the 2014 medicare part B is not being raised to $247.00 a month.
    Guess what the letter blames for the sharp cost increase.
    Has per Medicare the rate will remain the same has this year. NO part B increase.

    edited 11/20/2013 - 2:49 AM
    It is easy to jump to conclusions about something as complex as the AFA. From what I have read about the act, and I read the entire act, and information that I received from clients in the health insurance industry, the impacts of the new law on specific individuals varies as a result of many factors. Some people will be hurt in the short run, some helped as you can read in the discussions above. In the longer run, it is more difficult to predict the impact on the act on specific individuals and the public at large. In the short run we clearly have some issues with people's coverage getting dropped and the difficulty people are encountering getting new coverage. I can't really say more about this without getting political and I am sure that on this forum there are many that agree with my views, and there are many that would disagree with them. So let's keep the forum for it's intended purpose.

    For me, I am under a large company health care policy. My plan has not changed that much. My company said that health care costs went up this year and they are absorbing the rise in cost. They have said that before and the result is normally smaller pay raises. How much of the increase in cost can be attributable to the AFA, I can only guess. I am sure that there are impacts from both the AFA and general trends in the health care industry. I don't know what the impact will be next year since the employer mandate is delayed for a year. I will hope for the best and plan for the worst.
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