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View Diary: Read This And You Just Might Save a Life. Really. (19 comments)

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  •  Here are the rates/benefits in my (1+ / 0-)
    Recommended by:
    jpmassar

    state for someone in my age group. I'm trying to figure out if people think this is reasonable/good coverage for people who are low income.

    Age: 55+ =  $425 $571 $441

    View a Summary of Benefits for the Standard, Extended, and HSA plans. (PDF – 810 KB)

    In addition to your monthly premium, you will pay other costs. In 2012, you will pay a $1,000 to $3,000 deductible, which varies by your plan option, for covered medical benefits (except for preventive services) before the plan starts to pay. A plan option may have a separate drug deductible. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $40 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your combined out-of-pocket costs for in-network and out-of-network covered services cannot be more than $7,000 per year. The maximum is even less if you use only in-network providers.

    •  Obviously it's not going fly for people who (1+ / 0-)
      Recommended by:
      KenBee

      are low income / low assets.

      But the maximum cost is around $10,000/yr.  So if you are able to afford that, but you otherwise can't get insurance because you have cancer or some equally horrible pre-existing condition, then you get to live instead of dying or going bankrupt because you can't afford the $100,000/yr it costs for treatment.

      Also note that, unless the PPACA is repealed or declared unconstitutional, you only have to pay out so much until 2014, when subsidized rates with no pre-existing condition exclusions apply to everyone.

      •  what does this mean? (1+ / 0-)
        Recommended by:
        jpmassar

        'But the maximum cost is around $10,000/yr.'

        comment before  says:
        'Your combined out-of-pocket costs for in-network and out-of-network covered services cannot be more than $7,000 per year.'

        confused, so what happens after $7000 or $10000 per year, coverage stops, coverage continues with no more out of pocket costs?

        my blue shield was about 600 a couple of years ago with no copays, this sounds similar, and not 'affordable' for poor people definitely.

        'Path2Health' is available in some norcal counties to some low income people....you should give a diary over to that, I can't puzzle it all out, I keep having 'questions' and stall.

        It's a program that I think may be a pilot program that will evolve into something else in/by 2014...a pre ObamaCare model maybe.

        From those who live like leeches on the people's lives, We must take back our land again, America!...Langston Hughes

        by KenBee on Sun Feb 19, 2012 at 01:58:07 PM PST

        [ Parent ]

        •  Coverage continues with no more out of pocket (1+ / 0-)
          Recommended by:
          KenBee

          costs.

        •  I didn't know about Path2Health. (1+ / 0-)
          Recommended by:
          KenBee

          The explanations on the web site seem fairly clear.  What is it that you are puzzling about?  Maybe I can decipher it for you.

          You have to live in one of the designated counties, not be eligibile for MediCal, and have an income below the Federal poverty level, to qualify.

          •  heh, thanks, I read it too.. (1+ / 0-)
            Recommended by:
            jpmassar

            I was hoping to hear more hands on experience, but it's so new many haven't heard about it even.

            I think it's a good start, it sure sounds good, but being poor and sick and having to navigate all that always seems such an uphill battle.

            The rates are Medicare or Medicare + 10%, there is dental care, out of area is ok, same day treatment (instead of waiting months  MONTHS!! dammit) for an infected tooth, same day treatment for mental illness and drug treatment too, some real needed changes from the way it's done around Sacramento for example..a comment about that here recently..ugh.

            Anyway, glad to inform, I can't wait to hear that it's helped somebody, (started 1/1/12) or even that they heard about it from me...and it worked for them.

            Here's hoping it works, those counties really need it.

            From those who live like leeches on the people's lives, We must take back our land again, America!...Langston Hughes

            by KenBee on Sun Feb 19, 2012 at 10:21:22 PM PST

            [ Parent ]

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