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It seems that when the Affordable Care Act is fully implemented, it will work I believe to provide what many Americans need.  However, I do have a problem with some of the high deductibles that are part and parcel of this act.  

Because as a provider, there are some who are unable to come up with their deductible when they need services. In fact, every day at our outpatient surgical care center, we have cancellations because there was a deductible that could not be met by the patient and their procedure was cancelled.

As those who are on Medicare for the first 80% of their bill and a secondary to cover the remaining 20% know, there is no need to pay a deductible.

I am wondering if there would be an insurance market or model for a secondary insurance to cover the deductible ranging from $2000-25000 so that the deductible would not be a factor in patients getting their services without the angst of worrying about the deductible.

Is this something that would be feasible?  To me the deductible is another doughnut hole in coverage.  

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Comment Preferences

  •  Better yet (12+ / 0-)

    How about insurance that covers the copays too?  Oh and dental.  If we keep this up it will never end.  There should be no deductible and no copays and everything should be covered.  

    It puts the lotion on its skin

    by Nada Lemming on Tue Oct 22, 2013 at 07:47:00 PM PDT

  •  Taking My Health Insurance Agent Exam This Friday (2+ / 0-)
    Recommended by:
    FishOutofWater, JamieG from Md

    So I'm still a long way from giving advice on this, but it seems like the ACA will be phasing out the high deductible policies in favor of higher copays, like 40% copays at the bronze level.

    I think what people would need would be a supplemental "Stop Loss Policy" that caps the copayments for the year.   I need to see what's available.

    Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

    by bernardpliers on Tue Oct 22, 2013 at 07:54:33 PM PDT

  •  The reason why we have high deductibles is (3+ / 0-)

    because we can't afford low deductibles (and we also can't afford to get sick).

    If there is some dual, or double, insurance, we're not going to be able to afford it either. My Filippino wife, being very religious, prays all of the time for good health, and that's really the only "program" that we're still money ahead on.

    There can be no protection locally if we're content to ignore the fact that there are no controls globally.

    by oldpotsmuggler on Tue Oct 22, 2013 at 07:58:21 PM PDT

    •  Thats why I do not like these high deductibles (2+ / 0-)
      Recommended by:
      FishOutofWater, JamieG from Md

      Many cannot afford it but if the secondary to cover deductible would cost $25-$100,this doughnut hole would be covered

      •  Why would a secondary deductible policy (5+ / 0-)

        be cheaper than adding that amount on to the original policy?

        Further, I have heard some horror stories where people have tried to do this, and the net effect is that the insurance companies bicker over who has to pay what, making it much much harder to get the bills paid.

        Fry, don't be a hero! It's not covered by our health plan!

        by elfling on Tue Oct 22, 2013 at 09:07:53 PM PDT

        [ Parent ]

        •  Because of the motivation (1+ / 0-)
          Recommended by:
          JamieG from Md

          The reality is that insurance companies want the high deductibles to discourage people from getting treatment. When a company is paying out fifty thousand dollars for treatment, the extra $3,000 if there were no deductible makes no difference in the economics, but that three thousand does keep a lot of people from getting treatment (not all treatments are life saving - someone can live with terrible knee pain).

          Its not that the insurance companies couldn't close that gap economically, they want that gap to exist.

          Since a gap insurance plan would have limited exposure, a company could do it cheaply. But it would have to be an upstart company.

  •  Single Payer (5+ / 0-)

    Kill all the health insurance companies. They are worse than bookies.

  •  That's what the Platinum Plans are for (6+ / 0-)

    I don't know how many are available; the insurance companies are required to offer Gold, Silver and Bronze but they don't have to offer Platinum. They will cover 90% of costs, but they can still have high deductibles.

    The high deductibles are by design. The people who dreamed up this system wanted to discourage the over-utilization they think is rampant. They want us to be cost-conscious, even though they know it's impossible for us to shop for medical services. And they want us to think twice about whether we really need care or not.

    If they'd wanted to, they would have included a plan that had very low out-of-pocket costs in return for higher premiums, as some of the Medigap plans have. But they don't even want the Medigap plans to have such good coverage anymore - there's talk of changing them to no longer cover the deductible.

    This is more American exceptionalism as far as I can see. I don't think any other developed countries use high costs to discourage people from getting medical care. On the contrary, they make it affordable to encourage people to get care when they need it.

    •  Your right the Gold and Platinum have much (1+ / 0-)
      Recommended by:

      lower deductibles.  Also the deductibles are lower if you're low income.

      But these $5,000/$10,000 medical deductible are outrageous.

      There are a small number of people who are abusers of healthcare but we should just deal with them and their mental problems and not make the vast majority suffer because of a few bad apples who are hypochondriacs.

      Congressional elections have consequences!

      by Cordyc on Wed Oct 23, 2013 at 12:11:05 AM PDT

      [ Parent ]

  •  My daughter got a new job (1+ / 0-)
    Recommended by:
    JamieG from Md

    a couple of years ago after being on unemployment for 10 months.  Shortly after she had a medical problem requiring an MRI.  She had a deductible of $500 on her new insurance plan.  She had only gotten a paycheck or two before she had to fork over a bunch of money--actually go in debt to pay it--because of the deductible.  I can't imagine if the deductible was $5000.  That's ridiculous.  Most of the plans in Oregon have at least a $2500 deductible for unsubsidized customers.  There are 3-4 that are lower.  That's terrible.

    Be bold. Be courageous. Americans are counting on you. Gabby Giffords.

    by Leftleaner on Wed Oct 23, 2013 at 12:51:40 AM PDT

  •  This already exists (1+ / 0-)
    Recommended by:

    When my work renewed the health insurance plans for the year, the deductible rose from $500 to $1000.

     They added a secondary insurance, designed to cover the increased deductible, so we the employees wouldn't have any additional costs.

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