Health Care Reform Part IV: The Trumpening

Discussion in 'Politics & Current Events' started by Knave, Dec 3, 2016.

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  1. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    it certainly should please the insurance companies that deductibles/out of pocket costs get reset part way through a calendar year.
     
  2. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    I can't speak to plans in Cali, but if you have a MA plan, the network is national.

    My parents have an Ohio MA and use it with in-network privileges with doctors in Florida every winter.

    There is no "small radius of included doctors" in any UHC plan I have heard of. But, California has their own BS rules on a variety of things, so maybe you should consider moving to a more consumer friendly state if they artificially limit carrier networks.:)
     
  3. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    One (small, Medicare only) company has an Advantage plan that includes my primary care physician. So this looks like an insurance company choice rather than something imposed by the state.
     
  4. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
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    The decision to join a carrier network is almost always the providers choice, not the carrier, especially in metro areas.

    There are exceptions, but usually it’s the provider that will not agree to the terms of the carrier network.

    There are also providers that are not interested in taking new clients and don’t need to add additional carriers.

    But again, in Ohio, if you are a UHC network provider, there is no “small radius”.
     
  5. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    #5380 M, Jul 22, 2020
    Last edited: Jul 22, 2020
    It's possible. Playing around on the UHC website, using my own zip code my doctor doesn't appear on the list at all, using a closer zip code, she appears but "is not accepting new patients", and in a zip code that's in the county where her office is, she is both listed and accepting new patients.

    On the plus side, there are 5 times as many Advantage plans in SF than the county where my doctor's office is!
     
  6. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
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    Columbus Crew
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    United States
    Advantage plans need to have docs in network available so rural counties have fewer choices. If there are no network docs in your county CMS won’t allow carriers to sell HMO’s in that county.
     
  7. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    That county - Contra Costa - is less densely populated than SF itself, but it has a population of over 1m and is "primarily suburban". So definitely not a rural county.

    https://en.wikipedia.org/wiki/Contra_Costa_County,_California
     
  8. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
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    Millonarios Bogota
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    Colombia
    Back door medicare for all?








    Sorry for the tweets but the document was too dense to get the important points.
     
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  9. ceezmad

    ceezmad Member+

    Mar 4, 2010
    Chicago
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    Chicago Red Stars
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    United States
    So can I be that guy?
     
  10. superdave

    superdave Member+

    Jul 14, 1999
    VB, VA
    Club:
    DC United
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  11. American Brummie

    Jun 19, 2009
    There Be Dragons Here
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    Birmingham City FC
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    United States
    I don't get it. Is there some difference between the US and everyone?
     
  12. Insurence unattached to employment.
     
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  13. xtomx

    xtomx Member+

    Chicago Fire
    Sep 6, 2001
    Northern Wisconsin, but not far from civilization
    Club:
    Chicago Fire
    Yes, we are Acceptional!
     
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  14. MattR

    MattR Member+

    Jun 14, 2003
    Reston
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  15. Yoshou

    Yoshou Fan of the CCL Champ

    May 12, 2009
    Seattle
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  16. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
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    Columbus Crew
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    Not unless they have depleted all other assets.
     
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  17. Yoshou

    Yoshou Fan of the CCL Champ

    May 12, 2009
    Seattle
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    Seattle Sounders
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    United States
    Expanded Medicaid is salary dependent. If their salary dropped to 0 + Unemployment, they'd be below the salary limits...
     
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  18. Q*bert Jones III

    Q*bert Jones III The People's Poet

    Feb 12, 2005
    Woodstock, NY
    Club:
    DC United
    I mean, most people would deplete all their assets the first time they pee in a $650 bottle.
     
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  19. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    Not with the extra $600 a week they were getting from the federal government until the end of July. Presumably we're now seeing more Medicaid enrollment post that.
     
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  20. Yoshou

    Yoshou Fan of the CCL Champ

    May 12, 2009
    Seattle
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    Seattle Sounders
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    Excellent point. They would, however, get a huge stipend from the government to get insurance off the exchange.
     
  21. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    #5396 M, Sep 9, 2020
    Last edited: Sep 9, 2020
    Depends on what their income was until the point of losing their job and thus what their income for the year likely ends up being. Additionally, I suspect many would pass knowing that their yearly deductible would restart. Many will presumably end up having three deductibles in the year - former employer, ACA, and (if they are lucky) new employer. It's a nonsense and highlights once again the foolishness of tying heath care access to employment.
     
  22. SamScouse

    SamScouse Member+

    Jun 1, 2015
    Toronto
    Club:
    Liverpool FC
    you guys need to find a way to make your health insurance system more complicated ....
     
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  23. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
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    Columbus Crew
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    It is salary dependent if you have no other assets to speak of. In addition to the monthly income there is a "total assets" number that is taken into consideration.
     
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  24. Yoshou

    Yoshou Fan of the CCL Champ

    May 12, 2009
    Seattle
    Club:
    Seattle Sounders
    Nat'l Team:
    United States
    Which states is that? Here in WA it is entirely income based.

    https://www.hca.wa.gov/health-care-...le-health-medicaid-coverage/individual-adults

    There isn’t even any mention of assets on the application. Just SSN, monthly income, household size, and immigration status..
     
  25. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Ohio is the only one I have experience with.

    IMG_1010.JPG

    The total resources is assets.

    For instance, if you need to be in a LTC facility, Medicaid will sell off your assets until they reach the minimum. If you have a house, they will allow the spouse to live there indefinitely but will own the property when no longer inhabited.
     

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