Bronze and Silver Obamacare Program are GARBAGE - Liberals let’s not forget this.

[Fort Fun Indiana]

So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ??

Slow down there, he of the neighbor's wife anecdote. Why didn't they take it? who was the insurance carrier? who was the doctor? You're leaving out a lot of details in your fable... er, anecdote.

 

[LoneLaugher]

The ACA Exchange, REJECTS anyone who can get on an insurance policy through their spouse's work... as far as getting subsidies is concerned.

EVEN IF IT IS TOO EXPENSIVE, for the spouse to be on the plan at the spouse's work.

His wife can purchase insurance on the exchange WITHOUT any subsidy help....and without any subsidy help, the insurance plan on the exchange would be even MORE EXPENSIVE than if he had added her to his work plan.

so, yes she can get a policy on the exchange WITHOUT any subsidy help....but that is just fruitless for them to do, because the exchange would be unaffordable for her, without the subsidies imo.

. That must be what happened then. She or he bought the plan for her and it came without subsidies I guess or as is according to you. Ok, but why was the plan rejected by medical facilities or they were directed to specific ones that were lower in quality because of the plan she had ? I mean they were paying $600.00 dollars a month, and the plan wasn't any good ?? So was it rejected because the medical field knew that it had no subsidies associated with it as you say ??

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

All of it.

 

[debbiedowner]

The ACA Exchange, REJECTS anyone who can get on an insurance policy through their spouse's work... as far as getting subsidies is concerned.

EVEN IF IT IS TOO EXPENSIVE, for the spouse to be on the plan at the spouse's work.

His wife can purchase insurance on the exchange WITHOUT any subsidy help....and without any subsidy help, the insurance plan on the exchange would be even MORE EXPENSIVE than if he had added her to his work plan.

so, yes she can get a policy on the exchange WITHOUT any subsidy help....but that is just fruitless for them to do, because the exchange would be unaffordable for her, without the subsidies imo.

. That must be what happened then. She or he bought the plan for her and it came without subsidies I guess or as is according to you. Ok, but why was the plan rejected by medical facilities or they were directed to specific ones that were lower in quality because of the plan she had ? I mean they were paying $600.00 dollars a month, and the plan wasn't any good ?? So was it rejected because the medical field knew that it had no subsidies associated with it as you say ??

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

 

[beagle9]

. That must be what happened then. She or he bought the plan for her and it came without subsidies I guess or as is according to you. Ok, but why was the plan rejected by medical facilities or they were directed to specific ones that were lower in quality because of the plan she had ? I mean they were paying $600.00 dollars a month, and the plan wasn't any good ?? So was it rejected because the medical field knew that it had no subsidies associated with it as you say ??

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

All of it.

. Care to answer the questions or you got no answers on this one ? Was it not proven a lie that people would be allowed or would be able to keep their existing plans or doctors ??? If these Doctors or plans became an out of network option, then of course specialist would refuse the ACA plan just as the ACA would refuse them because of no payment transfers allowed right ?

 

[LoneLaugher]

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

All of it.

. Care to answer the questions or you got no answers on this one ? Was it not proven a lie that people would be allowed or would be able to keep their existing plans or doctors ??? If these Doctors or plans became an out of network option, then of course specialist would refuse the ACA plan just as the ACA would refuse them because of no payment transfers allowed right ?

You are trying too hard. It's boring.

 

[beagle9]

. That must be what happened then. She or he bought the plan for her and it came without subsidies I guess or as is according to you. Ok, but why was the plan rejected by medical facilities or they were directed to specific ones that were lower in quality because of the plan she had ? I mean they were paying $600.00 dollars a month, and the plan wasn't any good ?? So was it rejected because the medical field knew that it had no subsidies associated with it as you say ??

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

 

[debbiedowner]

I see all these horror stories and I suppose there are a couple here and there that are legit but as many that are out there on the internet are just not believable.

No offense to the navigator's here, but who the fuck would entrust their health insurance to a NON LICENSED agent? None of them knew what the particular insurance company they put you with the summary of benefits much less the provider network. This also goes for some dildo that sits at home and goes to healthcare.gov and does it themselves. WTF do you know about health insurance? NOTHING. If someone had an insurance office with 150 years of experience they sure the hell weren't very good for not coming up with a load of suggestions.

Yes, some dumb fuck doctors said they were not accepting the plans until they realized they signed a contract with a provider for that particular plan, whether on or off exchange the contract was the contract.

After a max out of pocket, you don't pay a fucking percentage of anything. You don't add your deductible plus your max out of pocket (yes I've seen that). Jesus Christ get your head out of your asses.

 

[debbiedowner]

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

See above, he might have known his trade but not his contracts. Most providers don't know who they have contracts with, someone does this for them. Everyone, when they call a provider and asks do you accept such and such cannot reply on the person answering the phone. Ask for the billing department and they can tell you what companies they are contracted with.

 

[beagle9]

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

See above, he might have known his trade but not his contracts.

. Again, didn't Obama say that people were going to be able to keep their plans and their doctors, and that their premiums weren't going to be higher than $2,500.00 dollars ?? Was that a lie of epic proportions or what ??? The ACA has a network contract or contracts ?? Thought it would be honored everywhere if it was subsidized by the government as a way to help people get the care and specialized care that even the affluent among us receive ?? If not then the networks basically equate to network death panels ?? If a specialized care is out of network, then your option is death if you can't obtain the specialized care needed through the network you have ??

 

[debbiedowner]

You are misinformed or lying.

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

All of it.

. Care to answer the questions or you got no answers on this one ? Was it not proven a lie that people would be allowed or would be able to keep their existing plans or doctors ??? If these Doctors or plans became an out of network option, then of course specialist would refuse the ACA plan just as the ACA would refuse them because of no payment transfers allowed right ?

Did they ask if it would make a difference if they hadn't bought on the exchange? If it did then that doc did accept it.

 

[debbiedowner]

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

See above, he might have known his trade but not his contracts.

. Again, didn't Obama say that people were going to be able to keep their plans and their doctors ?? Was that a lie of epic proportions or what ???

If they accepted off exchange they were under contract to accept it on exchange.

 

[Care4all]

when you look for a plan on the exchange, customers have tools to help them see if the plan works for them....some plans don't cover out of network doctors, some cover only 50% of the cost or 60% of the cost if you see an out of network doctor, some plans may not cover the medications you use, some plans may not have the doctors you use in their network....

Thus the exchange....it gives you the tools to check and see if your medications are covered under the plan, the tools to see if the kind of doctors you anticipate using are in the network...

Health Insurance is much more complicated than one would think. I spent hours sometimes with elderly couples but not 65 yet, trying to choose a plan that was best for them....

It's so much easier to just pick a plan from your work benefit offered....by just trusting your HR department to have picked the most universal plan coverage....either way, you just have the choice of what they offer you if you want the benefit.

 

[debbiedowner]

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

See above, he might have known his trade but not his contracts.

. Again, didn't Obama say that people were going to be able to keep their plans and their doctors ?? Was that a lie of epic proportions or what ???

You don't get it. An ACA plan didn't have to bought on exchange, you only went there if you wanted a subsidy and then match up that same plan off, again I bet the doctor did accept it and didn't fucking know it.

 

[debbiedowner]

when you look for a plan on the exchange, customers have tools to help them see if the plan works for them....some plans don't cover out of network doctors, some cover only 50% of the cost or 60% of the cost if you see an out of network doctor, some plans may not cover the medications you use, some plans may not have the doctors you use in their network....

Thus the exchange....it gives you the tools to check and see if your medications are covered under the plan, the tools to see if the kind of doctors you anticipate using are in the network...

Health Insurance is much more complicated than one would think. I spent hours sometimes with elderly couples but not 65 yet, trying to choose a plan that was best for them....

It's so much easier to just pick a plan from your work benefit offered....by just trusting your HR department to have picked the most universal plan coverage....either way, you just have the choice of what they offer you if you want the benefit.

While I agree, do you know most of the provider lookup was wrong? Every year during oep we received bulletins that their providers were showing wrong, that is why you use an agent.

 

[debbiedowner]

when you look for a plan on the exchange, customers have tools to help them see if the plan works for them....some plans don't cover out of network doctors, some cover only 50% of the cost or 60% of the cost if you see an out of network doctor, some plans may not cover the medications you use, some plans may not have the doctors you use in their network....

Thus the exchange....it gives you the tools to check and see if your medications are covered under the plan, the tools to see if the kind of doctors you anticipate using are in the network...

Health Insurance is much more complicated than one would think. I spent hours sometimes with elderly couples but not 65 yet, trying to choose a plan that was best for them....

It's so much easier to just pick a plan from your work benefit offered....by just trusting your HR department to have picked the most universal plan coverage....either way, you just have the choice of what they offer you if you want the benefit.

The very few times I have had to call the marketplace, whatever call center I may reach, they have no, idea what I'm talking about. Obama should not have opened this to any unlicensed people, 30 hours of training is far from being qualified. I am sure there were a handful like you that did their due diligence but by far not many of them knew what they were doing there and were quite nasty to licensed insurance agents.

 

[Care4all]

when you look for a plan on the exchange, customers have tools to help them see if the plan works for them....some plans don't cover out of network doctors, some cover only 50% of the cost or 60% of the cost if you see an out of network doctor, some plans may not cover the medications you use, some plans may not have the doctors you use in their network....

Thus the exchange....it gives you the tools to check and see if your medications are covered under the plan, the tools to see if the kind of doctors you anticipate using are in the network...

Health Insurance is much more complicated than one would think. I spent hours sometimes with elderly couples but not 65 yet, trying to choose a plan that was best for them....

It's so much easier to just pick a plan from your work benefit offered....by just trusting your HR department to have picked the most universal plan coverage....either way, you just have the choice of what they offer you if you want the benefit.

While I agree, do you know most of the provider lookup was wrong? Every year during oep we received bulletins that their providers were showing wrong, that is why you use an agent.

No, I did not know that.... was that the case in every state?

Up here in Maine, there are so few choices for the customers....only 2 providers when they first opened, and I believe they increased their providers by 50%, meaning they now have 3 providers....the silver plans in this State, are only 5 plans to choose from....hopefully they got it right???

 

[beagle9]

. Care to tell me where it is that I am misinformed or that I'm lying ?

I already have.

Your neighbor's wife did not buy a plan on the ACA exchange only to be refused medical care. There is no such thing as an ACA approved plan that isn't any good.

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

All of it.

. Care to answer the questions or you got no answers on this one ? Was it not proven a lie that people would be allowed or would be able to keep their existing plans or doctors ??? If these Doctors or plans became an out of network option, then of course specialist would refuse the ACA plan just as the ACA would refuse them because of no payment transfers allowed right ?

Did they ask if it would make a difference if they hadn't bought on the exchange? If it did then that doc did accept it.

. Not sure what you're saying or asking here. Ask who if it would make a difference ?

 

[beagle9]

. So your saying that medical facilities that provide specialized care for specific problems aren't telling a person with an ACA plan that they don't accept that insurance ?? Because that's what took place, and then his wife had to go to a facility or Doctor that did take the insurance, but they felt that the care would be far less on what they were hoping for, and it was far less than they were hoping for.

Now what ?

So they can't see the specialist of choice right ? Kind of like "you can keep your plan or doctor" right ?? That was a proven huge lie wasn't it ?? So where am I lying now ??

It's not that they didn't accept an ACA plan it's they were not in the network for the particular insurance company. If they had have been in network they would have been required by their contract with that insurance company to accept it.

. Why wouldn't a renown specialist not be in the network ?? Charge to much for his specialized services maybe ?? So other words now we get into death panels because if a patient has to opt for the cheaper care, then doesn't that place that patient in danger of dying because she can't get the care that might save her life or in the case of not dying to at least make her life more tolerable and less painful ?

See above, he might have known his trade but not his contracts.

. Again, didn't Obama say that people were going to be able to keep their plans and their doctors ?? Was that a lie of epic proportions or what ???

If they accepted off exchange they were under contract to accept it on exchange.

I'm lost..

 

[beagle9]

Merry Christmas to all... Gotta go. ☺

 

[beagle9]

Hope everyone has a great one, and remember Jesus is the reason for the Christmas season. Peace.