Insurance Rant

January 27, 2014 at 5:05 pm (Uncategorized) (, , , , , , )

I know I haven’t been posting too much and that’s mostly because I try to abide by the adage that if you can’t say anything nice, you shouldn’t say anything at all.  I’m still job searching and while I’ve had at least two interviews a week every week so far this month, nothing has completely come through for me.  I’m trying to stay optimistic though and have two new recruiters I’m meeting with this week so hopefully my phone will continue to ring and I’ll find something sooner rather than later.

The weather also sucks, which of course never helps.  I’ve been logging some good gym time (except today; more on that later) but that’s about the only thing I’ve been doing.  The days seem to run together all too easily and that’s a little crazy.  For instance – I’ll be 30 in 8 days.  That’s even crazier!  It would be a wonderful birthday present to have a job by then but I won’t hold my breath.  I’m saving that to blow out all those damn candles anyway.

Since the days have been blurring together, I’m doing my best to stay on top of my bills.  Don’t worry, credit score, I haven’t missed any yet.  In an effort to keep on the ball, I logged onto my health insurance site earlier today to make a payment for next month.  The company I worked for that closed last month tripled our insurance payments recently so I was forced to get my own independent plan.  It’s not exactly cheap but since my luck would have me falling and breaking every bone in my leg the minute I tried to go sans insurance, I thought it best to remain covered.  I encountered a snafu last month when they double-billed me for my January payment but after spending a good deal of time on the phone, I was assured it had been straightened out.  According to the woman I talked to then, at least.  So while I’ve been lucky in that I haven’t needed to use it, I’ve spent this month blissfully thinking I was fully covered.  Until today.  When I got online to make my payment for February, I was told my policy was cancelled on January 1st.

Excuse me, what?

Can’t they just throw a dog a bone?

Apparently the lady I spoke to last month lied.  Or was confused, or hated me or something.  Even though they kept my original payment for January, they weren’t covering me – obviously, this did not please me.  At the time of my typing this, I have been on the phone for 3 hours, 7 minutes and 17 seconds trying to straighten this out.  I kind of feel like Phoebe in that episode of Friends where she stays on hold three straight days because at some point it just became a matter of principle.  In that episode, she was dismayed to learn that she had dialed an 888 number that wasn’t toll-free.  I sort of feel like that because I’ve used an insane amount of my paltry cell phone minutes to figure this out.  I’m very proud of myself though, I have not cussed or screamed and I’ve only broken down in tears once, so I’m considering myself a winner right now.  It also looks like they’re going to be able to work this out and do so in a way that it does not show I had a lapse in coverage, which is great because in my mind I didn’t.  Apparently this is a lesson in why I should start recording all of my phone conversations.

Why isn’t stuff like dealing with shitty insurance companies and policies taught to us in high school?  I sure think this would have benefited me more than that geology class I was forced to pass.

Okay.  Still on hold and still hoping this will all work out in my favor.  In order for it to REALLY work out in my favor, I’ll get a new job ASAP and it will pay at least some if not most of my insurance for me.  C’mon jobby job job, I know you’re out there!  You wouldn’t want to disappoint an old woman, now would you?

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Thanks, Obama!

October 7, 2013 at 11:44 am (Uncategorized) (, , , , , , , )

While the nation rants and rages over the Affordable Health Care Act, I’d just like to say how it is directly affecting me.  I realize that I’m pretty healthy and don’t need to utilize my insurance much (thankfully, because even for the healthy that stuff is expensive as hell) but I do have one prescription I get each month.  That would be my birth control.  I’ve been taking The Pill basically for as long as I’ve been getting periods because mine were particularly unmanageable as a teenager and the pill really helped.  Of course, once I got older I enjoyed the other perks of contraception, but I’ve always had to pay for it.  Even being completely covered by an insurance plan, I’ve had to shell out roughly $15 a month for my pills.  While I realize that isn’t a lot, an extra $180 a year could come in handy.  I could spend it on candy!  Or ice cream!  Or Cheeze-Its!  Or gas to go home for a couple of weekends!  Or more candy!

Thanks to the Affordable Health Care Act, I now get to save that cash each month as my pills are covered.  They’re actually an entirelly different type of pill

Free!

All this for the low low price of NOTHING!

than I used to take and I’ll now only get my period once every three months instead of once every month.  While I like the checks and balances of a monthly period, I also like not paying for birth control and paying way less for tampons and chocolate bars.

Our healthcare system in America is far from perfect (it’s actually pretty awful).  I’m not naive to think that Obamacare will really help everyone who needs it and I’m not even positive it’s going to help me much more than the whole free birth control thing.  What I do know is that it’s at least a step in the right direction and fighting over funding something that’s already been passed into a law is just kind of dumb.

For a more concise breakdown over what damage government shutdown is actually doing, please read this blog post by The Bloggess (who’s pretty great in her own right).  She also outlines a few ways you can help, mostly by donating to Feeding America (which helps the food pantry I volunteer for, among countless others) and by donating blood.  This political standoff is hurting many, many people and it’s really just because the two political parties that we’re stuck with can’t seem to compromise or even get along.  It’s embarrassing as an American, especially since there’s nothing I can actually do about it.

Stupid politicians.  I guess if I wanted to get paid for not doing my job I should’ve moved to Washington.

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So Now What?

June 29, 2012 at 11:19 am (Uncategorized) (, , , )

Unless you’re living under a rock (in which case, how are you using a computer?), you’ve probably heard all about the new health care coverage plan – not so affectionately dubbed Obamacare –  that the Supreme Court voted on yesterday.  It’s a confusing and divisive issue but I really do think that knowledge is power (cue 90’s inspirational message here) so I’m hoping I can help clear up some of that here.  Below is text from a website that I frequent and I believe it breaks down this health care plan so most anyone can understand the basics.  I know it’s long and a lot of it might be dry reading (not everything is 50 Shades of Grey) but this is important stuff and it affects you whether you like it or not.  Besides, if these insanely hot temperatures persist over the next few years, you might start using your health insurance more than you can now imagine.  So go ahead and learn a little more about it.

Okay, explained like you’re a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:

What people call “Obamacare” is actually the Patient Protection and Affordable Care Act. However, people were calling it “Obamacare” before everyone even hammered out what it would be. It’s a term mostly used by people who don’t like the PPACA, and it’s become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn’t have to.

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

(Note: Page numbers listed in citations are the page numbers within the actual document, not the page numbers of the PDF file)

Already in effect:

  • It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )
  • It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 216, sec. 2501 )
  • It establishes a non-profit group, that the government doesn’t directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181 )
  • It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )
  • It makes a “high-risk pool” for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of “pre-existing conditions” altogether. For now, people who already have health issues that would be considered “pre-existing conditions” can still get insurance, but at different rates than people without them. ( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec. 2702 )
  • It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 47, sec. 2705 )
  • It renews some old policies, and calls for the appointment of various positions.
  • It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )
  • It says that health insurance companies can no longer tell customers that they won’t get any more coverage because they have hit a “lifetime limit”. Basically, if someone has paid for health insurance, that company can’t tell that person that he’s used that insurance too much throughout his life so they won’t cover him any more. They can’t do this for lifetime spending, and they’re limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )
  • Kids can continue to be covered by their parents’ health insurance until they’re 26. ( Citation: Page 15, sec. 2714 )
  • No more “pre-existing conditions” for kids under the age of 19. ( Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )
  • Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 47, sec. 2794 )
  • People in a “Medicare Gap” get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 379, sec. 3301 )
  • Insurers can’t just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )
  • Insurers have to tell customers what they’re spending money on. (Instead of just “administrative fee”, they have to be more specific).
  • Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they’re turned down. ( Citation: Page 42, sec. 2719 )
  • Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 699, sec. 6402 )
  • Medicare extends to smaller hospitals. ( Citation: Starting on page 344, the entire section “Part II” seems to deal with this )
  • Medicare patients with chronic illnesses must be monitored more thoroughly.
  • Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 492, sec. 4202 )
  • A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ). ( Citation: Page 36, sec. 1103 )
  • A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note – this program was temporary. It already ended) ( Citation: Page 830, sec. 9023 )
  • A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they’re not price-gouging customers. ( Citation: Page 22, sec. 1101 )
  • A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn’t paying for the Aspirin you bought for that hangover. ( Citation: Page 800, sec. 9003 )
  • Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 800, sec. 9002 )
  • Any new health plans must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 14, sec. 2713 )

1/1/2013

  • If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word “tiny”, a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we’re talking about people in the top 5% of earners. ( Citation: Page 818, sec. 9015 )

1/1/2014

This is when a lot of the really big changes happen.

  • No more “pre-existing conditions”. At all. People will be charged the same regardless of their medical history. ( Citation: Page 45, sec. 2704, Page 46, sec. 2701, and Page 57, sec. 1255 )
  • If you can afford insurance but do not get it, you will be charged a fee. This is the “mandate” that people are talking about. Basically, it’s a trade-off for the “pre-existing conditions” bit, saying that since insurers now have to cover you regardless of what you have, you can’t just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you’ll have to pay the fee instead, unless of course you’re not buying insurance because you just can’t afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it’s considered a tax on the uninsured and not a penalty for not buying insurance… nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 145, sec. 5000A, and here is the actual court ruling for those who wish to read it. )

Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can’t afford?

Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you’re worried about it. You can see it here.

Okay, have we got that settled? Okay, moving on…

  • Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 138, sec. 1421 )
  • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
  • Insurers now can’t do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )
  • Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 62, sec. 1302 )
  • Cut some Medicare spending
  • Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 801, sec. 9005 )
  • Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. ( Citation: Page 88, sec. 1311 )
  • Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won’t be footing their health care bills any more than any other American citizen. ( Citation: Page 81, sec. 1312 )
  • A new tax on pharmaceutical companies.
  • A new tax on the purchase of medical devices.
  • A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they’ll get taxed.
  • The amount you can deduct from your taxes for medical expenses increases.

An adorable picture of a baby panda as a reward because you are still reading

1/1/2015

  • Doctors’ pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you’re looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

1/1/2017

  • If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )

2018

  • All health care plans must now cover preventive care (not just the new ones).
  • A new tax on “Cadillac” health care plans (more expensive plans for rich people who want fancier coverage).

2020

  • The elimination of the “Medicare gap”

.

Aaaaand that’s it right there.

The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it’s not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.

Plus, as previously mentioned, it’s necessary if you’re doing away with “pre-existing conditions” because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.

Whew! Hope that answers the question!

Edits: Fixing typos.

Edit 2: Wow… people have a lot of questions. I’m afraid I can’t get to them now (got to go to work), but I’ll try to later.

Edit 3: Okay, I’m at work, so I can’t go really in-depth for some of the more complex questions just now, but I’ll try and address the simpler ones. Also, a few I’m seeing repeatedly:

  • For those looking for a source… well, here is the text of the bill, all 974 pages of it (as it sits currently after being amended multiple times). I can’t point out page numbers just now, but they’re there if you want them.
  • The website that was to be established, I think, is http://www.healthcare.gov/.
  • A lot of people are concerned about the 1/1/2015 bit that says that doctors’ pay will be tied to quality, not quantity. Because so many people want to know more about this, I’ve sought out what I believe to be the pertinent sections (From Page 307, section 3007). It looks like this part alters a part of another bill, the Social Security Act, passed a long while ago. That bill already regulates how doctors’ pay is determined. The PPACA just changes the criteria. Judging by how professionals are writing about it, it looks like this is just referring to Medicaid and Medicare. Basically, this is changing how much the government pays to doctors and medical groups, in situations where they are already responsible for pay.

Edit 4: Numerous people are pointing out I said “Medicare” when I meant “Medicaid”. Whoops. Fixed (I think).

Edit 5: Apparently I messed up the acronym (initialism?). Fixed.

Edit 6: Fixed a few more places where I mixed up terms (it was late, I was tired). Also, for everyone asking if they can post this elsewhere, feel free to.

Edit 7: Okay, I need to get to work. Thanks to everyone for the kind comments, and I hope I’ve addressed the questions most of you have (that I can actually answer). I just want to be sure to say, I’m just a guy. I’m no expert, and everything I posted here I attribute mostly to Wikipedia or the actual bill itself, with an occasional Google search to clarify stuff. I am absolutely not a difinitive source or expert. I was just trying to simplify things as best I can without dumbing them down. I’m glad that many of you found this helpful.

Edit 8: Wow, this has spread all over the internet… and I’m kinda’ embarrassed because what spread included all of my 2AM typos and mistakes. Well, it’s too late to undo my mistakes now that the floodgates have opened. I only hope that people aren’t too harsh on me for the stuff I’ve tried to go back and correct.

Edit 9: Added a few citations (easy-to-find stuff). But I gotta’ run, so the rest will have to wait.

Edit 10: Adding a few more citations (it’ll probably take me a while to get to all of them) and a few more additional entries as well.

Edit 11: Tons more citations!

Edit 12: I updated this with a reference to the recent court ruling on the mandate, and address the question everyone seems to be asking about it (“What if I can’t afford to buy insurance?”)

Edit 13: Okay, I’ve started up a “Obamacare” Point-By-Point, where I’m starting to go through the bill point by point and summarize it in the same order that everything is actually in the bill, so that hopefully, when I’m done, you can just use my version as a sort of Cliff’s Notes version of the bill. Whether or not I continue doing this depends on how much interest people have in it, but I figured I’d let you guys know about it here.

Edit 14: Adding in a few more citations and spelling/grammar edits.

Full source for even more information

I think when you get down to it, most everyone will be in favor of at least certain aspects of this bill.  I think it’s sad that certain politicians will do or say anything to get one of their own back in the White House, even if it means distorting pieces of new legislation.  The best thing the general public can do is to keep ourselves informed, so hopefully this post will help you do just that!

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Turn Your Head and Cough

June 3, 2010 at 1:21 pm (Uncategorized) (, , , , , )

Apologies all around for the lack of a post yesterday.  I was not around my office or even a computer, as I took the day off to have a couple of medical check ups (everything’s fine, no worries there).  Lots of waiting, filling out forms and the usual thrilling activities that go along with a trip to the doctor ensued.  This included wearing the fashionable paper robe, which I really wish I could’ve taken home with me.  I never knew such comfort existed until I donned myself in a cheaply made, synthetic paper material that barely covered my own ass.

I had to have some blood drawn, which always freaks me out a little and makes me wish for my mommy.  I was proud of myself for actually being able to take a peek at my arm while the needle was inserted without crying or passing out, so I feel like I’m making gains.  Looking at the vials of blood after it was removed from my body made me a bit nauseous but I was able to feign being a grown up and I did not lose my lunch.  I was actually feeling pretty good about my whole doctor experience until the very end – when they asked me to pee in a cup.

Anxiety set in.  I had been fighting the urge to urinate all through my examination and the minute someone told me I had to, it went away.  Awesome.  I took the little cup and locked myself in the bathroom, where we had a staring contest.  I eventually won and we got down to business.  Unfortunately, I have yet to figure out a way to pee in a cup without also peeing all over my hand, so yeah, that happened.  If any female out there has a pro tip they would like to share, I am all ears.  I’m not sure if it’s my lack of dexterity, general clumsiness or the wrath of the urination gods, but I’ve never gracefully completed that part of a visit to the doctor.  However, since I’m pretty sure the only other way to obtain a pee sample is to be hooked up to a catheter, I am 100% totally fine with a little splash on my phalanges.

Also, I’m very thankful I have health insurance.  I saw what some of the tests would cost sans insurance benefits, and wow is that a lot.  I hope to one day live in a place that doesn’t bankrupt its citizens for medical bills, but since that’s not happening right now I’ll just be glad for what I’ve got.

Pee soaked hand and all.

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