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E*TRADE Financial Corporation Message Board

  • caveatemptorbum caveatemptorbum Jan 31, 2014 3:09 PM Flag

    the dishonest gop talk about the ACA and keeping your doctor

    the simple truth is that you can use whatever doctor you like.

    the ACA has a max out of pocket for a single person of $6300 and so, no matter what doctor, and no matter if it was a $100K major medical catastrophe, that patient would never pay more than the $6300.

    This is the same as insurance has always been. My employer insurance has a network, and they have changed that network, adding some doctors and dropping others. and again, it is the same thing, a person can choose ANY doctor, however if one out of the net work is chosen, it will cost more for some things (not all as most preventive is now without any copay)........but the increased cost stops at the limit of the max copay

    SortNewest  |  Oldest  |  Most Replied Expand all replies
    • Your confused about the 6300 dollar deductible. Once you pay your 6300 dollar deductible THEN the insurance will pick up 70 or80 percent of your bill.
      You haven't done this insurance thing very long have you?

      • 1 Reply to cavalieroa
      • no, you are obviously among the legion of boobus gop who are totally clueless as to how health insurance works..... so here goes it ignoramus:
        for a bronze plan

        Deductible for an individual enrollee $5,000
        Annual cap on out-of-pocket costs for an individual $6,300

        Definition: (of out of pocket maximum)
        The yearly out-of-pocket maximum is the highest or total amount your health insurance company requires you to pay towards the cost of your health care.

        Out-of-pocket expenses are what you pay for health-related services above and beyond your monthly premium.
        The out-of-pocket maximum helps protect you from very high additional costs. In most cases, once you reach your health plan's out-of-pocket maximum, your insurance company will cover 100% of the costs they consider to be medically necessary

        So. lets say a person with a bronze plan gets a $100K bill.... what would they pay?

        well, they would pay 100% of the bill up to $5081
        then you would pay 40% of the bill until the max out of pocket is reached, then the plan pays 100%

        so this person would pay $6300 and the insurer would pay $93700.
        ++++++++++++++++++++++
        here is another example, from a plan offered by blue cross
        A health insurance example

        Let’s say you need health care. Imagine that you’ve had a serious accident and you have $50,000 in covered medical expenses.
        Deductible: $5,000
        Coinsurance: 20% (silver plan)

        Out-of-pocket maximum: $6,000

        How it works

        1. In this example, you’re responsible for the first $5,000 (your deductible).

        2. Then, until you reach the out-of-pocket maximum, you’re responsible for 20% coinsurance. Since the expenses are high, you’ll reach $6,000.

        3. Your health plan pays the rest of the covered expenses.

        4. For the rest of the year, you won’t need to pay anything for covered medical expenses.

        The costs for this incident

        You pay: $6,000

        Your health insurance pays: $44,000

        Total $50,000

    • is the following a fair summary of what you posted?

      obama said
      " you can keep your doctor, period."

      but what you're saying is that
      you can keep your doctor, period if you're willing to pay the additional costs required".

      • 1 Reply to pebble.ubetcha
      • are you stupid or what?
        for instance did you miss it that there is NO extra cost for using ANY doctor for a preventive service, there is NO copay for a preventive service..................did you miss it that because of the max out of pocket and individual would pay NO MORE than $6300 and no matter if it was a major medical expense costing $100K and NO MATTER WHAT doctor.? see, NO ADDITIONAL COST.

        did you miss it that this is the way insurance has ALWAYS been? Insurers have ALWAYS had net works and these networks could be change anytime..... but still... you could use ANY doctor?

        you are typically dishonest.

 
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