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Frontline Ltd. Message Board

  • rogere1946 rogere1946 Aug 18, 2014 3:48 PM Flag

    ACA area of coverage that was not available before

    You have no insurance. you get into an accident and blow out your knee. If your lucky you get surgery to "fix" the knee (maybe not since it is not life threatening so to go from ER to Hospital for treatment with no insurance and no medicare is not required but under ACA all could get surgery.

    OK lets say you get the surgery somehow without insurance and not on medicade nore midecare and no insurance. You get NO physical therapy to get you back to your job or life. ACA being insurance will pay for this and get you well again. The working folks who do not want to pay for ACA I nsurance (the youngsters)
    are the ones who would gain most from this. Young and working to get ahead too cheap or stupid to buy insurance or even have a pre existing condition that would not allow any coverage. They injure themselves with a situation that will keep them out of the work force. Some will lose their jobs, some will go untreated beyond the ER. PT helps them heal and get back to work faster. thus ACA will be a blessing to those who find themselves in that situation. How many? One is enough if it you, your son or daughter since the cost to "fix" the problem will be a family affair.

    One of my older PT guys a right wing GOP guy (very nice guy and yes we get alone good) was saying that with ACA more might be able to get PT thus job security for him. Was he for it? Of course not lol.

    Yes the insurance that is selected would determind if any treatment would be available but if one was smart they could get insurance that would protect their faster recovery from an injury. All job related injuries get PT treatment and medicare pays a flat 1900.00 bucks for treatment with an addition 1800.00 if a need or condition is bad enough to warrant such treatment.

    Another example of things you do not think about unless you be walking in those shoes or trying to start walking again with help from PT.

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    • My inexpensive catastrophic plan has/had essentially the same "all in" out-of-pocket cost as the cheapest ACA mandated plan. It covers(ed) PT. The premium is / was 1/2 that of the cheapest ACA mandated plan.

      Perhaps you can explain how **doubling** the premium for basic insurance will encourage young folks to purchase coverage where they had been reluctant to do so before. Please explain.

    • Hi Mr. Rogere,

      A couple of thoughts on this.

      For the younger people without insurance coverage, that have very low premium payments, I don't think there is anything that you have suggested, that will push them over the line and get them to purchase insurance.

      Also, when that person has that problem with their knee, they now have a new medical situation. Within 2 weeks they can get insurance. This would then cover their PT if covered as you say.

      The biggest resistance to coverage for young people I think, past the premiums though low especially if subsidized, is the deductible. It seems to me that if the premiums are trivial, the deductible doesn't actually impact the decision very much. But if premiums are high, combined with a high deductible, it just looks like wasted money most of the time. The young tend to think of themselves as invincible, and don't expect that they will be the one that needs the help.

      Hospitals are still doing free services for the poor, but are looking into changing their policies.

      "Hospitals rethink charity for those passing on Obamacare"

      modernhealthcareDOTKOM/article/20140308/MAGAZINE/303089981

      "Millions of Americans eligible for Obamacare premium subsidies are considering whether to buy health insurance before the March 31 open enrollment deadline. Officials at UnityPoint Health-Trinity, with four hospitals in Iowa and Illinois, are debating how to proceed if their patients don't get coverage.

      They are mulling how to handle charity care for uninsured, non-Medicaid-eligible patients who come in for treatment and who could have but did not obtain subsidized coverage through the federal insurance exchange. Their question is whether such patients should receive full charity care—either free care or deep discounts on their bills—when they had a source of affordable coverage under the Patient Protection and Affordable Care Act and did not take advantage of it. "
      -------------------

      That's what's going to bite them

      JMT BOL BS

      • 1 Reply to barbershores
      • "The biggest resistance to coverage for young people I think, past the premiums though low especially if subsidized, is the deductible. It seems to me that if the premiums are trivial, the deductible doesn't actually impact the decision very much. But if premiums are high, combined with a high deductible, it just looks like wasted money most of the time. The young tend to think of themselves as invincible, and don't expect that they will be the one that needs the help."

        So true. I have a 27 year old son, college educated and self employed, who still has not gotten around to getting health care insurance for the very reasons you describe.

 
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