ACA/Obamacare for American Cruisers Abroad MERGED THREADS

[SV THIRD DAY]

I'm in a position where I need a Colonosopy every year....
In the US I was paying $3500 to $5000 for the procedure.
Then I discover, while cruising and living in Mexico, that I can pay $385 for the Colonosopy done with the same of better equipment by a Dr with every bit of training and experience as the Dr in the USA. No forms to fill out. No SS number this, health insurance that. I just gave the Doc $385 and he gave me a DVD of the prodedure so I can compare my cronic condition from year to year to better monitor it. I could never get a recording of the procedure in the USA due to Malppartice concerns...Plus I have something fun to show a parties...ha ah ah.

I will never have a Colononsopy agian in the USA...plus there is no Big Government system keeping my records to screw me down the road...let the NSA do that without me giving them the help.

I somehow managed to do all this without some Govennt beurocrat or asking my neighbor to pay for it....WOW....imagine that....taking personal responsibility....

[Therapy]

Originally Posted by rebel heart

I've seen plan costs change because the PPACA requires plans to meet certain minimum "essential health benefits". No annual max, no lifetime max, ambulance services, and mental health are among the big ones. So for plans that didn't cover those that now have to, the costs have gone up.

For plans that did have those services, the costs have remained relatively unchanged and the proposed argument is the costs should come down because of increased competition.

I am late finding this thread and usually read it all before commenting but not today, sorry.

Maybe no maxes but....

From talking to others that have begun research, I am not seeing reduced costs here. Only raised ones. I will see about me specifically after the hordes quit crashing the site.

Competition = Pfftt.
They still restrict you to your state. No nationwide shopping.

The insurance companies are loving it.

[goboatingnow]

Originally Posted by jkindredpdx

My parameters: 59yrs in 2014, Single, non tobacco, no pre-existings. The $230/mo I quoted was the least expensive for which I was eligible. $5,000 is the highest deductible I'm allowed. $6350 is maximum OOP/Out Of Pocket (most I'd have to pay). After that it's covered 100%. Some plans provide free or co-pay preventative care below the deductible is reached. Don't know about prescriptions. That is what I gleaned from the FAQs posted on the site for Oregon. I assume each state has differences.

$500-$1000 ded is priced about $350-$600/mo. I didn't see an option for an HSA, but I would deposit into one if I can, you can then use those dollars to cover the payments, co-pay, and not covered procedures if any tax free. I don't qualify for subsidy but I understand there is a sliding Tax break.

SO let my poor European head get around all the TLAs.

You pay 230 a month, but have a 5000 deductible, and 6550 OOP

so lets say you have a procedure, that costs 20K, does that mean you pay 5000 ( as the deductible ) and hence on any other subsequents claims you only pay 1350 , am I right.

So after the deductible are you covered for the total cost of the procedure upto any limit. if the procedure is below the deductible have you to pay that all yourself?

Does co-pay come into this , is there a co-pay or is it just a deductible

actuarial healthcare plans wreck my head.

Tks , appreciate the replies

dave

[Boatguy30]

Originally Posted by SV THIRD DAY

I'm in a position where I need a Colonosopy every year....
In the US I was paying $3500 to $5000 for the procedure.
Then I discover, while cruising and living in Mexico, that I can pay $385 for the Colonosopy done with the same of better equipment by a Dr with every bit of training and experience as the Dr in the USA. No forms to fill out. No SS number this, health insurance that. I just gave the Doc $385 and he gave me a DVD of the prodedure so I can compare my cronic condition from year to year to better monitor it. I could never get a recording of the procedure in the USA due to Malppartice concerns...Plus I have something fun to show a parties...ha ah ah.

I will never have a Colononsopy agian in the USA...plus there is no Big Government system keeping my records to screw me down the road...let the NSA do that without me giving them the help.

I somehow managed to do all this without some Govennt beurocrat or asking my neighbor to pay for it....WOW....imagine that....taking personal responsibility....

I assume this means that you will never enroll in Medicare. You wouldn't want your neighbor paying any of your freight.

To me this it what's all about. You look around and most bemoaning reform are either on VA, Medicare, spouse is a school teachers, or is close to 65 and wants to loaf along just a bit longer.

While I appreciate that no one likes taxes and helping "those" other people. this is the way healthcare works in 1st world countries.

I also know plenty would prefer to keep their retirement cost of living low even if it means the US sliding toward third world labor laws and environmental conditions. not me and however many other millions of Americans that voted in 2008 and 2012

[goboatingnow]

Originally Posted by SV THIRD DAY

I'm in a position where I need a Colonosopy every year....
In the US I was paying $3500 to $5000 for the procedure.
Then I discover, while cruising and living in Mexico, that I can pay $385 for the Colonosopy done with the same of better equipment by a Dr with every bit of training and experience as the Dr in the USA. No forms to fill out. No SS number this, health insurance that. I just gave the Doc $385 and he gave me a DVD of the prodedure so I can compare my cronic condition from year to year to better monitor it. I could never get a recording of the procedure in the USA due to Malppartice concerns...Plus I have something fun to show a parties...ha ah ah.

I will never have a Colononsopy agian in the USA...plus there is no Big Government system keeping my records to screw me down the road...let the NSA do that without me giving them the help.

I somehow managed to do all this without some Govennt beurocrat or asking my neighbor to pay for it....WOW....imagine that....taking personal responsibility....

Thats fine, but unfortunately , even in cheaper countries, certain procedure and or their associated drugs get very expensive. what happens when you cant afford the costs. do we just put you in a black bag?

You think you can find a heart transplant for 50 quid like.

dave

[sailpower]

Originally Posted by MBLittle

I assume you mean republicans.

If you have been following this then you know that is not the correct answer.

This forum is not the place to get into all of the politics. I am carefully not arguing for or against the ACA but simply pointing out how it came to be.

My comments stand as accurate facts regardless of political persuasion. Is it reasonable to you that anyone should be exempted from this sweeping change most particularly those that passed it?

It is now the law of the land. Clearly there are winners and losers. Ten years from now we will know how it all worked out.

[Boatguy30]

Originally Posted by belizesailor

Depends on your overhead, its not what you make but what you spend. When I was a young engineer only making $40K, I had plenty of cash because my overhead was almost zero. I now have friends making 10x that who would have trouble putting their hands on $6K because they have huge overhead.

Also, borrowing 6K, or owing that to the medical service providers, is certainly far from an insurmountable burden on $40K.

I've been hearing interviews with employers about how there employees won't even be able to pay the $40 or so a month the cheapest policy will cost the lowest paid people with the subs.

Seriously, pay the guy a quarter (.$25) more an hour and have a happier, healthier, more productive worker.

somewhere we have lost all sight of the value in having a reasonable secure society.

[goboatingnow]

Originally Posted by sailpower

If you have been following this then you know that is not the correct answer.

This forum is not the place to get into all of the politics. I am carefully not arguing for or against the ACA but simply pointing out how it came to be.

My comments stand as accurate facts regardless of political persuasion. Is it reasonable to you that anyone should be exempted from this sweeping change most particularly those that passed it?

It is now the law of the land. Clearly there are winners and losers. Ten years from now we will know how it all worked out.

Wiki clearly says its a myth that congressmen and Senators can bypass the ACA, I quote

The ACA requires that members of Congress and their staffs obtain health insurance either through an exchange or some other program approved by the law (such as Medicare), instead of using the current government program (the Federal Employees Health Benefits Program); and the federal government will, like large private employers, maintain its contributions to the new health insurance plans of federal employees.

SO....

dave

[Boatguy30]

Originally Posted by Pete7

Suddenly the UK's National Health Service including the ambulance service funded centrally by Government looks like a model of simplicity. Whether it is affordable in the future decades is a different question, but health care regardless of problem is free at the point of treatment including all follow up appointments. Visits to your doctor also free, with minor charge $10 for prescription drugs. The true cost being incorporated in general taxation.

Oh and it works when you are visiting other foreign exotic European counties as well which is kind of neat when you go sailing.

Pete

Don't forget the private hospitals for the rich. the zero cost thing is surprising. In NZ you pay like $40 to see a doctor unless you are very poor and doctors don't have to take you in that case if they don't want to.

there is also a private system, but most the older folks are in the public system not in a separate politically off limit Medicare system like the US so it keeps enough pressure on the politicians to keep the system reasonable for all.

In Canada, they are very proud they have no private hospitals. But wealthy Canadians just come to the US for care and tell us how much better it is just to pay cash.

[Boatguy30]

Originally Posted by goboatingnow

Wiki clearly says its a myth that congressmen and Senators can bypass the ACA, I quote



SO....

dave

Ok, here's the real deal was just on NPR

Staffers used to get their coverage paid for. Congress was going to give them a lump sum like Trader joes is. So they would have the same deal as before just thru different means.

Now, AM radio gets wind of this and all of a sudden congress staffers are getting a special deal even though it was the same deal they had before.

Now, they have a MAJOR net pay cut as they have to pay out of pocket.

On the upside, will make sure they become lobbyists that much sooner.

[Ocean Girl]

Originally Posted by belizesailor

Wow, good luck for, and to you. Had a freind just a couple of years ago diagnosed with a large brain tumor. No coverage, hit him hard financially, but he was in strong fianancial condition and it was a survivable hit, he lived thru it too.

Hope the ACA works well for you and your outcome is good.

If your up for it, keep us posted on how it works out.

Thanks, I'm cured. Though they had to break a lot of things to cure me. Kinda like replacing the chain plates on a boat, the process isn't pretty, boats a mess, but once it's all put back together she is good to go, and better for it

Pre existing condition has not been a problem so far, but when we drop my husband's employee insurance to go cruising, I was concerned I would never get covered again.

I'm glad your friend recovered, its a crazy ride.

[DiverChick71]

Originally Posted by Ocean Girl

Thanks, I'm cured. Though they had to break a lot of things to cure me. Kinda like replacing the chain plates on a boat, the process isn't pretty, boats a mess, but once it's all put back together she is good to go, and better for it Pre existing condition has not been a problem so far, but when we drop my husband's employee insurance to go cruising, I was concerned I would never get covered again. I'm glad your friend recovered, its a crazy ride.

I disagree with a lot if ACA, but I am go

[goboatingnow]

Originally Posted by Boatguy30

Don't forget the private hospitals for the rich. the zero cost thing is surprising. In NZ you pay like $40 to see a doctor unless you are very poor and doctors don't have to take you in that case if they don't want to.

there is also a private system, but most the older folks are in the public system not in a separate politically off limit Medicare system like the US so it keeps enough pressure on the politicians to keep the system reasonable for all.

In Canada, they are very proud they have no private hospitals. But wealthy Canadians just come to the US for care and tell us how much better it is just to pay cash.

You cannot criticise a health system, by what the "rich" do. Whether they pay direct , take out huge insurance schemes or frequent hospitals that look like the RItz Carlton is simply irrelevant. Who is to say they get better treatment anyway , they seem to die like the rest of us.

the UK is very unusual in that there is no accounting for moral hazard. but the system seems to work and is dear to the populace. you tamper with it at your peril in the UK.

Most European countries tend to have partial single payer systems of one form or another, which blanket cover for the poor ( ie below a income line) . The balance is made up in several ways. in some countries say like Sweden the balance is very small, typically capped or 3%. in France the balance is 30%, Germany has a standarised national insurance scheme and outside that private insurance, ( its has a certain co-pay to prevent moral hazard). Ireland has free hospital care , though not GP care, unless below poverty line, but doesn't have the money to fund it properly and hence resources are strched and most people , earning a wage take out insurance to access private facilites ( often in public hospitals) Ive used the French, UK and Irish systems , I prefer the french as it seems the best resourced, The NHS is struggling under this current silly gov.


You have to look at the generality of people, rather then the rich
dave

[DiverChick71]

Originally Posted by Ocean Girl

Thanks, I'm cured. Though they had to break a lot of things to cure me. Kinda like replacing the chain plates on a boat, the process isn't pretty, boats a mess, but once it's all put back together she is good to go, and better for it Pre existing condition has not been a problem so far, but when we drop my husband's employee insurance to go cruising, I was concerned I would never get covered again. I'm glad your friend recovered, its a crazy ride.

I disagreed with a lot of ACA but as a nurse, I was happy to see that pre-existing conditions were addressed.

Btw my ex was just one year into remission with cancer when we went to Costa Rica to spend a couple of years hanging out. His care there was excellent and his appt with an oncologist was about $80 USD. His doc was US trained, as is my ob-gn.

[Boatguy30]

Originally Posted by goboatingnow

You cannot criticise a health system, by what the "rich" do. Whether they pay direct , take out huge insurance schemes or frequent hospitals that look like the RItz Carlton is simply irrelevant. Who is to say they get better treatment anyway , they seem to die like the rest of us.

the UK is very unusual in that there is no accounting for moral hazard. but the system seems to work and is dear to the populace. you tamper with it at your peril in the UK.

Most European countries tend to have partial single payer systems of one form or another, which blanket cover for the poor ( ie below a income line) . The balance is made up in several ways. in some countries say like Sweden the balance is very small, typically capped or 3%. in France the balance is 30%, Germany has a standarised national insurance scheme and outside that private insurance, ( its has a certain co-pay to prevent moral hazard).


You have to look at the generality of people, rather then the rich
dave

No you see, people in the US have come to expect their hospitals to look like that. That's one of the things making it all so expensive! the pretense of quality.

when my daughter was born in NZ, the small country hospital was being renovated and you had to enter maternity thru the service area behind the hospital. Looks like going thru the Chernobyl site or something.

She had great care, was in the hospital w/ baby for 6 days. Would have been sent home in 36 hours or so in the US and separated from baby. when she was released they had just completed the new fancy sliding glass front door to the ward!