Affordable Care Act - catastrophic plans cancelled

[CatInHand]

Originally Posted by Stugots

Open enrollment for 2014 is Oct 1, 2013 to March 31, 2014.
https://www.healthcare.gov/glossary/...llment-period/

And come on man, don't be like that.

What Stu said. The rules are pretty clear, if you take a few minutes to read them.

[SURV69]

many posters that either are or expect to be full time sailing & liveaboard , seem to "earn"(I used the term loosely), much less than 40k a year.

For me I get a retirement of $750.00 per month until the V.A. supplement kicks in.

It appears to me that many full time cruisers/liveaboards will benefit from the new health care.

Personally I get V.A. medical and love it.

From what I've seen, most sailors I've met, are not "rich" and live lives of watching pennies.

I don't care much for the ACA, but isn't it really a much better ... much safer way to go for the majority of full-time boaters?

[colemj]

Originally Posted by Mark Johnson

Since most Americans are so opposed to this form of socialized health care

Until they turn 65, apparently. My father, who is living on social security and medicare, rails against socialized medicine and social liberals, etc.

He doesn't understand the irony.

The following is a serious question based on a lack of my understanding and not a debating point I'm trying to make:

People keep talking about self-insuring and only getting insurance if something big happens. If one decides not to get insurance unless something catastrophic happens that would cost a lot of money, how does one go about then obtaining insurance? I know they now cannot deny pre-existing conditions, but do you just show up at a hospital and demand an instant insurance form and write a premium check?

Even if the problem isn't acute and you could wait a short period of time before needing the healthcare, will you be able to get insurance in a week or two after they process the paperwork or whatever?

Mark

[Group9]

Originally Posted by Stugots

Open enrollment for 2014 is Oct 1, 2013 to March 31, 2014.
https://www.healthcare.gov/glossary/...llment-period/

And come on man, don't be like that.

Be like what? I know a lot of firms and businesses that could sure benefit from consulting with you (not to mention HHS and the WH).

You seem to be a lot more sure of what is going to happen with it than the people who designed it and are running it.

[Cotemar]

Originally Posted by colemj

Until they turn 65, apparently. My father, who is living on social security and medicare, rails against socialized medicine and social liberals, etc.

He doesn't understand the irony.

The following is a serious question based on a lack of my understanding and not a debating point I'm trying to make:

People keep talking about self-insuring and only getting insurance if something big happens. If one decides not to get insurance unless something catastrophic happens that would cost a lot of money, how does one go about then obtaining insurance? I know they now cannot deny pre-existing conditions, but do you just show up at a hospital and demand an instant insurance form and write a premium check?

Even if the problem isn't acute and you could wait a short period of time before needing the healthcare, will you be able to get insurance in a week or two after they process the paperwork or whatever?

Mark

Mark,

You have been cruising for many years now. Do you have medical insurance?

Every year I meet long time cruisers and ask how much it cost them to cruise per year and how much their medical insurance cost?

The nice family I met this year (2013) in Newport RI. had two young kids aboard and they had been out for 5 years. They said that it cost them $18,000 usd per year to cruise with most going to boat maintenance.

When I asked where the kids were born, she said right back here, pointing to the stern stateroom.
She said that they do not have medical insurance and if anything major came up they would hop on a plane for their homeland of Honduras as the medical is as good as the US and much cheaper.

[softgoodsint]

My comment about "going naked" is timing and about "self insuring" is costs. I was also lucky for a few years w/o coverage, but am sleeping better with my [expensive] $10K deductible policy.
The reason I say that is my Dentist's experience (obviously good income - owns practice). Living in a city of a million (not venturing into a jungle), bitten by a Brown Recluse Spider at home, she would have had a hard time getting coverage as she rushed to the ER. A year of meds & other treatment, she shared that if she hadn't have coverage, her out of pocket would have been $60K.
So I understand the just in time part, if you've just been diagnosed and you're a week or two before some treatment, but I don't think that can be foolproof in cases like this or accident. What would happen with a major injury scenario where you wouldn't be able to submit paperwork and wait?
P.S. I appreciate the importance of "being constructive" with this topic and am honoring that request. I'm happy for those who are helped by this.

[CarlF]

Originally Posted by Group9

You seem to be a lot more sure of what is going to happen with it than the people who designed it and are running it.

Nonsense, the people running this know just what's going on and have done a good job despite a lot of states trying to make it harder than necessary.

The plans are ready and priced. Sure, the web site had some early problems but that's true of just about every new web site. Take a breath. No one will be worried about the web site in a few months.

Wait until December to sign up on the web site (the insurance doesn't even start until Jan 1) or call the telephone number that works just fine now. Geez.

Unless you have a six figure income , ACA seems like a great thing for US cruisers. And I don't think Obama is even a sailor

[colemj]

Originally Posted by Cotemar

Mark,

You have been cruising for many years now. Do you have medical insurance?

Every year I meet long time cruisers and ask how much it cost them to cruise per year and how much their medical insurance cost?

The nice family I met this year (2013) in Newport RI. had two young kids aboard and they had been out for 5 years. They said that it cost them $18,000 usd per year to cruise with most going to boat maintenance.

When I asked where the kids were born, she said right back here, pointing to the stern stateroom.
She said that they do not have medical insurance and if anything major came up they would hop on a plane for their homeland of Honduras as the medical is as good as the US and much cheaper.

We have a catastrophic plan through Blue Cross. There are no benefits and we are on the hook for the first $10,000, after which they pay. If we have a catastrophic illness on Dec. 31, we pay $10,000 and on Jan 1, we pay another $10,000 - after which they graciously pay until Dec 31 until hitting us up again.

This so-called "health plan" costs us $4,000/yr (more than our boat insurance in hurricane zones and a 3X higher deductible) for two healthy people ages 45 and 50 with no prior health problems or conditions. The price of this tremendous service has increased 20% each year for the past 5 years.

While Blue Cross and the rest of the US calls it "health insurance", we have never seen it in this light. To us it is "investment and asset insurance" - the entire purpose of which is to protect everything we own from being taken away from us in one fell swoop by a catastrophic illness. We don't view it in any way as purchasing access to affordable health care.

So I guess the answer to your question is No, we do not have medical insurance. Our assets are insured to a moderate level of care, however.

Your acquaintance is correct. We have yet to go anywhere that did not have as good, or better, health care than the US. And that includes all of what the US considers third world nations. When we do need healthcare, we simply go get it immediately and pay for it with the money we have in our pockets.

Literally. For $100, you can get an eye exam and treatment for a scratched cornea, a diagnosis and antibiotics for an ear infection, and get your teeth cleaned. And I don't mean $100 for each of those, although a filling will cost another $25 if you have hit the sugar too hard. Throw in another $50 and a dermatologist will remove that funny looking skin patch. All in modern, clean facilities with excellent physicians and dentists. And access is immediate or almost immediate - we get treatment upon walk-in or within a day or two for things like dental appointments. In the US, we usually can't get routine medical treatment at all because we aren't an "existing patient" or cannot wait two months for the next opening.

It is so ridiculously good and inexpensive outside the US, that we cannot understand why people in the US do not just fly to Guatemala or Panama or Mexico or Colombia or anywhere else for non-emergency medical care. You could fly to Panama (the major hospital is owned and operated by Johns Hopkins) or Guatemala, stay in a nice hotel, go to a state-of-the-art hospital or clinical facility and get cataract surgery with new state-of-the-art lens implants, then get a root canal and go home all total for less than 50% of the cost of doing it in the US (I pulled up these two medical examples because we have friends who have recently done just these and know the cost difference). Plus you get to lay on a beach under a palm tree or go visit some Mayan ruins.

Mark

[Stugots]

Originally Posted by Group9

Be like what? I know a lot of firms and businesses that could sure benefit from consulting with you (not to mention HHS and the WH).

You seem to be a lot more sure of what is going to happen with it than the people who designed it and are running it.

You asked a specific question. I provided an answer to your question. Not sure what the problem is.

[rebel heart]

Originally Posted by colemj

Until they turn 65, apparently. My father, who is living on social security and medicare, rails against socialized medicine and social liberals, etc.

He doesn't understand the irony.

Exact same case with my parents. Railing against social services as they withdraw social security cash from the ATM and use VA/Medicaire funding.

[sailorboy1]

People need to keep in mind that for those answers that involve "self insurance" for big things where they say they will "hop on a plane to XX" or to those that say if something happens they will travel to somewhere else less expensive; that all this assumes you CAN do this!

When I had my heart attack earlier in the year I couldn't just catch a plane and go somewhere else. The above thinking is only good if whatever you have can wait a few days!

[colemj]

Originally Posted by sailorboy1

When I had my heart attack earlier in the year I couldn't just catch a plane and go somewhere else. The above thinking is only good if whatever you have can wait a few days!

And even if you could, that type of illness is still expensive in other countries, relative to many people's bank accounts. This is why we have catastrophic asset insurance (I no longer refer to it as medical insurance).

Mark

[goboatingnow]

Originally Posted by transmitterdan

Since the preexisting condition limitation is gone can you go "naked" and if something happens sign up then?

Surely , there will be clauses to prevent that type of moral hazard. In my case this side of the pond there is a 13 week before the first claim. There is no pre conditions ( as its community rated ) but there is a delay.

I suspect the small print will attempt to mitigate that issue

Dave

[colemj]

Originally Posted by goboatingnow

Surely , there will be clauses to prevent that type of moral hazard.

If I can ever get past the sign-in page I will let you know.

Mark

[Captain Bill]

I saw a thing on TV that said that all current catostrophic plans could remain in place to 2015 even if they did not meet the ACA requirements. They just could not sell new policies not meeting the ACA requirements. If companies are canceling existing policies because they don't meet the ACA requirements for new policies, that is a company business decision, not a requirement of the ACA. It sounds to me like a bunch of crooks looking to force you to a higher end policy a year before it is required and lining their pockets.