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Old 05-11-2013, 09:20   #211
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Re: Affordable Care Act - catastrophic plans cancelled

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There was a thread dealing with ACA and "Obamacare" that was closed down by the moderators because of sniping and politics in the thread. THIS IS THE MOST IMPORTANT ISSUE AFFECTING CRUISERS LIVING ABOARD IN OTHER COUNTRIES.

We had a "catastrophic" care plan by Blue Cross Blue Shield that had a $10,000 deductible. We have never reached the deductible, so essentially this is just money we spent to insure against a catastrophic illness. We paid about $650 per month. That plan is not considered ACA compliant, so it has been cancelled, and the "mapped plan" with its "added benefits" (that we will never use) is $1,200 per month. This borders on making cruising impractical.

I understand that if you live out of the country for 330 days a year, you can get an exemption from buying a policy, but we spend 60-90 days in the US, depending on circumstances. We are considering going "naked," with NO insurance at all, for the first time in our lives. It seems like the opposite effect of what is intended. It's a not a good choice, but it may be what allows us to stay out here. We will pay a penalty, initially of 1% of income from what I understand. And that penalty is, of course, for nothing. If we get cancer or seriously sick in some way we will not have coverage.

For routine care I find the European system to be fine. We are now in Turkey and health care is affordable and available. Still, like many others, if I get seriously sick I want to go "home" for treatment.

I am interested in what others see as the best options. Stay away from opinions and politics so we can discuss this important issue.
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Old 05-11-2013, 09:24   #212
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Re: Affordable Care Act - catastrophic plans cancelled

I suppose cruisers need a plan that does not include free preventative care. It seems like that would lower the cost for those who truly just want catastrophic.
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Old 05-11-2013, 09:26   #213
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Re: Affordable Care Act - catastrophic plans cancelled

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Actually, you don't have to do that. All you have to do is charge more for insurance to the folks to eat too many. That is the beauty of the free market.

Unless, of course, the government gets involved.
There isn't a free market for health care in the U.S., and there is no cost transparency or basis for competition. It's an interconnected set of monopolies who set their own rates among each other.
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Old 05-11-2013, 09:32   #214
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Re: Affordable Care Act - catastrophic plans cancelled

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Because after being fired for turning in my boss for fraudulent use of government money, I've been blacklisted by the small working community I'm in.

So with two degrees and 20+ years of experience, I am unemployable in my field.
Move somewhere else, and/or change "fields". I have.

"Life isn't fair, and people don't act right." Me.

So what's your strategy for catastrophic care under the new ACA mandates while cruising ? Or did I miss that post ?
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Old 05-11-2013, 09:40   #215
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Re: Affordable Care Act - catastrophic plans cancelled

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Move somewhere else, and/or change "fields". I have.
I have, of course, but success isn't instantaneous. ATM, health insurance is beyond my means, and if some of y'all had your way, you would keep it that way.
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Old 05-11-2013, 09:41   #216
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Re: Affordable Care Act - catastrophic plans cancelled

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So what's your strategy for catastrophic care under the new ACA mandates while cruising ? Or did I miss that post ?
Oh, just get healthcare elsewhere. I'm not a huge fan of the US health system.
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Old 05-11-2013, 09:43   #217
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
There isn't a free market for health care in
the U.S., and there is no cost transparency or basis for competition. It's an
interconnected set of monopolies who set their own rates among each other.
^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^
Beam me up Scotty, no sign of intelligent life here.

Sorry I just couldn't resist.
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Old 05-11-2013, 09:48   #218
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
There isn't a free market for health care in the U.S., and there is no cost transparency or basis for competition. It's an interconnected set of monopolies who set their own rates among each other.
Not true. I have exclusively paid cash for care for over 2 years. I suspect that the "cash pay" marketplace is going to expand as folks face higher deductibles and scarcity of care.

Today I am checking into an ultrasound of my gall bladder (if I can ever get off of CF). So far, I have found 2 places where I can afford to have it done.

Check out American Association of Physicians and Surgeons
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Old 05-11-2013, 09:51   #219
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Re: Affordable Care Act - catastrophic plans cancelled

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Only for emergencies:
Emergency Medical Treatment & Labor Act (EMTALA) - Centers for Medicare & Medicaid Services

I doubt hospitals take anyone with a runny nose, unless they suspect pneumonia or TB or something.
One of my best friends is an ER doctor. They don't turn anyone away, no matter what their complaint, and no matter how minor. And, he says it appears that everyone in the hood knows it, too.
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Old 05-11-2013, 09:52   #220
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Re: Affordable Care Act - catastrophic plans cancelled

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I suspect that the "cash pay" marketplace is going to expand as folks face higher deductibles and scarcity of care.
A lot of people suspect that is going to be the end result of all of this.
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Old 05-11-2013, 09:55   #221
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Re: Affordable Care Act - catastrophic plans cancelled

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I have, of course, but success isn't
instantaneous. ATM, health insurance is beyond my means, and if some of
y'all had your way, you would keep it that way.
Well I can assure you I am not one of the "some" you refer to.

I found a way, and I truly hope you do to.

Please excuse me now. I need to go clean my glasses as the world
is starting to look sh*ty again.
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Old 05-11-2013, 10:02   #222
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Re: Affordable Care Act - catastrophic plans cancelled

I didn't have health insurance from the time I moved away from home at 18, until I got my first real job at 26. I had to have knee surgery two years before that, and had to save up for a year to get pay for it.

It never dawned on me that it might be someone else's problem.
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Old 05-11-2013, 10:10   #223
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Re: Affordable Care Act - catastrophic plans cancelled

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I didn't have health insurance from the time I moved away from home at 18, until I got my first real job at 26. I had to have knee surgery two years before that, and had to save up for a year to get pay for it.

It never dawned on me that it might be someone else's problem.
Did you want a crown?

I'm 50 years old. Any health issues now are 1) unlikely anything I'll be able to plan for. and 2) really expensive.

Not sure how long ago your surgery was, but the cost of health care has steadily been increasing over the last several years.
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Old 05-11-2013, 10:15   #224
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Re: Affordable Care Act - catastrophic plans cancelled

And this is why the situation needs to be addressed:
State of Working America preview: A staggering rise in health insurance costs | Economic Policy Institute

At some point (soon, without intervention), only the wealthy would be able to afford health insurance. Note that this is pre-"Obamacare".

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Old 05-11-2013, 10:18   #225
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Re: Affordable Care Act - catastrophic plans cancelled

Woops, sorry OP.

Maybe the best catastrophic plan is no insurance and either plan to keep everything out of the US, or have a pile of cash in the bank to cover emergencies.
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