No, you didn’t check the plan details. Preventative visits, checkups, and many other items are included. Please check pages 2-5 of the Plan details to see what services are included. Everything you mentioned is, in fact, covered and free of out-of-pocket charges.
Boy, you’re not listening, are you? A person who meets your demographics in DeKalb County, GA can buy a $429/month bronze plan. That’s $5,148/year, not $11.5k. They can buy a much better Platinum plan for $626/month, or $7,512/year.
As a percentage term, this is about 10-13% of income, which can be argued as high. But I don’t know where your $11.5k figure comes from as it isn’t listed in the plans I’m viewing:
“Health plans for one individual, age 60, living in De Kalb County, GA. Based on your household size and income, you do not appear to qualify for help paying for coverage.” ($50k income, not eligible for assistance.)
I see. The “No Charge after Deductible” on the first page was misleading. Ok - so the person’s out of pocket costs may be $1-2K or so if they want to see some people that are not in network (and as I pointed out before, one way these companies make these premiums lower is by narrowing networks by up to 50-70% from regular insurance policies). That’s still around 14% of income. ACA “standard” of affordability is 9% of income. So - not “affordable”. And that’s in the county that you picked where the premiums are something like 30-40% lower than in other counties.
Again, this person is of your rigged demographic, of which (as I noted) may comprise as many as 2-5 million people across the country, or .6% - 1.4% of the total US population, most of whom already have qualified plans.
And if a million people suffer, who cares. As long as you got your government handout (on their backs).
What do you care about suffering? You’re the one arguing for a system that leaves 40+ million without health coverage and has bankrupted millions more.
By the way, I question the accuracy of that benefits page you posted. Here’s an example. This page
lists no charge for drugs, under any circumstances. Whereas the first page you look at says “No charge, after deductible”. Since this is a bronze plan, there is no way there is no charge for drugs, ever. Thus, I would say any “No charge” items on the PDF are the “No charge, after deductible” types. Which would certainly increase the costs quite a bit for that hypothetical 60-year-old. Probably to 20%-30% of his income. But hey, who cares, as long as **JohnT **gets his government handout.
If you question the cite, I got it off the healthcare.gov “Plan Details” link for the plan itself. Otoh, if you can’t notice that you’re comparing two different plans, then I don’t know what to say.
The terminology is the same. It’s the same site and the same format of the page. There is no way the bronze plan would have “No Charge” for any drugs, ever. Which means that in that brochure, “No Charge” means “No Charge after Deductible”. Which is what the front page says, before you go to the PDF.
nm…
That’s for everybody, there are two more pages of additional services offered to women and children which are available through all Exchange plans, even the one you’re looking at, Terr.
What does this have to do with charges for drugs? Or visits to a GP or a specialist that are not “preventive”?
If you insist, I can call Blue Cross and clarify whether that hypothetical 60-year-old would have to pay full price for drugs and non-preventive doc visits until he fills his deductible. Would you believe me if I did? If you wouldn’t, why don’t you call them.
You don’t have to call BCBS. It says what it says on the documents and citations I provided, which came from Healthcare.gov.
Let me repeat myself…
The Link: http://apps.humana.com/marketing/documents.asp?file=2103881
The Quote: “(Deductible)… Doesn’t apply to preventive care and prescription drugs”
The Page #: 1, in the “Deductible” row, explaining how the deductible works.
The Link: http://apps.humana.com/marketing/documents.asp?file=2103881
The Quote: “If you need drugs to treat your illness or condition: Generic and brand-named drugs: No Charge (Retail), No Charge (Mail Order)”
The Page #: 3, in the first row, explaining how the prescription drug coverage works.
Please note that this is the plan you chose for your hypothetical 60yo single male earning twice the average wage in Calhoun County, GA. Why you moved from Georgia to Texas in your arguments, I have no idea.
But feel free to call. I’ll gladly await
Btw, via Humana there’s a $600 plan for your guy living in Calhoun County, GA.
You didn’t prove “many.” That’s your wild, vague, out of the hat guess.
Second, you didn’t compare it to what they paid BEFORE ACA, for either insurance or out-of-pocket medical expenses.
I appreciate your desire to find facts, but you’re just not doing a good enough job of it. Your off the cuff hypotheticals aren’t a scientific study. Let’s wait for the professionals to do the analysis.
You are wrong.
Here is the brochure for this plan: http://apps.humana.com/marketing/documents.asp?file=2057913
For normal (non-preventive) doctor visits, and for prescription drugs it say, clearly:
“This plan pays 100% after you pay your deductible.”
And for prescription drugs, specifically and explicitly:
“You pay for each covered prescription fill or refill until you’ve
paid your deductible.”
Don’t know how to make it clearer for you.
So - the first $6500 is the hypothetical 60-year-old’s responsibility. Which raises his costs of insurance to 20% to 30% of income in Calhoun county. And to 15%-20% in DeKalb. Shockingly expensive.
Why do you keep bringing up separate plans, Terr? Do you not know what you’re doing? Please note that you are comparing differing plans to find the one that has the (in your mind) worst cost/benefit balance, and saying “See, THIS is the one that matches my complaints!”
Let me point it out to you: In the original plan you cited, prescription drug coverage was included. Congratulations on finding a plan where it is not included.
:rolleyes:
It is the same EXACT plan that you cited in the post I quoted.
To help you understand:
This is what you cited: http://apps.humana.com/marketing/documents.asp?file=2103881
This is what I cited: http://apps.humana.com/marketing/documents.asp?file=2057913
Exactly the same plan. You are wrong and can’t admit it.
Some of the comments on this story have to be seen to be believed.
My apologies, Terr, you are correct. I think your document makes it clearer than mine, which has a single sentence explaining how pages 2-5 relate to the overall plan: “See the chart starting on page 2 for how much you pay for covered services after you meet the deductible.”
Again, my apologies.
The fact that this person rarely or doesn’t exist in the counties you mentioned still stands, however. 