The only way our country will ever be able to get control of it's health care costs which is at the heart of the whole crisis.

PACEDOG#1 wrote:

Bob wrote:

Dreamsglore wrote: I agree it won't be perfect but it will be better than what we have now

What we have now sucks. What we're changing to sucks. It was nothing but a convoluted 2500 pages worth of stuff that resulted from all sorts of political paybacks to congressmen to get them to vote for it.
It is to health care what this was to aviation...

LOLOLOLOOL:twisted:

PACEDOG#1 wrote:

Dreamsglore wrote:

PACEDOG#1 wrote:So how does Obamacare help the uninsured? It looks like they will STILL be uninsured because the prices are worse than what many people can get now. Wasn't this supposed to create health insurance for everyone that everyone could afford? Hmmmm I call it massive failure.

Dreams keeps kicking the can saying she has her plan and will stick with it, but in her cold heart she isn't caring about those who will still remain uninsured and now get a TAX penalty on top of their other annual expenses to live. Wasn't she one of the ones calling Republicans selfish for not wanting health insurance for everyone? I think so.

I sure hope the lawyers have their paperwork ready to go on January 1st next year and get the ball rolling on the lawsuit that WILL be legal to file against this boondoggle. Once it is seen by the courts as a TAX that is illegal, then it will get dismantled.

Why don't you educate yourself about the law PD before you continue to make stupid statements? It's already been decided.What is wrong w/ you?

No, it hasn't been decided. It WAS decided it was a TAX and until the TAX is actually in effect (next January), it cannot be argued over in the courts. Those were the words of Chief Justice John Roberts.

PACEDOG#1 wrote:HA, you will see Dreams. There is going to be a Battle Royale over this once it is 2014.

Dreamsglore wrote:

It's the law... it's been decided.

Dreamsglore wrote:

PACEDOG#1 wrote:HA, you will see Dreams. There is going to be a Battle Royale over this once it is 2014.

It's the law,PD. It's been decided. Get some help.

Bob wrote:

Dreamsglore wrote:

It's the law... it's been decided.

If that's your argument then you would have been a good advocate for slavery and prohibition.

Bob wrote:

Dreamsglore wrote:

It's the law... it's been decided.

If that's your argument then you would have been a good advocate for slavery and prohibition.

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Dreamsglore wrote:

PBulldog2 wrote:

Dreamsglore wrote:

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

And this is what makes me so damned angry. Why should the government be paying private business a subsidy for this? It's a bizarre collusion between government and private enterprise. This should never have been allowed to happen.

The subsidy is only for small businesses who can't afford the healthcare costs.

Yella wrote:

Bob wrote:There's a reason why I'm getting free medications from Publix. Why I'm getting $4 drugs from Walmart, Target and other sources.
I'm actually no longer even bothering to use the drug plan that comes with the health insurance policy I pay for. Unbelievably, even though I am paying the insurance company to subsidize the drug costs with that plan, the net cost of buying my medications is less when I completely ignore the plan and buy all my medications without any insurance involvement.
Additional to the free drugs and $4 drugs, I buy a K-Mart plan for $10/year which gives me one of my blood pressure meds for $12 (90 pills) that would cost a lot more if bought through the drug plan.
And the only med I can't get from those sources I get from a Canadian pharmacy for a fraction of what I would pay otherwise.
And I'm not alone on this. My friend just got on Medicare. If she uses the drug plan that comes with the Medigap policy she's buying, one damn drug out of the many she's prescribed is going to put her in the "doughnut hole".
The retail value of that drug is $3500/year. The doughnut hole starts at $2900. If you're not Medicare and don't know what the doughnut hole is you can google that.
We've figured out that she can buy the drug from Canada for $171 (for 90 pills) which is only about twice what her co-pay would be using the medigap drug plan. BUT since she won't be adding a retail value of $3500 to the running total for the doughnut hole, buying the drug from Canada could save her into the thousands.

There is one word which explains all this. Competition. These corporations are having to compete and that's what's lowered the price of these meds.
Walmart started this to attract customers to the store. Target had to compete and follow suit or they would lose customers to Walmart. And then other retailers had to do the same.
That is what brings the costs down.

But it shouldn't have to end with medications. These same corporations could be in the business of delivering primary medical care and if they were doing so, the same scenario of competition would occur.
Instead of doing nothing to control these skyrocketing costs, the government should be fostering that as a partial solution.
Private enterprise engaged in full-out competition is the ONLY way to get control of these costs. Period.

The Pharmaceutical Corporations jack up the prices of the meds since the Gummit is paying. That's why the CEQs make millions.

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

doubtingthomas wrote:

Dreamsglore wrote:

PBulldog2 wrote:

Dreamsglore wrote:

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

And this is what makes me so damned angry. Why should the government be paying private business a subsidy for this? It's a bizarre collusion between government and private enterprise. This should never have been allowed to happen.

The subsidy is only for small businesses who can't afford the healthcare costs.

Again anyone HOME? The subsidies are for individual health insurance in the exchange.

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Jesus Christ, hello anyone home up there? If you do not qualify for a subsidy why the hell would you purchase in the exchange. Again Florida has to put their citizens into the Federal Faciliated Exchange Florida will not have an exchange.

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Jesus Christ, hello anyone home up there? If you do not qualify for a subsidy why the hell would you purchase in the exchange. Again Florida has to put their citizens into the Federal Faciliated Exchange Florida will not have an exchange.

It is my understanding anyone can purchase from the exchange as it will be competitive. Why would you purchase outside of something that would be more expensive? The whole purpose of exchanges is to bring down healthcare costs. So you're saying people w/o subsidies will have to pay more for their insurance outside the exchange.? No, you're not giving correct info.I think you're trying to split hairs here. Fl. will have an exchange run by the govt. whether it's a federal exchange everyone participates in or not Fl. will still be in an exchange.

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Jesus Christ, hello anyone home up there? If you do not qualify for a subsidy why the hell would you purchase in the exchange. Again Florida has to put their citizens into the Federal Faciliated Exchange Florida will not have an exchange.

It is my understanding anyone can purchase from the exchange as it will be competitive. Why would you purchase outside of something that would be more expensive? The whole purpose of exchanges is to bring down healthcare costs. So you're saying people w/o subsidies will have to pay more for their insurance outside the exchange.? No, you're not giving correct info.I think you're trying to split hairs here. Fl. will have an exchange run by the govt. whether it's a federal exchange everyone participates in or not Fl. will still be in an exchange.

when you have been in the insurance business as long as 20 years and have studied the PPACA then you may be qualified to give advice. But for now, the only thing you know is that there will be federal exchange in Florida and some people will qualify for a subsidy. I am giving the correct information. The prez can say anything he wants that it will cheaper in the exchange and it will for a very small percentage of people and not everyone can purchase on the exchange.

Bob wrote:By the time I was less than 30 years old, dreamsglore, I learned something that is an absolute guaranteed truth about life. And I'm not someone who's list of those is very big.
I learned that someone who is a pro is almost always more knowledgeable than someone who is an amateur, no matter whatever the issue is.
The problem is most pros have an agenda that amateurs don't.
But after observing this many times over an almost 40 year period, I've learned that some of those are really sincere. It's usually whenever they aint trying to sell me something. lol
And my appraisal is doubtingthomas isn't trying to sell me something and is just wanting to share his knowledge. So if I were you I'd pay attention to him.

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Jesus Christ, hello anyone home up there? If you do not qualify for a subsidy why the hell would you purchase in the exchange. Again Florida has to put their citizens into the Federal Faciliated Exchange Florida will not have an exchange.

It is my understanding anyone can purchase from the exchange as it will be competitive. Why would you purchase outside of something that would be more expensive? The whole purpose of exchanges is to bring down healthcare costs. So you're saying people w/o subsidies will have to pay more for their insurance outside the exchange.? No, you're not giving correct info.I think you're trying to split hairs here. Fl. will have an exchange run by the govt. whether it's a federal exchange everyone participates in or not Fl. will still be in an exchange.

when you have been in the insurance business as long as 20 years and have studied the PPACA then you may be qualified to give advice. But for now, the only thing you know is that there will be federal exchange in Florida and some people will qualify for a subsidy. I am giving the correct information. The prez can say anything he wants that it will cheaper in the exchange and it will for a very small percentage of people and not everyone can purchase on the exchange.

Nobody gave advice. I can read like most Americans. Just goes to show you don't believe what people post here on the forums.You will be greatly misled.

http://www.politifact.com/truth-o-meter/promises/obameter/promise/520/if-you-dont-have-insurance-or-dont-insurance-you-h/

PkrBum wrote:I guess if I were the sort that would support a law before I knew what was in it... it wouldn't matter when I did.

Dreamsglore wrote:

Bob wrote:By the time I was less than 30 years old, dreamsglore, I learned something that is an absolute guaranteed truth about life. And I'm not someone who's list of those is very big.
I learned that someone who is a pro is almost always more knowledgeable than someone who is an amateur, no matter whatever the issue is.
The problem is most pros have an agenda that amateurs don't.
But after observing this many times over an almost 40 year period, I've learned that some of those are really sincere. It's usually whenever they aint trying to sell me something. lol
And my appraisal is doubtingthomas isn't trying to sell me something and is just wanting to share his knowledge. So if I were you I'd pay attention to him.

Well, I don't mind people sharing their knowledge,Bob if it's accurate but as you can read for yourself from factcheck,it's not correct. So don't go believing because someone's in the field they're reporting something accurately.All he is doing is reading it... just like you and I can. It doesn't take a pro to read and comprehend.

Dreamsglore wrote:

PkrBum wrote:I guess if I were the sort that would support a law before I knew what was in it... it wouldn't matter when I did.

We knew what was in it. The President went all over the country talking about it. Where were you?

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:

Dreamsglore wrote:

doubtingthomas wrote:Below are the plans apparently approved already in Texas by Humana:

A family of 4 - parents both age 40, 2 kids ages 6 & 10, zip code 78708

Platinum - $0 deductible - $2852 monthly
Gold - $0 deductible - $2576 monthly
Silver - $0 deductible - $1656
Bronze with a $6,250 deductible - $1034 monthly
Bronze HSA - $4,250 deductible - $925 monthly
And those all say "HMO" on them, and the prescriptions must be filled at Wal-mart.


Contrast that to current traditional plans with a much larger network:
Enhanced Copay 80% plan - $1000 deductible - $788 monthly
Enhanced HSA 100% plan - $5,000 deductible - $516 monthly


On the Bronze at $1034 monthly, the brief summary of benefits says:
Annual deductible of:
$6,250 - you pay $1,034.91/month

Diagnostic illness/injury office visits are included with your plan for a copay for the first 6 visits; there is a $35 copay for a primary care physician visit and a $60 copay for a specialist, $60 for an urgent care visit to a Concentra Clinic and $100 for an urgent care visit to a Non-Concentra Clinic. The plan pays 100% after you pay your deductible for all additional visits
100% coverage for preventive care office visits for primary care physician

Inpatient and outpatient hospital services are paid at 100% after deductible for covered expenses

Prescription coverage included with separate deductible and copays (see details below)


What's the medical deductible?

Individual coverage annual medical deductible: $6,250
Family coverage annual medical deductible: $12,500
Copays do not apply to the deductible
Expenses applied to the medical deductible won't apply to the prescription drug deductible
What’s the coverage for preventive care services?

Plan pays 100% on all in-network preventive care services provided by your primary care physician before you have met your deductible. This includes preventive office visits, lab and X-rays.

What's the coverage for diagnostic illness or injury office visits?

For the first 6 visits the plan pays 100% of covered expenses after your $35 copay for office visits to your in-network primary care physician. Copays for in-network urgent care visits to a Concentra Clinic are $60 and Non-Concentra Clinics are $100. Copays for in-network specialists visits are $60 and require a referral from your primary care physician. After your first 6 visits the plan pays 100% after you pay your deductible.

What's the coverage for lab and x-rays?

For diagnostic labs or X-rays during an office visit or urgent care visit the plan covers the first $500 per person then 100% after you pay your deductible.

What's the coinsurance percentage for hospital services?

For in-network inpatient services, once you meet your annual deductible, this plan pays 100% coinsurance for most covered medical expenses from in-network providers. For in-network outpatient services your plan covers the first $500 per person for labs and X-rays and then pays 100% after you pay your deductible.

What's the coverage for emergency room services?

Your plan pays 100% of covered expenses, once you meet your deductible.

Does the plan include prescription drug coverage?

Yes prescription coverage is included with the coverage outline below.

There is a $1,500 deductible which is separate from your medical deductible. The prescription drug deductible does not apply to Level One drugs.
Prescriptions must be filled at Walmart pharmacies or through mail-order service at RightSourceRx.com
If you use an out-of-network pharmacy, there is no coverage
Prescription drug deductibles and copays apply to the plan out-of-pocket maximum
Plan pays 100% for covered services after the plan out-of-pocket maximum is satisfied
Drug levels and copays
$5 copay for Level One: Preferred generics
$25 copay for Level Two: Non-preferred generics
$65 copay for Level Three: Preferred brands
50% for Level Four: Non-preferred brands
50% for Level Five: Specialty drugs
To find out what level your prescription is in, visitHumana.comand select Drug List under Insurance for Individuals

They won't be paying $1062 a month.That's just silly and wrong.You left out the Govt. will subsidize the payment and you will wind up paying about 30% of that.

The above plans aren't exchange plans so they won't be subsidized, you don't have to go thru the any exchange, you can still purchase outside the exchange.

Why would you go outside the exchange then and pay more? That doesn't make any sense. Fl. will have an exchange.It will just be run by the Govt.

Jesus Christ, hello anyone home up there? If you do not qualify for a subsidy why the hell would you purchase in the exchange. Again Florida has to put their citizens into the Federal Faciliated Exchange Florida will not have an exchange.

It is my understanding anyone can purchase from the exchange as it will be competitive. Why would you purchase outside of something that would be more expensive? The whole purpose of exchanges is to bring down healthcare costs. So you're saying people w/o subsidies will have to pay more for their insurance outside the exchange.? No, you're not giving correct info.I think you're trying to split hairs here. Fl. will have an exchange run by the govt. whether it's a federal exchange everyone participates in or not Fl. will still be in an exchange.

when you have been in the insurance business as long as 20 years and have studied the PPACA then you may be qualified to give advice. But for now, the only thing you know is that there will be federal exchange in Florida and some people will qualify for a subsidy. I am giving the correct information. The prez can say anything he wants that it will cheaper in the exchange and it will for a very small percentage of people and not everyone can purchase on the exchange.

Nobody gave advice. I can read like most Americans. Just goes to show you don't believe what people post here on the forums.You will be greatly misled.

http://www.politifact.com/truth-o-meter/promises/obameter/promise/520/if-you-dont-have-insurance-or-dont-insurance-you-h/

That article is funny, dated in March 2012 and there has been too many intrepretations and final rules written on each part since then. Good luck if you believe those articles, a little is true but not most of it. You will see miss know it all.