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.

Bob wrote:If Walmart starts selling insurance it will kick some Blue Cross and Humana ass. It WILL find ways to deliver the goods cheaper.
And then Target and Walgreens and CVS will have to get in the act too.
I only hope it also gets into the medical care delivery business. Those goddamn hospitals and doctor owned clinics are nothing but Taj Mahals of waste and inefficiency and overpaid prima donnas.

doubtingthomas wrote:Those plans are not exchange plans, you see every insurance company can design their own plans as long as they are metal and also since I posted that a few minutes ago it isn't accurate because when someone ran the quotes side by side for a single person male vs female the rates were not the same for same age as they will be next year and there is no maternity which there will be next year. So maybe Humana in Texas is putting up teaser rates to discourage people.

Bob you will never know, I doubt the contracted price of drugs before hand. Maybe someone at the pharmacy will tell you but don't think so. Hell it's hard if not impossible to get a hospital or doctor to tell you. You usually don't know until you receive the explanation of benefits.

W_T_M wrote:Welcome back to the forum.

Whose sock are you...?

Yomama wrote:

W_T_M wrote:Welcome back to the forum.

Whose sock are you...?

He doesn't remind me of anybody, W.

You have a guess????

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

Nekochan wrote:

Yomama wrote:

W_T_M wrote:Welcome back to the forum.

Whose sock are you...?

He doesn't remind me of anybody, W.

You have a guess????

Only those who have non-liberal views are accused of being a sock.

PBulldog2 wrote:

Nekochan wrote:

Yomama wrote:

W_T_M wrote:Welcome back to the forum.

Whose sock are you...?

He doesn't remind me of anybody, W.

You have a guess????

Only those who have non-liberal views are accused of being a sock.

I expect I know who it is. The last time I thought I knew who someone was I was wrong, though....so just ignore me.

doubtingthomas wrote:The IRS article going on assumptions, you know what that means. Besides if most of the populace will qualify for some kind of subsidy so they won't see this directly but indirectly with higher taxes somewhere.

No competition for exchanges, don't know where this came from.

Florida will use the Federal exchange because Scott refuses to participate at the moment.

Not everyone can purchase on exchange. Only the one's who receive a subsidy. Of course this is the plan today HHS could change that. There will be an open enrollment starting Oct this year that runs thru March 31, 2014. You will be required to fill out a 21 page application mostly electronically and you will have to let whoever helps you ie, agent, broker, navigator, walmart greeter have access to your 2012 tax return. There will be 3 agencies in the fed govt that has to approve your application, IRS, DOL and HHS. Who knows they may throw another one or two agencies in there. By 2015 most of the actual insurance agents that can help you will either not want to or be out of the business. If you go thru a so called navigator over the phone they are cannot be a licensed insurance agent and won't really know shit how insurance works.

Exchange plans are expected to be strict HMO's (they haven't decided that yet) and small networks.

Can you keep your plan that obama said you could? Probably not. Anyone that purchased after March 2010 will be migrated to one of the metal plans. Anyone who has a so called grandfathered plan may be able to keep it for awhile, but there has not been any policies written in that block of business with insurance companies since 2010. Therefore your rates will price you out of that nice grandfathered plan in about a year. By the end of this year the plan (individual) you are on now may have seen a rate increase of 40 plus %. Group plans that for the past two years have had minimal increases will start rising fast.

Thru at least 2015 and maybe beyond anyone over 65 will actually have the best insurance either by original medicare and supplement or Medicare Advantage.

I can see now that this is designed to fail so a single payer system will be in place down the road.

One last thing if you are on a plan now and are going to be considered in the 100-400% poverty level is to keep an eye out mid summer and get with your agent or agent and see what you gain or lose if you re apply and go into an exchange to get the subsidy. Hell might as well take advantage while you can.

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

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.

Dreamsglore wrote:

doubtingthomas wrote:The IRS article going on assumptions, you know what that means. Besides if most of the populace will qualify for some kind of subsidy so they won't see this directly but indirectly with higher taxes somewhere.

No competition for exchanges, don't know where this came from.

Florida will use the Federal exchange because Scott refuses to participate at the moment.

Not everyone can purchase on exchange. Only the one's who receive a subsidy. Of course this is the plan today HHS could change that. There will be an open enrollment starting Oct this year that runs thru March 31, 2014. You will be required to fill out a 21 page application mostly electronically and you will have to let whoever helps you ie, agent, broker, navigator, walmart greeter have access to your 2012 tax return. There will be 3 agencies in the fed govt that has to approve your application, IRS, DOL and HHS. Who knows they may throw another one or two agencies in there. By 2015 most of the actual insurance agents that can help you will either not want to or be out of the business. If you go thru a so called navigator over the phone they are cannot be a licensed insurance agent and won't really know shit how insurance works.

Exchange plans are expected to be strict HMO's (they haven't decided that yet) and small networks.

Can you keep your plan that obama said you could? Probably not. Anyone that purchased after March 2010 will be migrated to one of the metal plans. Anyone who has a so called grandfathered plan may be able to keep it for awhile, but there has not been any policies written in that block of business with insurance companies since 2010. Therefore your rates will price you out of that nice grandfathered plan in about a year. By the end of this year the plan (individual) you are on now may have seen a rate increase of 40 plus %. Group plans that for the past two years have had minimal increases will start rising fast.

Thru at least 2015 and maybe beyond anyone over 65 will actually have the best insurance either by original medicare and supplement or Medicare Advantage.

I can see now that this is designed to fail so a single payer system will be in place down the road.

One last thing if you are on a plan now and are going to be considered in the 100-400% poverty level is to keep an eye out mid summer and get with your agent or agent and see what you gain or lose if you re apply and go into an exchange to get the subsidy. Hell might as well take advantage while you can.

I don't think what your saying is accurate. I am keeping my plan as I have employer sponsored insurance and don't qualify for the subsidy. Whether it's a federal exchange or state, it's still an exchange which will lower prices. I went to the calculator and it's says I don't qualify.

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:

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.

Bob wrote:You need to understand something, doubtingthomas. Dreamsglore's perspective on all this is that the best health care system we could possibly have is one which is being managed by obama, pelosi, reid, michael moore and the pundits on MSNBC. No one is more competent to run a health care system than they are.

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.

Bob wrote:You need to understand something, doubtingthomas. Dreamsglore's perspective on all this is that the best health care system we could possibly have is one which is being managed by obama, pelosi, reid, michael moore and the pundits on MSNBC. No one is more competent to run a health care system than they are.

Dreamsglore wrote:
That's a silly statement, Bob since none of them will be running it. I agree it won't be perfect but it will be better than what we have now as far as people getting medical care and that is the whole point of Obamacare.

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.

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

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...

PACEDOG#1 wrote:

Dreamsglore wrote:
That's a silly statement, Bob since none of them will be running it. I agree it won't be perfect but it will be better than what we have now as far as people getting medical care and that is the whole point of Obamacare.

How will they have healthcare when they cannot afford the premiums??HOWHOWHOW???

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?