ACA Info Exchange

By: BriarCraft , 6:34 AM GMT on November 08, 2013

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First, please note that this is NOT a political discussion. Whatever your feelings about it, the ACA is the law of the land and it is taking effect. Sort of.

Second, no pictures in this header. Sorry! I promise I'll go take pictures of something soon and come up with a more entertaining blog. In the mean time...

The Affordable Care Act aka ObamaCare has been in the news a lot lately, and for good reason. When it first passed into law, I couldn't see why we had to wait four years for it to take effect. Okay, so health insurance companies modify their policies and, presto-chango, it's done.

If you ever have been in doubt about the government's ability to complicate things, take a look at our tax code. As a former pro, I can truthfully say it drove me to retire early because it just kept getting more and more convoluted. Reading the Tax Code made my eyes cross trying to make sense of it. Then there is the funny-but-true adage, "To err is human, but to really foul things up you need a computer." And there you go.

My experience with the ACA so far:

I went to healthcare.gov back in August to check things out. Because Washington state is an active participant, I was redirected to WAHealthPlanFinder.org.

No real info was available in August or September. I decided not to take part in the initial deluge of queries the first few days in October. I waited until the 8th.

Creating an account and sign-in name was quite a challenge. I understand why. There is a lot of confidential information involved in this whole process; they need to make sure I am who I say I am. I was prepared for some security questions, but they presented me with some really insidious multiple-choice questions about where I used to live or what bank I used to use or when I applied for a car loan. They really got me to thinking and, frankly, I had to guess at one of the answers because the month and year I applied for a car loan was almost right, to the point that I doubted myself. Anyway, it took me 40 minutes to create an account and sign in with it. And I was brain-dead, so I quit for the day.

October 9, I went back to fill out the application and got stuck on about the 4th or 5th screen with an error. It said my tax filing status of married filing jointly was not the same as my spouse's. Huh??? I checked my marriage certificate and last year's tax return. Yep. DH is my spouse and we filed jointly.

I quit and went back a few days later to see if they had fixed the problem yet. Nor had they after 10 days. So I scanned our Form 1040 and submitted it securely through the WAHealthPlanFinder website. In the comment section I tried to explain the situation. Even though the comment section could supposedly take 500 characters, I was only allowed to type about half of one line. Try making an understandable explanation of the problem and proof being provided in 56 characters!

I periodically checked the website for the status of the submitted document and it indicated someone was verifying the information.

On October 31, I got a reminder letter that I hadn't finished filling out my application yet. Duh!

The website was down for the next several days, but when I finally got on, I saw there was still an error message on my application, but it was a different error now. I finally got rid of DH, changed myself to single, back to married, and re-entered DH. It took with no error message and I completed the application.

Now I can start looking at my options. Being in a rural county, my choices are Premera Blue Cross or Premera Blue Cross or an HMO whose nearest clinic is 54 miles away. Guess I'll go with Blue Cross. The annual stop-loss amounts are all the same. The differences are strictly in deductible amounts, co-pay amounts, and prescription coverage. Not much choice, but I'll deal with it.

Now I learn that the subsidy is actually a tax credit that you get on your yearly tax return, but you have the option of taking it monthly, in advance, to reduce your premium. The catch is that if your income turns out to be higher than you estimate, you will have to pay back some or all of the premium subsidy on your tax return. That could be a painful hit.

So, that's my experience so far. What about you?

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19. kozycolorado
4:51 PM GMT on December 06, 2013
My ACA experience update: I qualified for the expanded Medicaid! I'm shocked and was in disbelief for a while. After thinking about it for a day or so, I realized that I wouldn't be in this position if it weren't for the ACA, so I have no problem accepting the Medicaid designation. I signed up with the Kaiser Medicaid plan. I had planned on signing up with Kaiser in the Marketplace anyway so now I get it for free, and if I get booted out of Medicaid at some time in the future, I won't have to change doctors again.

I still have a nagging feeling that they have made a mistake, LOL! How in the world are they going to pay for all of the new Medicaid members?

The only hoops I had to jump through to navigate the system were the phone calls which each had me on hold for up to 25 minutes to speak with the next available person. And it took Medicaid 39 days to make the determination.
Member Since: May 2, 2013 Posts: 0 Comments: 14
18. WunderAlertBot (Admin)
5:14 AM GMT on November 11, 2013
BriarCraft has created a new entry.
17. Ylee
2:31 AM GMT on November 09, 2013
All I can say is thank God I'm in a Union shop where my benefits are in a contract and can't be changed. I feel for all you guys who are stuggling though this!
Member Since: February 3, 2011 Posts: 86 Comments: 14582
16. BriarCraft
12:11 AM GMT on November 09, 2013
(not an ad, but something I thought might be of interest to some of the gardeners around WUville)

Submit your Fruit & Vegetable Pictures! Win seeds!

Submit photos of ripe fruit and vegetables growing before you harvest. All entries are displayed at the link below. If selected your photo will be tagged with a ribbon and featured on a product page on their website & you'll receive 5 FREE Peaceful Valley brand organic vegetable seed packs of your choice!



Now, I know for a fact there are WUphotographer/growers out there who can do better than that!
http://groworganic.com/organic-gardening/photos
Member Since: June 21, 2004 Posts: 71 Comments: 3616
15. BriarCraft
10:04 PM GMT on November 08, 2013
Mike: Okay, keep on photographing those abandoned cars. I do enjoy them.

The Kaiser health care model is one of those that people either love or hate. I've had good experiences with them, too, at various times. They are not an option here under the ACA.

----------------------------

And now for something totally different, and because I'm a huge fan of our National Wildlife Refuges:



In honor of our veterans, all federal public lands have free admission November 9, 10, 11. Veteran or not, be thankful for our NWR system. There is at least one in every state. Chances are, there is one within easy driving distance of where you live.
Member Since: June 21, 2004 Posts: 71 Comments: 3616
14. clearlakemike
6:49 PM GMT on November 08, 2013
Mike: I'm afraid the only way for you to get at that NHS is to become one of Sandi's neighbors. That would probably also eliminate one of your fun photo ops: derelict cars. 8- )

no, not gonna happen...I ain't giving up these derelict car photo ops. I am having just too much fun here :)

Like Karen, I have been with Kaiser for about 30 years. I guess that is the closest I will get to NHS, unless of course I decide to seek asylum in the EU but that is another story for another day, lol. Kaiser is hit or miss. Kaiser San Francisco and Kaiser Hawaii Region are ok and I have had some very, very good doctors and nurses at both regions. I have heard some Kaisers are better than others though. The more "desirable" areas seem to attract the better talent and they stay for a long time. I had the same doctor at Kaiser SF for 20 years until I left the region. For all I know, he may still be there. The doctors here and there are world class specialists. Very up to date and well educated and experienced. I have no complaints.
Member Since: November 21, 2004 Posts: 138 Comments: 1555
13. BriarCraft
6:41 PM GMT on November 08, 2013
On an unrelated note, send your thoughts and prayers to the people of the Phillipines where typhoon Haiyan is one of the strongest typhoons ever to hit land, forcing millions to take shelter.

Packing sustained winds of up to 320 km/h (199mph), Typhoon Haiyan left at least three people dead, but it may be days before the full damage is known. The storm ripped apart buildings and triggered landslides as it ploughed across the country's central islands. Officials said more than 12 million people were at risk, but the storm's rapid passing could limit its impact.
Member Since: June 21, 2004 Posts: 71 Comments: 3616
12. BriarCraft
6:31 PM GMT on November 08, 2013
YCD: Those numbers you linked were one of the big debate points during the legislative process for the ACA. I certainly believe the numbers for the U.S. People whose medical iinsurance is paid by their employer have no idea of what it costs. My current coverage costs $5200 a year and the "affordable" coverage will up to $6500 in 2014 before any subsidy. It comes with a much higher deductible, but a lower stop-loss cap. So if I get sick, I can look forward to forking out as much as $13,000.

Sandi: Sorry I made you cough so hard. But glad I gave you the chuckle that started it.

Your health care system is much more efficient and less costly than ours. And I know from your experience last year, that the quality and availability of care is just fine. Of course, you are at least 30 years ahead of us in perfecting it. Wonder if I'll live long enough to see a good system here?

Prose: "All we need is for the elephants and the donkeys to start working together for the sake of the Nation and the people they purport to represent." You've got that right. I do wish there was a way to knock their heads together until they got some sense. Barring that, the only thing I can think of is to vote in a whole new batch of Representatives and hope for the best. Healthcare isn't the only problem that they can't seem to be bothered to fix.

Mike: I'm afraid the only way for you to get at that NHS is to become one of Sandi's neighbors. That would probably also eliminate one of your fun photo ops: derelict cars. 8- )

KozyCO: Thanks for joining in and sharing the fun times you are having. The problems and frustrations you describe are different than what is occurring here, which blows my theory. I was under the impression that the states were just putting their own insurance marketplace on the back end of the federal application process. Obviously not, or they would not require you to prove your citizenship. Even though WA got confused about my marital status, they never questioned my citizenship despite the fact that I was born in another state.

I hope you'll let us know how it all turns out and what hoops you have to jump through along the way.

Karen: I won't give you grief. You and your husband earned those benefits and you were lucky enough not to have them taken away by tea party governors or bankrupted cities. My parents have it just as good or better than you, thanks to my dad's blue collar labor union. Younger members of the same union won't have nearly such good benefits when they retire.

DH will start on Medicare early next year, so he only has to worry about some sort of other coverage for a couple of months. Because of that, we're separately figuring out what each of us is going to do. Like you, I hardly ever go to the doctor, so I'll probably go with a higher deductible plan.
Member Since: June 21, 2004 Posts: 71 Comments: 3616
11. SBKaren
5:52 PM GMT on November 08, 2013
Thankfully we have not had to apply for any health coverage, other than Medicare for hubby. We have health coverage through his retirement plan (worked for state for over 32 years). I am still covered under his retirement plan and he is now covered through Medicare. We are both using Kaiser and have had Kaiser for over 30 years, so going with their Medicare plan (rated 5 out of 5 stars) was easy.

Now, before some folks give us grief for being so lucky to have our health care provided for us by the state (we do make a contribution, but they make the bulk of it), I just want to state that we fell into a special category because of the date he started with the state. Two years after he became permanent, the offer stopped. Also, my hubby was not in the higher elevations of state employment. We are able to live on what he brings home through his retirement income (and SSN) because we lived modestly back then, and now. I know a good many people who would never be able to make it on what he brings home.

I'm still working part time, but I'm considered a 49% employee, so I receive no benefits. That's why I am so thankful that I am covered through hubby's benefits.

All that said, both of us are pretty healthy people. We rarely have to go to the doctor, and the only prescription I have is for Lovastatin (generic). I go to my yearly doctor visits for 'female' visits, and hubby went to the doctor for a dermatology visit for the 1st time this year. I'll also go to that yearly, as I have a lot of sun damage that I want to keep an eye on. So, in all honesty, I probably go once a year, at the most twice, and the same for hubby. Luckily, neither of us have been sick enough to visit the doctor for anything else (knocking....no pounding on wood!)
Member Since: February 21, 2005 Posts: 195 Comments: 14511
10. kozycolorado
4:32 PM GMT on November 08, 2013
Hi, I've lurked since Sandy last year. I'm willing to share my ACA experience so far. Originally I didn't think I would be in need of it, but DH's employer has ended spouse coverage on their plan as of Jan. 1, 2014. He says that it's the law.

In Colorado we have the marketplace called Connect for Health Colorado where we can browse plans and check out the estimated premiums before actually applying. However, it's not possible to get an accurate estimate in my situation. The site assumes that since I use the couple's income, that my DH needs coverage also. Once I get further in the application, I will be able to indicate that I am the only one needing it.

I started the application on 10/21/13 and as soon as I stated that I would like to apply for the tax credit, I was directed to the state Medicaid site where I had to complete another application. That took about 45 minutes. I did not give any info other than income. They wanted to know what kind of cars we had, our checking account info, asset info along with other unnecessary stuff. My understanding is that info is not required for ACA. I am still waiting to receive a denial from them before I can continue with the rest of the Connect for Health application. I have made a few phone calls asking how long the Medicaid process takes. I've been told it can take up to 45 days. One of the people I spoke with told me that even if I'm denied by Medicaid I will still need to prove my US citizenship for the tax credits. (Even though I've been on the IRS logs for 40 years, LOL.) I had to hand deliver my original birth certificate along with my drivers license to a local Dept. of Human Services. They in turn faxed certified copies of my documents to ? Medicaid, I think.

I have since heard on the news that the Connect for Health site now has the ability to perform the Medicaid application and give a denial/approval within 2 hours! Of course, since I have already started the process, I'm not allowed to start over for a faster result.

I have seen on the CFH Facebook site that many people are experiencing issues with the site such as accounts not being recognized, or difficulty logging in. Fingers crossed that I get my Medicaid denial quickly, and the rest of the process is problem-free. Well, I can hope, can't I?

I have made copies of several different plans documents so that I can spend time comparing them. I have worked with health insurance/medical bills in the past. I feel for those who have no experience and are trying to figure things out. It's not easy!



Member Since: May 2, 2013 Posts: 0 Comments: 14
9. clearlakemike
4:08 PM GMT on November 08, 2013
Don't 'they' say, Laughter is the best Medicine? Can I get that at the NHS also??
Member Since: November 21, 2004 Posts: 138 Comments: 1555
8. clearlakemike
4:06 PM GMT on November 08, 2013
Quoting 5. sandiquiz:
Oh, please tell DH that making me laugh out loud when I have a cold is not a good move.....

DH (with tongue in cheek) is positive that she is allergic to cats.

I read the above line and began to laugh, then cough, and coughed for ten minutes until my insides hurt!!! lol

Soft fruit of any kind do not freeze well, for instance, strawberries and raspberries.... if I am going to freeze those I usually make a sugared puree, (the posh word is coulis), and then serve it, when defrosted, with ice cream.


LOL!
Member Since: November 21, 2004 Posts: 138 Comments: 1555
7. sandiquiz
2:06 PM GMT on November 08, 2013
I actually went back and read your header.... (Does that sound familiar? lol)

Here in the UK we do have a two tier system, where you all belong to the NHS, and all hospital treatment and hospitalisation are free, but you pay "towards" dentistry, eye tests and glasses, and prescriptions. I am at the happy age where I no longer pay for some of it...'cos once you are on a State pension the prescription drugs and all eye tests are free. You still pay towards dentistry treatment, and for any glasses you choose.

The second level of medical care is a "private insurance" the biggest being BUPA.
What does it give you if you are rich and actually 'join'? (BTW many large companies give private medical insurance as one of the salary benefits.)
It gives you almost instant medical treatment, in a Private Hospital, with 'supposedly' the top notch doctors, whereas with the NHS you get put on a waiting list....unless, I may hasten to add, the problem is serious, then you are dealt with straight away!

And as for the 'top notch' doctors.... the surgeon who performed on me last year is actually the top gyne surgeon at the local BUPA hospital, but also works for the NHS!

As to computers and form filling... "don't get me started!"
Member Since: October 29, 2005 Posts: 277 Comments: 25346
6. Proserpina
1:41 PM GMT on November 08, 2013
To be honest, I have not involved myself with the OC or any kind of Care. I let my husband handle the health insurance that we have in addition to our Medicare. At least now that I am retired. I did take care of my own health insurance when I worked. So I only know the bits and pieces I hear on the news. Stupidity and ignorance is not the way to go but it is working for me right now (insurance speaking of course). I know that it is an important issue and I do hope that this country comes up with a working solution. All we need is for the elephants and the donkeys to start working together for the sake of the Nation and the people they purport to represent.

Ok, good morning and may your day be what you want it to be.
Member Since: May 6, 2008 Posts: 165 Comments: 17907
5. sandiquiz
8:59 AM GMT on November 08, 2013
Oh, please tell DH that making me laugh out loud when I have a cold is not a good move.....

DH (with tongue in cheek) is positive that she is allergic to cats.

I read the above line and began to laugh, then cough, and coughed for ten minutes until my insides hurt!!! lol

Soft fruit of any kind do not freeze well, for instance, strawberries and raspberries.... if I am going to freeze those I usually make a sugared puree, (the posh word is coulis), and then serve it, when defrosted, with ice cream.
Member Since: October 29, 2005 Posts: 277 Comments: 25346
4. ycd0108
7:22 AM GMT on November 08, 2013
Evening BriarCraft:
What, no photos?
We called your "Cat Tail" a "Bull Rush", don't know why.
I thought you might be interested in this table:
http://en.wikipedia.org/wiki/List_of_countries_by _total_health_expenditure_(PPP)_per_capita
Member Since: January 1, 2008 Posts: 171 Comments: 4415
3. BriarCraft
7:15 AM GMT on November 08, 2013
Me, too, Mike. I think it would be much simpler for everyone except the insurance companies. I do expect it will improve in time. As I recall, Medicare had all sorts of problems to begin with, but now the seniors who depend on it wouldn't trade it away for anything.
Member Since: June 21, 2004 Posts: 71 Comments: 3616
2. clearlakemike
7:02 AM GMT on November 08, 2013
I would prefer Sandi's NHS instead. No mess no fuss.
Member Since: November 21, 2004 Posts: 138 Comments: 1555
1. BriarCraft
6:36 AM GMT on November 08, 2013
from my previous blog:
Quoting 52. BriarCraft:
Poppy: I'm glad the calendar arrived in one piece. Even with a padded envelope, odd-sized items sometimes get torn apart in the automated process.

Sandi: Unfortunately, pears do not freeze well, nor do apples. Years ago, when I first got a freezer I thought I was done with canning, but pears, applesauce, and tuna persist in being canned or not preserved at all

The vet came up with one other thing to try with Squeak -- a course of 4 injections of an anti-inflammatory drug. Squeak doesn't mind injections, as she has had monthly decongestant shots for the past two years to manage her chronic sinus condition. DH (with tongue in cheek) is positive that she is allergic to cats.

GG: You haven't tasted my applesauce or you wouldn't say that ;- ) Seriously, though, 30 pounds sounds like a lot of apples, but it only filled 20 pint jars and I'll give a few of those away to family.

It's nice to know that you and others don't think we're heartless. Given how cats age, her 17½ years is about the same as 86 human years. At that age, major surgery is not really advised for humans either.

Ylee: Re-repairing the roof? I'll just bet there's a story behind that statement. This will be our first roof repair, but I know another is coming before too many more years, just because of the age of the shingles.

I'm glad I don't have to mess with fixing kids' vehicles. It's been more than enough just dealing with my own this year.

Prose: Thanks for showing me that photo. It really is exceptional and very artistic, so I can see how you won a Flickr award for it.

My patience certainly is shortened when I'm not feeling well, so I'm sure that your unhappiness with Mimi is more to do with that than anything else. Just remember, puppyhood is temporary. She will outgrow it!

WTS: Actually, I ran out of time last night and didn't make it through all of those wonderful Ireland photos. You can look forward to more WUmail notifications that you've got comments!

Tomato juice for cats? That's a new one to me. I've heard it's good for de-skunking cats, but feeding it to them? An internet search came up with all sorts of conflicting info. Tell me more, please.
Member Since: June 21, 2004 Posts: 71 Comments: 3616

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Live. Love. Harm no one. Help when you can. Be happy.

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