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deekzee
LIF Zygote
Member since 8/10 26 total posts
Name:
Dee
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X Post: Family Medical Insurance
My baby is due in July. My estimated health care for family will be over $1000/month out of pocket, with my employers health care through Aetna. For myself right now, its only $140/month, but adding on people is much more. My DH's insurance is not any better (he pays $400 for indiv through his employer--small company)
I am very torn on making my husband and/or baby go through Obama care once she is born in July.
Anyone have a similar bill for famiy care?
Anyone have experience with Obamacare? My HR manager said to stay away from it as you always have to fight w/Dr's and no Dr's want to accept it.
Thanks!
Stressing out mother to be!
Message edited 5/5/2014 4:52:24 PM.
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Posted 5/5/14 4:32 PM  |
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Long Island Weddings
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Paramount
Sweet!
Member since 7/12 4287 total posts
Name:
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Re: X Post: Family Medical Costs
Just so you know the Affordable health care act was made for people like you. People who are forced to spend 1K a month for health care.
And its "main stream" insurance. You go on and see what plans are available at what price. Its Aetna, Blue cross etc.
To the best of my understanding, a doctor does not know you have "ACA" health insurance. They know you have Aetna or Blue Cross.
But the ACA is made FOR people like you.
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| Posted 5/5/14 4:45 PM |
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WannaBeAMom11
LIF Adult
Member since 1/11 7391 total posts
Name:
Name
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X Post: Family Medical Costs
Your HR rep is a moron. As pp said you pick a company. No where does it say ACA. We just got our new rates and for now we are sticking with dh's company but will probably jump ship next year.
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| Posted 5/5/14 4:47 PM |
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deekzee
LIF Zygote
Member since 8/10 26 total posts
Name:
Dee
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X Post: Family Medical Costs
I was just calling pediatricians to see what they took and they had a specific list of 'obamacare' insurance plans they take. I dont know it all sucks.
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| Posted 5/5/14 4:50 PM |
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blue11
LIF Adult
Member since 2/11 1706 total posts
Name:
kat
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X Post: Family Medical Costs
Make sure you research the plans on the exchange, especially having a LO. Check and call doctors to see which plans they accept and understand the deductibles and co-insurance for each plan. We go to the doctor a lot with kids and it can add up! The reason some of the plans are cheaper are because you pay more out of pocket.
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| Posted 5/5/14 4:54 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: X Post: Family Medical Insurance
Posted by Paramount
Just so you know the Affordable health care act was made for people like you. People who are forced to spend 1K a month for health care.
And its "main stream" insurance. You go on and see what plans are available at what price. Its Aetna, Blue cross etc.
To the best of my understanding, a doctor does not know you have "ACA" health insurance. They know you have Aetna or Blue Cross.
But the ACA is made FOR people like you.
NOT TRUE!!!!!!!! Many doctors do NOT accept the "ACA" versions of these plans. You have to be VERY careful. They HAVE to know if it is ACA or NOT, there are MAJOR differences between the two, ACA & commercial.
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| Posted 5/5/14 5:00 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: X Post: Family Medical Insurance
Posted by WannaBeAMom11
Your HR rep is a moron. As pp said you pick a company. No where does it say ACA. We just got our new rates and for now we are sticking with dh's company but will probably jump ship next year.
Every doctors office will KNOW if it's ACA or not, and many don't accept the ACA versions. It's unfortunate, but it's the truth.
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| Posted 5/5/14 5:01 PM |
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deekzee
LIF Zygote
Member since 8/10 26 total posts
Name:
Dee
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X Post: Family Medical Insurance
Its all so confusing and horrible!
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| Posted 5/5/14 5:01 PM |
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LSP2005
Bunny kisses are so cute!
Member since 5/05 19458 total posts
Name:
L
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Re: X Post: Family Medical Insurance
I would call your and your husband's insurance and see if whether having a child is considered a life event that would enable him and the new baby to be on his plan and if they could join the plan when the baby is born.
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| Posted 5/5/14 5:04 PM |
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deekzee
LIF Zygote
Member since 8/10 26 total posts
Name:
Dee
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X Post: Family Medical Insurance
LSP2005 - Thats already in cost I assumed above. Mine is the cheapest out of ours--- when she is born, we'd pay that much for her to go on and for all 3 of us.
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| Posted 5/5/14 5:06 PM |
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CunningOne
***
Member since 5/05 26975 total posts
Name:
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Re: X Post: Family Medical Insurance
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
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| Posted 5/5/14 7:26 PM |
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CunningOne
***
Member since 5/05 26975 total posts
Name:
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Re: X Post: Family Medical Insurance
Posted by jessnbrian
Posted by WannaBeAMom11
Your HR rep is a moron. As pp said you pick a company. No where does it say ACA. We just got our new rates and for now we are sticking with dh's company but will probably jump ship next year.
Every doctors office will KNOW if it's ACA or not, and many don't accept the ACA versions. It's unfortunate, but it's the truth.
Very true. I gave the ER nurse my insurance card, she took one look at it and said, oh, "Healthcare Exchange?" It looks like my old cards I always had, so I have no idea how they know, but they do.
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| Posted 5/5/14 7:29 PM |
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alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
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Re: X Post: Family Medical Insurance
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
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| Posted 5/5/14 7:52 PM |
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blue11
LIF Adult
Member since 2/11 1706 total posts
Name:
kat
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Re: X Post: Family Medical Insurance
Posted by alli3131
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
Yes if you present in the emergency room you must be treated. They can tell by the type of empire plan that its the exchange.
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| Posted 5/5/14 8:35 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: X Post: Family Medical Insurance
Posted by blue11
Posted by alli3131
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
Yes if you present in the emergency room you must be treated. They can tell by the type of empire plan that its the exchange.
They have to treat you, but the insurance doesn't have to pay.....
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| Posted 5/5/14 10:06 PM |
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ali120206
2 Boys
Member since 7/06 17792 total posts
Name:
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Re: X Post: Family Medical Insurance
Posted by jessnbrian
Posted by WannaBeAMom11
Your HR rep is a moron. As pp said you pick a company. No where does it say ACA. We just got our new rates and for now we are sticking with dh's company but will probably jump ship next year.
Every doctors office will KNOW if it's ACA or not, and many don't accept the ACA versions. It's unfortunate, but it's the truth.
To keep costs down, many of the ACA plans use what they call "narrow networks" which means that they don't have access to as many providers as the group plans.
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| Posted 5/6/14 8:28 AM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: X Post: Family Medical Insurance
Posted by ali120206
Posted by jessnbrian
Posted by WannaBeAMom11
Your HR rep is a moron. As pp said you pick a company. No where does it say ACA. We just got our new rates and for now we are sticking with dh's company but will probably jump ship next year.
Every doctors office will KNOW if it's ACA or not, and many don't accept the ACA versions. It's unfortunate, but it's the truth.
To keep costs down, many of the ACA plans use what they call "narrow networks" which means that they don't have access to as many providers as the group plans.
BINGO, this is the truth, however, one of the major reasons why the network is so small is because these plans are reimbursing less than medicaid, so doctors can't afford to accept it.
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| Posted 5/6/14 9:47 AM |
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SecretlyTTC14
LIF Adult
Member since 12/13 1770 total posts
Name:
B
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Re: X Post: Family Medical Insurance
We have a BCBS plan through ACA. It's not affordable but DH is now self employed and I am pg so it is better then nothing. We pay almost $1k a month for just DH and I, we have a huge deductible, and they fight me on everything. I've had to appeal almost everything so far.
Like a pp said, the receptionists at the Dr's office know it's from the health exchange. They treat me like it's a hassle for them to even take it. If I had a choice, I would def go with private insurance through an employer even if it cost a little bit more per month.
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| Posted 5/6/14 10:03 AM |
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MrsA1012
love my little girl !
Member since 9/10 5777 total posts
Name:
Me
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Re: X Post: Family Medical Insurance
Posted by jessnbrian
Posted by Paramount
Just so you know the Affordable health care act was made for people like you. People who are forced to spend 1K a month for health care.
And its "main stream" insurance. You go on and see what plans are available at what price. Its Aetna, Blue cross etc.
To the best of my understanding, a doctor does not know you have "ACA" health insurance. They know you have Aetna or Blue Cross.
But the ACA is made FOR people like you.
NOT TRUE!!!!!!!! Many doctors do NOT accept the "ACA" versions of these plans. You have to be VERY careful. They HAVE to know if it is ACA or NOT, there are MAJOR differences between the two, ACA & commercial.
. This is what I've heard from my doctor friends as well.
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| Posted 5/6/14 10:04 AM |
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SecretlyTTC14
LIF Adult
Member since 12/13 1770 total posts
Name:
B
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Re: X Post: Family Medical Insurance
Posted by jessnbrian
Posted by blue11
Posted by alli3131
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
Yes if you present in the emergency room you must be treated. They can tell by the type of empire plan that its the exchange.
They have to treat you, but the insurance doesn't have to pay.....
This exactly. I have no out-of-network coverage with my plan so even though any hospital has to treat me... I will get stuck with the bill for it. The closest hospital that is in-network is 25 miles away from my home.
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| Posted 5/6/14 10:06 AM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: X Post: Family Medical Insurance
Posted by MrsA1012
Posted by jessnbrian
Posted by Paramount
Just so you know the Affordable health care act was made for people like you. People who are forced to spend 1K a month for health care.
And its "main stream" insurance. You go on and see what plans are available at what price. Its Aetna, Blue cross etc.
To the best of my understanding, a doctor does not know you have "ACA" health insurance. They know you have Aetna or Blue Cross.
But the ACA is made FOR people like you.
NOT TRUE!!!!!!!! Many doctors do NOT accept the "ACA" versions of these plans. You have to be VERY careful. They HAVE to know if it is ACA or NOT, there are MAJOR differences between the two, ACA & commercial.
. This is what I've heard from my doctor friends as well.
BCBS exchange plans I can ABSOLUTELY tell by the card - they have specific alphanumeric prefixes. Oxford I haven't seen yet, but they also have indicators on the card themselves. The other exchange plan that we accept is "NSLIJ CareConnect", it is both an exchange plan AND a commercial plan. I LOVE it as a manager. It reimburses well and quickly, and thus far they have been VERY easy to work with. BCBS, for us is no different FOR THE MOST PART than other BCBS products, except that it requires referrals from PCP's, AND the high deductibles.
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| Posted 5/6/14 10:13 AM |
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BargainMama
LIF Adult
Member since 5/09 15657 total posts
Name:
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Re: X Post: Family Medical Insurance
Posted by SecretlyTTC14
Posted by jessnbrian
Posted by blue11
Posted by alli3131
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
Yes if you present in the emergency room you must be treated. They can tell by the type of empire plan that its the exchange.
They have to treat you, but the insurance doesn't have to pay.....
This exactly. I have no out-of-network coverage with my plan so even though any hospital has to treat me... I will get stuck with the bill for it. The closest hospital that is in-network is 25 miles away from my home.
I was told by two different hospitals and my insurance company, that they HAVE to take insurance payment in the event of an emergency. This was also noted recently in the news.
And I'm not sure of the other plans, but Fidelis notates Bronze, Silver and Gold right on the card. Many providers take the medicaid/medicare version of the insurances, but not the exchange version.
Message edited 5/6/2014 11:05:46 AM.
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| Posted 5/6/14 11:04 AM |
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bunnyluck
LIF Adult
Member since 1/14 3196 total posts
Name:
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X Post: Family Medical Insurance
I would avoid it unless you absolutely can't swing it through your employer sponsored plan. I have heard too many horror stories. My mom has health care through the exchange (my fathers plan dropped her after ACA rolled out!). She is contantly fighting with her insurance company and has a difficult time finding doctors/hospitals who accept her plan.
I think you need to consider the price difference at the end of the day between going through the ACA exchange and putting your family on your current plan. If it's only a few hundred dollars I think it is worth the piece of mind to use commercial insurance. You can always make cuts elsewhere - healthcare is not a place to sacrifice especially with a baby on the way.
Message edited 5/6/2014 11:14:13 AM.
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| Posted 5/6/14 11:12 AM |
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deekzee
LIF Zygote
Member since 8/10 26 total posts
Name:
Dee
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X Post: Family Medical Insurance
I really appreciate everyone's input!
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| Posted 5/6/14 11:20 AM |
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SecretlyTTC14
LIF Adult
Member since 12/13 1770 total posts
Name:
B
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Re: X Post: Family Medical Insurance
Posted by BargainMama
Posted by SecretlyTTC14
Posted by jessnbrian
Posted by blue11
Posted by alli3131
Posted by CunningOne
We have Empire BCBS through ACA (obamacare) and I don't care what anyone says, it's not affordable. We have a low level plan (minimal coverage) and we still pay $1100 a month for family coverage. Yet, that was still cheaper than the $800/week plan DH's employer was offering.
Anyway, I didn't have any issues with doctors. We researched the plan before getting it and all our doctors are in it.
The trouble we are having is hospitals. None of the major 3 that we would consider using take it. The one we would use that takes it is a considerable distance should we need it for anything. And all our doctors happen to be affiliated with hospitals that don't take the insurance (Winthrop and St. Francis).
Should it be an emergency they will take any insurance.
Yes if you present in the emergency room you must be treated. They can tell by the type of empire plan that its the exchange.
They have to treat you, but the insurance doesn't have to pay.....
This exactly. I have no out-of-network coverage with my plan so even though any hospital has to treat me... I will get stuck with the bill for it. The closest hospital that is in-network is 25 miles away from my home.
I was told by two different hospitals and my insurance company, that they HAVE to take insurance payment in the event of an emergency. This was also noted recently in the news.
And I'm not sure of the other plans, but Fidelis notates Bronze, Silver and Gold right on the card. Many providers take the medicaid/medicare version of the insurances, but not the exchange version.
I was told the exact opposite by my dr, the hospital, and by BCBS. They said even if it's an emergency, I have no out-of-network coverage. Which worries me but, none of the plans through the health care exchange have the hospitals near my house listed as in-network so it's not like I even had a choice.
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| Posted 5/6/14 11:51 AM |
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