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A quick suggestion. If things are really this dire sign up for platinum coverage under a total in-network HMO like Kaiser. Platinum 90 0/10 as an example. If

A quick suggestion. If things are really this dire sign up for platinum coverage under a total in-network HMO like Kaiser. Platinum 90 0/10 as an example. If you have serious medical costs these plans are MAJORLY subsidized because they don't discriminate on pre-existing conditions. You CANNOT go out of network.

DaiPlusPlus 7y ago
This doesn’t help if you have pre-existing debts. Also, there are no Platinum plans where I live (western WA), some counties, especially rural, low-density areas, sometimes only have one plan provider for individuals for people who don’t qualify for Medicaid - and they aren’t obligated to provide even a Gold-level plan. We need universal coverage, now.
lotsofpulp 7y ago
No health insurance can deny insurance coverage for pre existing conditions since ACA was passed.
- wil421 7y ago
  Relevant government website. It’s been this way since 2014. No one in the US should be talking about pre existing conditions anymore. [1]https://www.healthcare.gov/glossary/pre-existing-condition/ https://www.healthcare.gov/glossary/pre-existing-condition/
- Animats 7y ago
  No. No US health insurance sold via the ACA marketplace can deny coverage for pre-existing conditions. There are new "short term" insurance policies which are not ACA compliant, and do not cover pre-existing conditions. [1] https://www.commonwealthfund.org/blog/2019/short-term-plans-large-bills-consumers https://www.commonwealthfund.org/blog/2019/short-term-plans-...
  - lotsofpulp 7y ago
    Thanks for that info. I don’t understand why those are allowed to exist, and more importantly, why people buy them.
    - ceejayoz 7y ago
      People buy them because 90% of the customers are happy evangelists. "I pay next to nothing for my health insurance!" The other 10% actually wound up having to use it, and discovered why the ACA said they don't count as insurance.
narrator 7y ago
That's the best thing about Kaiser. The care may only be adequate, but the no surprise out of network bills makes it better than any of the other plans.
- dillondoyle 7y ago
  Is this really true though? I have kaiser I think silver marketplace plan. While they did cover a good chunk of a semi-recent hospital cost (out of state emergency with no Kaiser in the state). I'm still getting new bills that Kaiser won't cover. But maybe I don't know enough to file complaint/forms to push back
  - privateSFacct 7y ago
    Yes it’s true - if you go to their facility no out of network bills. You may still end up w a bunch for different services but all considered in network. If you have an high deductible plan you'll still pay that whack. If you have gold / platinum no deductible plans you'll pay your co-pay. You CANNOT go out if network though - that's really the deal / tradeoff. If you travel a lot, have a fav specialist etc may not be a good fit - a national ppo may work better or us within us coverage for specific trips. Generally you can get $100K coverage for trips > 100 miles away from your home + 1 night away from home as part of your insurance package (exceptions related to traveling for medical work, getting drunk and hurting yourself etc).

DaiPlusPlus 7y ago

This doesn’t help if you have pre-existing debts. Also, there are no Platinum plans where I live (western WA), some counties, especially rural, low-density areas, sometimes only have one plan provider for individuals for people who don’t qualify for Medicaid - and they aren’t obligated to provide even a Gold-level plan. We need universal coverage, now.

lotsofpulp 7y ago

No health insurance can deny insurance coverage for pre existing conditions since ACA was passed.

wil421 7y ago
Relevant government website. It’s been this way since 2014. No one in the US should be talking about pre existing conditions anymore. [1]https://www.healthcare.gov/glossary/pre-existing-condition/ https://www.healthcare.gov/glossary/pre-existing-condition/
Animats 7y ago
No. No US health insurance sold via the ACA marketplace can deny coverage for pre-existing conditions. There are new "short term" insurance policies which are not ACA compliant, and do not cover pre-existing conditions. [1] https://www.commonwealthfund.org/blog/2019/short-term-plans-large-bills-consumers https://www.commonwealthfund.org/blog/2019/short-term-plans-...
- lotsofpulp 7y ago
  Thanks for that info. I don’t understand why those are allowed to exist, and more importantly, why people buy them.
  - ceejayoz 7y ago
    People buy them because 90% of the customers are happy evangelists. "I pay next to nothing for my health insurance!" The other 10% actually wound up having to use it, and discovered why the ACA said they don't count as insurance.

narrator 7y ago

That's the best thing about Kaiser. The care may only be adequate, but the no surprise out of network bills makes it better than any of the other plans.

dillondoyle 7y ago
Is this really true though? I have kaiser I think silver marketplace plan. While they did cover a good chunk of a semi-recent hospital cost (out of state emergency with no Kaiser in the state). I'm still getting new bills that Kaiser won't cover. But maybe I don't know enough to file complaint/forms to push back
- privateSFacct 7y ago
  Yes it’s true - if you go to their facility no out of network bills. You may still end up w a bunch for different services but all considered in network. If you have an high deductible plan you'll still pay that whack. If you have gold / platinum no deductible plans you'll pay your co-pay. You CANNOT go out if network though - that's really the deal / tradeoff. If you travel a lot, have a fav specialist etc may not be a good fit - a national ppo may work better or us within us coverage for specific trips. Generally you can get $100K coverage for trips > 100 miles away from your home + 1 night away from home as part of your insurance package (exceptions related to traveling for medical work, getting drunk and hurting yourself etc).