3 ms·

ACA increases the subscriber pool. The main issue now is the high deductibles which causes folks to ration care. Otherwise your premiums are scaled based on i

ACA increases the subscriber pool. The main issue now is the high deductibles which causes folks to ration care. Otherwise your premiums are scaled based on income. You also do get some primary care visits included and a few other things. That's so you catch things earlier before they get expensive. What the ACA really does though, is reduce the financial impact of a catastrophic event. So you are covered and out of pocket say a max of $10k vs $100k+. So let's say you get diagnosed with cancer, well the $10k is manageable (excluding the insurance games).

mgkimsal 4y ago
Assuming that 10 or 100k of services is 'in network'. The only plan I can remotely afford now offers no functionality in any 'out of network' facility. The columns are all just 'n/a'.
- theGnuMe 4y ago
  Sure but that's ok. If you cannot get equivalent care nearby "in network" then you can go out of network and get covered. They won't like it and it can take negotiation but you have that option. All emergency care for example operates this way. This is why the ACA stuff uses your zip code to offer plans. Remember most of these are State and Federal partnerships with private companies. The companies are just offering up their "networks". You and the State are paying the premiums.. One way to think about it is that the state is paying the employer portion. This is way better than how it use to be...
  - mgkimsal 4y ago
    "then you can go out of network and get covered" I can get the care, but nothing in what you're describing sounds like what my paperwork details say. It indicates that any non-emergency services undertaken outside of their network will not be dealt with at all. I'm not sure how this is 'better' than what it used to be, with 'used to be' being last year's plan that would, at least, deal with services delivered out of network, with some % split up to a deductible.

mgkimsal 4y ago

Assuming that 10 or 100k of services is 'in network'. The only plan I can remotely afford now offers no functionality in any 'out of network' facility. The columns are all just 'n/a'.

theGnuMe 4y ago
Sure but that's ok. If you cannot get equivalent care nearby "in network" then you can go out of network and get covered. They won't like it and it can take negotiation but you have that option. All emergency care for example operates this way. This is why the ACA stuff uses your zip code to offer plans. Remember most of these are State and Federal partnerships with private companies. The companies are just offering up their "networks". You and the State are paying the premiums.. One way to think about it is that the state is paying the employer portion. This is way better than how it use to be...
- mgkimsal 4y ago
  "then you can go out of network and get covered" I can get the care, but nothing in what you're describing sounds like what my paperwork details say. It indicates that any non-emergency services undertaken outside of their network will not be dealt with at all. I'm not sure how this is 'better' than what it used to be, with 'used to be' being last year's plan that would, at least, deal with services delivered out of network, with some % split up to a deductible.