Will Obamacare affect CFers and their medicine negatively?
- Thread starter Enzo2311
- Start date
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welshwitch
Guest
Aside from the website issues, there is a small group of people who love their insurance and don't want to change it, but whose insurance is being cancelled. They are now forced to sign up for Obamacare and pay much more for it.
I suppose it may differ from state to state. I was notified back in June that my current insurance would end Dec. 31st--because of the availability of ACA I assumed--but that I would be sent options to consider. I am on a New York State low-cost program (BCBS is my carrier) and I did indeed receive the information last week. I have not gone online to research the different programs in depth, but I know that one of the options being offered me was a continuation through my BCBS that would automatically kick in if I do nothing by mid-December. The price quoted was about $40 less than my current HMO. Again, I haven't checked details; such as deductibles, meds and doctors covered, etc. so I'm hoping that remains the same. Other options being offered by NY State seem to be plans comparable or less expensive than the current state run coverage that I have. I would check ACA or state affiliated options you may have.
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welshwitch
Guest
Yes this is in CA.
Simba15
Member
no one knows - not even the gpvt
I have CF. I am also a medical provider. As a provider I have received NO information about obama care. None. That said I love in CT and we are the first state in the nation to role it out. People are saying it is good - especially for us. There NO penalty for a pre-existing condition. No one can deny you. I am told you go into a center (we have them here) and they give you 7-8 options you can pick from and buy. Good luck getting any information ahead of time.
I have CF. I am also a medical provider. As a provider I have received NO information about obama care. None. That said I love in CT and we are the first state in the nation to role it out. People are saying it is good - especially for us. There NO penalty for a pre-existing condition. No one can deny you. I am told you go into a center (we have them here) and they give you 7-8 options you can pick from and buy. Good luck getting any information ahead of time.
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hammerpocket
Guest
Enzo2311, you don't give any reason why Obamacare/ACA might affect you. You say your mom works for a school district in Nevada. Does she have insurance through her employer? Is that insurance going away? If her insurance plan isn't changing you shouldn't have anything to worry about. If she has to sign up through the ACA, but doesn't make much money, she will probably qualify for a payment subsidy to offset the cost.
politicaljules
New member
We had great insurance. We had never been denied for any pre-existing condition from three different insurance companies. In fact the HIPAA law already addressed the fact that was against the law, but it's too late now. Obamacare is never going away no matter what negative affects it has on everyone.
This year, our great insurance was discontinued and we were forced into a different plan to comply with obamacare regulations. Our premiums went up slightly, but the hidden costs are horrendous and I have no idea how we will pay for them. First of all our doctor is no longer in our network. This is the pulmonary specialist we see for cystic fibrosis. There is no plan to include him in network, so we lost our doctor unless we want to pay out of pocket.
The out of pocket costs have tripled. $6000 deductibles. Another $15,000 out of pocket (which is basically a fancy word for a second level deductible.)
I do not know if we will be allowed to keep our expensive cf drugs like cayston or TOBI, but we will pay a lot more to fill them. $80-$160 copays. Several medicines will no longer be covered like PPI's.
We've cut back so much as the economy has declined over the last 8 years. I have no idea where to cutback now. We don't qualify for assistance or subsidies, so don't ask.
I have a friend who's child was on medicaid and they paid nothing for their care. Obamacare stopped that and gave them a new plan for their child and a monthly premium of $100 complete with new deductibles and other out of pocket costs. It sounds like not very much but this family is very poor, and already struggling. As we are too struggling. I know there is nothing we can do now except for shake our heads to everyone that wanted this monstrosity. It may help a tiny amount of people that I only read about online, but it really hurts a whole lot of real people. That is not what was promised.
We were promised that we could keep our plans. Instead we can only keep the plans that obamcare deems acceptable. We were told we could keep our doctor. That was an outright lie.
Now that it has been discovered to contain so much strife and corruption, does obama want to do the right thing, pull it back and fix it? Not on your life. This is his baby and he will force it on the good people of this country forever.
This year, our great insurance was discontinued and we were forced into a different plan to comply with obamacare regulations. Our premiums went up slightly, but the hidden costs are horrendous and I have no idea how we will pay for them. First of all our doctor is no longer in our network. This is the pulmonary specialist we see for cystic fibrosis. There is no plan to include him in network, so we lost our doctor unless we want to pay out of pocket.
The out of pocket costs have tripled. $6000 deductibles. Another $15,000 out of pocket (which is basically a fancy word for a second level deductible.)
I do not know if we will be allowed to keep our expensive cf drugs like cayston or TOBI, but we will pay a lot more to fill them. $80-$160 copays. Several medicines will no longer be covered like PPI's.
We've cut back so much as the economy has declined over the last 8 years. I have no idea where to cutback now. We don't qualify for assistance or subsidies, so don't ask.
I have a friend who's child was on medicaid and they paid nothing for their care. Obamacare stopped that and gave them a new plan for their child and a monthly premium of $100 complete with new deductibles and other out of pocket costs. It sounds like not very much but this family is very poor, and already struggling. As we are too struggling. I know there is nothing we can do now except for shake our heads to everyone that wanted this monstrosity. It may help a tiny amount of people that I only read about online, but it really hurts a whole lot of real people. That is not what was promised.
We were promised that we could keep our plans. Instead we can only keep the plans that obamcare deems acceptable. We were told we could keep our doctor. That was an outright lie.
Now that it has been discovered to contain so much strife and corruption, does obama want to do the right thing, pull it back and fix it? Not on your life. This is his baby and he will force it on the good people of this country forever.
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welshwitch
Guest
Ugh, so sorry Jules. That's terrible.
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RytheStunner
Guest
I don't buy the 2nd part of your story. People on Medicaid are NOT affected and do not have their Medicaid stripped away due to the ACA. If they did indeed have it stripped, it was because they were re-evaulated and no longer qualified, which would have happened anyway, ACA or not.
Aboveallislove
Super Moderator
The short-term impact for those with CF will really depend on your current insurance (or lack thereof) and where you live. For some with insurance through employers, it will not change at all, other than the typical way it changes every year, with minor increases in premiums, co-pays, etc. For others who have insurance through employers, it could change by the dropping of a CF spouse, changing of insurance options and networks and much more substantial increases in premiums. (As an example, my employer's insurance is going up 10%. DH's 50%.) For others who are on the individual market, it is very likely to change with the losing of the insurance and then getting through the exchange, which might be better or worse. For those uninsured completely, it will give an opportunity to obtain insurance through exchange or expanded medcaid. How much it costs and how good it is will depend on the state medcaid expansion, exchange options and the financial situation. For those who have through a state "high risk exchange" or a "special health services" program, it could be lost if the state drops those in response to the now available insurance exchange and then it would come through the exchange. For those who will have different insurance, for CFers it would seem the biggest concern is what if the network doesn't cover your CF doctor or hospital? I know that many of the top hospitals are only covered by a few of the available policies on the exchanges, so it would be important to know the network in making a choice.
Aboveallislove
Super Moderator
No, bill. The insurance policies in the exchange, like most insurance policies, have networks of doctors and hospitals that are in network and out of network. To cut costs many off the exchange policies are limiting the networks and do not cover major medical centers. There should be at least one or two which include the hospitals with cf centers, but it is important for covers to make sure they select plans that have networks that cover those clinics since there are what only 110 certified cf centers in the entire us and those are usually the biggest medical centers.
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Patti Rowland
Guest
Obamacare
Obamacare would not have affected your friend's medicaid.
Also, people were still being denied coverage due to preexisting conditions up till now. I dont know what you are talking about with the HIPAA law.
The cancellation notice you received from the insurance company probably gave you another option you could keep if you did nothing - but it was not much better or in your case losing your doctor, worse. Its because of these for profit in my opinion CRIMINAL insurance companies that Obamacare became necessary in the first place. Many pushed for a public option like medicare for all ~ but the insurance company paid millions to prevent this. Hundred of millions actually. REad the insurance companies pledge to be good partners in Obamacare if the public option was eliminated. Then they stabbed their fellow Americans in the back.
You would do better to shop the ACA marketplace to find a better plan than the one you were offered by your insurance company. Unfortunately , the website is an admitted disaster right now but in the long run I feel optimistic that Obamacare will be a benefit to our families with members born with a "pre-existing" condition.
Obamacare would not have affected your friend's medicaid.
Also, people were still being denied coverage due to preexisting conditions up till now. I dont know what you are talking about with the HIPAA law.
The cancellation notice you received from the insurance company probably gave you another option you could keep if you did nothing - but it was not much better or in your case losing your doctor, worse. Its because of these for profit in my opinion CRIMINAL insurance companies that Obamacare became necessary in the first place. Many pushed for a public option like medicare for all ~ but the insurance company paid millions to prevent this. Hundred of millions actually. REad the insurance companies pledge to be good partners in Obamacare if the public option was eliminated. Then they stabbed their fellow Americans in the back.
You would do better to shop the ACA marketplace to find a better plan than the one you were offered by your insurance company. Unfortunately , the website is an admitted disaster right now but in the long run I feel optimistic that Obamacare will be a benefit to our families with members born with a "pre-existing" condition.
Aboveallislove
Super Moderator
HIPPA does preclude denial of insurance based on pre-existing conditions. After DS's denial I called the CF lawyer because of that fear and she assured me that it could not be denied and explained that is the is the "portable" in the Health Insurance Protection and Portability Act". But that only helped those who have insurance. There will be winners and losers, even in the CF world. Also, if the State's Medicaid is a "special health" kind for CF, the state might well decide to stop that because of the insurance exchange. At least one state has stopped offering insurance through its "high risk" pools putting those folks in the exchange.
Aboveallislove:
Many years ago, when I was about to go onto medicare, I attended several meetings for Part B coverage. Now medicare does not restrict admission to any hospital but some Part B insurance companies do, most have no restrictions. Here in Massachusetts, I know that both Tufts Medical and Fallon limit to a network. My carrier allows me to go anywhere.
All of the policies under the AHCA will be with private insurance companies, so I am sure that some will have networks. Buyer beware.
Bill
Many years ago, when I was about to go onto medicare, I attended several meetings for Part B coverage. Now medicare does not restrict admission to any hospital but some Part B insurance companies do, most have no restrictions. Here in Massachusetts, I know that both Tufts Medical and Fallon limit to a network. My carrier allows me to go anywhere.
All of the policies under the AHCA will be with private insurance companies, so I am sure that some will have networks. Buyer beware.
Bill
For both my husband's employer and my employer we now have more options of insurance plans to pick from, but for me all options cost more then last year as far as total out of pocket expense. My husband had one option that was the same and so we chose that option. As far as Obama care my options on the exchange were all much higher cost then my husband's employer because we are not entitled to any subsidy from the government because we have employer sponsored insurance option. I can see how some people will have a significant increase in cost if their employer offers healthcare, but only the minimum required by Obama care and then they are not eligible for any subsidy if they go through the exchange. Unfortunately many who purposely have a higher education level and chose jobs based on benefits verses pay will stand to lose the most from Obama Care. I agree with the principal of it, but the actual result is frightening.
turtle10000000
New member
I'm going to put aside political points for this post and just state a fact for my insurance. I have BCBS of South Carolina (through my father's insurance), Tricare south, AND Texas Medicaid, yet even with three insurances I'm getting a new co-payment bill for PULMOZYME of $200! It used to be $3 which was covered by TX Medicaid but now I don't know what I'm going to do! My dad is trying to help pay for it, but with four other siblings with CF that is going to be $1000 total! FYI, my father doesn't qualify for a subsidy, he has 7 kids and my mom was a stay-at-home type. I'm scared of notices for other medicines that are expensive but necessary for CF (and CFRD) but I don't know what I'm going to do. Right now I'm going to school as a medical transcriptionist so that I can work from home and still try to support myself at least (plus I love the medical field) and I hope it's still able to provide the benefits I need in the long run. Personally, I think people who are chronically ill and need medical treatment/support just to live should be provided the treatments they need so long as they are going to school or working, but not everyone needs that type/level of care. Now it seems the people who actually need the treatments and medicines are getting screwed over. Hopefully something will be done to modify or fix this mess.
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hammerpocket
Guest
turtle10000000, you should look into the patient assistance programs on the Genentech (Pulmozyme) website. They may have a program that can help with your high copay.