Losing my monthly fills ins coverage due to Obamacare come Jan 2014

[GuyMontag 1,264]

Pardon my ignorance but how does Obamacare dictate to an insurance company what it can and cannot cover? I'm honestly asking because I don't know how that works. Thanks.

[donna12 742]

Guy, beats me, all I know is I'm covered now and starting Jan 1 all bariatric services will cease due to Obamacare I got my letter this past Saturday in the mail and I was on the phone with them for over an hr yesterday discussing different plans for myself and all will not cover any bariatric surgeries or aftercare. When I had my surgery last year I had BCBS of Michigan with my ex I was still on his policy and as he had to pay for my ins in our divorce and then a month later it expired and I had to seek it on my own and the only thing I could get that I could afford was Anthem BCBS KY and then half way thru the yr they raised the premium on me.

[tiggergramma 129]

I think it is truly bully behavior of your insurance company to opt out of providing ongoing coverage and claiming it is the result of the ACA. They appear to be taking advantage of a loop hole in the ACA, which is very unfortunate for you.

I would begin a letter campaign to Katherine Sebelius and don't stop until you have some help.

[donna12 742]

I think it is truly bully behavior of your insurance company to opt out of providing ongoing coverage and claiming it is the result of the ACA. They appear to be taking advantage of a loop hole in the ACA, which is very unfortunate for you.

I would begin a letter campaign to Katherine Sebelius and don't stop until you have some help.

thanks so much for this information I will do this! Thanks again.

[DELETE THIS ACCOUNT! 12,703]

Pardon my ignorance but how does Obamacare dictate to an insurance company what it can and cannot cover? I'm honestly asking because I don't know how that works. Thanks.

The short version is this: Existing healthcare can be grandfathered in "as is". So if you have health insurance through your employer that you like, you can keep it exactly as is. However if you leave that plan, you can never go back to it. The reason you cannot go back to it is because under the Obamacare laws, all insurance must adhere to the guidelines set by the government. If a carrier offers more or less coverage- they are fined heavily.

This won't go into effect for a couple years, btw. But, insurance companies are trying to make changes gradually prior to then. Also, insurance costs are going up considerably because of all this, forcing carriers to cut their coverage to recoup the costs on their end.

[Sharpie 3,306]

@Cheryl my insurance has always paid for my fills.. most plans that approved surgery should pay for the after care.. statements that everyone has to pay for fills out of pocket are simply not true.. Obamacare will change the way we all get our healthcare forever... sadly people like Donna will suffer the consequences.. the health care exchanges set up by the Feds will dicatate what and how you receive health care... period...

[rmalikone 108]

Hoping that politics stays out of the forum! People become defensive of their beliefs and will fracture the forum. To me it seems that there is a feel good vibe here and would hate to lose that.

[PJ Geeser 108]

our insurance agent called and said we can expect an approx. 26 percent increase....upping our Quarterly payment by about yet ANOTHER 1000.00 per quarter....Jesus Christ...are you kidding me????!!! I was furious. I dont understand how all the government bullshit works but ITS NOT WORKING!!!!! Ridiculous! So now our family of 5 will be paying 20,000.00 to 21,000.00 a year for health insurance.

I dont know if we can keep on with a 4000.00 a year increase in the premium ....so tell me...how does this make it affordable for everyone??????

[donna12 742]

The short version is this: Existing healthcare can be grandfathered in "as is". So if you have health insurance through your employer that you like, you can keep it exactly as is. However if you leave that plan, you can never go back to it. The reason you cannot go back to it is because under the Obamacare laws, all insurance must adhere to the guidelines set by the government. If a carrier offers more or less coverage- they are fined heavily.

This won't go into effect for a couple years, btw. But, insurance companies are trying to make changes gradually prior to then. Also, insurance costs are going up considerably because of all this, forcing carriers to cut their coverage to recoup the costs on their end.

Well since I don't work and get my ins on my own that counts me out and I could have been grandfathered in had I had this ins prior to 2010 but I didn't get this ins until my ex's ran out and I had to get some on my own which was July 2012 so still leaves me out to be grandfathered in. I was told today by an agent and don't know if they were blowing smoke up my arrrsss or not but they told me that Obamacare was doing away with all, eventually, bariatric surgeries and after care, has anyone heard this? scarry.

[☠carolinagirl☠ 18,721]

@Cheryl my insurance has always paid for my fills.. most plans that approved surgery should pay for the after care.. statements that everyone has to pay for fills out of pocket are simply not true.. Obamacare will change the way we all get our healthcare forever... sadly people like Donna will suffer the consequences.. the health care exchanges set up by the Feds will dicatate what and how you receive health care... period...

my ins pays for my fills (hadnt had one yet) but when i do, i just pay a 12 co pay....like with my dr visits....had me doing a WTF head shake reading some of this stuff

[rmalikone 108]

I buy my insurance (BCBS) and ACA has nothing to do with MY insurance, I also have heard that if you are covered by your employer nothing will change either. On the other hand I also buy my wifes insurance and BCBS sent a letter saying that her policy will be dropped in a years time.

Go figure my policy OK but hers isn't. And why do we still have 1 year?

Had 3rd fill yesterday and had to pay a co-pay($30), my policy OK's first 3 month's of fills & from here on out I'll pay specialist co-pay rate.

[m1aman 944]

My insurance has been paying for my fills also.

I know obummer claims we can keep our current health insurance if we want to. Okay we will see how true that really is in due time. I don't believe anything that man says unless it is about his ego. Socialism, plain and simple.

[DELETE THIS ACCOUNT! 12,703]

As far as keeping your own insurance- yes you can. However, there are very strict stipulations to that. When "day 1" happens and Obamacare is fully active, if you have insurance through an employer you can keep it. You will then be grandfathered in at whatever your current coverage is (though there's no guarantees on premiums). However, if you leave that coverage at any time, you CAN NOT go back to the same plan. If you get married, your spouse would have a different plan than you. If you had a baby, same thing. Essentially you could work with a new employee at the same company and you could have totally different insurance because you were grandfathered in and they were hired after "day 1".

This is what the actual Obamacare bill says, btw.

[Lady VS 1,147]

The short version is this: Existing healthcare can be grandfathered in "as is". So if you have health insurance through your employer that you like' date=' you can keep it exactly as is. However if you leave that plan, you can never go back to it. The reason you cannot go back to it is because under the Obamacare laws, all insurance must adhere to the guidelines set by the government. If a carrier offers more or less coverage- they are fined heavily.

This won't go into effect for a couple years, btw. But, insurance companies are trying to make changes gradually prior to then. Also, insurance costs are going up considerably because of all this, forcing carriers to cut their coverage to recoup the costs on their end.[/quote']

This is exactly the information I was given by our benefits office so I'm definitely not changing a thing.

[neenee717 37]

Perhaps as suggested you can work along with your physician on making pymts. Check the self pay price. My doc charges about 90 dollars for basic fill visit. I've found also when insurance was billed the docs bill insurance way more than self pay price