DPChallenge: A Digital Photography Contest You are not logged in. (log in or register) 
 

DPChallenge Forums >> General Discussion >> Why…
Pages:  
Showing posts 1 - 15 of 15, (reverse)
AuthorThread
 06/20/2009 07:04:08 PM · #1
â€Â¦would The American Recovery and Reinvestment Act of 2009 (ARRA) disqualify someone just because they have Medicare?

Medicare doesn̢۪t pay for a couple of my doctors and none of my prescriptions.

I would like a good answer to that question.

For those that don̢۪t know what the ARRA is here is a brief description for the HHS.gov website.

The American Recovery and Reinvestment Act of 2009 (ARRA) provides for premium reductions and additional election opportunities for health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly called COBRA. Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider through a tax credit. The premium reduction applies to periods of health coverage beginning on or after February 17, 2009 and lasts for up to nine months for those eligible for COBRA during the period beginning September 1, 2008 and ending December 31, 2009 due to an involuntary termination of employment that occurred during that period. The TAA Health Coverage Improvement Act of 2009, enacted as part of ARRA, also made changes with regard to COBRA continuation coverage.


Please lets keep this out of rant. Thank!
Scott
 06/20/2009 07:13:41 PM · #2
1. Do you have health insurance under COBRA, having lost your health insurance through involuntary termination from your employment?

2. Even if, I believe if, I believe this benefit is only available if you have "no other source of insurance coverage" -- presumably this includes MediCare, MediCaid, or private insurance (as through a partner or parent's coverage).
 06/20/2009 07:27:32 PM · #3
Originally posted by GeneralE:
1. Do you have health insurance under COBRA, having lost your health insurance through involuntary termination from your employment?

2. Even if, I believe if, I believe this benefit is only available if you have "no other source of insurance coverage" -- presumably this includes MediCare, MediCaid, or private insurance (as through a partner or parent's coverage).


I have sent in the form for cobra online and faxed the ARRA application. Everything was a go until I told them I had Medicare. I'm disabled (under 65) and have Medicare, because of that I don't qualify for the ARRA reduction or extention.

If Medicare would not have disqualified me below is what we would of had to pay.

Beneficiary and family $772.14 x 35% = $270.25 /mo.

But since they did disqualify me just because I have Medicare below is what we will have to pay.

Beneficiary and Children $593.64 x 35% = $207.77
Beneficiary Only (ME) $498.78 x 100% = $498.78
--------------------------------------------------
Total $ 706.55 / mo.

That's almost the same as the full family at 100%

Message edited by author 2009-06-20 19:32:39.
 06/20/2009 07:47:49 PM · #4
Well, I think the health insurance industry is the biggest single impediment to improving health in this country, so I'm not surprised they've been able to collude with Congress to figure out a way to screw it up, even if unintentionally.

Wait until Monday morning and ask someone at your Congressional Representative's office the same question; send them your stats.
 06/20/2009 08:01:44 PM · #5
Originally posted by GeneralE:
Well, I think the health insurance industry is the biggest single impediment to improving health in this country, so I'm not surprised they've been able to collude with Congress to figure out a way to screw it up, even if unintentionally.

Wait until Monday morning and ask someone at your Congressional Representative's office the same question; send them your stats.


I agree.
 06/20/2009 08:17:59 PM · #6
Originally posted by SDW:
â€Â¦would The American Recovery and Reinvestment Act of 2009 (ARRA) disqualify someone just because they have Medicare?

Medicare doesn̢۪t pay for a couple of my doctors and none of my prescriptions.

I would like a good answer to that question.

For those that don̢۪t know what the ARRA is here is a brief description for the HHS.gov website.

The American Recovery and Reinvestment Act of 2009 (ARRA) provides for premium reductions and additional election opportunities for health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly called COBRA. Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider through a tax credit. The premium reduction applies to periods of health coverage beginning on or after February 17, 2009 and lasts for up to nine months for those eligible for COBRA during the period beginning September 1, 2008 and ending December 31, 2009 due to an involuntary termination of employment that occurred during that period. The TAA Health Coverage Improvement Act of 2009, enacted as part of ARRA, also made changes with regard to COBRA continuation coverage.


Please lets keep this out of rant. Thank!
Scott


Scott I can tell you that healthcare and insurance are two very sore spots for me. I can't give you an answer to your question, or why they did or didn't do what they did. But I can give you another example of healthcare help by the government that screws the people who really need it. I provide healthcare insurance to my family through my main day job. This past year they more then doubled our weekly payments for family coverage to over $170 a week. There is a State program for healthcare insurance with reduced or free premiums that my son qualifies for. We meet every single requirement to pay 5% of our monthly income for insurance payments which would save me literally thousands per year in premiums and copays and deductibles. The only niche is I have to leave him uninsured for 6 months as that is the only requirement not met. Now if anyone knows anything about my son's medical conditions I would literally be playing financial suicide to not have insurance on him for even one day. Instead I had to drop insurance on my wife and buy an individual policy on her through another company to try and save some $$$ and still have everyone insured.

Matt
 06/20/2009 08:27:46 PM · #7
Originally posted by MattO:


Scott I can tell you that healthcare and insurance are two very sore spots for me. I can't give you an answer to your question, or why they did or didn't do what they did. But I can give you another example of healthcare help by the government that screws the people who really need it. I provide healthcare insurance to my family through my main day job. This past year they more then doubled our weekly payments for family coverage to over $170 a week. There is a State program for healthcare insurance with reduced or free premiums that my son qualifies for. We meet every single requirement to pay 5% of our monthly income for insurance payments which would save me literally thousands per year in premiums and copays and deductibles. The only niche is I have to leave him uninsured for 6 months as that is the only requirement not met. Now if anyone knows anything about my son's medical conditions I would literally be playing financial suicide to not have insurance on him for even one day. Instead I had to drop insurance on my wife and buy an individual policy on her through another company to try and save some $$$ and still have everyone insured.

Matt

I know what your talking about. At this point the best I can do is go with COBRA coverage for my wife and children at $207.25/mo. Leaving me with only Medicare at $96.00/mo. (which will not cover half of the doctors an no medications). Then add Medicare part D at $55.74/mo. through another insurance company. An possibly have to get a Medicare supplement policy for around $130/mo. to make up the difference. A total of $488.99/mo. and that still will not give me the coverage I had under my wife plan before she was laid off. We were paying $276/mo through here employer with great coverage.
06/20/2009 10:56:02 PM · #8
Holy $h17.... Im glad I am canadian. Those are some crazy costs.
 06/20/2009 11:11:31 PM · #9
Originally posted by VitaminB:
Holy $h17.... Im glad I am canadian. Those are some crazy costs.

This is a serious question (no politics).

How do you rate your health care system? Are their long waits? Can you choose your own doctors, hospitals, pharmacy's? Do you have to pay to get faster treatment in the event of illness?

I would like to ask a real person instead of hearing things from the media. I would support a health care system if it would not put patients in jeopardy with waiting list and let the doctors decide if the patient needs a particular procedure. It would beat paying more than my rent for insurance. :)

Thanks in advance for any answers.

Message edited by author 2009-06-20 23:22:19.
 06/20/2009 11:18:11 PM · #10
Originally posted by SDW:
Originally posted by VitaminB:
Holy $h17.... Im glad I am canadian. Those are some crazy costs.

This is a serious question (no politics).

How do you rate your health care system? Are their long waits? Can you choose your own doctors, hospitals, pharmacy's? Do you have to pay to get faster treatment in the event of illness?

I would like to ask a real person instead of hearing things from the media. I would support a health care system if it would not put patients in jeopardy with waiting list and letting the doctors decide if the patient needs a particular procedure. It would beat paying more than my rent for insurance. :)

Thanks in advance for any answers.


and add to this -- how does the canadian tax system compare to the us's (as far as taxes paid by an individual)?
 06/20/2009 11:57:06 PM · #11
I get to chose my own family doctor, and have also gone through the process of changing doctors, which wasnt complicated.

Pharmacy wise, I can choose any pharmacy I want, though drugs are not covered by the govt... though many employer plans do cover it.

Wait times in hospitals can vary. I have only been to emerg twice, one for stitches, and I was in and out within 45 minutes (though this is not the norm)... another for a sprained wrist at 3am, that took 3 hours.

There are very long waits for things like specialists, MRI's, CAT scans etc. The doctors do have a large part in deciding when a patient gets a procedure, as you need referrals to see specialists.

But, for the most part, all canadians have the peace of mind knowing that our health is covered. That is what is invaluable to me. The system we have is not perfect, but it beats worrying about whether or not you can afford to get sick or not.

Tax wise, we are taxed more than our neighbors, but if you factor in the cost of insurance that many americans have to cover, I dont know if we are taxed more.

But... I should state that I am a relatively healthy 31 year old, so I havent had a lot of exposure to our health care system, other than minor illnesses and injuries. My comment was purely reactionary to the costs associated with your health insurance.
 06/21/2009 12:03:29 AM · #12
I am not sure I can answer everything but I will answer as far as my family situation goes.

I am 30 years old married with a 3 year old son.

My family doctor was the man who delivered me and I can usually see him that day or the next if he is busy. I do know there are other doctors out there with longer waits, my wife's doc before we were married would take 2 weeks sometimes to see her. If you have an urgent issue (and its not terribly complicated) sometimes it is better to go to a walk-in clinic.

I have never paid a penny to see my doctor but there are some things you may need to pay for. Not all docs charge these but they are acceptable in the OHIP (Ontario health insurance program) system. Things like a return to work note might cost $10 and to get some forms filled out might be $10. Physicals I think might cost between $30 and $50. All of these things are well spelled out on a sheet posted in the examination room.

Specialists can be difficult to get into, it all depends on demand. It will be a month after referral to get my wife in to a neurologist (migraines) but the family doc ruled out more severe things first by getting a cat scan done (wait time ~1 week cost $0).

There are other specialties that fall outside the OHIP system for adults like dentists and optometrists but do have some coverage for minors.

Unless you are on government assistance or have private insurance you have to pay for your prescriptions (way cheaper than in the US).

Please feel free to ask any questions of my situation that you are curious about. I am fortunate that for as long as I can remember I have been covered either under my father's extended heath care insurance or my own (I work for the same government funded school board he does). I did splurge and spend an extra ~$50 a night to get my wife a private room when our son was born. I have had very few time that I was "out of pocket" for any expenses.

That includes the birth of my son and a surgery he needed when he was two.

BTW my wife received 55% of her salary for the entire year she took off work to spend with our son.

One other thing, there are many government programs that provide funding for special needs. My son was diagnosed with autism almost a year ago and we have received speech therapy, subsidized daycare and tax breaks so far, and are awaiting the funding for ABA to start (don't get me started).

If you have questions about what is covered and what is not it varies by province and so does taxes. My taxes are a bad example of a typical household but according to a few sites the average Canadian is taxed 42%. That number though is terribly misleading as it includes ALL sales taxes, government fees such as license plate renewals and gas taxes. Also keep in mind that we have a sliding tax scale where the first ~$9000 is not taxed and there are levels of taxation beyond that.

I apologize for such a long response but I feel we really get a bad (communist) image up here because the capitalist health care industry is afraid of loosing the free reign they have over their patients wallets.

Canada's solution is not perfect but we don't have people up here deciding between getting medical help or putting a roof over their head.

Fire away with any other questions you have.
 06/22/2009 12:26:05 PM · #13
A bit of good news

Today I found out from ARRA that ALL of my family, including myself, were approved for the premium reduction. So instead of having to pay over $700/mo. it will be just $277.25. And that will give us the same coverage as we had before we lost our benefits.

I called COBRA to make sure they didn't make a mistake. The representative at COBRA told me that my wife's former employer approved the dependents of my wife's insurance even though I have Medicare. The reason stated; She lost her job due to layoff and at no fault of her own.

If I'm willing to complain, I must be man enough to give credit where credit is do. I thank my wife's former employer for accepting our application reduction in full.

Scott
 06/22/2009 12:29:05 PM · #14
Congratulations -- that IS good news.
 06/22/2009 01:14:18 PM · #15
Originally posted by VitaminB:
...There are very long waits for things like specialists, MRI's, CAT scans etc. The doctors do have a large part in deciding when a patient gets a procedure, as you need referrals to see specialists....

My daughter had a seizure, we brought her to emergency, she was in the MRI within about 40 minutes.
Pages:  
Current Server Time: 08/28/2025 12:53:53 PM

Please log in or register to post to the forums.


Home - Challenges - Community - League - Photos - Cameras - Lenses - Learn - Help - Terms of Use - Privacy - Top ^
DPChallenge, and website content and design, Copyright © 2001-2025 Challenging Technologies, LLC.
All digital photo copyrights belong to the photographers and may not be used without permission.
Current Server Time: 08/28/2025 12:53:53 PM EDT.