PPACA and misinformation/malinformation

chavez · RIP MHL 04/25/1958 - 01/11/2006

So my boss' father (a licensed life, health, and annuity agent) told me today that his grandson (my boss' nephew) cut his finger the other day and tried to go to the ER (where he waited forever and eventually left - we both agree he should have gone to urgent care).

Anyhow, this led him to tell me something I found very odd. He told me his grandson (37yo, no dependents) has a policy that costs 300+ per month and has a 9k deductible. Immediately, I knew this could not be correct, as even bronze plans have a deductible of 5k (and a max OOP of 6350). Further, a bronze plan for an unmarried 37yo individual is as low as 240/mo according to the exchange. IOW: he was not even close to being correct.

So I ask, has anyone else experienced this with others? I mean, he is 100% brainwashed by Faux News, so I took what he said with a massive grain of salt. But the problem remains: are people that misinformed (or MALinformed) of the actual costs involved? And this guy is a licensed agent with active health insurance clientele!

eeven73 · Posted: Apr 28, 2014 12:40 pm Post subject:

Perhaps he was confused between his deductible and family deductible?

FWIW,I just looked on Moda Healths website and a policy for a 37yr old with a 9K family deductible is $333per month.

eeven73 · Posted: Apr 28, 2014 12:44 pm Post subject:

https://www.modahealth.com/pdfs/mailings/2013/903308.pdf

eeven73 · Posted: Apr 28, 2014 12:49 pm Post subject:

My reading comprehension is low.

No Dependents.

Maybe he has read the plan like the one above and is just confused in regards to his deductible. The 300 something figure seems pretty real though.

chavez · RIP MHL 04/25/1958 - 01/11/2006

Moda isn't a carrier here (that pdf was for Alaska).

At first I thought that, but he'd be low there anyway (although you could get coverage for 1 parent + 1 child for mid-300s). In CA, the bronze plan for 1 parent + 1 child has the same deductible of 5k/per ind with a max OOP of 10k.

So IDK where he got his numbers, because they are just completely wrong.

chavez · RIP MHL 04/25/1958 - 01/11/2006

I suppose he could be confused, but he really shouldn't be. It took me appx 30 seconds to pop on to the CoveredCA site (CA's exchange) and look up the numbers.

It's not the premium number that is making me scratch my head it's the deductible number. I mean, he's not even in the same universe. This to me, is concerning given that the info is readily (and easily) accessible.

Love or hate PPACA, I hope one would at least want to have the info correct to accurately form the basis for an opinion. Of course, that isn't how it works, but I would never rec someone use him as their source of health insurance knowledge, and he's a licensed professional!

eeven73 · Posted: Apr 28, 2014 1:16 pm Post subject:

Well I would look on Cover Oregon but........

I just posted that because from what I know Moda is real competitive on rates here in Oregon. Didn't realize it was Alaska. Embarassed

I don't think the mid 300's is absolutly wrong on a bronze plan from what I have seen. What I have heard(anecdotally) is that some of the bottom priced plans are a bitch to use because of "network".

eeven73 · Posted: Apr 28, 2014 1:19 pm Post subject:

Posted right after you.

I am sure it(his confusion) is a function of

1.) World is full of idiots(not a personal attack on your aquaintence)

2.) Healthcare plans are still quite complex in jargon. Deductible, Co-Insurance, Out of Pocket...........

chavez · RIP MHL 04/25/1958 - 01/11/2006

eeven73, I think you may be right, but he does have a firm grasp on #2.

The network for the plans I was using as basis were Blue Cross and have the same network as they did before. I used to have them (little over 1 year ago) and I had a pretty massive list of providers to choose from.

I'm guessing I could find a bronze plan using that age (37) that would run mid-300's, but in my estimation that would be the company saying "we have to offer this, but we don't want anyone to sign up for it". Mostly because it is more than 25% more expensive than almost all competitors.

On another (related) note: I am friends with a couple of local MD's that were positively swamped with new patients from January until just last month. This was a good amount of work for them, but is quite good for their bottom lines!

eeven73 · Posted: Apr 28, 2014 1:36 pm Post subject:

Okie Boarder · Ladies Man Joined: 03 Mar 2008 Posts: 10056 City: Edmond

I've seen and heard similar, but when I check it out, it doesn't quite match up. I know when I priced it out on the exchange for myself, as best I could since OK doesn't really participate like CA, I found the numbers didn't look horrible. Obviously they are a fair amount higher than I pay now, but my company heavily subsidizes our coverage.