Chicago area and the ACA / Obamacare plans (university, pharmacy)

[sfcambridge]

Now Northwestern Hospital doesn't accept any Obamacare plans.

It seems to be moving towards a system where the only people who will be able to get insurance plans that allow them to access the best hospitals are people on a employer paid plan.

[cbsmom]

What are people's thoughts on the advocate system?
I hate that we won't have Northwestern, U of C or Rush available to us...would mean we'd have to change all our doctors.

An insurance agent suggested that my husband create a group plan (he is self employed - by making me his partner, we could create a small business group and thereby purchase group health insurance), which would open us up to many more plans. Has anyone looked into/done this?

[Vlajos]

Start planning for something else. Our new president and Congress plan to abolish the ACA.

[JacksonPanther]

Originally Posted by Vlajos

Start planning for something else. Our new president and Congress plan to abolish the ACA.

Those of you with preexisting conditions, God help you. Because the USA won't.

[sfcambridge]

I've been holding out posting, as I am still in a bit of shock...

Despite all the problems with Obamacare, I don't think it is possible to go back now. Even Trump has stated that they would not leave a gap in coverage for people currently using Obamacare plans, new options would still require insurance companies not to deny people for pre-existing conditions (awaiting how this will work....), and it will take time to transition to something new. Nothing will happen overnight.

I also have spoken to a few people about what to do for 2016. When choosing a plan for 2016, look at it as choosing a plan that might only last for 1 year. So ask yourself... what can I manage with for just one year?

For me, it will be dealing with a less optimal, but tolerable hospital system, and paying out of network level co-insurance or paying cash if no out of network coverage (with a self-pay discount) for the one specialist that I will see a year at Northwestern. Since I will have a high deductible plan anyway, it wont be that different it dollars spent for me. And I like to keep the same doctors.

If you want to continue to see all of your doctors and a non-covered hospital, that is hard. CBSMom - I was also told about the option you are considering. BUT I don't think you can have family or spouse as the one additional employee in your husband's business. If you can find another employee that is non-family, then it could work.

https://www.healthcare.gov/small-bus...shop-coverage/

But if your husband has found a private insurance company willing to offer you a group plan via your husband's business of you+him, I would recommend running it by someone who is not working on commission for the insurance companies before you sign the dotted line.

[nana053]

Originally Posted by JacksonPanther

Those of you with preexisting conditions, God help you. Because the USA won't.

To be fair, Trump says he wants to keep that provision of the ACA and also the provision allowing college students to stay on their parents insurance. Whether or not he can actually get anything through congress will be the test.

I will be interested to see how he would keep those provisions and pay for them. One of the reasons that premiums increased was that people who had no coverage could now get coverage and people who had pre-existing conditions were being covered.

If he manages to appeal the ACA, will all those poor people who could not get insurance prior still be eligible for Medicaid? Will medicare be gutted for those of us who retired?

[Gemini1963]

Originally Posted by sfcambridge

So ask yourself... what can I manage with for just one year?

For me, it will be dealing with a less optimal, but tolerable hospital system, and paying out of network level co-insurance or paying cash if no out of network coverage (with a self-pay discount) for the one specialist that I will see a year at Northwestern. Since I will have a high deductible plan anyway, it wont be that different it dollars spent for me. And I like to keep the same doctors.

This is where we're coming down, too -- a one-year, "good enough" plan (we hope) for 2017. We're going with the Blue Cross Blue Shield high deductible plan that is linked to Advocate. We are close to Advocate Christ Medical in Oak Lawn, which (for what it's worth) is rated well on the U.S. News ranking. (Again, for what it's worth.)

Best Hospitals in Illinois | US News Best Hospitals

[oakparkdude]

Ryan also wants to block grant Medicaid and voucherize Medicare.

[frostopsy]

Originally Posted by JacksonPanther

Those of you with preexisting conditions, God help you. Because the USA won't.

Some how, we made it up the the ACA mandating, and we will make it when it's gone. The problem is, you can't go without insurance and just sign up for it when it's needed. It's irresponsible and one of the reasons (amoung many) why the ACA is failing people.

There are options for helping people get insurance who have pre-excisting conditions. Maybe have an option enrollment once a year with a promos at sign up that you must maintain the insurance for a set amount of time? Who knows, but I'm optimistic things will turn around for everyone, from those who don't qualify for subsidies and lost their doctor, to the people most in need of insurance or cannot afford it.

[sfcambridge]

So has anyone looked at the Obamacare plans in our area for 2018?

Does your plan still exist? If not, what are you choosing?

How much have your premiums increased?