ObamaCare is a complete FNG disaster

[chaos]

Stop talking so much sense.   

[Primemuscle]

“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE, and have money left over,” Mr Trump wrote in a social media post.

Which better healthcare insurance companies is Trump referring to?

[Grape Ape]

Which better healthcare insurance companies is Trump referring to?

Purchasing health care is possible without insurance companies.

[Primemuscle]

Purchasing health care is possible without insurance companies.

Yes, it is. If Coach still has this insurance, several years ago, he was a big proponent of an alternative co-op healthcare coverage.

For the most part, my health insurance, which is Regence Medicare Advantage Classic plan, covers all my needs with a reasonable premium of $73 a month this year. Overall,  the premiums have increased, and I think they will do so for 2026, so who knows how I will feel about it in the future? I may have more benefits than I need. Currently, they include vision, dental and audio and much of the cost of associated equipment, such as glasses, hearing aids, and some restorative dental work, which is something I have rarely needed. It also covers mental health care, which some ‘getbiggers’ have suggested I need. LOL!

This year I opted for a new pair of glasses even though my prescription had not changed. I went all out and picked out really nice frames and every possible feature for the lenses. The full price was nearly $2,000 but I only paid $850 with Regence provided Vision Service Plan. A couple of years ago Regence added Truhearing hearing aids, prior to this they only covered exams. Instead of paying $6,000 for hearing aids, the last time I replaced them, I only paid a $1,000 co-pay for each hearing aid. If I remember correctly, restorative dental work, such as crowns, are paid at 50%. All I mostly need is to have my teeth cleaned twice a year, which is fully covered.

My kids have Tricare which is the military's equivalent of Medicare. Although, my son and family who live in Germany prefer the German healthcare system to Tricare.

[B_B_C]

Has Obamacare been aborted yet?

[Primemuscle]

Has Obamacare been aborted yet?

Not yet. The way that concept has been going for many years, maybe never.

[funk51]

    Let's get something straight right here, I hope Trump does get it right and improves the health care affordability problem to benefit "ALL'  Americans, but after 9 years of saying that he will  do it and not actually doing it,  I not too optimistic.

[IroNat]

Yes, it is. If Coach still has this insurance, several years ago, he was a big proponent of an alternative co-op healthcare coverage.

For the most part, my health insurance, which is Regence Medicare Advantage Classic plan, covers all my needs with a reasonable premium of $73 a month this year. Overall,  the premiums have increased, and I think they will do so for 2026, so who knows how I will feel about it in the future? I may have more benefits than I need. Currently, they include vision, dental and audio and much of the cost of associated equipment, such as glasses, hearing aids, and some restorative dental work, which is something I have rarely needed. It also covers mental health care, which some ‘getbiggers’ have suggested I need. LOL!

This year I opted for a new pair of glasses even though my prescription had not changed. I went all out and picked out really nice frames and every possible feature for the lenses. The full price was nearly $2,000 but I only paid $850 with Regence provided Vision Service Plan. A couple of years ago Regence added Truhearing hearing aids, prior to this they only covered exams. Instead of paying $6,000 for hearing aids, the last time I replaced them, I only paid a $1,000 co-pay for each hearing aid. If I remember correctly, restorative dental work, such as crowns, are paid at 50%. All I mostly need is to have my teeth cleaned twice a year, which is fully covered.

My kids have Tricare which is the military's equivalent of Medicare. Although, my son and family who live in Germany prefer the German healthcare system to Tricare.

$73/mo is quite low.

https://www.medicarefaq.com/blog/the-hidden-trade-offs-of-0-premium-medicare-advantage-plans/

While low cost plans look cost-effective upfront, the real costs often appear later through higher copayments, coinsurance, and out-of-pocket maximums.

[Primemuscle]

$73/mo is quite low.

https://www.medicarefaq.com/blog/the-hidden-trade-offs-of-0-premium-medicare-advantage-plans/

While low cost plans look cost-effective upfront, the real costs often appear later through higher copayments, coinsurance, and out-of-pocket maximums.

I did not know the $73 premiums on my Regence Medicare Advantage plan were low. Medicare Advantage plan premiums vary by location, the amount of the copays and any additional healthcare coverages such as dental and vison. I think this is the highest they have been since I first chose Regence Medicare Advantage when I retired when I was 65 years old, sixteen years ago. Of course, the full amount of the my healthcare insurance premium including Medicare Part B adds another $180 is $253. Compared to full cost of the healthcare coverage I had through my employer, Medicare Advantage including Medicare Part B is very low. So, I am not complaining.

Fortunately, I enjoy very good health. So, like most insurance, Medicare Advantage is there in the event I have an expensive healthcare issue, it would not 'break the bank'.

[IroNat]

I did not know the $73 premiums on my Regence Medicare Advantage plan were low. Medicare Advantage plan premiums vary by location, the amount of the copays and any additional healthcare coverages such as dental and vison. I think this is the highest they have been since I first chose Regence Medicare Advantage when I retired when I was 65 years old, sixteen years ago. Of course, the full amount of the my healthcare insurance premium including Medicare Part B adds another $180 is $253. Compared to full cost of the healthcare coverage I had through my employer, Medicare Advantage including Medicare Part B is very low. So, I am not complaining.

Fortunately, I enjoy very good health. So, like most insurance, Medicare Advantage is there in the event I have an expensive healthcare issue, it would not 'break the bank'.

What are your deductibles and co-pays.

Also what are your personal financial limits if you get a serious medical issue?

Are you covered if you go outside of your local area for treatment?

Does your plan require approval by the insurance carrier for procedures?

[chaos]

What are your deductibles and co-pays.

Also what are your personal financial limits if you get a serious medical issue?

Are you covered if you go outside of your local area for treatment?

Does your plan require approval by the insurance carrier for procedures?

Don't forget to ask his blood type, date of birth and  SS#

[Primemuscle]

What are your deductibles and co-pays.

Also what are your personal financial limits if you get a serious medical issue?

Are you covered if you go outside of your local area for treatment?

Does your plan require approval by the insurance carrier for procedures?

Medicare Advantage plays by the same rules as regular Medicare for the most part. If I could, I would provide you with a link to Regence's evidence of coverage pages but unfortunately, they are available only to people who have Regence Medicare Advantage. I have what is called the Classic plan. It has neither the lowest nor the greatest level of benefits in its array of plan options. So, I will cut and paste some of the information you asked about.

Medicare advantage Plans vary by location. Some are not available at all in rurual areas. Areas with the highest medical costs also have the highest premimums. co-pays, co-insurance, deductibles, and max out of pocket.

COPAYS

This is the flat amount you pay when visiting a provider or facility. Additional out-of-pocket costs may apply depending on your plan details and the type of services rendered. In some cases, copays apply only after satisfying your deductible.

Telehealth
You pay $0
Immunizations (preventive)
You pay $0
Primary care office visit
You pay $0
Specialist office visit
You pay $40
Urgent care visit
You pay $40
Emergency room visit
You pay $125 (waved if you are admitted to hospital)
Rehabilitative outpatient services
You pay $30
Outpatient substance use disorder treatment
You pay $25 (I believe there are some limitations)
Mental health office visit
You pay $25 (there is a limit on the number of visits)

COINSURANCE

This is the percentage of total costs you owe when your plan doesn’t cover 100% of services rendered. In some cases, coinsurance applies only after satisfying your deductible up to a maximum amount, this is called your out-of-pocket maximum.
Telehealth
You pay 0%
Immunizations (preventive)
You pay 0%
Primary care office visit
You pay 0%
Ambulatory surgery center (facility/professional)
You pay 20%
Hospital outpatient
You pay 20%

Some, but not all services require preauthorization. Note: I have yet to need a preauthorization to see a specialist.

You asked, “What are your personal financial limits if you get a serious medical issue?”

There is no lifetime benefit maximum for Medicare Advantage (part C). $14,000 is the most I pay out-of-pocket per year, for both in and out of network (out of area) coverage. After which Medicare pays 100%.

There is a maximum annual limit for my out-of-pocket costs.

Neither Medicare nor Medicare Advantage provide coverage when out of the country, with some exceptions.

You asked, “Are you covered if you go outside of your local area for treatment?”

You can go out of network for medical services, but the co-pays are higher. Neither Medicare nor Medicare Advantage provide coverage when out of the country, with some exceptions.

Vision, hearing and dental are each different in terms of what is or is not covered. For example, when I got new glasses this year the full price for them was $1,800 and I paid a little over $800. The co-pay for hearing aids is up to $1,000 per hearing aid through TruHearing. Otherwise, they are not covered. Annual hearing exams are covered. Preventative dental care, which includes cleaning and x-rays, is covered at 100%. Restorative work, such as fillings and crowns is covered at 50%.d

Prescription drugs are covered at several different tiers. Co-pays also vary depending on whether you get your prescription(s) filled at a preferred (in-network) pharmacy or out-of-network pharmacy. I use an in-network but non-preferred pharmacy. They usually come close to the same out of pocket I would pay at a preferred pharmacy. There is a deductible which must be met prior to just paying co-pays

This should give you a pretty good idea of what a Medicare Advantage plan covers. Like any health insurance coverage, it is imperative you read all the details of the plan, so you know in advance what is covered and at what rate. Whether you have private health insurance, employer provided health insurance, Medicare, Medicaid, or Tri-Care (Veterans), study your evidence of coverage and learn how to work within the system/plan (not work the system). It is better to be prepared for your costs and the level of coverage rather than to be surprised about it after the fact, only to find out you could have used a different option and saved yourself money and any hassle.