Insurance You Can't Even Use | Affordable Care Act Plans | Health Insurance Deep Dive Ep. 3.2

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  • Опубликовано: 30 сен 2024

Комментарии • 78

  • @NurseLiz
    @NurseLiz  2 года назад +2

    Sources:
    www.verywellhealth.com/actuarial-value-and-your-health-insurance-4147819
    www.healthcare.gov/choose-a-plan/plans-categories/
    pennie.com/
    www.ehealthinsurance.com/resources/individual-and-family/does-your-state-require-you-to-have-health-insurance
    www.healthcare.gov/
    www.ehealthinsurance.com/resources/individual-and-family/obamacare-hardship-exemption
    www.investopedia.com/terms/h/hardship-exemption.asp#:~:text=The%20term%20hardship%20exemption%20referred,personal%20and%2For%20financial%20circumstances.&text=Individuals%20who%20weren't%20able%20to%20afford%20coverage%20could%20apply,where%20no%20penalty%20was%20assessed.
    www.healthcare.gov/health-coverage-exemptions/hardship-exemptions/
    www.verywellhealth.com/gold-plan-health-insurance-what-is-it-1738728
    www.ehealthinsurance.com/resources/individual-and-family/does-your-state-require-you-to-have-health-insurance
    www.healthcare.gov/taxes/no-health-coverage/
    www.healthcare.gov/fees/fee-for-not-being-covered/
    www.ehealthinsurance.com/resources/affordable-care-act/obamacare-tax-penalties
    www.commonwealthfund.org/blog/2018/healthy-low-income-people-greater-health-risks
    www.healthcare.gov/glossary/co-payment/
    www.healthcare.gov/glossary/deductible/
    www.healthmarkets.com/resources/health-insurance/platinum-plan/
    www.obamacareplans.com/platinum.html?_ci=28114223&_ai=935511&_d=c;CQ0-3n1teJDpzIT3DJe2Z3Of47CyGNrRs9eC15gBCfND4o_E9s53QlTnZGWGZGnl4_PCyRIA&gclid=Cj0KCQiAoNWOBhCwARIsAAiHnEjW5UxbpR8rMtlmSyJ6ecKbEFNxzRv0FP7Mp-vmgfBZaKQPvfLR9I4aAlHtEALw_wcB

    • @eyemnew2991
      @eyemnew2991 2 года назад +1

      I don't know why insurance companies put all this information out.
      A lot of people right now either can't get insurance or can't afford it.....no job...no paycheck..no insurance.

  • @MartySalo
    @MartySalo Год назад +5

    Hey Nurse Liz, almost a six million dollar kid here. 1982 car bike collision, I was bike, number 6 hot load on an aero-medical helicopter transport in Norfolk Virginia, 10 days pediatric ICU, 39 more days in hospital/coma. Brought home to hospital bed in living room. Life is good though. I have a TBI, I'm now 51 years old, and some deficits. I was an employee with the VA hospital for 23 years, I have healthcare from the government. I guess it is good insurance. Expensive, but I see ENT for mastoid bowl debridement about 4 times a year, and other doctors. And wife has more complicated things going on. We are fortunate to have the insurance we have which enables seeing healthcare providers. Most often the healthcare providers are at the local university. I've not needed much TBI specific care lately. Did have an MRI to provide documentation for my TBI, nueropsych eval (testing), and other stuff to provide documentation when I sought medical retirement. Some bosses were jerks, caused stress, and I didn't know all the things to say. Good stuff. I am better now.

  • @fernando.estrella
    @fernando.estrella 2 года назад +14

    Liz, Thank you for this video. I’m a freshly graduated Nursing Student. My job doesn’t start until February and my insurance won’t kick in until March. Prior to graduating I had a plan through the market place for $36 a month with the subsidy. Now that I’ve graduated and moved back home with my parents, the market place has decided “JK you don’t get the subsidy anymore so now you need to pay $440 a month for your insurance”. Obviously as a broke post college student, I can’t afford that. So I’m stuck with the choice of paying for it or holding out 2 months until I get work insurance while being uninsured.
    The cherry on top is I got sick this past week and had to pay an out of pocket urgent care visit to get seen 😂. Healthcare and health insurance in this country is a SCAM

    • @NurseLiz
      @NurseLiz  2 года назад +2

      Ugh I am SO SORRY you're going through that! The system is so broken and hurts so many people. I hope you can find a solution until your new job's insurance kicks in!

  • @sidneyoverland6869
    @sidneyoverland6869 Год назад +7

    I’m ended up on a Blue Shield Silver HMO & called the clinic I am assigned to make Appt. with the doctor I am assigned. They told me the next available Appt. Is June 2023. They e-mailed my doctor & nobody called me back.
    I called Blue Shield & kept being put on hold. She told me she was going to help me & disconnected me, but didn’t call back.
    They take a $1000 a month as long as they can for an HMO that keeps you from seeing an available doctor.
    In order too see a doctor you have to pay an additional $500 for a PPO.
    They want you to die. They want you to die.
    They left me with no doctor to go to & I needed to be seen. I was also overdue for everything & told I couldn’t get an appointment for almost a year.
    In California, legally, they have to see you within two weeks or sooner if you are sick.

    • @HeatherBelling
      @HeatherBelling Год назад

      I man I miss Cali p, ur comment just made me know why I need to move back to that state as soon as I am able

    • @sidneyoverland6869
      @sidneyoverland6869 Год назад

      @@HeatherBelling ?

    • @jet7518
      @jet7518 Год назад +1

      In California here, even sick I can't see my PCP in two weeks, scheduling at least a month out, they send me to urgent care.

    • @user-cu3xn4xj3i
      @user-cu3xn4xj3i 5 месяцев назад

      Absolutely, they want us to die.

  • @kathypaup
    @kathypaup Год назад +3

    It’s sad that our worth as humans in this country is based on our ability to work at a high paying job or career. Health insurance outside of the ACA is just as crazy with premiums, copays, deductibles, prior authorizations, HMOs, PPOs and in network and out of network. Sounds like the ACA just followed the status quo. Insurance is just another huge corporation. You should do a video on how difficult it is to get SSI disability and also Medicaid.

  • @hunty92
    @hunty92 2 года назад +8

    Last year, just for myself, I paid a total of $574 a month for a plan with a $7,300 deductible, which I could only use at our local university’s facilities and “community health centers”. Additionally, even though it should have been in network, i had to forego physical therapy because it would have cost me >$300 a visit. Subsidized, my rate was about $200 a month, but, since I moved, they took a very needed $4,700 out of my federal refund. This system is a joke. This country is a joke.

    • @MNP208
      @MNP208 Год назад

      ALWAYS pay out of pocket for physical therapy! They give you a big discount. I pay around $100/visit for PT and never use my insurance. Of course, this cost will vary depending on where you live.

  • @lori5946
    @lori5946 Год назад +3

    Marketplace sucks.

  • @briannamurray804
    @briannamurray804 2 года назад +12

    I have cerebral palsy. Is it bad that I already knew most of this? This was really well researched, Liz. I wish I could have you as a healthcare provider.

    • @margigannon1748
      @margigannon1748 2 года назад

      Why would it be bad that you know that?

    • @briannamurray804
      @briannamurray804 2 года назад +1

      Margi Gannon ACA insurance plans are basically a scam. I know a lot about insurance so that I can get the medical care I need. I just think it’s sad that I have to know all of these things to avoid an insurance company taking advantage of me.

  • @MNP208
    @MNP208 Год назад +2

    My husband and I currently have a 2023 Bronze plan. Our "cost sharing" is: deductible $9,100 per person, $18,200 max out of pocket. Routine annual physicals are covered, but we pay some $ for labs. Mammogram and colonoscopy are covered. If we have a musculoskeletal issue, we ALWAYS see a PT first and pay cash. PTs charge around $100 - $150/visit if you don't use insurance. Otherwise, we try to stay away from the health care system. Currently, we don't have any preexisting conditions that require us to see a provider routinely. Luckily, we had our children in the 1990's when childbirth was covered.

  • @lauranason1822
    @lauranason1822 2 года назад +6

    I always wondered why I could no longer bring up any concerns at my annual physical...well now I know! BTW, I call my monthly premium for my lowly Bronze plan my extortion payment. In my state there are 4 levels depending which county you live in. Of course I live in one with one of the highest premiums...which county is the lowest?? The wealthiest! Go figure! Great video...now, how to affect change!??

    • @NurseLiz
      @NurseLiz  2 года назад +4

      It's morbidly hilarious that you call it your extortion payment. Making the best of the situation through humor! And don't worry, in future videos we will be talking about ways to seek change, so stick around!

  • @jaxrunner904
    @jaxrunner904 2 года назад +8

    I think it’s absolutely crazy that no one explains this to you in your schooling as a healthcare worker, at least not at the associate level and bellow… still waiting to see if it’s addressed in the BSN. You would think understanding your patients on that level would take more precedence.

    • @NurseLiz
      @NurseLiz  2 года назад +3

      It was addressed in my BSN, so probs don't want to be getting your hopes up! And you would think it would, and I will when I run the world

    • @MNP208
      @MNP208 Год назад

      They just skim over the content. We didn't learn it in detail.

    • @jet7518
      @jet7518 Год назад

      They should also teach you to screen anyone on these plans for depression. Even if they were not depressed before they will be after they sign up.

  • @t.k.3895
    @t.k.3895 2 года назад +9

    Thank you for the deep dive. I really think healthcare was broke before this act. Way before the ACA.

    • @NurseLiz
      @NurseLiz  2 года назад +3

      Oh I totally agree. It was even worse before

    • @Jen-zz7nv
      @Jen-zz7nv 2 года назад

      It definitely was broken before this, in my experience however its gotten way worse. Our premiums have grown to be more than our mortgage and we have a substantially less amount of coverage. In 2000 our son had a surgery to fix a congenital kidney defect (which took 6 years and as many different doctors to diagnose.) It was completely covered. (And my husband was a blue collar guy I was a stay at home mom. ) More recently I was in an accident and needed spine surgery and it almost bankrupted us.

  • @Starry_Night_Sky7455
    @Starry_Night_Sky7455 Месяц назад +1

    I love your delivery. Yeah it's all so absurd that all you can do is 😂 laugh to keep from going insane. This needs to be shared, and shared, and shared.

  • @emilycecil860
    @emilycecil860 2 года назад +9

    You are a natural teacher. Thank you for putting these videos out.

    • @m.c.7920
      @m.c.7920 2 года назад +1

      I think she was onto something when she started out going to school to be a teacher but adult and health care education is more her thing

    • @NurseLiz
      @NurseLiz  2 года назад +2

      Thank you! Maybe one day I'll go into education, but right now, I'd just rage against the system for not being able to teach things that are actually applicable

  • @eyemnew2991
    @eyemnew2991 2 года назад +3

    You know what's bad about insurance..
    What
    Finding the insurance you want
    That's a good thing.
    No, that's bad.
    Why's that bad
    Finding the insurance you want and can't buy it.
    Oh, that's bad
    No, that's good
    Why's that good.
    If I don't buy insurance I still have that money.
    Well that's a good thing
    No, that's bad
    Why's that bad
    I still don't have insurance
    Well that's bad
    No, it's a good thing
    Why's that a good thing
    Because if I don't have a job so I can buy insurance, what good does looking for insurance accomplish if I can't buy insurance with money I don't have because of a job I don't have.
    Good point 😐

    • @NurseLiz
      @NurseLiz  2 года назад

      This is so perfect, I wish I could pin two top comments!

  • @m.c.7920
    @m.c.7920 2 года назад +4

    OMG the amount of times I nodded and shook my head in this video... this makes me question my path to PA school

  • @steffybael1245
    @steffybael1245 2 года назад +1

    a doctor prescribed be a drug to treat a condition. that drug caused me to get a life threatening disease called Diabetes. so who should pay for my medical treatments related to my diabetes?
    should it be that high paid rich as hell doctor, or the rich as hell pharmaceutical company that make a drug that caused my disease, maybe it should be the FDA , who approved that drug for consumer use or should tax payers be required to pay the costs?
    it is said that when a doctor diagnoses a new type 2 diabetic patient, that the doctor calls his financial planner and tells him to buy him another apartment building!
    i have a silver plan, i have a $400 deductible for medical and so does my wife. that makes a $800a year deductible! my wife is a nurses aid and makes $17 an hour, while i make $330 a month on social security!
    i inherited a large sum of money in 2017 and went to buy insurance and was told that unless we earned $1000 a month, they would not sell me a plan!! so i had ZERO insurance. so i paid CASH for all my meds and doctor visits!!
    january 2019 i got STAPH A in most of my body, i spent 3 weeks in the big city hospital getting butchered up real good (1 of my scars on one of my legs is 10 inches long!!) then i spent 2 months ,1 week in my local hospital) i got on the plan but it did not start until after the first week in my local hospital. so i had around 1/2 million dollars for the first month of hospital stay and surgeons etc...NOT THERE i cant do even 1 push up! where i use to walk 4 miles with no problem , it now takes me 45 minutes to walk just 1 mile and im all in!!
    if you form a corporation, and put your property in the corporation then the corp charges you rent for use of those things, you OWN NOTHING!! just like the FILTHY RICH!!

  • @mihaichiriac174
    @mihaichiriac174 2 года назад +5

    Liz . Hope your efforts gonna help . Love your passion.

    • @NurseLiz
      @NurseLiz  2 года назад

      passion, rage, same things lol

  • @Passionate_Potato
    @Passionate_Potato 2 года назад +2

    I hope we get first world healthcare within my lifetime.

  • @ElizabethRodriguez-pn7bk
    @ElizabethRodriguez-pn7bk 2 года назад +3

    Super helpful, i just got mine today because i need mental help. I have worked in a dental office so i know that when i see HMO, the patient always ends up paying anyway. There is always a code that is not covered by the HMO.

  • @boybiboy21
    @boybiboy21 2 года назад +3

    you should totally become an educator on our nurse politics/ethics class on my NP program lol

  • @nikki.londonuk6881
    @nikki.londonuk6881 5 месяцев назад

    Watching this makes me so Grateful we have the NHS here in the uk,we can brake bones have operations give birth in hospital and NOT PAY A PENNY no medical bills no nothing(our taxes go towards that)I feel so sorry for Americans who can’t even go to the doctors if ill cos it costs them money let alone any meds they may need to have!,why can’t ur country have universal healthcare like the uk Canada and other countries!why can’t the states be like us and just have taxes go towards healthcare so EVERYONE can get the healthcare they need,It’s fucking disgusting how a country like the USA can’t put its peoples health first without trying to make money for the bigwigs!!…It’s awful that u have to decide between healthcare,affording rent or buying groceries!!!😔🥺

  • @sidneyoverland6869
    @sidneyoverland6869 Год назад +1

    I had a PPO when I lived in the rich county next door. All of my doctors were back in the rich county. I moved to a poor county & suddenly, I couldn’t have a PPO. Suddenly, I started having problems with my plan when I moved to the next county.
    It’s clear they don’t want us to have access to healthcare with the A team in the rich county.
    I live in a poor county & now I can’t get a doctor appointment…..

  • @nada13_08
    @nada13_08 Месяц назад

    Whats insane is that insurances companies want to pretend its a steal to get 60% covered by insurance... but if you just tell people you don't have insurance and shop around for prices in cash, you can almost always find a place that does it out of packet for half "market" price. If that doesn't show you its a scam, idk what does.

  • @MrOsasco
    @MrOsasco 8 дней назад

    Health insurance companies must repond to the shareholders, not the customers

  • @jet7518
    @jet7518 Год назад

    Its the same cost, its just whether you pay up front or pay later. So either pay a ton upfront and get "healthcare" (good luck with that) or pay less (still a lot) and dont get healthcare because can't afford $4750 deductible. But mostly the actual care sucks anyway. Or pay a fine and then try to pay out of pocket ir just don't go or be ok with dying when your time is up.

  • @nin_the_destroyer2602
    @nin_the_destroyer2602 2 года назад +1

    My nursing school requires health insurance but no longer offers student plans, while simultaneously encouraging students to work part-time or not at all because the program is so rigorous. I'm looking at a premium of $325 a month for two years just to maintain this. It's really bad out here and affects everyone in different ways. Nursing school is already expensive, and now they're pulling this stunt.
    P.S. I'm pretty sure Pennie only offers catastrophic plans to those under 30.

  • @Jen-zz7nv
    @Jen-zz7nv 2 года назад +3

    What a wealth of information. Thanks for doing all the research! I hope your bp handled it ok.

    • @NurseLiz
      @NurseLiz  2 года назад +1

      it's still recovery, to be honest lol

  • @nursegaines3519
    @nursegaines3519 2 года назад +1

    👌🏿Really like your content

    • @NurseLiz
      @NurseLiz  2 года назад +1

      I appreciate that!

  • @pegaseg70
    @pegaseg70 2 года назад

    My Swiss ass: "YEAH! LET'S FIX THAT BROKEN SYSTEM" !!!
    (Tbh, our system is very meh too working close to yours, I would like to change it too)

  • @Maya-hw9ch
    @Maya-hw9ch 2 года назад +1

    Idk what the answer is but I think looking at some kind of Universal Healthcare is a start.

    • @NurseLiz
      @NurseLiz  2 года назад +1

      Definitely a start!

    • @HeatherBelling
      @HeatherBelling Год назад +1

      how about just starting with eliminating all health insurance corporations completely and leaving healthcare to the doctors and other practitioners

  • @yetanothercsstudent
    @yetanothercsstudent 2 года назад +1

    I've always wanted to be a hulking bronze god. Now I'll have to reevaluate my priorities.

  • @margigannon1748
    @margigannon1748 2 года назад +1

    Could you like lose your license for that? Although like I don’t know if they would know how would they know? Sorry I really am curious

    • @ivylayne1649
      @ivylayne1649 2 года назад

      For sharing her opinion? No.

    • @NurseLiz
      @NurseLiz  2 года назад +1

      If you're referring to your other comment: Just asking I know you’re probably not supposed to do this but as a doctor or nurse practitioner if somebody brought up other issues can you just not tell their insurance like how would they know? Just wondering
      If it's s simple question about health, we can answer it, but if it needs a follow-up or a procedure or intervention or treatment, we have to chart it and bill it a certain way in case of an audit, because if that happened, the legal ramifications would be very bad.

  • @susanbrown7185
    @susanbrown7185 Год назад

    Thank u currently looking to buy my insurance❤. !!!!!

  • @bluebubblegum57
    @bluebubblegum57 2 года назад

    How much do nurses pay for practise insurance in the US? In Canada it is covered by some unions and or some professional organizations will cover it. Also most hospitals in Canada are unionized. Is this the case in the US?

    • @NurseLiz
      @NurseLiz  2 года назад

      Nursing malpractice insurance is usually $80-150 a year. Not many people buy it though. It’s never covered by unions or organizations as far as I know. Some hospitals in the US are unionized. Don’t know the percentage. I’ve only ever worked as nurse at a unionized hospital

  • @margigannon1748
    @margigannon1748 2 года назад

    Just asking I know you’re probably not supposed to do this but as a doctor or nurse practitioner if somebody brought up other issues can you just not tell their insurance like how would they know? Just wondering

    • @NurseLiz
      @NurseLiz  2 года назад

      Hey Margi, I answered this on your other comment!

  • @fnhc2023
    @fnhc2023 2 года назад

    It seems like sliding scale

  • @janietrain
    @janietrain 2 года назад +3

    A lot of the problem is that all 50 states were supposed to expand Medicaid to cover more people. Many Republican states refused to use the federal money allotted for that just to punish then President Obama and attempt to make the ACA fail. The ACA plans for people who are employed aren't super popular because they're expensive and have a high deductible, but at least people can now walk into a doctor's office and get a physical, a mammogram, a colonoscopy and birth control. Before the ACA an uninsured person couldn't even afford to walk into a primary care office. It's not great, but we are much better off now.

    • @janietrain
      @janietrain 2 года назад +1

      Also, the penalty was designed to get healthy young people into the pool to lower the overall cost of healthcare. The problem was that very low income people who couldn't afford insurance or the penalty should have been able to qualify for Medicaid.

    • @ga6589
      @ga6589 2 года назад +1

      @@janietrain The tax penalty for not having insurance was done away with in 2019.

    • @NurseLiz
      @NurseLiz  2 года назад +2

      oh absolutely things are better than they were in some areas, and I think it was ridiculous that Medicaid was not federally mandated to expand coverage. I think the ACA was an important step forward in some respects, but it has a long way to go to being good.

  • @NANA-nd1kq
    @NANA-nd1kq 2 месяца назад

    Direct-pay is the solution.
    Pre-ACA, there were affordable catastrophic care policies available.
    Vote for a government which will reinstate conditions allowing for catastrophic insurance + HSAs. Then patients will shop for medical care and competition will drive prices lower. Outcomes also improve: see Singapore model.