r/obamacare

▲ 12 r/obamacare+1 crossposts

anyone here avoid seeing doctors or specialist due to not knowing total cost?

I personally don't have an issue with buying things, fixing things because i know the cost before everything starts, however, because of this health insurance, not knowing what it will be cost bothers me so much that i avoid seeing doctor as much as possible, yes, I have a high deductible plan, the insurance thinks, the first $3k is basically free money, but i don't want to risk going to a doctor and get like $700 surprised bill, which I often seeing here.

This works great for health insurance companies that collects high premium and know people will try to avoid seeing doctors as long as possible. Whoever came up with the high deductible is a genius businessman. sucks for consumers and it should be illegal.

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u/PrestigiousDrag7674 — 1 day ago

I've just realized that my Ambetter ACA plan is dogsh1t

First I see a primary care physician who doesn't want to continue to prescribe the maintenance sleep Rx that I have been on for over 30 years, telling me that I should see a psychiatrist. So I call up Ambetter saying this, but what do you know, there are only 3 psychiatrists in the plan, and none of them want to deal with anyone having insomnia issues.

I have put in an escalation with healthcare.gov to allow me to get another plan (Blue Cross), which although it is $300/m more, has my current primary-care physician in network. I have escalated wthis with Ambetter, and they are "working on it:, although they have not found a psychiatrist that will work out.

I will be seeing my old doc as self-pay ($130), also getting the Rx on my own. What the h3ll am I paying the $80/mo for my plan for such garbage. And the ironic thing is that when I was on Medicaid, my primary-care physician was in network (I still had to pay for my Rx, since Medicaid doesn't pay for that Rx either).

u/swampwiz — 2 days ago

Manipulating income for Silver Plan w/ CSR

So I’ve very tentatively looked into early retirement, meaning 5 years before Medicare eligibility and I was just tapping around on an AI asking questions and so I have a question to real people who might know something about this:

The AI, Gemini, said that if you keep your income between $15,060 and $22,590 that you can get a subsidize silver plan with cost sharing reductions for next to nothing, relatively speaking.

First question: is this still a thing, or was the AI trained on old information?

Second question: My main source of income before Social Security and a pension would kick in would be income from a Roth IRA. Gemini said that income from a Roth IRA, since it’s not taxable, would not count. So I could get a part-time job and earn within the range written above and then get additional income from my Roth IRA and still be eligible for relatively low cost health insurance through a silver plan with cost sharing reductions. Is this true?

Thanks.

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u/wlow3 — 3 days ago
▲ 10 r/obamacare+2 crossposts

Do I need to stay with my employer healthcare coverage or should I switch to marketplace plan in VA.

What do I do if my healthcare coverage with my employer is more than doubling and gives way worse coverage?

For example, I paid $65.00+/- in 2024 a week for decent coverage for me plus dependent with my employer paying $300.00 a month.

in 2025 I paid $95.00 +/- a week for better coverage for me plus a dependent with my employer paying $350.00 a month.

For 2026 it is increasing to $205.00+/- a week for terrible coverage and a super high deductible for me and my dependent with my employer paying $400.00 a month.

I looked into Marketplace Health Coverage and it is about $350.00 cheaper a month and exactly the same coverage I have currently that expires May 31st.

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u/Emzilla11 — 8 days ago