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[Tell] me about mental health care coverage in PPACA. Is there parity with medical coverage for all plans now (individual as well as group)? Are all plans required to offer mental health coverage? If so, what services will be mandated to be covered vs. optional? Will they be able to play games like limiting the number of office visits or requiring pre-authorizations for everything? Neophyte fucked around with this message at 05:08 on Mar 24, 2013 |
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Mar 24, 2013 05:03
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| # ¿ Apr 19, 2024 00:08 |
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Has there been any administration or Congressional efforts regarding the 400% FPL -> 400%+$1 subsidy hard cutoff? I mean, it's an extreme example but Jesus Christ that's a big potential hit for people. It's like what people complain about marginal tax brackets costing them money, but this time it's actually true!
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Oct 31, 2013 03:20
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I got plan quotes on my state BCBS site, and since they're the only company offering insurance (and I don't qualify for any subsidies) that's what I'll be paying next year. I tried to figure out, using crude generalized numbers, what the best plan would be for various levels of generic "medical expenses". I typed up a big long post with a bunch of figures and  but they don't really matter and nobody would care. So here's the jist:Medical expenses of $0-$2000 next year? - my best choice is the cheapest bronze plan, where you basically pay all costs up to $5500. Not too surprising, if you're not going to be spending much money on medical care get the cheapest plan you can. $2000-$7000 - the best choice is the second highest premium plan, a gold plan with $0 deductible, 30% coinsurance, and $5000 max. $7000+ - the best choice is the highest premium (and only) platinum plan, with a $500 deductible, 20% coinsurance, and $1500 out-of-pocket max. Two things that surprised me: 1) Any premium savings from higher-deductible plans in the same metal tiers was always outweighed by the increased deductible expense. 2) None of the silver plans I looked at were the best choice at any of the (admittedly abstract and generic) spending levels. And this is the metal tier that is considered the "default" choice! Also somewhat surprising was how quickly the platinum plan became the best choice. $7K in medical sounds like a lot, but that's what I'd be billed. Getting $7000 in medical bills in one year isn't that big a hurdle. Just a few moderately-serious illnesses or injuries - or any single serious problem - and you're probably there or well over. This was just a very broad and generalized look at these plans, and no doubt in specific, real-world, medical spending situations some silver tier and/or higher-deductible plans would be better choices. But still, not what I expected.
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Nov 1, 2013 02:38
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