flacaltenn
Diamond Member
flacaltenn said:That was selected out of GROUP of Cigna plans and has the most MINIMAL network of providers.
Looks like virtually every acute care hospital in Nashville is in that plan's network. So whichever one your hypothetical kid went to was in.
For instance. I looked at one of these plans. I have bi-annual derm appointments. They are BOOKED 4 to 6 months in advance. The skinny plan that you picked uses a network with ONE dermatology group within 20 miles of my location... And it wasn't anyone that I WANTED to use.
Not sure why we need a dermatologist to fix the child's clavicle. But that network has at least 30 dermatologists within 20 miles of Nashville.
And NEITHER of these calculations account for the ACTUAL health needs of the REST of that family..
That year- it's VERY likely that on THAT plan -- they would come close or exceed the FAMILY deductible of $1600.. Another $500 or $800 out of their pockets.
If more people break more bones and use more services, they'll pay more for health care, sure. Their income is still substantially protected by their out-of-pocket limit. Hitting the family OOP max would require two family members to each incur costs of at least $17.3K. That is to say, family costs of $34.6K. Hard to argue in that situation their premiums + OOP contributions aren't worth it.
But I guess we could further expand Medicaid to even higher incomes so they pay nothing if that's what you're getting at.
I'm not IN Nashville. My preferred hospital is in NONE of the plans that I can afford without subsidy. I am SUBSIDIZING all those Medicaid expansion folks. MY premiums are TEN TIMES what the "expansion" folks pay.
Medicare costs should not be HIDDEN in the Pool. That's what they did. It's quite possible that Medicare plans state by state ought to INCLUDE a paid up CATASTROPHIC health plan thru the market providers. But under the terms of O'care --- CATASTROPHIC plans are illegal. Medicaid costs need to be covered by the GENERAL taxpayer base.
Hitting the family OOP max would require two family members to each incur costs of at least $17.3K. That is to say, family costs of $34.6K
Don't know where you got this. The FAMILY deductible is $1600 for the crappy clinic plan you cherry picked. The only time you hit the higher OOP limits is when you've used OUT OF NETWORK or UNPREFERRED providers. Which might happen under a "skinny network" plan..