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Re: WHY NOT - AARP and health insurance for members under age 65????

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Message 11 of 32

@GailL1 wrote:

@DonF503732 wrote:

I think Ellen (@ellenb640249) is correct. Why wouldn't AARP members have offers of insurance, similar to those receiving medicare benefits?

 

Ellen knows, as I assume it would be GAIL replying in a somewhat "wise-guy" tone, that AARP is not an insurance company. HELLO..... what do you think we're stupid?

 

I have been self-employed since 1989, paying my own health insurance for our family of six.  Do the math, the total premiums I paid in health insruance alone would provide for a pretty nice pension, huh?

 

I think the real disconnect here is that AARP member that are 60 years, with kids at home or in college, that are being quoted $2,500 to $3,000 for monthly health insurance premiums, a middle of the road Obamacare Plan is $2,600.

 

Most membership organizations are the same.  They do anything for a buck, to keep money coming in.  Why not receive allow AARP to get their $20 or $30 per month commission on a well put together health insurance plan for the members that are under 65 years old.  And please keep in mind that most of us don't need all the coverages afforded in the ACA.  The members are in need of a "lower cost alternative."  That was the whole point of Ellen's question.


I (and my husband), like you, Don, was self-employed for the vast majority of my working careeer - since 1979.  We stayed insured via small group, association plans or individual coverage and we were NEVER Un-insured or Under-insured.  Husband died in 2006 and when I retired, I was paying a hefty premium for coverage.  Thank goodness, that all ended before Obamacare went into effect after being grandfathered for 12 months..

 

I know you aren't stupid, Don, but I fail to see how this would save too many people in premium cost.  Maybe you can explain it to me but do consider these facts -

1.  People who are the younger members here can get a big premium subsidy for their heathcare coverage if theybuy a policy on the exchange and their income is less than 400% of the Federal Poverty level - State or Federal.  So they probably won't be interested in association coverage.

2.  People in this age group tend to be less healthy than younger people so there will be few younger folks interested in this coverage to help balance out the health risk of the older crowd..  The younger folks could be the disabled - who need coverage for that 24 month SSDI period before they can go on Medicare.  So it sounds like to me, the association group might be on the UN-healthier side - driving up private insurance premiums.

3.  The main culprit in premium increases since Obamacare took affect is that insurers have to accept everybody regardless of health condition - before, remember, insurers could deny peoply coverage based on some pre-existing condition or at the very least deny coverage for the condition for a specific amount of time.

 

It sounds like our President is considering sanctioning these type of association plans - now whether or not there will be some way which he can change the (by law) essential health benefits coverage - and offer many of them to only those who need them, like by riders, or allow insurers to deny coverage for some pre-existing condition, I don't know.

Perhaps AARP/UHC will consider offering them but I don't think it will be a panacea for high premium because here we are dealing with those higher in age with a lot of chronic health conditions and perhaps some very, very costly conditions to treat.

 

If we want to get premium cost down (for everybody) it will have to be at the source - we use a lot of healthcare, we use a lot of unnecessary health care, we use a lot of health care that has to be reapeated again because it failed the 1st time because of conditions going into the procedures, we have many type diagnositic test and other medical infrastructure at our beckoning in some areas and then deserts areas in others.  We use a lot of medications for a lot of chronic conditions - we do not approve medications based on efficacy - INCLUDING COST.

 

Until we start controlling these cost - health care coverage cost, including Medicare, will continue to rise faster than our pocketbooks. 

 

We can continue to play these games with health care coverage when the main culprit for high and higher premiums is the system itself and how we use it for what and when.

 

You do know how Medicare and its various parts work - don't you.  Meaning it is vastly subsidized by the government out of the General Fund.  The only part of it that is premium and subsidy free is Part A (HI insurance) - that's where those working year's tax withholding go and it is going broke very fast.

2018 Social Security and Medicare Trustee Report Summary

 

Both Social Security and Medicare face long-term financing shortfalls under currently scheduled benefits and financing.. . . . .

. . . . Social Security and Medicare together accounted for 42 percent of Federal program expenditures in fiscal year 2017. . . . Social Security and Medicare together accounted for 42 percent of Federal program expenditures in fiscal year 2017. . . .

. . . .

The Medicare program has two separate trust funds, the Hospital Insurance (HI) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund. HI, otherwise known as Medicare Part A, helps pay for hospital, home health services following hospital stays, skilled nursing facility, and hospice care for the aged and disabled. SMI consists of separate accounts for Medicare Part B and Part D. Part B helps pay for physician, outpatient hospital, home health, and other services for the aged and disabled who have voluntarily enrolled. Part D provides subsidized access to drug insurance coverage on a voluntary basis for all beneficiaries, as well as premium and cost-sharing subsidies for low-income enrollees.

 

The Trustees project that the HI Trust Fund will be depleted in 2026, three years earlier than projected in last year’s report. At that time dedicated revenues will be sufficient to pay 91 percent of HI costs.  The Trustees project that the share of HI cost that can be financed with HI dedicated revenues will decline slowly to 78 percent in 2039, and will then rise gradually to 85 percent in 2092. The HI fund again fails the test of short-range financial adequacy, as its trust fund ratio is already below 100 percent of annual costs, and is expected to decline continuously until reserve depletion in 2026. 

 

read MORE at the link provided

 

 

 

 

 


 

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Re: WHY NOT - AARP and health insurance for members under age 65????

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Message 12 of 32

@DonF503732 wrote:

I think Ellen (@ellenb640249) is correct. Why wouldn't AARP members have offers of insurance, similar to those receiving medicare benefits?

 

Ellen knows, as I assume it would be GAIL replying in a somewhat "wise-guy" tone, that AARP is not an insurance company. HELLO..... what do you think we're stupid?

 

I have been self-employed since 1989, paying my own health insurance for our family of six.  Do the math, the total premiums I paid in health insruance alone would provide for a pretty nice pension, huh?

 

I think the real disconnect here is that AARP member that are 60 years, with kids at home or in college, that are being quoted $2,500 to $3,000 for monthly health insurance premiums, a middle of the road Obamacare Plan is $2,600.

 

Most membership organizations are the same.  They do anything for a buck, to keep money coming in.  Why not receive allow AARP to get their $20 or $30 per month commission on a well put together health insurance plan for the members that are under 65 years old.  And please keep in mind that most of us don't need all the coverages afforded in the ACA.  The members are in need of a "lower cost alternative."  That was the whole point of Ellen's question.


I (and my husband), like you, Don, was self-employed for the vast majority of my working careeer - since 1979.  We stayed insured via small group, association plans or individual coverage and we were NEVER Un-insured or Under-insured.  Husband died in 2006 and when I retired, I was paying a hefty premium for coverage.  Thank goodness, that all ended before Obamacare went into effect after being grandfathered for 12 months..

 

I know you aren't stupid, Don, but I fail to see how this would save too many people in premium cost.  Maybe you can explain it to me but do consider these facts -

1.  People who are the younger members here can get a big premium subsidy for their heathcare coverage if theybuy a policy on the exchange and their income is less than 400% of the Federal Poverty level - State or Federal.  So they probably won't be interested in association coverage.

2.  People in this age group tend to be less healthy than younger people so there will be few younger folks interested in this coverage to help balance out the health risk of the older crowd..  The younger folks could be the disabled - who need coverage for that 24 month SSDI period before they can go on Medicare.  So it sounds like to me, the association group might be on the UN-healthier side - driving up private insurance premiums.

3.  The main culprit in premium increases since Obamacare took affect is that insurers have to accept everybody regardless of health condition - before, remember, insurers could deny peoply coverage based on some pre-existing condition or at the very least deny coverage for the condition for a specific amount of time.

 

It sounds like our President is considering sanctioning these type of association plans - now whether or not there will be some way which he can change the (by law) essential health benefits coverage - and offer many of them to only those who need them, like by riders, or allow insurers to deny coverage for some pre-existing condition, I don't know.

Perhaps AARP/UHC will consider offering them but I don't think it will be a panacea for high premium because here we are dealing with those higher in age with a lot of chronic health conditions and perhaps some very, very costly conditions to treat.

 

If we want to get premium cost down (for everybody) it will have to be at the source - we use a lot of healthcare, we use a lot of unnecessary health care, we use a lot of health care that has to be reapeated again because it failed the 1st time because of conditions going into the procedures, we have many type diagnositic test and other medical infrastructure at our beckoning in some areas and then deserts areas in others.  We use a lot of medications for a lot of chronic conditions - we do not approve medications based on efficacy - INCLUDING COST.

 

Until we start controlling these cost - health care coverage cost, including Medicare, will continue to rise faster than our pocketbooks. 

 

We can continue to play these games with health care coverage when the main culprit for high and higher premiums is the system itself and how we use it for what and when.

 

You do know how Medicare and its various parts work - don't you.  Meaning it is vastly subsidized by the government out of the General Fund.  The only part of it that is premium and subsidy free is Part A (HI insurance) - that's where those working year's tax withholding go and it is going broke very fast.

2018 Social Security and Medicare Trustee Report Summary

 

Both Social Security and Medicare face long-term financing shortfalls under currently scheduled benefits and financing.. . . . .

. . . . Social Security and Medicare together accounted for 42 percent of Federal program expenditures in fiscal year 2017. . . . Social Security and Medicare together accounted for 42 percent of Federal program expenditures in fiscal year 2017. . . .

. . . .

The Medicare program has two separate trust funds, the Hospital Insurance (HI) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund. HI, otherwise known as Medicare Part A, helps pay for hospital, home health services following hospital stays, skilled nursing facility, and hospice care for the aged and disabled. SMI consists of separate accounts for Medicare Part B and Part D. Part B helps pay for physician, outpatient hospital, home health, and other services for the aged and disabled who have voluntarily enrolled. Part D provides subsidized access to drug insurance coverage on a voluntary basis for all beneficiaries, as well as premium and cost-sharing subsidies for low-income enrollees.

 

The Trustees project that the HI Trust Fund will be depleted in 2026, three years earlier than projected in last year’s report. At that time dedicated revenues will be sufficient to pay 91 percent of HI costs.  The Trustees project that the share of HI cost that can be financed with HI dedicated revenues will decline slowly to 78 percent in 2039, and will then rise gradually to 85 percent in 2092. The HI fund again fails the test of short-range financial adequacy, as its trust fund ratio is already below 100 percent of annual costs, and is expected to decline continuously until reserve depletion in 2026. 

 

read MORE at the link provided

 

 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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WHY NOT - AARP and health insurance for members under age 65????

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Message 13 of 32

I think Ellen (@ellenb640249) is correct. Why wouldn't AARP members have offers of insurance, similar to those receiving medicare benefits?

 

Ellen knows, as I assume it would be GAIL replying in a somewhat "wise-guy" tone, that AARP is not an insurance company. HELLO..... what do you think we're stupid?

 

I have been self-employed since 1989, paying my own health insurance for our family of six.  Do the math, the total premiums I paid in health insruance alone would provide for a pretty nice pension, huh?

 

I think the real disconnect here is that AARP member that are 60 years, with kids at home or in college, that are being quoted $2,500 to $3,000 for monthly health insurance premiums, a middle of the road Obamacare Plan is $2,600.

 

Most membership organizations are the same.  They do anything for a buck, to keep money coming in.  Why not receive allow AARP to get their $20 or $30 per month commission on a well put together health insurance plan for the members that are under 65 years old.  And please keep in mind that most of us don't need all the coverages afforded in the ACA.  The members are in need of a "lower cost alternative."  That was the whole point of Ellen's question.

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Re: AARP and health insurance for members under age 65????

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Message 14 of 32

@ellenb640249 wrote:

Valid points, but this does not address the fact that even normal, healthy individuals aged 50-64 have to pay extreme premiums and deductibles because we don't have the benefit of a group. AARP could provide such a group for us to join. Even if it helped lower our premiums and deductibles by a fraction, that would help.

 

Please do something about this. AARP is supposed to be our organization too. It's not just for people over 65. We're hurting out here!

 

Thank you,

 

Ellen


Now let's think about how this might work -

1.  AARP is NOT an Insurer - even for Medicare Advantage pland and Medigap (Medicare Supplemental) plans which are currently offered under their name umbrella, they are NOT the actual insurer - they are affilliated with United Healthcare for this coverage.  They do make money from this arrangement as they do with other affilliations.

A national insurer like UHC would still be setting up the networks and formularies, deductibles, opays, etc.

 

2.  Group coverage is not a panacea for lower rates because it still depends on the age makeup of the group - Under the ACA rules, there is still a 3X age up-rating allowed.

The only reason why Group coverage like the Employer type is beneficial is because the employers shares in the cost of the policies and may I add BOTH the employer and the employee save on taxes too. 

Plus they also have a wider age group of employees to help balance out the risk especially from chronic conditions which seems to be concentrated in greater numbers in the age group of 55 - 64.

 

I posted this yesterday on this very forum - notice the red highlighted area..

The Price Tag To Help Make Health Insurance Affordable For Americans? Nearly $700 Billion A Year
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Message 1 of 1

 

Bloomberg 05.23.2018 - It Costs $685 Billion a Year to Subsidize U.S. Health Insurance

 

It will cost the U.S. government almost $700 billion in subsidies this year help provide Americans under age 65 with health insurance through their jobs or in government-sponsored health programs, according to a report from the nonpartisan Congressional Budget Office.

 

The subsidies come from four main categories.

  • About $296 billion is federal spending on programs like Medicaid and the Children’s Health Insurance Program, which help insure low-income people.
  • Almost as big are the tax write-offs that employers take for providing coverage to their workers - $ 279 billion
  • Medicare-eligible people, such as the disabled, account for $82 billion.
  • Subsidies for Obamacare and for other individual coverage are at $55 billion.
 

In total, the subsidies are equivalent to about 3.4 percent of the U.S. gross domestic product.

 

We already have income based subsidized coverage in the individual marketplece - Obamacare - to compare with this employer group coverage - that is what the subsidies in Obamacare were based upon.

 

Employer Group coverage is also climbing in cost - both premiums and deductibles/copays.

 

I could go on and on.  But tell me, anybody, exactly how/why do you think an AARP sponsored health Group for those age 55 - 64 would save money for those who would enroll??????

 

We have a problem with the cost of healthcare -

We have a problem with the amount and cost of healthcare which we use - (as compared to other countries)

We have a problem with the cost of medicine - especially of the newer type.

Fixing these things and more in order to reduce our health care cost would help everybody but there maybe winners and losers compared to what we have now - based on how other countries do it.

 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: AARP and health insurance for members under age 65????

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Message 15 of 32

Valid points, but this does not address the fact that even normal, healthy individuals aged 50-64 have to pay extreme premiums and deductibles because we don't have the benefit of a group. AARP could provide such a group for us to join. Even if it helped lower our premiums and deductibles by a fraction, that would help.

 

Please do something about this. AARP is supposed to be our organization too. It's not just for people over 65. We're hurting out here!

 

Thank you,

 

Ellen

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Re: AARP and health insurance for members under age 65????

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Message 16 of 32

@c721357s

Getting a little older does NOT change the outcome of chronic conditions which took years in the making -  CDC.goc - Older Persons' Health Data 2016

 

I believe you know very little about Medicare -  discussing only Medicare Part A and Part B

Your mother's Medigap only pays the 20% which Medicare does NOT cover, all or a portion of the deductibles depending upon which plan she has purchased.

 

So let's look at the rest of her cost which her Medigap does NOT cover in Medicare.

 

1.  You did not count the years and years of payroll tax deductions which she and her employer paid for Medicare Part A - Part A is premium free IF a person is vested into the program by paying these payroll deducted cost.  If they are not fortunate enough to have done this, their buy-in to Medicare Part A is over $ 400 per month.

 

2.  You did not count the beneficiary Part B premium which she pays every month as a deduction from her SS benefit - currently at about $ 134 per month for all beneficiaries.  Now this represents ONLY the beneficiaries premium cost in Part B - of which will continue to go up unless something is done.  This beneficiary premium cost ONLY represent 25% of the Part B Program

 

3.  The remaining 75% of the cost of the Part B program comes from the TAXPAYERS from the General Fund - here again this is continuing to rise unless changes happen.

 

4.  If you are fortunate enough to be a high income senior beneficiary - that means currently bringing in over $ 85,000 in annual income, you will also be assessed an additional premium each month called the IRMMA (Income Related Medicare Monthly Adjustment)

Be fore-warned, this income IRMMA threshold is illusive and could go down to cover more people and bring more income into the Part B (and Part D) program.

 

So when you are making your comparison in cost between you and your Medicare eligible Mom - make sure you are comparing apples to apples.  Medicare.gov - Medicare 2018 Cost at a Glance

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: AARP and health insurance for members under age 65????

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Message 17 of 32

I am not sure you can say the group between 55 and 65 are in ill health. I can tell you that my mother who is 83 years old pays $216 per month for her supplemental insurance. In fact she recently received a letter from her supplemental health insurance telling her that her insurance will not go up. Yet she was hospitalized twice in two days and also a few weeks earlier. She see her regular doctor every 90 days, a kidney specialist every 90 days and now a cardiologist every 60 or 90 days. She had also broke her ankle a year and 1/2 ago so was hospitalized for that and sent to a rehab facility for two or 3 months. As a healthly 64 year old, I pay $700 per month yet only go to the doctor once or twice a year. It doesn't make sense to me that an elderly person, especially someone like my mother who is a fall risk (partially because of alcohol use) pays so much less. I really think that medical insurance just has to be regulated because it continually goes up more than the cost of living. I am glad I will soon be eligible for Medicare but am worried that Medicare will be seeing cuts now that the tax cuts for billionnaires passed and will add more than a trillion dollars to our naitonal debt when any savings should go towards paying down our huge debt, fighting homelessness, the opiod crisis and upgrading our aging infrastructure.

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Re: AARP and health insurance for members under age 65????

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Message 18 of 32

@m724960qwrote:
I couldn't have said it better ellenb640249. GaiL1, I DO NOT qualify for a subsidy, I am a stay at home caregiver & I have a pre-existing condition that keeps me from getting private insurance. For private insurance they put the pre-existing clause into it so it forces us to have to buy Obamacare. I called several of those so called brokers & one even hung up on me.

There are enough of us at the 50 - 64 age range that AARP could negotiate a better deal.

Obamacare did away with the pre-existing condition exclusion - it is against the law in most all health plans, on and off the exchange, unless the plan is one of the very few which was grandfathered in, to deny a person health care coverage because of a pre-existing conditions.

 

My reply to ellenb640249 below will explain many other points especially this point from my reply below:

If AARP only insured those who are 55-64 years old under some policy umbrella, there is the consideration that this is the age group that could be the sickest and the most costly. This is the group with the heart problems, the weight problems, the cholesterol problems, the muscular - skeleton problems, the bad back, the costly brand name drugs, the group that wants to be saved from many a difficult illness no matter the cost and on and on . . . . .   There would be NO Young and Healthy to balance out the risk factor, helping premiums to stay down.

 

:

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: AARP and health insurance for members under age 65????

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Message 19 of 32

@ellenb640249

I was self-employed, along with my husband, beginning in 1979 until I went on Medicare when I turned 65.  So I do know the price of individual plans, especially those of us who had to use that coverage because we did not have any benefits supplied by an employer.

 

All of our claims were paid as agreed under our individual plans.  In fact the insurer, when my husband became gravely ill in 2005, went above and beyond.  Our plan was great and we stuck with it through thick and thin - with our premiums being above $ 900 each when my husband died in 2006 (we were not 60 years old) - that's OVER $ 21,000 per year but the coverage was excellent..  He had terminal cancer - our wonderful policy at that time had a $500 deductible, then 80/20, a rider which added no copay or deductible if we went to (any) Emergency room for emergency care (we traveled alot), a drug plan with a $ 150 deductible and after that a $ 25 copay - and some of his oral cancer medication topped $ 4000 a month retail even in 2005.  They supplied everything we needed during his illness and at the end even to the point of helping my husband participate in our daughters wedding three weeks before he died with their supply of (usually over the limit) DME.  You are right, those type of policies are no more.

 

Obamacare changed everything in the individual marketplace with the non-exclusion of pre-existing conditions and coverage of all the EHB since many of those EHB pre-Obamacare were covered by rider issuance for those in the individual marketplace, and a new lower rating by age.

 

I am not a fan of Obamacare and can see exactly why premiums have risen extremely.  I can see exactly why some insurance companies have decided to leave specific geographical individual marketplaces.  But it is what it is - people who have EXTREME costly conditions can now get coverage with no questions asked.  No more denial of pre-existing conditions, no matter how sick or costly one might be.  And no more of the extreme rating by age.  The charging extra to smokers under Obamacare is not enforced in many (most) states.

 

So now we are paying hefty premiums for all of this, and healthy deductibles too just to help keep the premiums in check.  But it is NOT working for those who do not get a subsidy because they are feeling the total financial pinch of this increase - for those with a subsidy, the government is feeling the pinch in premiums, not the beneficiary.

CNN 10.15.2017 - Rising Obamacare premiums anger those paying full price

 

Within the Farm Bill that failed in the House last week was a provision to help to establish some type of Association type plans ( the topic) which many on the left think would erode the ACA, (HA, HA) like it is not already eroded - but the Farm Bill did not pass.

Kaiser Health News 05.08.2018 -How The Farm Bill Could Erode Part Of The ACA

 

States are now coming up with ideas to help improve the situation especially for those who get no subsidy.  These folks are also looking elsewhere for their coverage.  They are going to Medi-share plans, they are buying multiple non-sanctioned shortterm plans.  Many states are trying to reinvent the reinsurance program in such a way to subsidize those medical cost for the ones that are extremely sick and costly to insurance companies which in turn makes premiums escalate.  Other ideas are to foster those co-op ideas so that people can join together to get coverage.

 

You said:

Why would a plan with AARP cost less? Because they could combine all of us 55-64 yr. olds who are self-employed, care givers, or otherwise employed in situations where they do not receive insurance coverage, and negotiate a reasonable group rate with the insurance companies, which could be at least as good as a corporate rate. The insurance companies basically screw individuals.

 

That's what Obamacare insurers are doing now for all age groups- negotiating rate and coverage.  If AARP only insured those who are 55-64 years old under some policy umbrella, there is the consideration that this is the age group that could be the sickest and the most costly. This is the group with the heart problems, the weight problems, the cholesterol problems, the muscular - skeleton problems, the bad back, the costly brand name drugs, the group that wants to be saved from many a difficult illness no matter the cost and on and on . . . . .   There would be NO Young and Healthy to balance out the risk factor, helping premiums to stay down.

 

If you need health insurance and don't get a subsidy, check what other type plans are available in your state - check with your states office of insurance.  YES, it will be expensive because people oin the individual marketplace - on or off the Exchange -  have more to cover under the Essential Health Benefits by law and NO-One can be refused a policy for a pre-existing condition by law and because of that, the nature of insurance, those in individual marketplace plans - must SHARE in the cost of coverage.

 

There are still a few plans out there which have been grandfathered that don't have those laws applied to them but these plans can also deny insurance coverage.

STATNews 11.13.2017 This Tennessee insurer doesn’t play by Obamacare’s rules — and the GOP sees it a...

 

Insurance is an actuarial risk assessment - all types.  Health insurance, the way it is now, has a very high actuarial risk assessment - Insurance companies aren't screwing people - by law they have a set amount which they must payout in healthcare cost - you get a refund if they don't.  The actuarial risk factors are the place where the problem is.  This is just an example of one - there are many, many more very costly conditions.

USAToday 05.31.2017 - Iowa teen’s $1 million-per-month illness no longer a secret

 

It is partly the same problem which plagues Medicare and Social Security - we are living longer, we have very costly ways which can keep us alive - and we all have to pay for these benefits - so yes, something does have to be done.

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: AARP and health insurance for members under age 65????

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Message 20 of 32
I couldn't have said it better ellenb640249. GaiL1, I DO NOT qualify for a subsidy, I am a stay at home caregiver & I have a pre-existing condition that keeps me from getting private insurance. For private insurance they put the pre-existing clause into it so it forces us to have to buy Obamacare. I called several of those so called brokers & one even hung up on me.

There are enough of us at the 50 - 64 age range that AARP could negotiate a better deal.
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