Affordable Care Act Users Guide for Nurses - page 2

Sentiments run high regarding the Affordable care Act, but whether one supports the new law or believes it to be a case of government over-reach, the fact is that the ACA is now the law and as nurses... Read More

  1. Visit  nursel56 profile page
    4
    The article is well written, but I'm with Viva and tntrn on this one. Even if we are to accept the facts vs myth as outlined by the OP, I've rarely had a patient respond with, "OK, thanks bye!" to patient education. There will be questions. I'd expect something as complicated as the ACA to be the same, and therein lies the problem.

    If my understanding is not comprehensive I don't feel qualified to act as a resource for insurance and health care coverage information. It is not a political issue to me, it's a "how can I best be of service to my patient?" issue, and sometimes that is referring them to those who do have expertise on the subject.
    MBARNBSN, Jessy_RN, herring_RN, and 1 other like this.
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  3. Visit  LadyFree28 profile page
    4
    There are people who are specialized in education patients about the ACA; a percentage are nurses; if anything, referring them to a phone number and or local office is the most resourceful and objective intervention nurses can do.

    I have referred my patients to case management, social work if necessary; there were positions I held where referrals to resources were on the nurse; I have no issue referring my population to the RIGHT resources.
    MBARNBSN, cardiacfreak, herring_RN, and 1 other like this.
  4. Visit  iono12345 profile page
    0
    I like the part where you will not go to jail, give it time...IRS driven, my scenario,you refuse to get insurance and then penalized in turn you do not pay the penalty, you do this for a few years. Eventually the IRS will garnish your wages and if that doesn't work, well get ready for debtors’ prison....wait and see...
    Last edit by Esme12 on Dec 20, '13 : Reason: Formatting
  5. Visit  whealer profile page
    6
    I work at a major medical office where we just had training about the ACA. Most, if not all of what the OP wrote down is factual.

    Also, personally I think it benefits all of us nurses to be well informed about how the ACA affects our patients, regardless of what we think of it. My take away from this article was that it's in our best interest to be knowledgeable about how it can make an impact on our patient's healthcare. I've seen doctors in my practice who use their familiarity with how insurance works to help patients financially.

    That said, this is all brand spanking new, so I can understand referring to brokers and insurance reps (for now) until healthcare professionals can learn to work with the system in a way that can ultimately benefit our patients.
    rebel902004, CosmicHymns, MBARNBSN, and 3 others like this.
  6. Visit  Havin' A Party! profile page
    4
    Can't agree that it's now the bedside nurses' responsibility to explain insurance coverage... or that it ever was.

    Surely someone at a facility should be accountable for this function, but not the clinical floor staff... that'd be ridiculous, IMHO.
  7. Visit  Raicho profile page
    9
    I understand that many nurses in certain facility settings may not discuss insurance with their patients. However, some of us do. I work in a specialty rehabilitation facility focusing on only spinal cord and brain injury. We have our patients, and their families, for 2-10 months. We talk about insurance all the time. Especially since there are very few insurance companies that really have good trauma/long term coverage for patients like these. It is a daily issue these patients, and their families deal with. Especially because their spouses have stopped working as well.

    As a result, us bedside nurses need to be able to discuss these issues. Yes, we have social workers, but they are not here 24/7, nurses are.

    You all are right, there is no law that states nurses are required to explain insurance to patients. But there is also no law that requires nurses to be compassionate. There is also no law that requires nurses to care about their patients. And yet we do. As nurses, I believe part of our job is to always strive to be better. I believe that means educating ourselves on laws and issues that affect our patients so we can discuss them intelligently.

    For those of you who think the Affirdable Care Act is a piece of garbage, please make sure you have done your own research and come to that conclusion on your own instead of listening to the propoganda and repeating stuff. Here is why I believe it is beneficial for all and these benefits outweigh the negative:

    1. You cannot be rejected, or dropped, for pre-existing conditions
    2. The insurance company cannot cap your benefits
    3. There is a basic core of services that all insurance plans must contain
    4. Maternity and newborn care is included
    5. Preventive and wellness care is included.

    As a single female, with no kids, and no intention of having kids, I still believe all of us will be better off with all of this.
  8. Visit  whealer profile page
    1
    Quote from Raicho
    You all are right, there is no law that states nurses are required to explain insurance to patients. But there is also no law that requires nurses to be compassionate. There is also no law that requires nurses to care about their patients. And yet we do. As nurses, I believe part of our job is to always strive to be better. I believe that means educating ourselves on laws and issues that affect our patients so we can discuss them intelligently.
    Well said!
    herring_RN likes this.
  9. Visit  Havin' A Party! profile page
    1
    Quote from Raicho
    ... Yes, we have social workers, but they are not here 24/7...
    Agree, that these staff members... or others so designated... should be the ones handling insurance questions.

    And if this staff is not present on weekends or nights, then they can speak with the patient or family the next day, or call them on the phone.

    At our facility (or any that I've previously worked at), I can't realistically expect clinical staff to be up to speed with all the changes / nuances of these laws and regs, and that of different insurance policy coverages.
    herring_RN likes this.
  10. Visit  Esme12 profile page
    1
    There are good points to the ACA/Obamacare.

    1. You cannot be rejected, or dropped, for pre-existing conditions
    2. The insurance company cannot cap your benefits
    3. There is a basic core of services that all insurance plans must contain
    4. My kids get to have insurance if they don't go to school/college

    However....to dispel one fact. Once on medicare you pay a monthly fee/premium, which I might add goes up every year, and your required supplemental goes up as well.

    It does nothing for those on a fixed income pay for the rising drug costs.

    Just saying.
    herring_RN likes this.
  11. Visit  Not_A_Hat_Person profile page
    3
    I support Obamacare, but I'm a nurse, not an insurance broker or an ACA navigator. If a patient has questions about the ACA, they should ask an ACA navigator or check out the website.
    SC_RNDude, CiscoNurse, and tntrn like this.
  12. Visit  tntrn profile page
    0
    Quote from Esme12
    There are good points to the ACA/Obamacare.

    1. You cannot be rejected, or dropped, for pre-existing conditions
    2. The insurance company cannot cap your benefits
    3. There is a basic core of services that all insurance plans must contain
    4. My kids get to have insurance if they don't go to school/college

    However....to dispel one fact. Once on medicare you pay a monthly fee/premium, which I might add goes up every year, and your required supplemental goes up as well.

    It does nothing for those on a fixed income pay for the rising drug costs.

    Just saying.

    Medicare Part A has no premium. Others parts do. We have a supplemental through my husband's retiree benefits and will pay for that premium through the HR department.
  13. Visit  Esme12 profile page
    0
    Quote from tntrn
    Medicare Part A has no premium. Others parts do. We have a supplemental through my husband's retiree benefits and will pay for that premium through the HR department.
    That is true it is for Part B. You are lucky your husband has a pension with benefits....not all seniors or disabled people do. I would however check your COLA statement that was just mailed and be sure they aren't charging you....they were me and it took MONTHS to stop them....as a matter of fact I am still arguing with them.
  14. Visit  juliezehrn profile page
    3
    What part of this article is opinion? Not playing devil's advocate here; I just don't see it. And I get asked to explain this quite often--from patients, friends, relatives...I just tell them that I'm a nurse, not an insurance salesman--but secretly I wish I did know more so I can understand its implications for healthcare in general.
    cazach0122, MBARNBSN, and cardiacfreak like this.


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