Affordable Care Act Users Guide for Nurses - page 3

by JB85

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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 we are obligated to make sure... Read More


  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 0
    Quote from Esme12
    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.


    If you mean the COLA from SS, they are not charging us anything for Medicare anything. Our only deductions are for income taxes.
  8. 2
    I think everyone should have a good understanding of it and not just opinions based on what they've heard, but I don't think it's the role of the nurse to explain insurance to the patient. As a patient, I would want my nurse only to be concerned with my medical needs, not how I was going to afford those needs.

    I support the ACA and I have since it was implemented by Mitt Romney in Massachusetts back in 2007. So many people were able to become insured who previously couldn't afford it and it worked well IMO.
    Not_A_Hat_Person and tntrn like this.
  9. 1
    The parts about premiums not going up and people not losing their coverage is pure opinion. While the affordable care act does not explicitly state that premiums will go or people need to be dropped, it is happening a lot. Peoples who current plans don't meet the "standard" of the bill have to be adjusted, and the new premium is so high that the person can not afford it. Therefore people are being forced to drop it, just check out the news on the extension for people who will lose their coverage because of this, this information is easy to find. Also, the "affordability" of the new coverage is being overstated and only examples of very young, healthy people are being publically talked about. The cheapest plans leave 40% of the bill for non-preventative services for the patient to cover, does anyone think that cutting 60% off of a $10,000 or $20,000 procedure makes it affordable? People will still not receive care they need.

    I am not against the affordable care act, and I hope a lot of good will come from it. But so far all I see is people losing their coverage and hospitals scrambling to cut pay and benefits to cover it. I worry that high risks patients will be refused services because they will be high risk for complications (which the government will try and say they will not pay for patient care that is a result of an error or infection). It will be simple economics, tell a physician they will not get paid for procedures where infections occur then they will "cherry pick" the patients and deny care for elective procedures for high risk patients--no one will work for free.

    This article had a lot of facts, and while it did not have any outright lies it did not portray an accurate description of the changes caused by the affordable care act. It was more like the propaganda that the government spent $1 million dollars to present the positives associated with the bill.
    tntrn likes this.
  10. 0
    Quote from tntrn
    If you mean the COLA from SS, they are not charging us anything for Medicare anything. Our only deductions are for income taxes.
    Medicare part b is taken out of your SS. If your have signed up for part B. When I started taking my SS at age 65( full benefit for my age at that time , it was $ 96.00 a month.This year it's $104. You can have income tax ,federal and state taken out if you wish. I don't as we pay a lump sum for taxes every quarter. The cost of living raise may or not happen every year depending on what the government and what they give. It's biased the rate of cost of living for the past year. And it's not always increased. There was a year or so so the COLA was wiped out with the increase of Medicare Part B.
    I do not use the part D ,drug coverage and I'm not sure if there is a monthly fee . I am sure some one here knows.


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