Another obamacare hassle

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TXgolfer said:
Not responsible????? Then why did they write it into the law?
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you had no problem with Arizona passing the state immigration law which mirrors federal immigration (a redundancy) and yet.... you have a problem with this?
 
jillio said:
This is utterly ridiculous. Nothing has changed. NO OTC DRUGS ARE COVERED UNDER ANY HEALTH CARE PLAN CURRENTLY IN EXISTENCE WITHOUT A PHYSICIANS PRESCIPTION. AND MANY PLANS DON'T COVER ANY MEDS AT ALL, OTC OR RX.

To insist that Obama is somehow responsible for a practice that has been going on for over 25 years and continues to this day is absurd.

Good sign that hatred for an individual has become a greater focus that imparting accurate information to friends and colleagues. Shameful.

I ask again, does your health care plan cover OTC drugs?

Here's another one. Check with your own physician. Doctors have been writing prescriptions for aspirin for many years, especially when they are dealing with a heart patient as a preventive measure. As most health care policies don't cover preventive treatment, they will write an RX to help the patient get insurance coverage.

Before you can say the health care reform has changed anything you need to know how it functions to begin with.
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Apparently CIGNA did.....I posted their link. *shrug*

My healthcare plan pays for ANYTHING and EVERYTHING :)
 
TXgolfer said:
Apparently CIGNA did.....I posted their link. *shrug*

My healthcare plan pays for ANYTHING and EVERYTHING :)
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why the :) ?

I wish I can :) too but the fact still remains that thousands of others don't get to :) when their insurances rejected their reimbursement request.
 
TXgolfer said:
Apparently CIGNA did.....I posted their link. *shrug*

My healthcare plan pays for ANYTHING and EVERYTHING :)
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You are either ignorant of the specifics of your health care plan, or you are lying.
 
Jiro said:
why the :) ?

I wish I can :) too but the fact still remains that thousands of others don't get to :) when their insurances rejected their reimbursement request.
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And no policy pays for "anything and everything."
 
Like I said, it makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.
 
Banjo said:
Like I said, it makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.
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Unless you have a policy that pays for anything and everything. And still whine about it.
 
TXgolfer said:
Are you positive those are the ONLY 2 options???
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Yep. Because if you pay fee for service out of your own pocket, there is no way that you can pay cash up front for all medical services. Especially if you are diagnosed with catastrophic disease.

So, you are either completely ignorant regarding your policy, or you are lying.
 
jillio said:
And no policy pays for "anything and everything."
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Who said policy....you asked about my health care plan


jillio said:
Yep. Because if you pay fee for service out of your own pocket, there is no way that you can pay cash up front for all medical services. Especially if you are diagnosed with catastrophic disease.

So, you are either completely ignorant regarding your policy, or you are lying.
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Ah....wrong again

AllDeaf.com - View Single Post - Key liberal congressman flips to 'yes' on health care vote

Granted this link refers to my daughter trust. Mine is actually a section of my living trust. I don't get tax relief from it.....but I get alot of freedom.

also granted I don't use it for an Advil....but, I could.
 
Jiro said:
A hassle? sure but this is good for us because this reduces reimbursement $$$ fraud. You have a problem with this minor hassle and yet... you have no problem with invasive screening at airport?

interesting.... :hmm:
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Just noting the hassle.... :) Not sure the hassle is "minor" Some have said getting in to see a Dr can be a big hassle. :dunno:
 
TXgolfer said:
Who said policy....you asked about my health care plan




Ah....wrong again

AllDeaf.com - View Single Post - Key liberal congressman flips to 'yes' on health care vote

Granted this link refers to my daughter trust. Mine is actually a section of my living trust. I don't get tax relief from it.....but I get alot of freedom.

also granted I don't use it for an Advil....but, I could.
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So...you are paying fee for service out of pocket. Nice way to try and twist it.

And if you are paying fee for service out of pocket, and are diagnosed with an illness that runs up millions in cost for care (easily done in a relatively short period of time), then what? Looks like a false sense of security at play there.

But none of that has anything to do with the OP. The article presents this as a change in function of the insurance and medical personel, and nothing could be further from the truth. But then, since you are already so well provided for, I wouldn't expect you to realize that.
 
jillio said:
So...you are paying fee for service out of pocket. Nice way to try and twist it.

And if you are paying fee for service out of pocket, and are diagnosed with an illness that runs up millions in cost for care (easily done in a relatively short period of time), then what? Looks like a false sense of security at play there.
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:shrug: You asked about my health care plan.....That is my health care plan. :)
 
jillio said:
But none of that has anything to do with the OP. The article presents this as a change in function of the insurance and medical personel, and nothing could be further from the truth. But then, since you are already so well provided for, I wouldn't expect you to realize that.
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Here are the CIGNA quotes again.....

From CIGNA

FSA, HRA, HSA: Eligible and Ineligible Expenses



Over-the-counter medicines and drugs - (starting 1/1/2011, most will require a doctor's prescription for reimbursement) Expenses are generally reimbursable unless used for general well-being or for purely cosmetic purposes.

Starting January 1, 2011, eligible expenses that will require a doctor's prescription for reimbursement may include, but are not limited to acetaminophen, acne products, allergy products, antacid remedies, antibiotic creams/ointments, anti-fungal foot sprays/creams, aspirin, baby care products, cold remedies, (including shower vapor tabs), cough syrups and drops, medicated eye and ear drops, ibuprofen, laxatives, migraine remedies, motion sickness, nasal sprays, pain relievers, sleep aids, teething gels, and topical creams for itching, stinging, burning, pain relief, sore healing or insect bites. See Kits and Vapor units and refills.
Items that will continue to be eligible without a doctor's prescription after January 1, 2011 include, but are not limited to band aids, bandages and wraps, braces and supports, catheters, contact lens solutions and supplies, contraceptives and family planning items, denture adhesives, insulin and diabetic supplies, diagnostic tests and monitors, and first aid supplies, peroxide and rubbing alcohol.
Over-the-counter supplies - Expenses paid for bandages, ACE® wraps, hot pads, Q-tips®, cotton balls, first aid kits, gauze bandages, home test kits (e.g. diabetic, pregnancy), and snake bite and bee sting kits are reimbursable. See Kits.
Ovulation Predictor Test - Test kits to assist in identification of ovulation are covered.
Oxygen - Amounts paid for oxygen or oxygen equipment to relieve breathing problems caused by a medical condition are reimbursable.
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FSA, HRA, HSA: Eligible and Ineligible Expenses



Starting January 1, 2011, you will not be able to use these spending accounts to pay for most over-the-counter drugs and medicines unless you have a doctor's prescription. You will not need a prescription for insulin and diabetic supplies
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jillio said:
And if you are paying fee for service out of pocket, and are diagnosed with an illness that runs up millions in cost for care (easily done in a relatively short period of time), then what? Looks like a false sense of security at play there.
.
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Yeah about that....

SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.

`(a) Prohibition-

`(1) IN GENERAL- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish--

`(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or

`(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary.

`(2) ANNUAL LIMITS PRIOR TO 2014- With respect to plan years beginning prior to January 1, 2014, a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, as determined by the Secretary. In defining the term `restricted annual limit' for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums.
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Better hope that illness holds off for a few years. Lifetime caps gone....annual caps.....not so much.

Lifetime and Annual limits (26 CFR § 54.9815-2711T, 29 CFR § 2590.715-2711, 45 CFR
§ 147.126)
The ACA and the interim final regulations generally prohibit annual or lifetime caps on
the dollar value of health benefits. They allow insurers to establish a “restricted annual limit” on
the dollar value of essential health benefits for plan years beginning prior to January 1, 2014. The
interim final rules outline the following schedule of minimum permitted annual limits for this
period:
• For a plan (or policy) year beginning on or after September 23, 2010 but before
September 23, 2011, $750,000;
• For a plan (or policy) year beginning on or after September 23, 2011 but before
September 23, 2012, $1,250,000; and
• For plan (or policy) years beginning on or after September 23, 2012 but before January 1,
2014, $2,000,000.
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http://www.dol.gov/ebsa/pdf/1210-AB43-0145.pdf
 
TXgolfer said:
Just noting the hassle.... :) Not sure the hassle is "minor" Some have said getting in to see a Dr can be a big hassle. :dunno:
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can't be any worse than "Advanced Imaging Screening" because it doesn't involve groping and civil lawsuit + fines :)
 
Jiro said:
can't be any worse than "Advanced Imaging Screening" because it doesn't involve groping and civil lawsuit + fines :)
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Yeah waiting a month to see a Dr due to a mandate is equal to 30 seconds in a scanner because you chose a particular mode of travel. :roll: If you still have the headache a month later the Dr is probably going to put you through a scanner as well. :lol:

And btw.....Both are happening under obama.
 
Banjo said:
It makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.
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Of course, it is.

Under our insurance/FSA, prescription is required if you want OTC drugs to be paid by insurance and FSA.

If you disagree or need buy OTC drugs in bulk size then just pay with your money.
 
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