Braces coming to this house, time for an SPN?

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Posted by admin | Posted in Samaritan Perks | Posted on 25-06-2015

Well, the time appears to be fast approaching, our first born is going to get braces. The poor kid will have them for a couple of years AND he’s a trumpet player. Ouch.

The other ouch is the cost. We haven’t had our final consultation yet, but the early estimate is about $5000 plus the $400 evaluation today and then retainers when they come off. I’d heard rumors to this effect, but hearing it straight from the dentist and knowing the quick timeline it still took my breath away. We don’t have dental insurance, every plan available was basically only going to cover an equivalent to what we paid in premiums (the caps are shockingly low… $1500?), and I can do that on my own.

And then I thought about Samaritan and their special prayer needs. I’ve seen dental needs come through my SPN list many times. Now I really know why! 🙂 In the event we can’t save enough to cover this on our own it’s so comforting to know that we could submit an SPN for it and have at least some of that cost shared by others. I’m pretty sure not all, but anything is a help, even if it’s just a few hundred dollars. We’ve been saving for this for a while, but it’s mixed in with our other medical savings, so hopefully the well doesn’t run dry. I can’t tell you what a relief it is to know about Samaritan’s SPN option, and to know that if we weren’t Samaritan members we’d really be stuck.

For the 800th time, thank you Lord for leading us to Samaritan Ministries!

Supreme Court says the subsidies are legal

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Posted by admin | Posted in ACA-Obamacare | Posted on 25-06-2015

By a vote of 6-3, the SCOTUS has once again saved Obamacare. I have to say, I’m a bit surprised by this ruling. Not that I should be, I just am. In the end I’ve decided it didn’t really matter, because if they had voted that subsidies weren’t legal because of technical wording in the ACA, Congress would have just written something to make them legal and we’d be right back where we are today, except we’d be able to know that those in charge of the highest court in our nation were still sound. As Justice Scalia said, “You would think the answer would be obvious — so obvious there would hardly be a need for the Supreme Court to hear a case about it.”

I am the most surprised because Justice Roberts said it was clear that Congress wanted these to be legal for the Federal Exchange policies. Prior precedent from SCOTUS rulings was that even though something may have been intended, if it wasn’t in the law then it doesn’t matter. And the threat of not having subsidies was used against the states in order to encourage them to all start their own state exchanges. So either the threat wasn’t real (dishonesty? surely not), or the intention really wasn’t for the subsidies to be legal at all for the federal exchange policies and the SCOTUS has ruled incorrectly.

The fact that SCOTUS strayed from their duty to read the law as it is and not to pass assumptions about what they think Congress wanted, that is perhaps one of the scariest things I’ve read about our government to date. SCOTUS has a responsibility to judge based on how the law is actually written, not on perceived notions, and they have truly failed in that regard.

“Something’s rotten in the state of Denmark” — Marcellus, from Hamlet 1.4

I did not relish the idea of millions have to scramble as their subsidies vanished, but I never expected that to be the final outcome anyway. Congress would fix it because the uproar would be deafening. I did expect that my Supreme Court would rule according to the law and follow their responsibility because if we can’t trust the highest court in the land to follow the rules then we have much bigger problems than subsidies. We appear to have another broken branch of our government. Again, I shouldn’t be surprised.

Overheard: ACA policy networks are confusing

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Posted by admin | Posted in ACA-Obamacare, Samaritan Perks | Posted on 16-06-2015

I was sitting at a sporting event this weekend and overheard some people sitting in the stands nearby talking about an ER visit their child had 5 months ago. Fortunately he is fine, but I specifically heard one of them say, “I don’t know if we took him to the right place for our insurance.” There was confusion about whether the ER and subsequent doctor visits were part of their insurance plan network. The matter was further complicated by a disagreement between a hospital group and their insurance company so facilities which are normally “in-network” aren’t necessary that way today (or during that visit) and they didn’t know what would happen billing wise because of that. Take note, this was 5 months ago and they still had questions.

I didn’t lean over and ask questions, but from the bits and pieces I heard it became clear to me that having an insurance policy was now a nightmare if you needed to use it. Not only are premiums expensive, but the little details are so frustrating at a time when you just want to take care of your family. Having to wonder which hospital is in-network vs out-of-network is NOT something I would even consider if my child was sick or injured. It’s just not. In an emergency I would take him to the closest place that could treat his needs. Especially if I’m on vacation.

Those poor people have the potential of paying a significant amount for those visits because of insurance fine print. Maybe they’ll get lucky, but odds are not in their favor. The hospital is already promising to balance bill (at full rack rate) anyone who has that particular insurance company, so they could be facing something very expensive completely on their own. As I listened I felt a deep sense of relief and calm that we have Samaritan. The network question isn’t even part of the equation, and any event happening 5 months ago would have already been paid 2-3 months ago. There wouldn’t be anything dragging on that long unless the hospital billing was slow. Samaritan’s processes and guidelines are so freeing when it comes to our family’s health care.

The changing landscape of health care in this country is breathtaking. It’s hard to keep up. There are big decision coming from the SCOTUS this month and that will only rock the boat even further. Once again, our membership in Samaritan is keeping us afloat and gives us a lifeline to people who care and are there to help.