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SK in CV
Participant[quote=joec]I was just commenting on what’s even accepted, not any rate/payments or reimbursement contracts. More of the “Do you take [fill in the blank insurance plan]?”
So as an example, I was saying if, say UCLA medical center doesn’t take Blue Shield ACA, then no matter what Blue Shield health plan you have, UCLA medical will never take it since they don’t have a provider/insurance contract with Blue Shield.
At least that’s what I’ve read.
Again, this is all self purchase and company plans might be different.[/quote]
Nothing has changed in that regard. It has nothing to specifically to do with the ACA. (And again, almost ALL policies are now ACA policies.) Telling a provider that you have Blue Cross is rarely sufficient. Blue Cross has dozens of different types of policies. Some providers may take all. Some take none. And some take only selected policies. It is all about reimbursement rates. That’s how the decision to accept insurance is made.
You might remember a few years ago, I think it was Scripps who decided not to accept Blue Cross. (It may have been another large carrier.) It was huge news in the industry. It was all because their reimbursement rates weren’t high enough.
Participant[quote=joec]Yes, you are very correct that all plans are now ACA compliant.
Someone correct me if I am wrong here, but I’ve read that if a provider network isn’t contracted to be offered through ACA, they also won’t be offered through private purchase directly outside ACA neither.
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It doesn’t work that way. Provider contracts (i.e., contracts between carriers and providers which outline how much providers will be paid for each service) are different, or at least can be different for each policy. Carriers don’t offer contracts on every policy to every provider and providers don’t necessarily accept each contract offered. So even if a carrier offers a similar policy both on and off an exchange, their reimbursement contracts to providers can be different for each, possibly resulting in at least slightly different provider networks. All perfectly legal.
Participant[quote=joec]
Not sure if anyone has used their ACA coverage yet, but I HAD Anthem Blue Cross thinking they had a good network, but their coverage and doctor/hospital access is EXTREMELY limited. Also, based on the law, ACA coverage should be the same as their regular plans in terms of doctor/hospital access so if they don’t have it in ACA, they probably would not have it even if you purchased outside of ACA (no idea on grandfathered plans).[/quote]
I’ve seen a lot of articles and comments (elsewhere, not here) indicating a lot of confusion about “ACA plans” or “Obamacare plans”. With minor exception, all private insurance is now ACA compliant, irrespective of whether the plan is provided through an employer, purchased on a state or the federal insurance exchange, or purchased privately outside the exchanges. Effectively, ALL insurance is now an “ACA plan”.
In some states, some carriers have identical plans available both in and outside the exchange. And identical means identical, the exact same provider network. But there is no requirement that carriers offer identical plans off the exchange. In some states, carriers offer no off-exchange policies. And there is no requirement that provider networks be similar. Nothing about this is new. Big carriers like Anthem and Aetna have always had dozens of plans and each one had their unique provider network. Often providers will contract for some carrier plans but not others.
Participant[quote=FlyerInHi]
I’ve wondered if messy people become more organized after they have children just to set a good example for their kids.[/quote]No.
Participant[quote=scaredyclassic]
In this vein I’d submit that being in very good physical condition really helps. Never too late. Speed agility strength endurance all useful.[/quote]And the at least temporary disabling of your gag reflex would be helpful.
Participant[quote=CDMA ENG]
Let me give an example… I am expecting my first born within the next 30 days. Because of that I know within the next 18 months I need to start changing my ways. I need to start drinking less soda… Stop playing any significant amount of video games… Watch less TV… Why? Because I didn’t want my child to develop these bad habits or use me as excuse to indulge in certain behaviors.
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You probably have it nailed as far as what will happen, but not the why. You won’t be influencing your child’s habits for at least the first year or two by playing video games. The reason you’ll give most of this stuff up is that you don’t want to be a dick of a partner. The one thing that shocked me when my kids were born is how damn time consuming they are. They suck up just about every available minute. Even when they’re sleeping.
Congratulations. I hope your experience matches mine, and your kids are the most fulfilling thing that ever happens to you.
Participant[quote=bearishgurl]
I’ve been in a LOT of older areas in this county, SK. Not only recently but down through the years. I used to do a lot of heavy precinct walking. I KNOW the demographic who lives in these areas. Most of them don’t change that much. Most of these people don’t move. In some of the blocks, maybe 1-3 houses change hands per decade![/quote]And your experience covers all the best areas of San Diego county and “ANY CA coastal county”? Really? True of all of Orange County and LA county? Because you walked some precincts?
Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]Oh, and a “slow down” in the “larger economy” has nothing to do with property values the best areas of San Diego County or ANY CA coastal counties, for that matter, as most of those owners are “retired” and a good portion of those properties have long been “paid off.”
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Where are you talking about that “most of those owners are “retired” and a good portion of those properties have long been “paid off.””?[/quote]
SK, I pride myself on my good memory. We’ve had this discussion before about your old stomping ground of Del Cerro and surrounds. I claimed a lot of the properties around there were paid off and you stated that you recently discovered on a visit that most of the properties on your old street have changed hands in recent years (this still doesn’t answer the question of whether these “new” owners have a mortgage … or not).
[/quote]
Ok, so you didn’t really meant that “Oh, and a “slow down” in the “larger economy” has nothing to do with property values the best areas of San Diego County or ANY CA coastal counties, for that matter, as most of those owners are “retired” and a good portion of those properties have long been “paid off.””.
What you meant is, there are a few blocks that you’ve looked at that the owners are retired and have their homes paid off, and think that should be the same across the county even though you have no idea what the situation is in the rest of the county. Understood.
Participant[quote=bearishgurl]Oh, and a “slow down” in the “larger economy” has nothing to do with property values the best areas of San Diego County or ANY CA coastal counties, for that matter, as most of those owners are “retired” and a good portion of those properties have long been “paid off.”
[/quote]
Where are you talking about that “most of those owners are “retired” and a good portion of those properties have long been “paid off.””?
Participant[quote=scaredyclassic]
no. why is oil up .5 v 3% for gold.
there is not a reason for anything that happens.[/quote]
Not for those 2. Correlation is almost non-existent. Silver is the weirder one. Up 5% and not that far from it’s 180 day high. Gold isn’t anywhere near that. And I just sold some junk silver last week.
ParticipantObama is going to speak on Iraq momentarily explains the now $11 jump in the last 45 minutes. The $20 before that, I got nothing.
ParticipantGreat recommendations, top to bottom.
Participant[quote=HLS]The biggest threat to this country (and possibly the world) that virtually nobody is talking about would be the collapse of the 401K system that people have been fooled into believing is a ‘safe’ vehicle for a secure retirement.
[/quote]
I’ve seen this referred to a few times and I don’t really follow. The “401K system” is a small, but not insignificant piece of the larger financial markets. And similarly, a small but more significant piece (about 20%) of the retirement plan market. If the financial markets collapse (as they did 6 or 7 years ago), retirement plans will fall similarly (though I think it’s roughly 40% of 401Ks are in fixed income instruments with substantially less risk).
I’ve never had a 401k, but I have been involved in a dozen or so presentations to 401k participants. Every single one of them included warnings of risk associated with the various investment options.
Is the expectation that the “401K system” has unique risks associated with it that are different from risks associated with other retirement plans or other financial investments?
Participant[quote=moneymaker]Has anyone ever licked the back of a toad to get high?[/quote]
My ex wife kissed me. She didn’t get high, but eventually she did get sick.
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