Who offers a NON-Obamacare health insurance plan in PR?

Curious to know who is asking these questions. MCS, SSS, Mucho Más are all good health insurance plans on the island .  REFORMA IF YOU have  no money.

My sister in law used La Reforma (government insurance), a few years ago she had her gallbladder removed and her out of pocket was $50. I had the same surgery done in the mainland and my deductible was closer to $4K. We have the same type of laparoscopic surgery done.

For what I have read, La Reforma used the Obama care funding in the island. There is a big push in the island to get more funding for the plan from the federal government. Currently, the island only get a fraction of the funding the states get,

There are privates insurance Blue Cross, Blue Shield, UGH and others, depending the type of coverage you want/needs will cost you. If you are on SS, Medicaid is also accepted by most providers.

I thought pr didn't have Obama care

it's part of the US....

PR does not have obamacare in the same way, but to my knowledge all plans need meet the obamacare requirements.
I could be wrong.

I have champva insurance because my husband is 100% disable veteran. Any place that accepts Medicare or Medicaid is supposed to take this insurance. However after driving around for days trying to find someplace that accepts this insurance I couldn't. I had to go to a Dr. Office and pay $30 instead. I called the va and kept getting contact #s finally had someone that told me 1 hospital in Puerto Rico takes this insurance. That hospital was a nightmare 13 hrs in the lobby waiting. I have never seen anything so bad.  They couldn't even give me all my test results they told me I had to comeback and go to the records dept. Which I haven't done because it's a 2 1/2 drive each direction.  If you have health issues this isn't the place you want to live. The health care is horrible

We're moving WHERE? wrote:

it's part of the US....

As iI understand, PR has been excepted from Obamacare plan/financing like the states. But citizens need still receive the same services under the guideline, Basically the financing is diferent for public and private plans.

I recently obtained Medicare so I was going to go with SSS but there was a rep for MCS outside of the Social Security office and I signed up with them.

They have been pretty good so far and I found a good Dr. here in Quebradilla who takes it. I even had a rep come to my housetoday to ccheck if everything was
good and she took my vitals, checked my meds and asked meany questions.

So thus far, it is good. They even cover blood tests
I have to get certain other tests which I believe they cover somewhat so I am
happy.

What is the cost? The cheapest I could find was almost $400 for 1 person. I already have insurance.

The Obama administration at first said the territories like PR had to be a part of Obamacare.  As a result, just like in the states, many people had their plans that they loved cancelled.  In place, inferior plans with lower benefits, higher deductibles, AND higher costs were offered.  My new plan, with lower benefits, higher deductibles, which is worse, tripled in price.  Eventually, the governments of the territories complained so loudly about the UN-affordability of the Obamacare plans that the Obama administration finally reversed course and suddenly claimed under the law that the territories were not required to have Obamacare plans.  However, it was too late in that the damage was done.  By that, many of the insurance companies serving PR had already cancelled the pre-Obamacare plans and replaced them with Obamacare compliant plans.  So now, even though PR residents are not required by law to have ACA/Obamacare plans, or face a penalty like residents in the states, the insurance companies in PR have not brought back the pre-Obamacare plans.  As far as I have been able to find, are only Obamacare compliant plans in PR, even though PR residents are now exempt from having such plans.     It goes to show how the government is ignoring the law and instead doing what it wants to do, the law be damned.

I need not remind how Obama lied, "If you like your plan you can keep it.  If you like your doctor, you can keep him/her.  The average family with save $2500 per year."   Of course this was a lie in order to get Obamacare passed and he KNEW it was a lie when he spouted it.  Moreover, additional costs for this are backloaded into 2016, conveniently AFTER the elections, so expect your rates to go much higher.  As Jonathan Gruber admitted,

http://www.politico.com/magazine/story/ … are-113369

"Ever since the videos started popping up, one after another, America has come to know Gruber—the MIT economist who worked closely on both Obamacare and Romneycare—as the guy who thinks voters are “stupid.” And the guy who thinks Obamacare was passed because of trickery."

March 16, 2011: Gruber spoke at the Pioneer Institute in Boston and discussed the so-called Cadillac tax on expensive health insurance plans.

“The only way we could take it on was first by mislabeling it, calling it a tax on insurance plans rather than a tax on people when we all know it's really a tax on people who hold those insurance plans.”

October 30, 2012: Gruber spoke during the Honors Colloquium of the University of Rhode Island in Kingston and described how a tax on insurance coverage can hit consumers—and why.

“We just tax the insurance companies, they pass it on in higher prices that offsets the tax break we get. …It’s a very clever, you know, basic exploitation of the lack of economic understanding of the American voter.”

October 17, 2013: Speaking at an expert panel at the University of Pennsylvania, Gruber gave his interpretation of the behind-the-scenes strategy in crafting and passing the health care law.

“This bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies. ... Lack of transparency is a huge political advantage. … Call it the stupidity of the American voter or whatever, but basically that was really, really critical to getting the thing to pass.”


This is simple math.  You can't have millions of people getting health insurance for so-called "free" without others paying for it.   It's not really "free."  Instead, the costs of it were shifted so that those who are paying for it, pay more to cover the freeloaders.  That's why the rates have gone up so much and will continue to go up.  Effectively, its a legalized form of government theft, forcing those that buy their insurance to pay more to cover those that don't pay for health insurance, so the non-payers can get it for "free."    People need to be smarter and realize "free stuff" as in government benefits aren't exactly free, except to the recipient, because SOMEONE has to pay for it.  What happens is the cost is shifted to someone else.

So, that's the behind the scenes of why things are as they are.  While Im healthy, had insurance for 15 years, never used it, I cancelled my insurance and now have none, because I do not want to support a wrongful system.   I can afford to buy an Obamacare compatible plan, that is triple the cost of my old plan, but do not want to support it.  Has anyone found a good solution?  I was told by an agent that the insurance companies may bring back non-Obamacare plans but I haven't seen that happen yet as far as I can tell.  To be clear, Im not talking about Medicare because I am too young for that.  My question pertains to those who have to buy their own health insurance plans.

sandrarduncan wrote:

I have champva insurance because my husband is 100% disable veteran. Any place that accepts Medicare or Medicaid is supposed to take this insurance. However after driving around for days trying to find someplace that accepts this insurance I couldn't. I had to go to a Dr. Office and pay $30 instead. I called the va and kept getting contact #s finally had someone that told me 1 hospital in Puerto Rico takes this insurance. That hospital was a nightmare 13 hrs in the lobby waiting. I have never seen anything so bad.  They couldn't even give me all my test results they told me I had to comeback and go to the records dept. Which I haven't done because it's a 2 1/2 drive each direction.  If you have health issues this isn't the place you want to live. The health care is horrible

Hello Sandra....I know about ChampVA.  All the best Hospitals in the Metro Area accept ChampVA. This includes El Presby, Pavia, Auxillio Mutuo, HIMA San Pablo Bayamon, and Dr.'s Center. Also you can go to the small ER centers that they call the CDT. There are also a lot of Dr.'s in the Metro Area that will accept it...although it is a difficult process and you have to keep calling around.  Well I have never been in an ER less than 8 hours...normally it is longer like 13...most of the time was spent sitting in the lobby...just waiting for labs or MRI results for hours...all major ER Rooms are like that in PR...it's insane. Hospitals and Healthcare are even worse on the West Coast...I have Family there so I know that's what everyone says.

sandrarduncan wrote:

What is the cost? The cheapest I could find was almost $400 for 1 person. I already have insurance.

A lot of the plans before you are 65 are based on age. The quote i got was 400 for me and 325 for the wife, neither of us are old enough for medicare so regular plans are fairly expensive. At least it was around what i butget for. But i am not yet in the island so that was just a quote.

Could all please stay on topic and NOT post about VA, Medicaid, Medicare plans?   To discuss those plans, please start a new thread.   This thread is about finding non-Obamacare plans in PR that one has to pay for themselves.

One alternative that I'm looking into is short term health plans, to avoid the UNAFFORDABLE Obamacare-style health insurance plans that are common in PR. 

Here is a link to one such place.  The rates seem low, but I need to contact them to be sure as to which doctors/hospitals will take accept their insurance.  The policies are through SwissCare, which I've never heard of before, probably because they are based in Hong Kong.

For example,
45 year old male, $500,000 lifetime limit, $5000 annual deductible, $108/month
45 year old male, $500,000 lifetime limit, $0 annual deductible, $159/month

http://www.pacificprime.com/compare-quotes/

csmi, you stated that you cancelled your insurance coverage.  Do you have to pay a penalty for not having it and if so, how much is it? 

This discussion is interesting!

PR residents are exempt from Obamacare, so you don't have to have insurance, unlike in the states, where if you don't have insurance you have to pay a fee.

Right, I did know that but have you moved to PR yet to get the exemption?  I was just curious because my brother will most likely have to pay a fine for 2015 tax year.

My understanding is that after you move to PR, you don't have to have health insurance.  Afterwards, you can cancel your policy and not have to pay a fee for not having insurance to the IRS.

As a side note, if you just moved here you need to enroll within 30 days or you will have to pay for 90 days before it goes into effect. This is what was explained to me by SSS.

Just curious, why do you have a problem with the affordable care act?

"Just curious, why do you have a problem with the affordable care act?"

As I explained above, it's a false and deceptive act, including the name "affordable."    Any reasonable thinking person who is 1 having to pay more, 2 getting a lower quality plan, with a higher deductible, 3 while being lied to by the government should have a problem with this.   In addition, even more of the price increases were backloaded to increase after 2016 in a political move to defer those extra increases until after the elections.

According to Avik Roy at Forbes, under Obamacare, the cheapest plan for men will be 99 percent more expensive than under the old law. For women in any given state, it will be 62 percent more expensive.

https://www.youtube.com/watch?v=_o65vMUk5so
Obama:  "If you like your health insurance  plan, you can keep it.  If you like your doctor, you can keep them.  Your rates will go down $2500/family/year."

https://www.youtube.com/watch?v=3otDQllQmsU
Obamacare- Lie To Me

https://www.youtube.com/watch?v=oJmzviO31XE
The Obamacare Lies

https://www.youtube.com/watch?v=2iXfdTizPuQ
The best video ever against Obamacare lies

https://www.youtube.com/watch?v=ta3Xd5V50PM
ACA Architect Confession: Created Lies For Obama - Jonaton Gruber
credits the "stupidity of the American voter" to get Obamacare passed

https://www.youtube.com/watch?v=oY13zsqXJPc
Jonathan Gruber: Obama lied to get Obamacare passed !!!!

http://dailysignal.com/2014/03/21/saved-2500-lately/
Back in 2010, Heritage experts said that “one of the major impacts” of Obamacare was that “individuals and families will see higher health insurance premiums.”

http://www.breitbart.com/big-government … terrified/
Aetna, America’s third-largest health insurer, announced that customers can expect 2015 premium spikes that in some states will be “over double digits.”

http://www.heritage.org/research/report … rance-fare
How Will You Fare in the Obamacare Exchanges?

http://www.realclearpolitics.com/articl … 20954.html
Obamacare: Lies All the Way Down

Wow, a lot of links. I'll look through those, it's good to hear from all sides. I honestly have no opinion on the subject since I don't have any direct experience with it. I only know that some ppl are angry and for others it has been literally life saving. I hope you find what you are looking for in regards to a suitable health plan.

Karenqc wrote:

Wow, a lot of links. I'll look through those, it's good to hear from all sides. I honestly have no opinion on the subject since I don't have any direct experience with it. I only know that some ppl are angry and for others it has been literally life saving. I hope you find what you are looking for in regards to a suitable health plan.

I used to have very good health insurance at work, ever since the act my price has gone up, the deductibles gone sky high and the service remained the same. So I am getting nothing for a lot more money. You got to love it.

On the other side of the coin, I used to not be able to get insurance for my family because of a pre-existing condition. The fact that an insurer could refuse service because they would have to pay out for a pre-existing condition is RIDICULOUS! Obamacare isn't perfect by any means, but at least now I and my family can be covered where we couldn't before.

I, personally, would love to see universal healthcare in my lifetime, but I don't see it happening. A person's life or death treatment shouldn't depend on how much money they make. Just my $.99

Most old insurance used to not cover pre existing conditions for just an inital period of 90 days and after that they were covered if i remember correctly.

That may have been the case for you and others, but in my case, it was not. I literally could not purchase insurance, PERIOD. I spent 3 years trying before I gave up. Which raises another point - Not only could they deny coverage for pre-existing conditions, they could create completely arbitrary rulings affecting different people in different ways. In my case, we couldn't get insurance. In someone else's case, they could, but could only get coverage for the existing conditions after 90 days. The entire system is a screwed up mess. Our healthcare system is a laughingstock of other developed nations who wonder how America, the superpower of the world, can have such a backwards system engineered to give more profit to the insurance companies while they simultaneously deny coverage for life saving treatments...

I'll get off my soapbox for now, but I just wanted to put it out there that Obamacare, as crappy as it is, at least allows us to get coverage...

"I only know that some ppl are angry and for others it has been literally life saving."

There are basically 2 main sides.  If you are a worker, you are paying MORE and getting LESS, like ReyP said, and justifiably upset.  If you are a freeloader, then you love Obamacare because it forces ReyP and millions of others to pay more to subsidize the freeloaders.  Now, I realize not everyone falls in 1 of those 2 sides, but those are the MAIN 2 sides on this issue.  It's basically government stealing from its most productive citizens, taking/stealing money from 1 group of people, and giving it to another group.  However, instead of using a gun, they used a pen to pass this law.  If presented honestly, it would not have passed.  Only by lying to the American citizens was it able to get passed.  The politicians responsible for this bait and switch need to be held accountable.

I agree, csmi, that the politicians should be held accountable.  My husband was reading just this morning that the insurance companies are making record profits since this change, unbelievable....no conscience!

http://finance.yahoo.com/news/democrats … 00257.html

Synopsis of article is that the democratic politicians, after having worked so hard to deceive the American public to get Obamacare passed, are now trying to distance themselves from it, as the health insurance rates rise even more. 

"How has that worked out? Just as well as Obamacare, as we have seen in three successive explosions in health-care premium rates. Even though prices skyrocketed for 2014 and 2015 coverage, insurers still underestimated the utilization of their plans under the Obamacare mandate. Delaware announced approval for premium hikes of 22.4 percent, while AIS’ Health Business Daily reported last week to its subscribers on a long list of approvals by states for double-digit premium increases.

The list includes key swing states such as Florida (16.2 percent for UnitedHealth, 13.9 percent for Aetna), Iowa (19.8 percent for an Aetna subsidiary), and Michigan (average increase of 11.4 percent across all 14 plans). The Street’s Brian O’Connell reported that insurers “are just now starting to get a firm grip on costs,” which has been complicated by “the underlying growth in health care costs,” and premiums may rise again by as much as 40 percent in some states.

Remember when President Obama promised that Obamacare would “bend the cost curve downward,” and that the exchanges would broaden consumer choice? Instead, consumers have seen premiums repeatedly skyrocket, and choices for less expensive coverage evaporate. AIS notes that Blue Cross Blue Shield will pull out of New Mexico, cutting 35,000 individual-market customers after losing over $19 million in 2015.

Why? The company was denied an application for a 51.6 percent average increase for its plans. Other insurers have shut down operations in state exchanges as well, or blinked out of existence altogether. O’Connell also points out that Obamacare has resulted in a series of mergers among insurers, noting, “Less competition means higher prices.”

So it’s really no surprise to see Democrats backing away from Obamacare. Voters who have watched their costs skyrocket and received little to nothing in return will not be fooled in 2016 when Democrats try to sell this as a big win for their health, physical or economic, especially since that election will take place immediately after the next series of premium spikes and plan closures will arrive during the 2017 open enrollment period.

Hillary Clinton’s sacrifice of the Cadillac tax for union support shows that Democrats have become more desperate in the five years since imposing the ACA over the opposition of the American public. If this continues, don’t expect the Cadillac tax to be the last line of retreat, either. "

Health care was cheaper under the old system, how can they ask for 40-50% more when the cost is already a lot more than it used to be?

Simple answer, Rey.   The people who are paying, are having to pay more to subsidize all the freeloaders who are getting "free" health insurance.  It's free to them, but not free to the others who are paying more so the others can get it for free.   

Its true what Jonathon Gruber said...many Americans are unaware of what it going on.   

Its simple economics.  To serve far more people with health insurance, the expenses and costs MUST go up.  The democrats claimed costs would go down by insuring more people.  That makes no sense.

It's similar to Venezuela where Maduro continued the policies of Chavez.  There was a program where they had the government go into electronic stores, taking them over, without compensation to the owner.  The government gave away the "government stolen" seized TV's to people as an indirect vote-buying effort.  Obamacare, Obamaphones, etc follow the same concept but not as blatantly. 
http://www.bbc.com/news/world-latin-america-24883849

If I was running for office, and gave everyone a free tv, I could become quite popular.  However, when private property rights are not respected, the producers/providers are inclined to stop producing/providing.  That's why there are shortages of even basic goods like toilet paper.  An economy is doubly harmed when the government steals from the producers and gives to the freeloaders, as both groups are discouraged from working.  Many of the smartest, most talented business owners closed up shop and move to Miami or other places instead of being forced to sell at a loss.  Likewise, in the US, the democratic machine has built a strong voting block of freeloaders who will vote to keep getting more free stuff.  In a way, can you blame someone for not working when the government has trained and conditioned them to not work?!?   The business people and factory owners got tired of pulling the wagon in Venezuela, and now there aren't enough people pulling the wagon.  The result is shortages of many products besides toilet paper.  People in Venezuela are dying for lack of medical supplies, for one.

http://www.usatoday.com/story/news/worl … s/3497003/

"Venezuela's President Nicolás Maduro intensified his perceived fight Monday against "bourgeois parasites" he accuses of an economic war against the socialist country by threatening to force more stores to sell their merchandise at cut-rate prices.

"I would bet that the next thing to disappear from shelves are televisions," said Alberto Ramos, an analyst at Goldman Sachs in New York. "What the government is doing is aggravating the picture. There is no economic justification for this."

The government said that five people had been arrested in the country's central city of Valencia for looting. Even Venezuelans who knew the policy was unsustainable were in line for a good deal.

"I have no love for this government," said Gabriela Campo, 33, a businesswoman hoping to take home a cut-price television and fridge. "They're doing this for nothing but political reasons, in time for December's elections.""

Similarly, Obama forced millions of Americans to buy Obamacare compliant policies, which caused millions, including me, to lose their plans.  Never mind that he lied and said "if you like your plan, you can keep it.

You got to love it!!!!!!!!
Unfortunately, it does not seem like the Republicans will be able to stop it.
So we seem to be stock with it.

That's why the democrats want all these refugees and illegal immigrants - votes!   Over 90% of refugees and illegal immigrants, if given voting rights in the US, vote democratic.  If these policies continue, the US as we know it will no longer exist.  It will become like many of the Latin American countries where socialists get elected.

Hi everybody,

I  strongly believed that we can all discuss on health system without referring to politics.

As you already know, political debates are not welcomed on Expat.com, it is strictly prohibited as we are not apt to deal with this kind of topics.

Due to the political posts here, it is best that we close this topic.

Thanks

Priscilla

( Topic closed  )