Obamacare Knee-Caps Customers

Administration Authorizes Caps on Expensive Surgeries Like Knee and Hip Replacement

Comment: Hey, remember that over-priced Obamacare plan they crammed down your throat, to get rid of that crappy “substandard” plan you thought you liked? Remember how this wasn’t a government takeover?  Good news!–the King has just decided your new plan doesn’t have to pay all your surgery costs. Isn’t that nifty, just what they promised?
  Even more good news–they’ll still pay for (part of) your heart transplant, but your surgery’s scheduled at Jiffy Lube. Don’t be late!

“The Obama administration has given the go-ahead for insurers and employers to use a new cost-control strategy that puts a hard dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.”


“The new strategy works like this:

Your health insurance plan slaps a hard limit on what it will pay for certain procedures, for example, hospital charges associated with knee and hip replacement operations. That’s called the reference price.

Say the limit is $30,000. The plan offers you a choice of hospitals. If you pick one that charges $40,000, you would owe $10,000 to the hospital plus your regular cost-sharing for the $30,000 that your plan covers.

And that extra $10,000 doesn’t count toward your plan’s annual limit on out-of-pocket costs.”

U.S. lets insurers cap what they’ll pay for procedures such as knee replacements
The Associated Press, 15 May 2014

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