By Jueseppi B.
The following success stories, that you WON’T hear about in the main stream media, are courtesy of the following: Kaiser Health News, Colorado Consumer Health Initiative, NOOGA.com, TECHLI.com, Philadelphia Weekly & KERA.org.
More than 20,000 people rely on the state run Texas Health Insurance Pool. The pool insures folks with pre-existing health conditions who can’t find coverage elsewhere. In a few months, that risk pool will no longer exist. And at least one North Texas family is celebrating. Right after he retired a decade ago, Bob Flood learned he had cancer and a kidney would have to be removed. Just one month after he lost his kidney, he lost his health insurance. “The only place I could get health insurance was through the Texas health risk pool. And that is 200 to 400 percent above what the average person pays,”
Flood says. Flood’s family policy was more than three thousand a month. His wife Amy says they tried to write the check once a year to avoid seeing the bill so often. “That was a sizeable chunk of change,” Amy Flood says. “And frankly I would have rather given it to other needy people rather than just to an insurance consortium.” But the Floods wanted to be responsible, so they agreed to grin and bear it. Thanks to the Affordable Care Act, they don’t have to anymore. “Now we have a policy which covers the three of us for less than a thousand dollars a month.”
More At KERA.org
From 2005 to 2009, I paid $15 for all office visits after meeting my out-of-pocket deductible. But starting in 2010, that number became $30 per office visit for my family doctor and $50 for any specialists—and with a chronic illness, most of my office visits involve specialists. So, with age 40 looming on the horizon, I had resigned myself to rearranging my life still further, to the reality that I’d need to find, somehow, significantly more money to spend on my private health insurance—since it isn’t something I can live without. Then Obamacare appeared.
With the Personal Choice Platinum Plan PPO, I’ll pay $429.96 per month as a tobacco non-user at age 39. And when I turn 40 a few months later—the source of my financial dread? I’ll pay $435.41 per month. That’s not just no huge increase after all. That’s fifty bucks a month less than I’m paying now. It gets better. Instead of paying my current $30 for a family doctor visit, I’ll pay only $10. I’ll pay $40 for a specialist instead of the $50 I now pay.
With my new Platinum Plan, prescriptions are priced in three tiers. A generic drug’s copay is $5; a brand name drug purchase is a $30 copay; and a non-formulary brand is a $50 copay. That’s the pricing at retail pharmacies—but my new plan also offers a mail-order option to my door through Future Scripts that will enable me to buy a three-month supply of prescription drugs at the cost of a two-month supply’s copay. What sorcery is this? Well—it’s Obamacare. This is what Obamacare is. It’s not the flawed website the media has been dwelling on. It’s the more affordable care structure the website is supposed to point us to—and that a simple phone call did point me to.
More At Philadelphia Weekly
On May 4th of this year, I was in a cab on a Saturday afternoon heading to the St. Louis Cinco de Mayo parade with two friends. My cab driver was texting and as a result rolled through a red light, we collided head-on with a van and I wound up in the hospital requiring 5 total surgeries and spent five and a half months in two hospitals and a nursing home. I have a new hip, will be in physical therapy for my shoulder for another year and without insurance I would have been doomed. My current bill for health insurance is $628.34/mo and only covers me.
This is insane. No one I know pays this much for health insurance, so when Healthcare.Gov was announced, I was cautiously optimistic- I had also gotten a letter from Blue Cross/Blue Shield of Illinois informing me my policy was being cancelled. After I chose my plan rated ‘gold’ here is my new bill for health insurance under Obamacare: I am saving $265.85/mo under Obamacare, for a total savings of $3,190.20/year This plan is far better than what I had before. My current plan has a deductible of $3,000 and has a $20 co-pay. Under Obamacare, my new plan has a $750 deductible and $30 co-pay for doctor’s visits.
For me, I’ll happily pay an extra $10 when I visit the doctor in return for a smaller copay for the important stuff. If you look, the most I’ll ever pay in one year is $6000- after that I am 100% covered for everything. If you look at my plan details, you’ll see that if I am in-network, after the deductible is covered ($750) then almost everything gets covered 100%. The biggest point for me is that my new plan under Obamacare is with Blue Cross/Blue Shield, the same company that my old plan was under. That means they were happily over-charging me for insurance and now, thanks to Obamacare, I have a better plan than I had before and I am paying less for it. Also of note- I did not qualify for subsidies- I am paying the full rate.
More At TECHLI.com
Chattanooga resident John VanHyning and his wife have gone without health insurance since July 2012. His wife is disabled, and the couple has two grandchildren who live with them, VanHyning said. He has a part-time job that pays a couple hundred dollars a week. Now, he has coverage that will go into effect Jan. 1 under the Affordable Care Act, commonly called Obamacare. Liberty Tax officials connected him with American Exchange, a local company whose leaders are helping residents nationwide connect with health insurance through the online marketplaces.
“I was even a little skeptical—how can they hook me up so easily when everybody else has [had so many problems?]” he said. Within about 40 minutes of going into Liberty Tax, where he made a phone call to American Exchange, he and his wife were signed up for health care coverage. It won’t cost the couple anything to get a silver plan through BlueCross BlueShield of Tennessee. The monthly premium cost for that plan is $683.64. But because of federal tax credits, the couple won’t have to pay any of that.
More At NOOGA.com
Sara and I are also both self-employed small business owners. While Margaret and I have no health issues, Sara has a pre-existing condition. In 2008, Sara was treated for a “mild” heart issue, specifically a super ventricular tachycardia (SVT). At the time, the procedure was recommended essentially because it “couldn’t hurt” to get this issue done. It was a simple, low-risk procedure and was completed in a few hours.
However, what the doctors didn’t tell us is that treatment for this problem (which was a problem in name only – Sara had no illness or issues) would make it impossible for her to obtain healthcare later in life. Using the new Colorado Health exchange, Sara, myself, and Margaret were quoted $590.65 per month for a family plan. The individual annual deductible is lower ($1,750 per person, $3,500 per family), there is 25% coinsurance, and it’s a “silver” plan (KP CO Silver), which seems like it should be an upgrade over existing policies.
What’s more, the whole family will share the same policy. They can visit the same doctors (not all doctors would take Sara’s insurance via Cover Colorado), use the same online health record management system via KP.org, etc. Through Connect for Health Colorado my family can save money and have a more comprehensive health plan that meets our needs thanks to Obamacare.
In January, part-time workers who have so-called “mini-med” health insurance plans with very limited benefits and annual caps on payments will begin to lose that coverage, which under the health care overhaul can’t be renewed after the beginning of the year. Many experts say it’s just as well, noting that part-timers likely will have better options in January. After the Affordable Care Act passed in 2010, nearly all plans were required to eliminate lifetime and annual dollar limits on benefits.
When Roberta Grindle was diagnosed with colon cancer in October, she blew through the $5,000 coverage limit on her mini-med plan almost immediately. Grindle, 62, worked 16 hours a week at a big box store near her home in Sebring, Fla., and paid $32 every two weeks for the store’s plan, the only coverage available to part-time workers.
The health law requires that employers offer health insurance to employees who work at least 30 hours a week or face penalties starting in January, but the Obama administration delayed that provision until 2015. Many part-time workers will have more options for better coverage starting in January. If their employer doesn’t offer a health plan, they can shop for insurance on the online marketplaces, and subsidies will be available to those with incomes up to 400 percent of the federal poverty level ($45,960 for an individual in 2013).
More At Kaiser Health News
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