Blindsided by the Obvious: Figuring Out Insurance Under Obama
A tale of woe from the frontlines of the Affordable Care Act.
November 13, 2013 - 11:38 pm
I really wasn’t too concerned about Obamacare personally. I have a good job, with decent — if not great — benefits, and while I was worried about the effect the ill-advised law would have on the nation as a whole, I figured I’d get to keep my insurance.
I was further convinced I didn’t need to worry about it when I got an email from my regional manager telling us that corporate had passed a miracle and we’d not be seeing a premium increase.
I fell for that one hook, line, and sinker.
Imagine my dismay when they finally started open enrollment and I discovered my plan — which I was not fond of, but which was at least affordable — had been eliminated.
We’d originally had three separate plans: a premium plan with superb bennies; a middle plan, which was not as comprehensive but was still pretty good; and a low-cost plan which, while not great, still provided decent coverage at a price I could sort of afford.
That, thanks to Obama, Kathleen Sebelius, Harry Reid, and Nancy Pelosi, has now been reduced to two plans — a premium plan and a high-deductible plan.
The high-deductible plan now runs the same $181.93 per paycheck I’d been paying to this point. Not cheap but at least affordable.
Except it has no prescription drug benefit. You pay the “negotiated rate.”
This is a problem since my wife has rheumatoid arthritis, serious asthma, and is pre-diabetic. She takes four or five pills a day, more on weekends because some of them are once a week.
Then there’s me. My health problems are not as serious, but I’m a chronic insomniac who needs meds to sleep, I have back problems and carpal tunnel syndrome (journalist, occupational hazard), and I have a few pills a night to take as well. We need that prescription benefit.
No joy if we go with the cheap plan. But I figure I can live with that if the rest of the plan is good.
Not so much.
Doctor copay? Nope. The plan will pay 60% of the doctor visit after the deductible. Hospitalizations (a serious consideration with my wife’s health issues)? After deductible. Emergency room visits? After deductible.
All of it after the $9,000 deductible.
So I look into the premium plan.
Well, there’s a $20 copay for doctor visits, a prescription benefit, and the deductible is a third what the cheap plan has, but ER visits, which were $100 under my old plan, are now $250 under the premium plan.