The Woodward News

Local News

December 28, 2013

Reporter navigates the path through Healthcare.gov

Woodward, Okla. — On the day before...deep sigh...the day before.... No, really, the real day before-the drop dead deadline to get your insurance on the government sponsored website, Healthcare.gov, I finally found out what I would pay.

The latest deadline for signing up via HealthCare.gov was Tuesday of this week (it has since kind of moved again a time or two).

Drum roll please.

So, when I got on the site on Monday, I found that for the catastrophic coverage I would pay $254 per month and for the best plan, $471 per month.

It's really not that bad.

When I came home from Iraq in 2008, I had to purchase insurance from the free market.

So it might help you to understand what I paid then and what I would pay now, were I to elect to get my health coverage from the site.

I am offering this information because are some pretty tall tales being told and embellished upon and then retold.

I'm not saying this debacle hasn't been, well, a debacle.

I'm just saying it helps us whine more effectively if we are at least using real numbers.

So finally, let's look at one normal person (that's me for argument's sake), making a normal, if not slightly impoverished wage and see just what I would pay now compared to what I was paying in 2008 when I purchased insurance on the regular market, as it was then.

Keep in mind, these are the prices I am offered because my employer offers coverage to me. If my employer did not offer coverage to me, the rate I would pay is literally less than one third of the rate.

For instance, making the same wage I entered (I'm not telling), if my employer did not offer coverage, I could get the same policy that cost me $254 for $54.

In 2008, after I got home from Iraq. my insurance was through Assurant.

It had a $35 doctor visit co-pay and a $2,000 deductible. The out of pocket maximum was $3,500 as I recall.

I had to pay 20 percent coinsurance on everything, even after reaching my deductible and I had a $1 million lifetime limit.

For this policy I started out paying $173 per month. Within eight months, it increased to $233 as I recall and then another four months later,it increased again to $280. The final insult was when, about five months later, it increased again to $311.

In all that time, I had not used the insurance at all. The one time I did attempt to use it, the hospital filed it but never once heard from the company.

I called the company and let them know I would not be paying their premium increase. I said to the fellow, "I haven't even used this insurance once."

He said, "Well, ma'am that is not how it works. Other people in your area where you live have used our insurance and so that is how the rates are tabulated."

Anyway, nothing is different now. We've been paying for everyone else for years. The difference is, the insurance companies just really didn't talk about it that much.

Then on Monday, I got online and took a look at what would have been available for me were I to choose to get my insurance on the exchange.

For the least expensive option, known as Blue Choice Bronze PPO 006, I would pay $254 per month. It has a $6,000 deductible, and the same out of pocket maximum per year. After you pay your deductible, my physician visits, generic prescriptions and ER visits are at no charge if you use an in network provider.

I have heard a lot of really unhappy people talking about the $6,000 deductible.

So let me tell you a quick and miserably true story.

My daughter and her husband are both independent contractors.

They were waiting to get insurance through the website because they knew they would qualify for low cost plans that were better than what they had priced on the open market.

Previously, they had looked into coverage and it was going to cost them nearly $800 per month on the open market.

Two weeks before they could enroll in the coverage on the website, my daughter's husband had a gallstone drop into his common bile duct and it caused severe and permanent damage to his pancreas.

That was October 21. He left the hospital yesterday and will most certainly have to return as he is in very guarded condition.

My daughter and her husband are more than $500,000 in debt as a result of his hospitalization. Their dream of ever owning a home is a distant memory and the stress this has caused them is immeasurable.

For them, $6,000 doesn't seem too bad.

So finally, I will tell you this. The most plush policy that I could buy is called the Gold $5 copay PPO. It would cost me $471 per month. It has a $5 copay for doctor visits, $5 prescriptions and an ER visit $250 co-pay and a $1,750 deductible.

Not bad, considering on the open market I was paying nearly that much and was still going to be out major bucks if I was hospitalized.

I can't that say I am at all impressed with the way they rolled out this program. It was like the Keystone Cops of the web-world.

But I can say, for me, those rates are doable and I don't qualify for any tax rebates.

I understand how idiotic it was to let this program affect otherwise effective insurance for already insured people and I also understand how incompetent so many of the current cabinet members seem. Not arguing those points at all.

Bottom line though, insurance is important.

Even for "healthy young people" like my 28-year-old daughter and her husband, who just three months ago were dreaming about buying a home and thought they could wait to get health insurance.

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