Lost and Found
In 2011, I lost my employer-provided health insurance when I decided to stop working full time. The pace of a full time teaching job, with its long hours and coming home at night to spend several more hours grading, became too much. I have fibromyalgia, and my hands are slowly becoming crippled by arthritis, so I made the decision to work only part time. Now I have two part time teaching jobs, but I have time to pace myself and rest when needed.
But I had no health insurance. My husband is already on Medicare, so my only choice was to purchase my own individual policy. I chose a policy I could afford with insurance company Blue Cross Blue Shield of Georgia, but the policy has a high deductible, pays for only three doctor visits a year, and covers no lab work, X-rays, or other diagnostic tests until the deductible is met. In 2012, the premium was increased by $50 a month. Money to pay the premiums has been coming out of our savings each month and is not being replaced. Not a good scenario, although much better than that faced by many other Americans
A Change is ‘Gonna’ Come
The implementation of the Affordable Care Act looked good to me, and I had been waiting for the health care exchange to be available so I could shop for a better policy. In September, my insurance company sent out a letter “explaining” the changes to come and advising policyholders to “renew early to keep your current plan design.”
Is My Insurance Company Deliberately Misleading Me?
After reading the letter at least six times and receiving an email from the insurance company on November 8, again asking me to “lock in 2013 rates,” my answer to the above question is a resounding YES. I am being told that:
- I can keep my current plan, but the monthly premium will increase by almost $100 a month beginning in December (this is the current 2013 rate I can “lock in”), and the new policy year will be extended until December, 2014
- My current plan will no longer be offered after August, 2014, and I must choose a new plan (so which is it; I can keep my plan until December of next year, or it will no longer be offered after August of next year?)
- The number of doctors and hospitals that they will cover is changing, and the number of medicines they cover also is smaller
- I can go on their website and shop for a new plan during open enrollment
- If I qualify for financial assistance (offered through the Affordable Care Act which they never mention) I must enroll through the health insurance marketplace (no web address provided), but since they are the company offering most of the policies on the insurance marketplace, I can continue to have insurance coverage through them
So I Went To the Healthcare.gov Website
Thanks to the Neanderthal legislature and governor of my state (Georgia) who refused to cooperate with the Affordable Care Act, we have no state healthcare exchange. So I went on the Obamacare site. On a day when Congresswoman Marsha Blackburn of Tennessee was waving papers in the air on live television and ranting about how the website was down at that very moment, I was on the website creating an account.
Because I am the obsessive type who reads every word, I read every word and moved back and forth between my insurance company’s website and the Obamacare site.
To qualify for the government tax credit that can lower monthly premium costs, it is absolutely necessary to go through the process of entering requested information on the healthcare.gov site. Household income determines tax credit. Because my husband is retired, his income includes only Social Security, a very small pension from his last employer, and a small income from a part time job.
I discovered to my delight that I am eligible for over $500 a month in tax credits. I can choose not to use the credits and receive that money back when I file my income tax return, to use a portion of the credits toward insurance now, or to use the entire amount.
Before you can look at policy options, you are asked about not only the state in which you live but also the county.
Policies are classified as Catastrophic, Bronze, Silver, Gold and Platinum based on their monthly premium costs and the amount of coverage they provide. In my state and county there are no Platinum policies available.
A Delightful Surprise
When I researched available plans I discovered that with my tax credit I can purchase a Gold level plan at almost $200 a month less than I would pay to keep my current plan, and the deductible would be considerably lower than what I have now.
So What’s the Problem?
The plan is offered by the same insurance company with which I have my current soon-to-unavailable policy. This is the same company that is changing the doctors and hospitals in their network. They pay nothing to out-of-network providers. To research their new provider list I had to click on at least 5 different links and then found a woefully inadequate list that they say is being updated weekly. None of my current doctors are on the list, not the primary care physician, the cardiologist (no cardiologists in my area are on the list), or the ob/gyn. Even the large regional hospital is not on the list. How do I know if my doctors will be added? Surely they will be. Why wouldn’t they be added? The bottom line is I don’t trust the insurance company.
And What’s Next?
The Obamacare website was easy to navigate, and I am delighted with my tax credits. New health insurance will provide better coverage and will be less expensive. Will I sign up today? No. I’m waiting until I see with my own eyes the names of the regional hospital and my own doctors on the insurance company’s provider list. Then I’ll sign up.
I’ll keep you updated…..