Here is my ACA Success Story: I have chronic conditions - several that are not treatable as of yet. Some are in remission. Before the ACA came into effect in 2010, my rates jumped to $298 per month, $2500 deductible and $10,000 OOP. Before that, the insurance actually worked as insurance. By this point, it no longer qualified as insurance and amounted to nothing more than a catastrophic plan. In 2010, after the ACA passed, my rates steadied and I saw no more increases. But the plan was ineffective on most things. However, it could no longer drop me and it dropped lifetime caps. In 2011, I saw my womens doctor and all I had to pay was the cost of the urinalysis. In 2012, I required an iron infusion. But I had to do it at the hospital. In 2013, I got a flu shot expecting to pay OOP, but it came back as $0. Later, I got a letter and a packet in the mail. BCBS was canceling my plan (I was never any happier over the news as it was already at the ten year mark and grandfathered in 2006 when they rolled out individual plans) and get this: BCBS was allowing me to CHOOSE. I was allowed to choose a lower share silver plan for less premiums or an exact same share gold plan for slightly higher premiums. I took a month to do the math comparing my old plan rates to the two options I had for the new plan. Well, guess what? I chose a gold plan. For less than $25 more each month, I can save at least $40 each month. And that $40 savings more than covers the new dental plan I get to have now! Before the ACA I was not allowed to even get a dental plan. When you have chronic conditions, your costs tend to be a lot higher and sometimes more stacked during certain months more than others. My new plan is $321.75 per month with a $500 deductible and a $5000 OOP (even the law limit of $6350 would have provided an automatic savings as compared to my old plan). My dental plan is $32 per month. I would have expected that by this point in the year that I would have reached the deductible, but get this: MOST of the healthcare services I get are covered at 100% of the allowed amount after copay not subject to the deductible! So here it is coming on the end of March, and I still havent met my $500 deductible because of all the covered services. In the four months of having this new policy and the three months of actually using it so far, I have gotten back a HUGE ROI (return on investment). My prescriptions are $20 less each month for each one. My doctors are the same copay I had before. Now I will admit one flaw to the ACA, even though a person receiving SSI can still qualify for assistance with the premiums, if the person lives in a non-expansion state and qualifies for SSI, the person automatically qualifies for Medicaid if the income and assets is less than $2000. With this being the case, and in a state like mine where Medicaid is essentially nothing but a supplemental policy and not guaranteed, the person must still have third party private insurance. So that is the only and most serious flaw with the ACA and the marketplace that I have found. Nonetheless, my healthcare has shown much better outcomes than ever before. The ACA put the power back in the hands of the doctors, the patients and the families of the patients. Just the other day, I needed rehydration IV therapy. Under the pre-ACA plan, this would have required one of two things: option one - wait for pre-approval and possibly die first or option two - go through the ER. Either way, it would have had to be done at the hospital which would have meant a minimum of $500-1000 with $300 of that being the facility fee alone! But under my new ACA-compliant plan, the doctors office (oncologist) was able to run it under the insurance and found it to be covered at 100% right there in the doctors office! So instead of risking me getting worse, they were able to move me into one of the recliner rooms with the IV pump and get me started right there. No unnecessary waits! If this one incident alone doesnt tell of a success with the ACA, I dont know what does or what will! Not everyone benefiting from the ACA gets assistance paying for their insurance, and even if they do, why does it matter? It is no different than someone getting assistance with college tuition. I would much rather see tax dollars helping people get insured than see them going for more unnecessary and frivolous wars or for poison ivy eating goats in New Jersey (no offense, but how does that help me in Alabama?). BTW, I live in Alabama yet the ACA IS working and saving REAL people REAL money. And I would love for my representatives to be able to read my own success story so they stop trying to hurt me and others like me.
Posted on: Sat, 29 Mar 2014 20:15:03 +0000
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