Monday, December 16, 2013

Health "insurance"

I try to steer clear of opening any can of worms on this blog by talking religion, politics, UFO sightings or whether there is a Santa Claus. But, I have one downfall. I'm looking at you, health care. 

My love/hate relationship with this subject could be because I make a good portion of my living writing about health care, but it's also because J & I have chosen a lifestyle (i.e., leaving the comforts of full-time jobs to hike the AT or taking contract work) in which we must purchase individual health care and so we live what the media headlines talk about. 

I've followed the Affordable Care Act (ACA) for my medical writing gigs for years, ever since it was just a twinkle in Obama's eye. It was actually kind of fun to watch it develop (that's the nerd side of me talking). I was one of those people who half-supported it because I thought something—anything—needed to happen with the U.S. health care system. Still, I knew it was a flawed plan. I am still in favor of certain aspects, like the free preventive care and fact that J was no longer going to be flat-out denied for individual insurance on the basis of his non-existent, but pre-existing, condition. Access to health care is a good thing. Especially since I have joined the ranks of the "pre-existing" condition stigma. 

Over the years, we've dodged some bullets. While we hiked the trail, J took advantage of the costly COBRA since he was denied individual insurance on the basis of his pre-existing condition and I found myself a cushy plan.

A year or so later, we found ourselves in need of individual plans again. J was not denied this time around, but there were blood tests and a long waiting period before we were enrolled in a very basic plan to suit us for the time being. 

That brings us to today when the playing field has changed again. 2014 is the big year when many of the elements of the ACA become a reality. 

As a result, my head is spinning these days, not with visions of sugarplums dancing in my head, but with analyses of super high monthly premiums, even higher annual deductibles and small lists of out-of-network providers. 

The thing is, there's this debate over "if you like your plan, you can keep it." Millions were getting unexpected cancellation letters and forced to find a new plan through the marketplace. Then Obama said he would make exceptions and grandfather people in on their current plans. I knew our plan did not qualify as one of the ACA-approved plans, but we never got a cancellation letter. I've called our insurance company more times than I want to admit to make sure our plan is not going away (until the end of 2014). 

Plus, I want to stay with my insurance for now, since I already racked up some hefty bills with my PE and may even meet my deductible this plan year! 

With that being said, we are not out of the woods. By keeping a non-approved ACA plan, we are subject to a tax penalty and won't receive the tax subsidy. You might ask why we took that path? 

Well, we looked into the "approved" plans being offered by our current insurer and the plans in the healthcare marketplace. Guess what? Double the cost of our current premium and double to triple the deductible we currently have. That's some sticker shock. That's not the only troubling element. The plans are just as complicated, if not worse, than our current plan. We, of course, make it even more complicated by wanting coverage nationwide (very few multi-state plans out there and WICKED expensive). Oh, and the tax subsidy everyone is talking about? Eh, not so awesome. 

In order to offer a little praise, know that the Healthcare.gov helpline is actually helpful. Granted you have to wait 15 minutes before talking to a representative. In a culture where people are too busy to finish the word delicious, but sleep in lines to buy the latest version of an iPad, patience is a grey area. I feel for these customer service reps. These reps may possibly have the worst jobs ever. They constantly put me on hold to either deal with their system freezing up (the technical glitches everyone is talking about do exist) or track down a supervisor to answer one of my questions. And even then, they are not usually complete answers. On a side note, calling customer service lines is a fun way to meet new people. My dad does it all the time (including the wee hours of the morning). He and the guy from Apple iCare just met up for lunch the other day in fact. 


And that, my friends, is the health insurance quandary, the place where heart attacks grow on trees. 

1 comment:

Misti said...

I'm still hopeful that these horrible things that may happen will resolve themselves. Maybe I'm pessimistic (or too optimistic on another spectrum) that the ins. companies are making the dire problems worse and falsely inflating their premiums because they don't want healthcare reform. Or maybe I'm just a conspiracy theorist.

But, thanks for sharing what is going on with you. It is definitely nice to hear someone's real life perspective on this!