Realities Of The Affordable Care Act Insurance Coverage So Far
Back in January I wrote a post here giving my opinion on signing up for health care coverage under the Affordable Care Act. It seems time to give some opinions on how it’s working out so far.
First off, the world didn’t collapse like conservatives were saying it would. There were no “death camps” no major protests, no scores of people losing their health coverage. True, some people did lose their coverage because it didn’t have the mandatory benefits the Act stated it must have. That brought the cost of coverage up for some people.
Also true is that some people have ended up paying higher premiums than they were paying before, even though realistically they’re getting more. That was one of the basic problems with the Act to begin with, in that it counted on state competition to keep prices down while acknowledging that in some states, like Arkansas, there wouldn’t be much competition, thus those folks would potentially end up paying more. Sometimes the problem with national “anything” is that it doesn’t take into account that things aren’t really the same everywhere.
Second, I’m glad that there’s a 15 day leeway to get the payments in. Over the winter I thought it was safer to stay in the location of where I’m consulting most of the time and only go home one extended weekend a month, as I’m traveling a lot right now, and that long weekend often meant I would miss the first of the month. And the insurance I selected hadn’t set up online payments yet, so I had to mail it in.
Third, I was pleasantly surprised to find that, even with the deductible my wife and I have (we purchased a silver plan), I got discounts on all of my diabetic supplies and medications. I wasn’t expecting that, thinking I was giving my insurance so I could bring down my deductible. I also got a discount on another prescription for something else; sweet!
Fourth, I did have a doctor’s appointment with the diabetes clinic and “knew” I would be paying that totally out of pocket. Turns out I was wrong on that front as well. It seems that based on contract, some of the amount for my appointment was adjusted off, and the insurance company actually paid $50, though I’m not sure why. I still had a nice sized bill, but it wasn’t too bad and I paid it off immediately.
Fifth, it turns out that there was some coverage for my lab work as well, which also included adjustments. As a point of disclosure, I picked a Blue Cross plan because I know them pretty well and, for traveling purposes, every medical facility in the country knows Blue Cross. What I hadn’t thought much about is that the Affordable Care plan has its own “group”, so to speak, and physicians and health care facilities negotiate fee schedules just like they do for employers.
Sixth, although this was a new payment for me, my wife’s part of the payment wasn’t as much of a difference as she thought it would be, though I’d told her it would work out. When she works (she travels also but is more of a traveling technician than a consultant) she had full insurance coverage, but had no coverage when she wasn’t working. This way, not only does she always have coverage but the difference between what she was paying for coverage and what she pays now was only $100; not bad at all.
In essence, way more good things happened that I wasn’t expecting. The bad thing… we’ve had problems getting our insurance cards for some reason, probably because neither of us are home. Also, they have a problem setting me up as the primary on the account, even though I’m the one who filled everything out and signed it… so be it.
And, to the government’s great surprise and the conservatives consternation, the target of 7 million subscribers was hit; I thought it would happen. Many others ended up with Medicaid coverage, which they may not like because of the stigma but, from my perspective as a health care consultant, it’s always better to have coverage than not; you never know when an emergency might come up.
What are your experiences with the Affordable Care Act plans? I hope they’re not bad, although I know for some people it will be.