I am an independent consultant, and my wife is independent as well. This means that we finally had to address the issue of health care because of the Affordable Care Act. Obviously this was something much different for us, but it’s especially different for someone like me, as my main background is as a consultant in health care finance. But that’s finance, not personal insurance, so this was an interesting process.

Sweet Dreams – Dulces Sueños, Room – Habitación de Hotel, Salamanca, HDR
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Right off the bat, I realized that all I’d been hearing about high deductible plans over the past 5 years or so was what this was going to be based on. At first I was astounded at how little coverage it seemed people were getting before they paid their deductible, and how much it would cost to get a traditional plan like what my wife and I were used to when we worked for major employers.

Then I remembered how much my COBRA letter was when I left the workforce 11 years ago, and then how much my wife’s letter was when she left in 2012, and I realized just how expensive health insurance really was. When one thinks about the contribution employees had to make to their own coverage and how much COBRA was, one learns just how much employers were paying for our coverage as part of our benefits. And COBRA was for health, dental and vision; this was something initially difficult to get my mind around.

The letter we received said we could continue the same coverage we were getting before at a rate of $1,700 a month. We do okay but that figure was way out of whack with our reality. However, when we started looking at the insurance plans we saw that though the price of a bronze level plan was only $415 a month, it came with an $7,500 deductible; that just wasn’t going to do. We also knew that we had to get a Blue Cross plan because we both travel, and Blue Cross is known all over the country. If we stayed local we had more options, most of which cost less but not all of them.

We ended up going with a Gold plan which is going to cost us just over $900 a month. That’s tough because we have other bills, but it makes the most sense for me. For one, our joint deductible is only $2,400, or $1,200 each. Two, it immediately covers a portion of our pharmaceuticals, which we’re lucky not to need a lot of but do have needs, especially diabetic meds and supplies.

We’re also gaining a covered physical every 3 years as part of the plan, along with $100 towards our gym membership each year. Because we have a low rate this will help a great deal. And the reason my last physical was 5 years ago is because that’s when I found out that it wasn’t covered by our insurance at the time, and the lab work wasn’t covered either since it was tied into the physical. That ended up costing me $700 alone; we weren’t very happy with that.

Of course we could have looked at the option of not getting coverage and paying the tax penalty, which starts at $95 per person or 1% of your total income this year and goes up each year from there (this year the max is $285 but after that…), but coverage seems to make sense, especially because we’re traveling. We don’t qualify for any discounts but most families do if they ask for it.

General thoughts… well, I’ve always advocated that everyone should have health care coverage, mentioned the first time in a piece back in January 2009, and I still believe that. I don’t believe this bill has ended up being fair to the middle class because of its mandatory coverage and penalties that only hurt the middle class. At the same time, I tend to believe that most of the people complaining about it that feel they can’t afford it haven’t fully looked into whether they’ll qualify for some kind of benefit or not, although I will acknowledge that it’s pretty hard on single people. And the process isn’t stress free; even for someone like me, with a background in dealing with insurance companies, it was initially confusing and distressing, though after I left it for a couple of weeks & went back to it (I tried getting in relatively early just to look around) I got a better handle on it.

I’d love to know what you’ve decided to do and how you felt about the process overall. I know this isn’t the plan that President Obama wanted, and he had nothing to do with how it’s all come down, but I do wish that he’d had a bit more input into some of what’s coming at us now.

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