I think it was last November when I first looked at the page for the new Affordable Health Insurance. Like a lot of Americans I had been hearing really great things about it and I was rather excited by the thought that Cookie and I might finally be able to get health insurance- I'd been without since my Ex and I divorced (and had racked up a 25K hospital bill for something that appeared to be appendicitis but wasn't), and Cookie hadn't had insurance since he fell off his parent's policy when he turned 18... In 1997.
I'd also heard some not-so-good things, but I'm an optimistic idiot sometimes. I wanted ACA to be a good thing because it could be a good thing, and my first visit to the website excited me- It informed me that because of what Cookie earned we would qualify for a $255/mo credit to use towards our health insurance and with that credit we could buy Blue Cross insurance for $137 dollars per month.
$137 a month! For two people! Awesome!
Alright, maybe not so awesome... That $137 would have to come from somewhere, and although we do alright money-wise, it's not like we have an extra $137 lying around every month that we can use to pay for something else. My car insurance would have to go- But that was OK. I didn't drive much anyways, plenty of people did just fine in a one car household, and if I wanted to put a really positive spin on it- It would really be good for The Diet if I couldn't just zip up to Kroger every time I got a sweet tooth and it would reduce my carbon footprint. I could be skinnier AND green!
Enter some procrastination and we finally got around to signing up in January. Or we tried to.
The website had a shit fit because Cookie's regular pay (which is what they base your tax credit off) and he gross salary were quite a bit different due to him working quite a bit of overtime. It had another fit because I didn't enter my SSN into one field (but did enter it at another part of the application) so the government thought I wasn't an American or something...
We had to sort that mess out.
It was finally March before we could complete the application and actually see the information regarding the plans we could pick... Suffice to say, we were not happy campers.
But we had no choice really- ACA was law, if we didn't enroll we'd end up having to pay fines, so we picked the cheapest plan we could (the afore mentioned Blue Cross bronze plan for $137 a month) and somehow convinced ourselves that we were not being hosed by the government and Blue Cross and somehow ACA would be as great as it was supposed to be... You know, making health care affordable for those of us would couldn't previously afford to buy insurance.
And then the Blue Cross Member Handbook came in the mail.
Confused, I scratched my noggin and called my mom. She had lots of experience with health insurance so maybe she could figure out if the booklet wasn't telling me what I thought it was telling me.
My mom's face was priceless. She said, "This is ludicrous. Without health insurance you'd go bankrupt if something bad happened, with this insurance you'll go bankrupt just trying to see a doctor AND if something bad happens."
You see, the deductible and the out-of-pocket expenses when you can only afford the Bronze plan are a bit steep...
They're both in the ballpark of $12,000... And I don't know about you, but I don't have 12K just sitting around waiting to be used in case I get sick.
And the way our policy is worded- Our insurance doesn't pay a co-pay for doctor or hospital visits until after we spend TWELVE THOUSAND DOLLARS on medical care.
$30 co-pay to visit the doctor... AFTER deductible. So if an office visit costs $80, we have to pay that $80 until we've spent $11,900... THEN it's only $30. I don't know about you, but I can't really afford to throw $80 at the Doctor every time I think I need to go see him (or her). And Dog forbid that I need to see a specialist or that we reproduce.
Then there's trips to the ER. A $250 co-pay AFTER deductible? Fat lot of good that does me before the deductible is met.
Hospital stays? $500... And then for both of those I'm responsible for 40% of the bill after we reach the out-of-pocket maximum. So for my last hospital visit with a 25K bill? I'd have to pony up 12K and then 40% of 13K...
How is this "affordable"?
Sure, we can sort of afford the insurance, but we sure as hell cannot afford to actually use it.
So I bet you can see why I'm a little (or a lot) pissed. We're being forced to pay for a service that we can't use, and what's the point of having insurance if you can't afford to use it? Oh, right... The insurance companies make bank. They get to pocket that $137 a month we pay them secure in the knowledge that it's will be incredibly unlikely that we'll force them to pay out anything unless we absolutely have no option but to go to the ER (we definitely won't be going to see a doctor any time soon).
So, ACA or no ACA, we're in the same boat we have been in- A major medical issue will bankrupt us, no ifs, ands, or buts.
So what's the point?
No comments:
Post a Comment