There was a time when I would've considered the ACA unnecessary. That I would've been annoyed by it. This was also a time where I had little to no interest in politics. It's funny how life has a way of humbling a person and teaching them something new about themselves on a regular basis. This is a story about how I ended up needing the help in order to make myself better.
"Well why didn't you just get a new inhaler?" I felt a sinking pit in my stomach. I was at a follow up visit to my doctor after ending up in the ER a few weeks before because bronchitis had made my asthma worse and I couldn't breathe. The first thing my doctor asked me was where my inhaler was when this had happened. After all, that was in my plan. I tried to explain to her that I only had one inhaler and it had been stolen the week before when I was riding the bus. Somehow, despite my explanation she didn't understand that since I was uninsured at the time, I just couldn't afford a new one. It was only after the ER trip that a friend of mine had pity on me and bought the inhaler for me.
I lost my insurance in April 2012 because I had been working at a call center that had outsourced its customer service department overseas. This was my fourth lay off in about six years. The whole time I had been trying to go back to school but in playing musical jobs I had never managed to do so. I decided to make school my focus and work secondary and deal with it.
Because I have asthma, I've never been able to get insurance without going through my work before. COBRA would've cost me over six hundred a month, and while my state had opened a high risk pool, it was still too expensive. My NP was awesome and made sure I got refills of my medication before I lost my insurance and gave me a list of community services for when I did lose it, because she knew I wouldn't be able to come back afterwards.
I did everything I could to make sure I would be taken care of. I signed up for a prescription plan at a local pharmacy, I found local clinic that was free, run on community donations. Still there are things that free clinics couldn't handle. Waiting all week to see a doctor because you got sick on Sunday and the free clinic is only open on Saturday isn't helpful when you're so sick you can't breathe. The doctors are volunteers so there's no guarantee of continuous care. In fact, the push is to get you into a local public health or community clinic, but they often were not taking new adult patients or were an hour drive away.
It was about a month after I lost my insurance when I found a lump on my right side, along the edge of the breast tissue. The free clinic provided me a referral but when I called the places they suggested I was turned away. I was told I was too young, that the office no longer provided services, or that they were out of funds for the year. I continued to fight to find a way to access services, but without a referral from a PCP I was getting nowhere. I finally took the time to bus out to one of the few clinics taking patients. They contacted a local imaging center attached to a public hospital to get me in. This started in June, I was finally in for imaging in October. In November I would get a biopsy and find out it was benign. It took me six months from start to finish to find out what was there.
It would be another year before I would get insurance again. In that time I ended up in the ER enough times the doctors started to recognize me. There really wasn't anything either of us could do. I couldn't manage my health without being able to afford regular doctor's visits and medication and they couldn't make a solution appear out of thin air. My wisdom teeth got infected and had to be removed but had to wait two months for a dentist who would help. I was on antibiotics so long I ended up with a GI infection. Bronchitis, allergic reaction, a set of second degree burns from how bad at cooking I can be. They got to deal with it all, despite the fact that most of these things were preventable.
All if this changed in January of last year. I live in one of the states that approved the Medicaid expansion and set up their own healthcare exchange. I was there on day one to shake hands with the Governor, tell him my story, and sign up. I stood up with him to others to encourage them to use the exchange as well. It is the only day of class I've missed since I started back.
Because of the Affordable Care Act I was able to get needed blood work that I had not been able to afford. Reliable access to medication. The first thing my PCP did, remembering how just a few months earlier I had ended up in the ER because I didn't have an inhaler was make sure to get me a prescription for one so I had a backup. One thing I know is I appreciate the opportunity more than I could ever express.
I know there are naysayers out there who will tell me that those things are not really free and that someone has to pay for them. One day I'll graduate and that person will be me. I seriously hope that I am paying to make sure someone gets the care they need with the money I pay into the system. It's saner than paying for what happens when they can't. The system we have isn't perfect, but it can only get better if we put effort into it.
You are the only person I've seen with that low of a deductible....everyone else's are 10000+. It is income based. The more money you make the higher the premium and higher deductible. And I don't see how it is really that affordable...I know people on min. wage and even at $300 a month, they can't afford that when they are being required to have it by law. That's a difference in keeping lights on and food in the house. I'm all for everyone having access to insurance, but it is flawed.
In California, FT at min wage qualifies you for a no deductible Anthem plan for $107/month, and a low deductible plan/low copay plan for $50/month. At $18,000/yr living with a couple of roommates in one of the many affordable areas of California (Central Valley) $50/mo is doable, right?
Specializes in Critical care, tele, Medical-Surgical.
A silver plan for a 30 year old in Los Angeles working full time for $9.61 /hour ($20,000.00 a year) costs $82.00 a month.
He or she would have a $500.00 yearly deductible and $50.00 brand name drug deductible.
Possible total yearly out of pocket for premiums and copays is $2,250.00.
A shop and compare to find information on different plans for a person's age, income, and location. Even though the link says, "Bad Request' it works for research purposes.
You are the only person I've seen with that low of a deductible....everyone else's are 10000+. It is income based. The more money you make the higher the premium and higher deductible. And I don't see how it is really that affordable...I know people on min. wage and even at $300 a month, they can't afford that when they are being required to have it by law. That's a difference in keeping lights on and food in the house. I'm all for everyone having access to insurance, but it is flawed.
That combination of numbers isn't really possible. Someone making minimum wage isn't going to pay $300 with a $10k deductible or anywhere close to that.
The price of coverage isn't actually income based, the amount of tax credits which help someone pay that price varies by income, so the amount someone is effectively paying changes by income up to a certain point (about 400% of poverty level).
There's no arguing that we spend a lot on healthcare, but we can't separate the amount our healthcare system costs and how much we pay into it through insurance and out-of-pocket costs; we can't all just pay less.
In Virginia, if you have 0 income, you still don't have full coverage health insurance. Affordable care act insurance, you must have an income. I'm a nurse with basic medicaid for gyn and birth control, I'm 52, so I basically have no coverage. New employers are giving insurance 60 and and 70 days after continuous employment, so I'm working as a nurse without health insurance until that time is up, just fyi.
Specializes in NICU, PICU, Transport, L&D, Hospice.
The Democrat Governor of Virginia has attempted to expand medicaid but the Republican legislature has prevented that expansion and there are no plans on their part to expand it in the future.
Government doesn't run things better; and the government trying to regulate insurance companies (which is not healthcare) to redistribute wealth by 1) making it mandatory to have health insurance (which does not guarantee access to healthcare) with 2) inflated prices for those who can afford to pay to subsidize thew few (320 million Americans, government still cannot validate the supposed 8 million on Obamacare) so they have insurance.
The other day I went through the NSNA partner site to get a quote on Obamacare. With our income, we could get a bronze package under $17.00 per month with $6,000 deductible where they would pay $50 towards a hospital stay with my wife and I paying the difference. Is that piece of mind that maybe the place I need to go will accept the insurance? And, how much in debt would my wife and I be if we had to stay in the hospital for a few days?
Obamacare is not healthcare, it is not access to healthcare; it's a Ponzi scheme built on lies.
Specializes in Critical care, tele, Medical-Surgical.
My daughter doesn't get a subsidy for her Bronze plan, she pays almose $250.00 a month. She has the nearly $6,000.00 in savings in case of an expensive illness or accident.
If she has to go to the hospital she will not have to pay more than a maximum of her deductible minus premiums and deductibles already paid.
Without insurance she would have to pay whatever the hospital charges.
Of course she is hoping not to get sick oe injured.
One factor some are not taking into account here, though, is the huge markups the American health care system puts on medical equipment, procedures and medications, for the purpose of offsetting those same deficits. You can see just how big these markups are, if you access any of these things in countries with single payer systems.
A couple of months ago, for example, I was visiting Turkey, and lost my thyroid medication. Having learned on Tripadvisor that Turkish pharmacies can dispense many medications without a prescription, I went to one, explained (with the help of an online translator) my dilemma, and they sold me three months' worth of my dosage. Cost to me: 12 Turkish lira (a little less than $6.00.)
Another time, several years ago, I ended up going to a French emergency room with a bad case of gastroenteritis. I received the same treatment I would in my own ER----blood work, IV fluids, antinausea medication----for about $200 total. For a noncitizen, who wasn't entitled to their national health care plan. At the time, I estimated that the same visit would have cost me at least $1500 back home.
We Americans don't think much about it when hospitals put a 1000% or even on occasion a 10,000% markup on the medications patients receive; we just figure that's the standard way it's done. But that's not the case in most other countries, nor is it the case in most other types of business transactions. Nor is that extra money going toward keeping costs down for consumers. How many brand new hospitals have gone up over the past 20 years, filled with luxurious amenities, beautifully landscaped campuses, and other bells and whistles that have nothing to do with health care itself? And who (and what) has been paying for it?
Government doesn't run things better; and the government trying to regulate insurance companies (which is not healthcare) to redistribute wealth by 1) making it mandatory to have health insurance (which does not guarantee access to healthcare)
It's not actually mandatory, you're free to help cover the costs of the services you are guaranteed even without buying insurance by paying a penalty that goes towards those costs. I get the desire to want something to be guaranteed to you, which acute care services are, and not have to pay for it but that's simply irresponsible behavior that shouldn't be legally allowed.
with 2) inflated prices for those who can afford to pay to subsidize thew few (320 million Americans, government still cannot validate the supposed 8 million on Obamacare) so they have insurance.
The cost of insurance plans is not increased by any amount at all to cover subsidies, those are tax credits.
The other day I went through the NSNA partner site to get a quote on Obamacare. With our income, we could get a bronze package under $17.00 per month with $6,000 deductible where they would pay $50 towards a hospital stay with my wife and I paying the difference.
I think you have that backwards since that wouldn't meet the current minimum value legally required hospital coverage. The $50 is more likely the copay, which is what you pay, not the limit of what the insurance will cover, since the insurance must cover at least 50-60% of the hospital bill, and 100% of it once your out-of-pocket limit is reached.
Is that piece of mind that maybe the place I need to go will accept the insurance? And, how much in debt would my wife and I be if we had to stay in the hospital for a few days?
Obamacare is not healthcare, it is not access to healthcare; it's a Ponzi scheme built on lies.
All insurers are required to cover any non-elective acute care hospitalizations, they can charge higher copays on out-of-network facilities. You can avoid that by choosing an open-network plan or choosing a plan that includes the hospital you would likely use in their network. If you don't want to potentially pay higher copays by using an out-of-network facility, don't choose that type of plan.
Specializes in Management, Med/Surg, Clinical Trainer.
That combination of numbers isn't really possible. Someone making minimum wage isn't going to pay $300 with a $10k deductible or anywhere close to that.
The price of coverage isn't actually income based, the amount of tax credits which help someone pay that price varies by income, so the amount someone is effectively paying changes by income up to a certain point (about 400% of poverty level).
There's no arguing that we spend a lot on healthcare, but we can't separate the amount our healthcare system costs and how much we pay into it through insurance and out-of-pocket costs; we can't all just pay less.
Or pay nothing at all. Sadly, there is a large learning curve that needs to be had by the public. People really need to understand that to grant more people access who potentially have not seen an MD in years and/or need a lot of care but who may pay a cheaper rate is not sustainable if everyone has cheap rates. Someone must foot the bill.
Libby1987
3,726 Posts
In California, FT at min wage qualifies you for a no deductible Anthem plan for $107/month, and a low deductible plan/low copay plan for $50/month. At $18,000/yr living with a couple of roommates in one of the many affordable areas of California (Central Valley) $50/mo is doable, right?