The Obama Diary

I’m not sure where to begin…so let me go back to a little over three years ago when I had to begin the process of purchasing health care on the individual market.

I was no longer able to stay on my parents plan and my COBRA coverage had run out from my previous employer (somewhat ironically selling Healthcare/Life insurance) and thus began an exhaustive search for an affordable option.

I had several pre-existing conditions due to basketball/tennis related injuries that required several surgeries and had moved backed to Indianapolis to help my father recover from serious heart problems. The job market wasn’t great at the time so I figured I would work part-time and go back to school.

After finally settling on what I thought would be the kind of coverage ideal for me, I purchased a plan from Anthem Blue Cross/Blue Shield. They are the largest insurance provider in the state and had a decent plan that fit my needs. It was called the Lumina 2500.

The plan was pretty cheap (139/month) considering it was on the individual market. The crux of the plan was I would have no co-pay for doctor visits/ER/pharmacy, but I had to pay the negotiated price between the provider/insurance companies in full.

For example: If I got sick and went to the family physician and the bill was ~ $200 I would end up paying $80, if the medicine was ~ $60 I would pay ~ 25 depending of if there was a generic available (the ~ $85 total all of went toward my deductible of $2500 which was also the maximum out-of-pocket for the year).

This plan worked for me because I knew no matter what happened in a given year I would never have more $4000 in expenses (including my premium). I only got one major cold during the three following years so I thought this was great. ABBS did jack my rate up ~20% every year (2014 premium was $180) but I could live with that since the Affordable Care Act would be available shortly.

To my chagrin, Gov. Pence did not set up a state exchange last year and also didn’t expand Medicaid.

At the end of 2013 I decided to go to school full-time in the hopes to get into a radiology program. At the same time I was hoping to find a better option on the national healthcare marketplace once it was rolled out. I came to find out that Anthem dominated the insurance market here in the state of Indiana (they were essentially the only company that joined the marketplace that had good in-network providers)….. the kicker was being a pseudo monopoly all their comparable plans were actually closer to $400/month. Since I didn’t have enough taxable income, I also didn’t qualify for any subsidies so I was stuck with my current plan & the expectation of a rate hike ever year…. or so I thought.

Around early Nov. 2014, Anthem announced that it was discontinuing my insurance plan and I had to find another one through them or another insurance company. The insurance commissioner of our state was one of only two in the country (according to Anthem, Connecticut was the other) that were not extending the grandfather clause of allowing you to keep your insurance plan if you liked it.

Continue reading ‘What the Affordable Care Act means to me…. coverage for $1/month!’