What Obamacare Did for Me

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In January I was kicked off my health insurance and forced to buy an Obamacare plan through my state’s health insurance exchange. Let me tell you about it.

My monthly premium is now $315. I am poor and struggle to pay this bill. In fact, the $1,500 I have paid so far this year would torture the poor working class people Obama promised to help. My premium on my old health insurance was roughly the same. I thought the whole idea of Obamacare was that if everyone bought health insurance then premiums would go down. Why, then, is an Obamacare plan still so expensive?

Here it is worth noting that what I pay is $315 a month, but my premium is officially $385 per month, lessened by a $70 per month “tax credit” that the government pays because I bought an Obamacare plan. I would not complain if Obama gave me poor coverage but at least paid my premiums for me (although when I say this I choose not to engage my readers in the lengthy debate about whether fully socialized medicine would be even more horrible than Obamacare). But $70 is little enough, compared to what I pay each month. So I am still getting price-gouged and I don’t get free health coverage, either — when free healthcare is what the liberals and socialists thought Obamacare would lead to.

If I catch a cold, my health insurance is useful. If I get seriously sick, I am totally screwed.

Obamacare is actually the worst of both worlds, because meanwhile, I’m not getting the quality of service that would have come from a true free-market product. For my $315 monthly premium, I get a plan that has a deductible of $3,000 for in-network hospitals and $6,000 for out-of-network doctors and out-of-network hospitals. (The deductible for in-network doctors is also $3,000, but it’s waived for in-network doctor’s office visits, which require only a $30 copay. But see below.)

Which poor people have $3,000 or $6,000 to spare? I certainly don't. If I catch a cold, my health insurance is useful. If I get seriously sick, I am totally screwed.

In the interests of fair and balanced journalism, I will tell you that I had a respiratory infection in March for which I saw a doctor and took an antibiotic, and I guess my doctor's bills and medicine costs would have been much higher if not for Obamacare. This does not alter the fact that I now live in chronic fear of getting very sick. Nor does it alter the fact that if I had saved up my $1,500 of premium payments instead of paying it I might have been able to bear the cost myself.

My plan is with Anthem Blue Cross, the biggest Obamacare provider nationwide. When I call them I am kept on hold for over an hour. This has happened a dozen times.

When I bought this plan the policy disclosures said the deductible was waived for visits to certain types of specialists, so in those cases I would be liable only for a $30 copay. I saw such a specialist in February and promptly sent in a claim. I heard nothing for a month, called to follow up, and was told they had lost it. I resubmitted the claim. They lost it again. I followed up yet again, and was told that because my specialist is out-of-network, the deductible was not waived. This is not what the plan had said. But it turned out not to matter, because they rejected the claim anyway, because of my doctor's bad handwriting on an Anthem form.

Anthem has told me that I may resubmit my claim for the February office visit, but the hassle of dealing with them has scared me away. And I hesitate to bother, anyway, because if the claim is allowed the only result may be $150 going toward a $6,000 deductible. At some point I may try to submit the claim a fourth time, but I don’t expect anything good to come of it.

This is a true story.

I tell this to my liberal mother and she says all insurers are greedy.

The plan was designed by Obama. But for political partisans, blame is always better to give than receive.




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Comments

Fred Mangels

I'm also on an Obamacare Anthem/Blue Cross plan. I went to my first doctor visit earlier this week. I'd called them some time earlier after hearing they accepted A/BC regular insurance, but not Obamacare. At the time they said they accepted and processed all A/BC plans the same way.

When I went in there on Monday, I was told they didn't even bother billing "Covered California" anymore and that I'd have to submit the claim myself. What happens after that is between me and A/BC. I sent in the claim form yesterday. I'm not expecting anything to come of it.

No surprise your mother blames the "greedy insurance companies". I'm hearing a lot of that here. Funny thing is, I'm getting the impression medical providers are generally accepting standard insurance policies. It's the Obamacare modified ones they're balking at.

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