I know that people have very strong
feelings on the ACA (which BTW, Is its name it's not "Obamacare").
For me, and many people I know, it's the best thing since sliced bread. Why?
Because we have Multiple Sclerosis (I also now have/had Cancer) and health insurers
don't like us.
This means before ACA if we lost our job
or became unable to work (raising hand - that pesky cancer thing) and we did
not have a spouse that had health insurance we were SOL. For those of you who
do not know acronyms that means Shit Out of Luck. I want to address some
questions people have asked me how ACA affects me and why I like it.
Question 1
"What about Medicare? If you have MS
you should get disability."
This makes me laugh a 'lot'. It's very
hard to get disability with MS. You have to jump through a lot of hoops to
prove you cannot work and even if you have support for your disability by way
of a Neurologist, Neuropsychologist, Physical Therapist, and an Occupational
Therapist, they can (and will) still deny you (raising hand). To be fair, in my
case my Cancer was mistaken for a worsening of MS but it was still
denied.
The other little bit of info that people
don't understand is that you have a two year waiting period after you are
approved for disability before you can qualify for Medicare. So, that is at
least two years with no medical coverage. What about Medicaid you ask? You have
to be destitute to qualify for Medicaid. Now, when I say you have to have NO
MONEY I mean you have to have NO MONEY. I was hospitalized for Cancer, approved
for emergency disability, and was getting 960 a month from SS and I ladies and
gentlemen did not qualify for Medicaid. Let that sink in.
I am lucky I was working until I got sick
and had money put aside for COBRA. Without COBRA I would be dead right now. No blog,
no talking about ACA just dead from cancer.
Question 2
"Well, it's going to be too
expensive. How are you going to pay for it?"
They have policies that range from 90 a
month to 400 a month depending on what you need. If you're healthy, never see a
doctor, and you're comfortable with a lower level of coverage go for the
cheapest one. I however, have a chronic disease.
Using my medication for an example -
Without insurance it would cost me $4600/month to purchase Copaxone without
insurance. That's just my MS medication. My cancer treatments were 12,000.00
each treatment I had 150 treatments at a bare minimum, not to mention my six
week hospitalization and the oral chemo (which was 900/script x 6
prescriptions) that I had to buy.
Would it be worth it to me to pay 400
dollars a month for insurance? You bet.
Question 3
"I don't want to cover stuff I don't
need like maternity care. I'm a guy, why should I pay for that?"
I like how it's always the guys who say
this. I never see a woman saying "I don't want to pay for Viagra and
Prostate Cancer!" even though we do pay for it. That is how insurance
works. We always pay for a base coverage that covers the basics of the plan
such as maternity care and prostate cancer. This has always been the state of
insurance. Why is it now an issue?
Question (really a statement) 4
Well you're different.
No I'm not. I personally know hundreds of
people with MS who would be in the same situation as me if something happened
to them, their spouse, or their financial situation.
Question (or another statement) 5
No one will take that! My doctor doesn't
take ACA.
Well ACA isn't insurance but Blue Cross
Blue Shield is, and that's what I have. Some individuals seem to be under the
misconception that ACA is its own separate health insurance. That is simply not
true. Do a search on the plan you choose (BCBS, Humana Aetna) to make sure your
doctor/medication is covered before you buy it. It's pretty simple and is what
I did.
I hope this little blog helped someone out
there understand ACA a little better.
I am with you on the improvements for those of us with disabilities who could not get insurance before. However, on the flip side, in my state (Texas) they did not extend medicaid benefits for for young males, or those who have little to no income. My son is 21 and I dropped him from my medical insurance because I naively thought that he would get affordable coverage. No so in Texas, the cheapest plan is 93 a month, with a 6000 deductible. The sad part is that this was not disclosed before my insurance required my renewal, otherwise, I would have kept him on my insurance, as that is the suggestion made by the AHA. You can remain on your parents insurance until you are 26.
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