Financial assistance helped this 63-year-old find coverage she can afford.
Elsie Brown of Detroit spent nearly 30 years of her life working hard, but when she was laid off she lost her health insurance. After her COBRA ran out, she went nearly two years without health insurance — a risky proposition for someone with high blood pressure and diabetes, both of which require ongoing care to prevent complications like stroke or vision loss.
“Without insurance, it was $100 just to see the doctor,” she says. “There were times I skipped going to the doctor, and even if I went I wouldn’t have blood work.” For people with diabetes, routine blood testing is essential.
Brown admits she was a little skeptical about the Affordable Care Act (ACA) at first. After all, there was plenty of negative press about the ACA, or Obamacare, when the Healthcare.gov marketplace had its rocky rollout. The site is working smoothly now, but instead of waiting Brown worked with a phone representative.
He quoted her a few different plans and explained her options, and Brown chose a Silver plan with a monthly premium in the $400 range. But because her Social Security income is only $1,600 a month, Brown qualified for tax subsidies that brought her premium payment down to 22 cents a month.
I have peace of mind, knowing it’s there if I need it. I wanted insurance. I’m trying to stay in good health — at least get an annual check-up, which is free now. I used to have to go to health fairs to get my blood pressure checked, but now I can see my doctor. I have the peace of mind knowing I have that little card.
Brown’s plan pays 70 percent of her annual healthcare costs, with a combined annual deductible for care and prescriptions of $6,100. There’s a $6,300 out-of-pocket maximum, which means that’s the most she ever has to pay in a year beyond her deductible. There’s no charge for in-network preventive care and screenings, or for the first $500 worth of lab work.
Plus, she was able to get in to see a doctor the day after she called for an appointment. Access to a doctor for routine care is key to living well with her chronic conditions.
“I’m going to the doctor next week, and I’m going to lose weight and be healthier so I can stop taking my diabetes pills,” Brown says. “It’s going to be a good year.”
Many Americans still don’t know they may be eligible for financial assistance. If you haven’t looked into getting coverage through Healthcare.gov, there’s no time to waste. Open enrollment for 2014 ends on March 31.
If you’re interested in volunteering to help people learn about their coverage and financial assistance options, Get Covered America is hosting Community Summits on Sat., Feb. 22 and Sun., Feb. 23. You’ll receive training to help you help the uninsured get covered before the deadline. Learn more and RSVP HERE. Have other questions about the ACA? Visit the Get Covered America website.
[Photo courtesy of Elsie Brown.]
