My Search For Affordable Healthcare
( 4UMF NEWS ) My Search For Affordable Healthcare:
On January 20th, 2009, the nation's first Black president put his left hand on the bible and was sworn in. Part of his campaign platform was to provide affordable healthcare for all American citizens. Shortly after taking office, President Obama immediately began working with Congress to come up with a near-impossible plan to insurance nearly 48 million uninsured Americans.
Despite strong opposition that threatened to permanently divide Congress, both sides finally agreed on a comprehensive bill. Fourteen months after taking the oath, President Obama signed the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010.
PPACA, commonly known as Obamacare, is the most significant piece of healthcare legislation introduced into law since Medicaid and Medicare over four decades ago. Obamacare's main goal is to reduce the number of uninsured Americas by providing subsidies, tax credits and mandates while simultaneously driving down the staggering cost of healthcare, which currently accounts for more than 17% of the nation’s Growth Domestic Product (GDP).
Additionally, it guarantees coverage to citizens with most pre-existing medical conditions at similar premium rates as other same-age applicants in their region. Those who choose to opt out of their employee-sponsored plans, Medicare, Medicaid or any other public health insurance programs and do not have their own coverage from a private provider will be forced to pay a penalty. Obamacare also requires small businesses with 50 employees or more who do not currently provide health insurance to help share some of the cost picked up by the government if their employees choose to take advantage of subsidies.
Instead of one huge pill for Americans to swallow, Obamacare has been rolled out in increments since becoming law. As the day for open enrollment slowly inched up, conservative Republican and Tea Party ‘activists’ in Washington brought the federal government to a screeching halt as a means of protest. While the two sides bicker back and forth while showing little signs of reaching a compromise, the uninsured and underinsured try to get their slice of the American dream in the form of adequate healthcare.
As a freelance journalist, I am afforded a lot of freedom. While there are benefits to creating your own schedule on any given day, the downfall is acquiring your own health insurance. As a member of a union of freelancers, medical coverage is offered to those looking to pay out of pocket into a system per month. Looking for coverage for just myself, here’s a breakdown of what type of coverage I receive for $345 per month:
$35 for primary office visits; $55 for specialist/ $15 for generic prescription drugs; $100 deductible for all other drugs
The dental offered works out to be $59.34 per month and that comes with a free dental check-up and cleaning every six months. Preventive services are completely covered and they’ll pick up the tab for 80% after $50 deductible. The plus is once you join, you can enroll in the Freelancer’s Medical program and visit their facility in downtown Brooklyn at no cost for any doctor's visits or services you have at the medical practice. However, the downside to that is it’s in downtown Brooklyn and unless you live in the area, which I don’t, it’s a hassle to bypass tons of doctors and medical practices trekking to Brooklyn.
Hoping to take advantage of Obamacare as part of my right as an American citizen, I decided to look for better coverage or at least more bang for my buck. My goal was trying to stay in the ballpark of $406. Of course the government shutdown affected operation of the website to enroll so while I watched commercials proclaiming this was the day affordable healthcare coverage was virtually guaranteed to all, it actually hadn’t come for me yet. Ten days after the open enrollment began and the ninth day of the government shutdown, I had a lot more luck accessing the site. As a resident of New York, I visited my state’s official health plan marketplace website. After registering as a new member, I filled in the necessary personal information about myself before I was presented with over 100 different options to choose from. My choices were packages ranged from bronze to platinum and started at a little over $300 and went up to well over a thousand dollars a month. I had 11 different insurers to choose from. Looking for a package that is relatively priced similar to the health insurance offered from the union but with more bells and whistles, I narrowed my choices down to Emblem Healthcare, Health Republic Insurance of New York and MetroPlus Health Plan, the affordable healthcare offered by the state of New York.
After comparing a dozen or so plans and I narrowed my choices down to a handful. Here’s the breakdown of my final options:
Health Republic Insurance of New York (Medical only) Bronze package: $307.12 per month/ 50% of all costs covered/ $10 for generic prescription drugs; $35 for brand name; $70 special *no vision
Emblem Healthcare (Medical only) Bronze package: $332.89 per month/ 50% all costs covered/ $10 for generic, $35 brand; $70 special * no vision
Metro Plus (Medical with Dental) Silver package: $374.42 per month/ $30 for primary doctor visit; $50 for special; $30 routine for dental visit; $30 for yearly eye exam/30% off prescription; $10 for generic, $35 brand; $70 special
Metro Plus (Medical with Dental) Silver package: $407.56 per month/ $30 for primary doctor visit; $50 for special; $30 routine for dental visit; $30 for yearly eye exam/30% off prescription; $10 for generic, $35 brand; $70 special
Metro Plus (Medical with Dental) Gold package: $412.79 per month three star rating $24 for primary office; $40 for dental;$25 for vision exam and pay 20% for prescriptions/ $10 for generic prescription drugs; $35 for name brand; $70 for special
While I like to think I have gold and platinum tastes, I decided to keep it real with myself and my wallet and I opted for the second silver package that offered a bit more options for emergency services. The biggest downfall of the health insurance offered by the union was hospital coverage was completely out of pocket. Annual visits to the doctors are important but it’s the accidents that happen out of the blue that will land you in the emergency room and a huge bill to stitch you back together that could really break a bank account.
Sidenote: I tried to apply for an exemption to see if I qualified for any help in obtaining the affordable healthcare that is causing such a ruckus in Congress but every time I clicked to apply, nothing happened. I’ll leave the conspiracy theories to you.
I chose what works best for me and my budget. While I do believe that affordable healthcare should be a natural-born right to every American citizen, it’s about time more affordable options are offered to the working and middle class and many Americans like me who are finding employment in less traditional outlets.
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