Today, Nov 15, I received notice from Anthem Blue Cross that my policy is cancelled as of Jan 1, 2014. 6 weeks, thanks Blue Cross! It's not a "junk" policy in any regard, and there was no specific reason given for its cancellation other than the possible ACA requirement on pre-existing conditions … that seems like all it took. The letter directs me to find a new policy on the Covered CA exchange.

This cancellation letter really is just a motivational letter, I was planning to shop the exchange anyway. But now I've got a looming deadline. Procrastination is a pre-existing condition.

I looked briefly on the Covered CA website to see a wide range of options. The Healthcare.gov and Covered CA were wicked fast …. what's the problem? I'll see if it continues this way as I complete the enrollment process.

I just got off the phone with my doctor's office to confirm that they will accept the various PPO's from the exchange …. they will. I can keep my doctor … he's part of a "365 membership" or conciege service that has an annual fee but has proven to be worth every cent. My wife can keep her doctor too.

So, this weekend my wife and I will shop on the CA Covered exchange and compare avaliable policies for the two of us and our 19-year old daughter. California seems to be a leader nationally in competent ACA implementation, so hopefully there will be a positive experience and maybe even a better policy to be found.

I will follow up here in the next several days to discuss what I find.

<yikes!>

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This is going to be a real and believable exercise for the folks here to watch, including me. Sorry you have to go through it, but I hope the results are positive for you and in reasonable time.


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Wait, there's more!

My sister-in-law (recently single, 50, unemployed) has asked for our help with ACA enrollment because computers are not her friend. I suspect she's going to find total coverage under Medicaid. She hates Obama …. but I bet that'll change quickly. We've scheduled Sunday brunch to see what works for her on Covered CA.

Yesterday I sat in on an AARP webinar to learn about the improvements to Medicare that the ACA has delivered. Pretty good stuff. I'm waiting a few more weeks to go to healthcare.gov to shop a plan for my daughter. Ohio didn't set up a state exchange, so we have to fly the mothership. But Guv K-sucks did opt in for the Medicaid expansion in Ohio, and just for ya-yas I may see if she qualifies. That goes into effect Dec 9.

Yeah, I'm hearing really good things about California and basically most of the states that actually have tried to make the ACA work. Unfortunately, Virginia is not so enlightened and has neither a state-sponsored exchange nor expanded Medicare (although McCauliffe ran on Medicare expansion, so we'll see if that changes any), so my experience has been solely with healthcare.gov …

I actually managed to create an account on day 1, although that account seems to have been borked from the get-go: I was never able to actually sign-in with it. So I waited a couple weeks for things to shake-out and was able to create another account and get to the actual insurance offerings. At this moment, healthcare.gov is working flawlessly for me.

The downside is that all of the least-expensive offerings are about $80/month more expensive than what I have right now -- I make too much $$ to qualify for any subsidies, so I have to pay full-boat. What I have right now I would classify as catastrophic coverage (i.e. high deductible, few benefits -- basically intended to keep everyone from going bankrupt if something terrible happens, but beyond that very few bells and whistles). The new offerings are undeniably more comprehensive (I'll get tremendous value from the maternity provisions =P) but there doesn't seem to be an equivalent tier available to me (apparently catastrophic coverage is only offered to those under 30) …

So it looks like I'll probably be paying more -- and getting more (even though I don't necessarily want more), which I guess is probably a good thing in the long run. But if this is my contribution for people not having to use the Emergency Room for colds and stuff, I'm willing to foot that extra bill …

If it turns-out that I'm just paying more for the same-ol' same-ol', though, I'll be pretty disappointed ...

FYI, about 7 weeks ago I had a trip to urgent care which led to a diagnostic ultrasound. (Blue Cross Anthem paid most, but I later got billed for about $300 for the complete visit.) Urgent care physician sent me to the emergency room with ultrasound results in hand thinking I need to be admitted … at the ER they asked why I was sent there, a doctor talked with me for 5 minutes and wrote me a perscription, a nurse came out and gave me a single injection. I was in and out in 30 minutes. Total ER hospital bill was $4600, Blue Cross Anthem paid all but $1800. Pissed me off big time but realized it probably saved my life. Blue Cross was not interested in looking into it further, that's how the system rolls. They paid $2800 for 5 minutes of the doctor's time and a single injection (which I continued with for a week and cost $16 each at the pharmacy.) This is why the system is broken. I got the experience first hand.

Current policy had gradually declined in benefits and I had previously accepted a higher deductible to keep premiums about the same. That decision has now come back to kick my @ss.

After that incident I became a patient of a great doctor, highly recommended and I know why. So now that I need him I find myself current in the political debate … because I want to keep him. So this is a very strong consideration in finding a new policy.


Step One : comparing plans on the exchange.

Spent a total of 20 minutes on CoveredCA website looking through 22 competing plans that my family of 3 qualified for. Range was from a Blue Cross Anthem Bronze at $258/mo to a Kaiser platinum at $1014. Yes, for $258/mo I can insure my family with a maximum out of pocket of $6350. I believe this means if I'm hospitalized for a week that's the most it's going to cost that includes the deductible. Wow.

After the first run through, we chose a Blue Sheild policy at $455/mo with no deductible. It compared exactly with Blue Cross Anthem plan at $567/mo. These rates reflect a premium assistance of $696! Thank you Federal Government. Will dig further into the details of the competing plans and confirm our local doctor, labs & hospital all accept the insurance policy.

From first appearances this could save us about $250/mo. in premiums with the higher plan. No deductible, unlimited lab work and doctors visits at $45 copay. X-ray and imaging at $65 co pay. Perscriptions at $19 copay. This is going to save us a lot.

I. Am. Impressed.

Now, on to the application process.

Saw a comparison the other day that shocked me but not too much..

In Texas and I hope other places, they have these 24 hr Urgent care clinics... you know the ones you go to late at night or on weekends when your regular MD is off. We've all heard those with NO insurance always go to the ER since they can't deny you like a regular Doc or these 24 Hr clinics can. AND we all pay for those "unpaid" visits of the uninsured.

Well the average cost even in the 24 hr Urgent care clinics is about $150 ! FOR the SAME treatment in an ER it can vary from $600 -1200 or 4 to 8 X more !! NOW you'd think even a moron would figure if we can get all covered it'd greatly reduce costs for ALL... AND the ER could be for real Emergencies, not mega expensive cold and flu clinics.

I don't know the numbers, so I'll say that up front. But add up the money we spend for health insurance. Add it up--start with the money that companies pay to cover their employees, plus whatever monthly payment the employees must make. Add deductibles. Add the cost of emergency room treatments. Add the cost of Medicaid. Add the cost of not allowing Medicare and Medicaid to negotiate lower costs for drugs. Add the indirect costs of people whose bad health leads to days not at work or lower productivity. Add the profit that insurance companies must make because they're in it for the profit not for the service. Put it all together and how in the name of arithmetic is it possible that we don't spend enough to run a single-payer health system. The dumbest thing that Obama did was to pass on single-payer.

Unfortunately, at that time, SP had as much chance of passing as a snowball in Hell. But it could be said that the screw-ups and half-assed "fixes" may open the door to SP in a couple of years. Especially if Dems regain the House and retain the Senate and WH.

R U OK?