Do you have health insurance? If you do not, you can get it through the Affordable Care Act.

NOTE: Open Enrollment Ends March 31

Since insurance companies can no longer deny coverage for preexisting conditions, or other reasons like age and weight, anyone can buy a policy. I live in California and we have a great state exchange called Covered California. One needs to run the numbers to see which policy makes the best sense. One can get premium support based on income. Even if you do not qualify for premium support, or do not wish to accept this support, you can get covered. Very low income earner can get coverage through Medicaid.

A Platinum Blue Shield Plan, without premium support, would cost around $1,000 a month. With premium support this plan costs $510 a month for an individual making $28,000 a year. A family with 3 individuals, two adults and one child, could have a yearly income of $65,000 with similar price. Check to see if your current health care providers accept insurance policy from whatever company you choose. Most of the companies had similar plan costs.

I went with Blue Shield only because I was sure that it was accepted by my health care providers, the San Jose Medical Group. As it turned out, they also accept many of the other insurance companies too.

Here is summary of the benefits for a Platinum level policy.



These numbers are approximate. Without any premium support, these policies would have cost around:

• Bronze: $500
• Silver: $625
• Gold: $760
• Platinum: $1000

Depending upon the individual's income, these prices drop dramatically. Pricing also varies on state and location.

Covered California has a handy calculator that gives an estimate. There are only a few thing you need to enter, one of them being a Zip Code. Since it is California, you can use 95126. The results will give prices for policies with and without premium support. There results also show the various policy and company options. This calculator is quick and easy and will give you an idea of the cost.

https://www.coveredca.com/shopandcompare/#calculator

Even if your state does not have an exchange, you can get coverage from the federal Web site:

https://www.healthcare.gov/

If your state government is in favor of the Affordable Care Act, the process is much easier and you may have more policy and company options.

Before deciding on a company you can check to see if your current health providers accept that particular company's policy.

NOTE: Open Enrollment Ends March 31

-Mark-

Just a quick question - did you mean for one of the medicade options to be medicare? I know quite a few of us are on medicare. Thanks.

I receive health insurance through my husband's employer.

Abby

Yes I did. My error was fixed by the forum administrators. Thanks to them.

I really want to make sure that anyone who does not have coverage knows they have the option of getting coverage, but the clock is ticking. Open enrollment for this cycle ends March 31. Getting healthcare insurance coverage has take a burden off of my shoulders.

There is a lot of disinformation floating around out there. I sent the following to the owner and manager of the taxicab company that employees me. When I was younger, I worked for his parents who owned the company at the time. I have known him for 35 years. I know in his heart of hearts he does have my best interest at heart, but he is a very conservative individual and does not like government intervention.

We exchange Email regularly, often hurdling friendly jabs at each other's particular political points of view, he the conservative and me the liberal. When I secured a policy through the Affordable Care Act, I sent him the following:

I’m really grateful that I can buy health insurance now. Beginning January my neurologist prescribe another drug. I am now up to 8 different prescriptions a day totaling $800 a month. My co-pay for all 8 prescriptions is $60 a month. The only reason the one drug is so expensive is that it is only offered by one company (no generic alternative) and it is rarely prescribed. He also prescribed a steroid, so to add insult to injury, I have to give up my dream of playing professional baseball.

I thought that he would be very happy for me, but here was his response:

My neighbor became a real estate agent about 10-years ago. He has struggled over the past few years… He, his wife and their 12-year old daughter had their policy cancelled as it was not an OBC qualified policy. (Remember, "if you like your plan, you can keep your plan"--- Lie!) They went on line to CCA and get the best price of 3X their last policy. So, if you see them, please thank them for paying for your medical and prescription costs!

Most stories like this are bunk. It is absurd on the face of it. So I did a bit or research and replied to him with the following:

What was the specific reason that their policy was canceled? How much were they paying and for what? I ran the numbers at CCA using the following data.

• 2 Adults age 45

• 1 Child under 18

• Yearly Income $65,000

Here were the results to cover all three for Blue Shield, accepted almost everywhere. If the family monthly income is lower, these prices would go down a bit. If the monthly income was higher, the cost world go up a bit. If the parents are much older, the prices would go up a bit.

• Bronze Monthly Premium: $370

• Silver Monthly Premium: $550

• Gold Monthly Premium: $730

• Platinum Monthly Premium: $903

Here is the calculator to check various pricing:

https://www.coveredca.com/shopandcompare/#calculator

One has to evaluate the their needs to chose which level policy is best for them. For me it was the Platinum policy. I am paying $510 a month for one person. If my treatment goes well, and if nothing really bad happens over the next two years, I will be paying $6,000 more than I will use. Without this coverage, I would have eventually ended up at VMC sometime over the next two years, and everybody would be paying for that.

I will include a screen shot of the benefits for the Gold Policy:

I know he was trying to sell me a load of "bunk" (we have a more technical term for the word "bunk" in the cab world, but decorum prevents me from using it in polite company). I would have loved to call him on this "bunk" directly, but from past history I found it best not to tell your boss that he is full of "bunk," but I will save that story for another day.

If, in fact, his real estate agent friend was paying 1/3 of the above mentioned costs to cover his family, it could not have been much of a policy.

BTW, I never did hear back from him on this topic after my response; this is his usual method of operation when I win an argument.

-Mark-

I put together the following examples of the costs and benefits of health insurance under the new laws. I selected Blue Shield, but there are many other companies from which to choose. For some reason the Blue Shield prices were a bit less that some of the other providers. The table was assembled with data from Covered California, our state exchange.

The first table shows the results for an individual policy for a 35-year old. It shows the cost without premium support, and it shows prices with premium support at the $35,000, $22,000, and $18,000 income levels.

The second table shows the results for a family of four with two 50-year old parents and with 2 under 18-year olds. It shows the cost without premium support, and it shows prices with premium support at the $65,000, $50,000, and $35,000 family income levels.

I included screen captures showing the health plan benefits at the Bronze, Silver, Gold, Platinum policy levels.

Open Enrollment Ends March 31st for this cycle. If you do not have health insurance this is a great opportunity to get it. You cannot be denied for any reason, not age, gender, or for having preexisting conditions. Also share this link with any uninsured persons you may know.

Check to see if your state has an exchange. If your state does not have an exchange, you can use the Federal Exchange:

https://www.healthcare.gov/

This link leads to Covered California, the California Exchange:

https://www.coveredca.com/

Personal Note: I got a Blue Shield Platinum Plan that went into force in January. I am paying $510 for this policy at the advanced age of 59. Without premium support, the Platinum Plan would have cost $1,000.

Beginning in the summer of 2012, I was a self-paying patient at the San Jose Medical Group. In November 2013 my neurologist prescribed 180 mg Mestinon Timespan tablets, having only been diagnoised with Myasthenia Gravis a few weeks earlier. The cost for 30 tablets was $240. I could not afford them at the time, so I passed on them, using only the Pyridostignine tablets, and muddled through the holiday season. Since I now have health insurance, I paid $25 for the Mestinon Timespan in January 2014.

My primary care doctor order a second CT scan to look more closely at my abdominal region. He thinks he sees a mass on my liver from my January 2014 chest CT scan. Instead of telling him I would need to wait until I saved the money to pay for it ($500 for a self-paying patient in advance), I simply scheduled it and had it done on Tuesday. My cost for the second CT scan is $125, billed later by Blue Shield. My doctor wanted to do a colonoscopy in November 2012, but I could not afford the $1,200 price. I will have the colonoscopy in February 2014, and if I am not mistaken, there is no change for it. If there is, I can now afford it because I have health insurance. For me, it is a new world. I now have more control over my life.

Self-paying patient are required to make payment before treatment, including blood tests, visits to the doctor, and for scans and X-Rays. Whenever I would visit my doctor, I needed to offer up a $150 deposit, cash or credit card. If the cost of the visit was less, I would get a refund on the deposit. If the cost was more, they would bill me later. A typical primary care doctor charge was $95 for a self-paying patient. A visit to the neurologist cost $250 in advance.

My life's goal before the Affordable Care Act was to survive until I could get Medicare. With Myasthenia Gravis, and the lack of health insurance or the money to pay for proper treatment myself, it might have been a difficult goal to reach. Somewhere along the line I would have ended up in a county hospital. I came close to it in September 2013 when I had sever Myasthenia Gravis symptoms. I think we all knows what that would have meant for the taxpayers.

In the ten years before the Affordable Car Act, I applied several time for health insurance, and was turned down every time. I had seen a chiropractor in the late 1990s due to back pain cause by poor posture sitting at my desk. My chiropractor taught me how to sit, and straightened my spine. The pain went away after ten adjustments, and it never returned. But there was a paper trail, and I felt obligated to include the history of back pain in the applications when asked. If I had lied, they would found out and deny any claim for preexisting conditions. This was the "good reason" to deny my applications. I believe the "real reason" was my 275-pound weight at the time. Had they sold me a policy in 2004 when I first applied, I would paid into the system without using it until the summer of 2012 when I sought out medical treatment, for what I know now is Myasthenia Gravis.