In Search of Healthcare

photo credit: apple's eyes studio

photo credit: apple’s eyes studio

This post was put aside because of the excitement of last week with the terrible explosion and the craziness of the media that followed but finally, here’s how we faired with the ACA aka Obamacare!

Post starts here:

So the time is drawing near folks, if you don’t have yourself all locked into some sort of healthcare then the men in black suits are coming to your door to take you away…Ha, not really but because of the law passed, like it or not, The Affordable healthcare Act requires everyone to buy some sort of health insurance coverage. I kinda hate that but there it is…

Since living in the US we have honestly only had healthcare coverage for one 12 mth period in 8 1/2 years. While not covered, we’ve had 2 emergencies and about 6 doctors visits, so it’s not like we are healthcare hogs or a drain on any social system. I totally understand the need for cover in emergency situations where hospital stays are required. The cost can ruin you but it’s still a flawed system because those insurance companies that you pay chose what they’l cover and how much they’ll cover and so it becomes your insurance provider and not your physician who ultimately decides your care… um wait. what?

I could talk for hours about the inequality, the lobbyists for the Pharmaceautical and health insurance giants and how they are all only in it for the money and not a healthy society. I could go on about how this system isn’t a fix and in fact by accepting this model, America will never, ever get a single payer system. But it could so easily be attained. If everyone was taxed 1% of their gross income then it would be funded. The rich would pay proportionately and the poor would be covered. If you want cosmetic or non emergency treatment then you buy extra coverage. It’s how most of the free world does it. There are no death panels, there is no denial of care . If you have a heart attack or cancer or delivery your baby you are covered because you have contributed your part in your taxes. The Government would have huge buying power and the healthcare companies would have to give better rates. See fixed…. it’s gonna be great in my Utopia….

But in the meantime if you haven’t already then you will need to jump through the hoops that require you to get covered before the end of this month. And that my friends is going to require a lot of coffee, booze and patience. It’s a jungle out there.  You go to site and begin by selecting your state. Well I’ve seen the tv ads and I just went straight to the New York marketplace. Made sense to me. I was half way through their arduous signing up when I needed assistance from the King, well he got the shits because this was my job and blah blah and what the hell am I doing on this I should be on… so I went because he put self doubt into me… I went to select my state and it wasn’t even there! The computer knew I had already done the right thing and refused to let me do it again. So the system has some intelligence. You can go to but it will direct you to each state’s market place because each state has different providers and different rates and that makes sense! Amazing. So after I said I was right (sometimes I can’t help myself,  he pissed me off! ) we continued on but the sign up is cumbersome, it crashed at one point , you can’t go back and change stuff when you realise what they’re asking isn’t what you thought they were asking, that’s kinda dumb.

I finally got through to the part where you can select plan, now here’s where it gets even more frustrating. According to the calculations, the children qualify for Child Health Plus, which is a program that covers everything for a reasonably low monthly fee per child but that means you can’t have a family policy. Which to begin with we thought was kinda stupid and so I had to search separately for family plans outside the Marketplace … because you know, research. I found plans but they were hideous and along the way I had to learn terms like copay and HMO  EPO and PPO and I don’t fucking know. Oh and deductible! That’s the one that really makes us laugh at this whole fucked up system…. so you pay thousands of dollar a year for insurance but if you get sick or injured, you have to pay the deductible before the insurance company will even begin to pay your medical bills so what exactly is the point again? Some of the reasonably priced policies had deductibles as high as 12,000, yes that’s 3 zeros! Unbelievable! For a family like us who don’t go to doctors or take regular prescription medicine that makes NO SENSE AT ALL. It’s a total waste of money and fuck wasting money right?

I am not ashamed to say we called in reinforcements on this one! Thanks Dan

So after extensive searching, I went back and looked at the market place for a ‘couples’ policy. The kids really are covered well on Child Health Plus. We don’t need any bells and whistles, we really only need coverage for emergencies and accidents but finding the right thing is so difficult and then once you do, you have to find out if the doctor you occasionally use is on it, which by the way they’re not, neither ours nor the kids’ but seriously the amount of times we go we’ll just pay and keep the insurance for broken arms and split chins because, for serious, if I get hit by a CITY bus then the City is paying every fucking cent of my care!

The wrap up? We have healthcare, which we don’t actually feel we need but it’s now the law so what are ya gonna do. Two separate policies, but combined they are the best over all value with services that work for us… AND a surprisingly low deductible on ours. It’s a totally painful process taking hours of searching, making decisions and phone calls so get to it kids, there’s not much time left.



Comments 10

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      We are about to pay a fortune every month that we really don’t need! It’s so stupid. We’ve spent less that $5000 on healthcare in 8 years and that includes 2 trips to the ER with Miss Gremlin.

  1. The whole cost of care is screwed up. Don’t get me started on it either.

    I got an EOB a few days ago for $6K for a pee test because I have to take medicine for chronic pain. My jaw hit the floor when I saw the EOB and shook my head. Its stuff like this that companies can get away with just because they can.

    I am thankful I have health coverage because I have major medical issues. You guys are lucky that you don’t get sick every often.

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  2. The current British government appears to be trying to send us down this route. There are a lot of problems with the NHS but your post makes it sound a lot better than this alternative.

  3. Fuck. Ugh. Fuck. That’s been me this whole time. My husband’s company offers healthcare for our family, at the cheap rate of 1,400 a month. Yes, 1,400. There is a special place in hell for everyone involved in making a TEACHER that works at a NON-PROFIT for special needs students pay that to cover his family! Like you, I had to take the cheaper route, and ended up with a 11,000 deductible so I could keep food on the table. Why are we not living in OZ?

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