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The Patient Protection and Affordable Health Care Act

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The Patient Protection and Affordable Health Care Act

The Devil's in the details

I’m so sick of arguing about health care reform in the abstract. It’s time to get down to the devilish details, and, boy are they devilish! I propose to write a series of articles for the River Journal which documents the effects of the Affordable Care Act in Bonner County . 

What is actually happening? 

Will the act benefit me? How, exactly?

Will it hurt me? How, exactly?

Do I want it to be repealed?  Perhaps if we pay attention to the details, and talk to each other about what the act  is doing or not doing for us, we will come to have a better idea of what we want and what we don’t want. This, in turn, could actually help our legislators! What a concept!

I’ll start with some actual experience with my husband’s health insurance with Blue Shield of Idaho. As a result of the legislation he was offered (not required to take) a new policy. He took it.

(Thumbs Up) His health insurance premiums went down by $30/month. 

(Thumbs Down) His deductible went up a couple of thousand dollars. 

DEVILISH DETAIL: A deductible is  not the same thing as a co-pay for doctor’s office visits or for medication. That is, some policies will pay for doctor’s office visits or medications even if your deductible is not met! Get it? (In a future article I will explain out-of-pocket expenses, which are an entirely different animal.)

(Thumbs Up) Under his old policy, he had to pay the entire cost of doctor’s visits. When he had a herniated disk, the visit to the surgeon in Coeur D’Alene cost over $300 for fifteen minutes. The same visit now would cost $35.

(Thumbs Up) He also used to pay the whole bill for his yearly check-up. Result: the only way he would go was if he was nagged. Now the visit is free, and so are some of the standard tests for preventive visits: like colon cancer screenings, screening for vitamin deficiencies during pregnancy, diabetes, high cholesterol, high blood pressure, and tobacco cessation counseling.

(Thumbs Up) He recently filled a generic prescription and found that under the new policy it was free.

BOTTOM LINE: We will save at least $1,000 a year on office visits, premiums and prescriptions. In two years we will have made up the difference in the deductible. If we don’t get seriously ill, we come out ahead. Hopefully having preventive check ups and tests will help us achieve this goal. If we get seriously ill, we are still protected from losing our home.

If you would like me to continue this series, have a question or a suggestion for me, or would like to contribute your own devilish detail, please contact me at: [email protected]

Nancy Gerth is a health researcher and grant writer, and is a consultant on Alzheimer’s care.


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Nancy Gerth is a freelance writer

Tagged as:

health care, insurance, health care reform, deductible, coverage, Blue Shield

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