Obamacare works!


This is my experience with Obamacare through the ConnectforHealthCo website. The registration process went smoothly. I created my account in 10 minutes.

There is no login on the home page, which is inconvenient (click on “Learn More” then “Shop Now” to log in). To qualify for financial assistance, click on “Do I Qualify” at the bottom of the login page. I answered a few questions, and my estimated premium assistance appeared. I had to complete a Medicaid application to qualify for the subsidy. This took 90 minutes. The application was denied in a minute. The process is time-consuming, but I still saved $7,817 in yearly premiums by signing up for Obamacare! Not bad for one-and-a-half hours work.

Here are my results. This is for a 61-year-old non-smoker with an income of about $20,000. I run 50-55 miles a week, am in excellent health, with no pre-existing conditions. It doesn’t matter. Whatever my health, only smoking would affect my premium.

I purchased a Silver Plan (silver plans pay 70 percent of medical expenses up to the deductible). Cost-sharing reduction (CSR) is available for some silver plans. After applying for the CSR, my deductible is $250, my maximum out-of-pocket cost is $1,200 per year, and my monthly premium is $116.01 ($1,392.12 yearly). There is a co-pay of $40 till I reach my maximum out-of-pocket cost.

Contrast that with my current Obamacare compliant private insurance plan: The deductible is $10,000 with a maximum out-of-pocket cost of $15,000. The monthly premium is $339.78, which works out to $4,077.36 per year. The co-pay varies from $75 to $200, depending on the procedure. The private plan pays 50 percent of expenses up to the deductible.

Now, I will save $2,685.24 on my yearly premium. My maximum out-of-pocket cost will be reduced by $13,800, and my deductible will be reduced by $9,750. My co-pays are reduced by $35 to $160.

There were other plans available. For a monthly premium of $28 ($336 yearly), I could purchase a Bronze Plan. Cost-sharing reductions are not available with bronze plans. Bronze plans pay 60 percent of medical expenses. The plan had a deductible of $6,300, maximum out-of-pocket cost of $6,300, and no co-pays. The website has a compare feature, making choosing between plans easy. A family of four, adults age 40, non-smokers earning $53,000 a year would pay $3,804 a year ($317 a month) after applying the subsidy. A 60-year-old couple, earning $25,000 a year would pay $1,129 a year ($94 a month) after applying the subsidy.

For a 27-year-old male, non-smoker, making $24,000 a year there are plans available for $216 a year. His penalty for not having insurance would be $240, so buying insured would cost less than paying the penalty. The real penalty would be not having insurance.

For the 5 percent of the insured facing cancellation because of Obamacare, I suggest reading your policy. These plans may contain exclusions for pre-existing conditions, cancellation at any time, yearly and lifetime caps, high deductibles, and few if any of the 10 essential health benefits required in Obamacare.

The essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental-health and substance-use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services, preventive and wellness services and chronic-disease management; and pediatric services, including oral and vision care.

The support staff at Connectforhealthco is superb. My wait times were from seconds to a few minutes.

The system had a glitch, which support was able to fix. They followed up with me later to be sure the login was working properly.

Though it wasn’t necessary, support called and helped me complete my purchase.

Do not purchase any plan without first completing and determining your federal subsidy and any applicable cost sharing reduction.

A plan purchased before applying the subsidy will result in your paying the full premium. You will receive the subsidy as a refund next year from the IRS after filing your 2014 tax return.

This truly is a Patient Protection and Affordable Care Act.

Contact Rep. Scott Tipton and tell him to stop being an ideologue. Tell him to support Obamacare.

It is past time to provide health care to all americans. Obamacare works.

Chip Tuthill lives with his wife Bernadette near his grandchildren. He is a Trustee for the town of Mancos. Reach him at chiptuthill@yahoo.com.

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