Scurrying down the Obamacare rabbit holeBlog added by Jim Katzaman on March 25, 2014
James Katzaman

Jim Katzaman

Glen Burnie, MD

Joined: February 10, 2014

In the final days leading up to the deadline to sign up for new health insurance plans, the Patient Protection and Affordable Care Act (PPACA) created its own version of March Madness. This was especially true for people who thought their coverage was OK with the new federal guidelines.

My rude awakening came when my wife told me her girlfriend — and one of my clients — had gotten a letter from her health insurer stating that her plan was not compliant with PPACA and was no longer offered. She received the letter in early March. Her coverage would end March 31. I thought all such letters would have been sent by late 2013, giving clients and agents time to assess the situation without hasty judgments.

Such is not the case in the brave new world of government-directed health care. It was time for an impromptu meeting to shop on my health care portal. Coincidentally, this was Selection Sunday, bringing new meaning to the day the NCAA never intended.

At first glance, my client’s old insurance seemed perfectly reasonable. She had paid $127 per month for a plan with a $2,500 deductible. There was a $30 co-pay for primary care visits. Being healthy, single and 40 years old with grown children, she visits her doctor twice a year for checkups. Being neither a Cadillac nor a Pinto, her health insurance best suited her needs and budget.

As far as I could tell from the insurer’s letter, the only thing not compliant about her old plan was that the company no longer offers it. So a-shopping we did go.

On the insurance portal we entered her ZIP code, gender, birth date and range of preferred premiums: $100 to $199. The first and only choice was a HSA-eligible bronze plan with a $6,000 deductible and $6,000 maximum in out-of-pocket expenses for the year. There was no co-pay. The premium was $146 — or $19 more than her old premium. No, she did not qualify for a government subsidy.

When we unchecked the premium range preference, more than a half dozen possibilities popped up — all more costly than the first proposal. The cheapest silver plan was exactly $100 more than her prior premium. She opted for the original bronze plan and submitted her application.

For $19 per month more, she would have health insurance with more than double her original deductible and no co-pay. This, according to PPACA guidelines, is more affordable than her old plan. By the way, the company with the winning offer is the same insurer who kicked her out because her original plan was not compliant.

And I thought Alice in Wonderland was a children’s book.
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