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How Obamacare Rates with Consumers One Year Later | The Fiscal Times
The Breier Family, Downers Grove, IL
Age: Dennis, 32, Kim, 31, and their four children (all under age 6)
Occupation: Dennis runs his own wealth management business; Kim is a stay-at-home mom.
Date signed up for Obamacare: 01/01/2014
Name of plan: BCBS PPO - Gold
Qualify for the subsidy? No
Monthly Premium: $1,171
Deductible: $3,500
The Breiers had great health coverage through Dennis's prior job at a bank, but he opened his own business in March last year while Kim was pregnant and needed an insurance plan to cover the pregnancy given her "pre-existing condition." With the pregnancy, a newborn on the way, and three young kids, the family visits the doctor frequently and therefore wanted a plan with a low deductible.
How He Chose His Plan: In addition to wealth management, Dennis is certified to sell health insurance, so he felt knowledgeable about the system and researched the plans online himself. He wanted a high-quality plan that would cover the many doctors his family visits, so he chose a PPO plan that kept their doctors in-network. Dennis makes just over the amount to qualify for the subsidy, so the plan was expensive. There was an HMO plan with a lower deductible, but he heard from friends that the HMO didn't cover as many doctors. “Because we have to be at the doctor a lot, we wanted one of the best plans, and this was essentially the best coverage we could get for the cost,” he says. He went directly to the BCBS website to sign up.
His Experience Using Medical Care So Far: His family has made about 15 to 20 visits to the doctor since signing up, and Dennis says they've had to dispute the bill almost every time over charges for things that should be covered. Then after two months of having the insurance and paying premiums, they received a notice that their insurance has been discontinued because the insurance company hadn't received any premium payments – their premium payments had been going to a different person's account.
Dennis and Kim had to make multiple phone calls and spent over 10 hours resolving the issue. In addition, when their son was born in March, they tried to add him to their policy and it took nearly four months for the paperwork to be processed. In July, they hired a health care agent to help them deal with their insurance company and things have been smoother since.
His Takeaway on Obamacare: “The insurance we had before Obamacare was far better than our new policy. The frustrating thing is it’s really expensive. You'd expect pretty good service for $1,100 a month, but the administrative work has been a nightmare. So much is slipping through the cracks. I’ve been with BCBS forever, but I will switch to a health savings account this year because of the tax deductions and the fact that our current premium is too high to continue.”
- See more at: How Obamacare Rates with Consumers One Year Later | The Fiscal Times
The Breier Family, Downers Grove, IL
Age: Dennis, 32, Kim, 31, and their four children (all under age 6)
Occupation: Dennis runs his own wealth management business; Kim is a stay-at-home mom.
Date signed up for Obamacare: 01/01/2014
Name of plan: BCBS PPO - Gold
Qualify for the subsidy? No
Monthly Premium: $1,171
Deductible: $3,500
The Breiers had great health coverage through Dennis's prior job at a bank, but he opened his own business in March last year while Kim was pregnant and needed an insurance plan to cover the pregnancy given her "pre-existing condition." With the pregnancy, a newborn on the way, and three young kids, the family visits the doctor frequently and therefore wanted a plan with a low deductible.
How He Chose His Plan: In addition to wealth management, Dennis is certified to sell health insurance, so he felt knowledgeable about the system and researched the plans online himself. He wanted a high-quality plan that would cover the many doctors his family visits, so he chose a PPO plan that kept their doctors in-network. Dennis makes just over the amount to qualify for the subsidy, so the plan was expensive. There was an HMO plan with a lower deductible, but he heard from friends that the HMO didn't cover as many doctors. “Because we have to be at the doctor a lot, we wanted one of the best plans, and this was essentially the best coverage we could get for the cost,” he says. He went directly to the BCBS website to sign up.
His Experience Using Medical Care So Far: His family has made about 15 to 20 visits to the doctor since signing up, and Dennis says they've had to dispute the bill almost every time over charges for things that should be covered. Then after two months of having the insurance and paying premiums, they received a notice that their insurance has been discontinued because the insurance company hadn't received any premium payments – their premium payments had been going to a different person's account.
Dennis and Kim had to make multiple phone calls and spent over 10 hours resolving the issue. In addition, when their son was born in March, they tried to add him to their policy and it took nearly four months for the paperwork to be processed. In July, they hired a health care agent to help them deal with their insurance company and things have been smoother since.
His Takeaway on Obamacare: “The insurance we had before Obamacare was far better than our new policy. The frustrating thing is it’s really expensive. You'd expect pretty good service for $1,100 a month, but the administrative work has been a nightmare. So much is slipping through the cracks. I’ve been with BCBS forever, but I will switch to a health savings account this year because of the tax deductions and the fact that our current premium is too high to continue.”
- See more at: How Obamacare Rates with Consumers One Year Later | The Fiscal Times