BREAKING NEWS

BREAKING NEWS

My medical insurance odyssey

This letter is purely informational and is not attempting to focus on any person, organization or government program. Its sole purpose is to let readers know (via my situation) about the current cost and complexities of acquiring medical insurance.

When working full time, I was paying $126 per month for a high-deductible medical insurance plan (through my employer), for myself, wife and daughter. Obviously I was paying only a portion of the actual cost and my employer was paying the balance.

In July of this year, I moved from full-time employee status to 8-hours-per-week. Because I started working less than the minimum required number of hours per week, I was no longer eligible for employer subsidized medical insurance. However, due to a federal government act called COBRA, I would be allowed to keep my existing medical insurance coverage for up to the following 18 months. Under the COBRA option, my same qualified high deductible medical insurance plan would cost me $1,515 per month. Due to this much higher cost, I declined the insurance.

So I decided to search the open market for medical insurance. In a relatively short period of time, I found a roughly benefit-equivalent, high-deductible medical insurance plan, for $748 per month. After about three weeks of filling out applications, completing medical history forms and signing medical information release forms, I was ready to pay my first month’s premium. A few days later, I received an email that my medical insurance coverage application was denied because I had a pre-existing medical condition. This was due to a medical issue which I had five years ago. Obviously this medical insurance policy was not Affordable Care Act (Obamacare) compliant. There is a misnomer about all medical insurance having to be Affordable Care Act compliant. This is not true. Some very healthy individuals and families are purchasing a less expensive, non-Obamacare compliant insurance. Then, at tax time, they just pay a yearly penalty (called a fee by the IRS and at www.healthcare.gov) when they file there federal tax return. Even though the individual-families are being penalized, they are still saving thousands on the cost of medical insurance.

My next step was to search for medical insurance through the Pennsylvania Health Insurance Exchange on the www.healthcare.gov web site. I found a slightly higher deductible and higher co-pay medical insurance policy that which included pre-existing conditions (Obamacare compliant) for $1,281 per month.

On Oct. 19, 2016, I was notified that it was now almost time to review-update my insurance coverage/application for next year. The medical insurance plan, which I was on, would no longer be available. A similar plan was suggested, with a different company. Based on my research, I was expecting the cost to increase by about 30 percent. So my monthly medical insurance premium would be about $1,665 per month. Fortunately for me and my family, my wife was able to obtain employment and her employer will be providing medical insurance.

About the first week of November 2016, I found out that my wife’s medical insurance would become effective Dec. 1, 2016. So, I started the process of canceling my Obamacare medical insurance, effective Dec. 1, 2016. After spending a lot of time on my insurance company web site and many phone calls, it was finally determined that I had to contact healthcare.gov to cancel my medical insurance. Several times I tried to cancel my medical insurance on the healthcare.gov web site. But it would not let me select Nov. 30, 2016 as my last day for insurance coverage. After several phone calls and holding for a very long time, I was able to speak to a healthcare.gov representative on Nov.  28, 2016. The best that the representative could do was to set a cancellation date of Dec.15, 2016.

I will have to pay the full $1,281 premium for the month of December 2016 and, after the cancellation is approved, I will be able to apply for a refund for a part of the month. Also, due to my cancellation, I may also be assessed a penalty (fee) for canceling my Obamacare insurance.

This letter is not meant to be any kind of complaint. My roof doesn’t leak, my pantry is full of food and God has blessed me beyond belief. This letter is just information for you, so that you can make knowledgeable decisions about any changes with regard to your medical insurance.

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