spacer

Home Blog Thrive Obama Care

Obama Care

First, how many of you do not have health insurance due to chronic pain?  What do you think about Obama care?  Please comment below!

The news is reporting how horrible the roll out of the website(s) are.  I know my website took longer than I thought 🙂   For me, as someone who coaches people with chronic pain to take back their lives, I believe that Obama care is so much more than a website.  I heard a pundit saying that the policy is the website.  What? That is a classic example of getting the map and the territory confused.

So what does it mean for those of us who have chronic conditions?  We can get preventative care, we can have insurance, we may get some financial support.  I am still researching for myself what would be best for my family.  This is one of the times that connecting with an agent or a community group can really support you to get the information and make decisions.  In order to make a good selection you need information both about yourself and insurance options.

  1. Deductible and services covered before deductible
  2. Premium
  3. Any subsidies you may be eligible
  4. Coverage and excluded coverage
  5. HSA is something you may want to look into
  6. What you typically need from coverage
  7. Included coverages for things that are important for your ongoing chronic conditions (pain etc)
  8. Drug coverage

See, an agent who knows the insurance side is important!  It is also important that you know what you need.  A coach, a counselor, accountant, or doctor may have ways of helping you with that.  Every State has their own exchanges and here are differences that will be important to understand.  I used to be a health insurance licensed in my State of Oregon so I know some terms that may help you to look at the big picture.

The three big items are money, coverage, and your needs.  Money comes into 1-5 above.  That is why I like to call it the Affordable Health Act.  So much of this is understanding the costs and benefits.

Costs

The deductible is the amount of money you need to spend on your own healthcare before coverage kicks in.  Due to the requirements–there will be some preventative coverages that are not subject to the deductible.  Here is how insurance companies share the risk with you.  They bet that you will be sick but not sick enough to reach the deductible.  You need to know how much you can afford to come out of your pocket before your insurance starts to kick in.

Premium is the amount that you pay monthly.  Most people see this as the cost of insurance but it is only part of the equation for cost along with the deductible, excluded coverage, subsidies, and tax benefits of HSA account. (See why I said accountant?)

Subsidies are the help that you can get for paying for the insurance.  You may find that you can afford a lower deductible plan because of the help that the government will give you.

HSA is a health savings account that you can put money in that you can use for health costs on a pretax basis.  You may be able to use it for health needs that are not covered by your policy–check on this with your agent.  Every year there are changes and they should be keeping up to date.

Coverage

Coverage is important to look at very carefully.  For instance I receive periodic Botox shots for my head tic (Spasmodic Torticollis).  This is something that I want to have covered due to them being about $1000 a pop!  Of course I could live without that but it does increase my quality of life by lowering the amount of the pain, difficulty falling asleep, and fatigue.

Your Needs

Sit down and make a list of  any ongoing treatments, drugs, therapies, and labs that you use.  Make another list of  alternative/complementary care and/or specialists you may need and what the access is.  Ask about these for plans that you are looking at.  If the plan doesn’t cover something, you need to put that into the cost equation.

Your needs will be an important part of your calculations!  Would it be better to pay out of pocket for some of these and save on premiums or make sure you can get what you know you need covered.  Remember if it is not covered by your policy, it doesn’t get applied to your deductible.

I hope this helps.  Call the exchanges if you can’t get through on the web portals.  Be proactive so you can have the time to find out about your subsidies possibilities