In a recent post, I mentioned Dr. David Belk, who has a website about the true cost of healthcare and how insurance – and “the system” -  make people pay more than is necessary. Dr. Belk’s website has gotten a lot of attention lately and many emails from people who have stories to tell.

Here are a few of the stories I found interesting. More can be found here:

My husband is self-employed, I work part time, and we have 3 kids in college. We pay for our own insurance, which besides being very expensive, also has a $2600/yr. deductible, and co-pays for everything. This is very difficult for us. What other options do we have? I have MS and am on expensive drugs, which our insurance won’t pay for at all; the drug manufacturer has a program for people without insurance coverage so I pay a 40/mo. copay. The health insurance cost is the main source of stress in our lives. What can we do?

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My husband recently  has received a $80,000.00 hospital bill which my insurance company is refusing to pay, because I was not pre-approved.  I am wondering what the protocol is to follow your plan with paying out of the pocket so to speak. Do I  contact the hospital and not follow thru with the insurance company, and is your plan just active in California I would like to talk with you and see what I need to do to get the best rate. Please call me at your convenience, because I need some help in order to do this the correct way.

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I used to manage a neuro practice and everything you say on this site rings true. We gave our patients the option to pay with cash and in almost all cases it was less then what we HAD to bill insurance. The only way for the market to adjust is if the financial relationship shifts back to the doctor and patient. We don’t use our car insurance to pay for car maintenance, why do we use it to pay for healthcare? Keep up the good work, let me know how I can help.

One of the many pieces of the Affordable Care Act (Obamacare to some), was the Pre-Existing Condition Insurance Plan (PCIP) which is available to people who have been denied health insurance because of a pre-existing condition.  An additional condition for participating in the PCIP is that people must have been without health insurance coverage for six months.

It was expected that several hundred thousand Americans would enroll in this plan, which is supposed to serve as a stop gap until everybody has access to health insurance in 2014.  But to date, only 18,000 Americans have enrolled in the plan, much to the surprise of the experts who know there are millions of uninsured Americans across the country.

To make the PCIP more attractive, the Department of Health and Human Services has reduced PCIP premiums by 40%. Arizona rates went from $550 to $334 for the standard option for people over 55. A 40 year old can now get coverage for $188 per month.

Three different coverage options are available through the PCIP: Standard, Extended, and HSA (health savings account).  The plans come with different premiums and different deductibles – but it is good health insurance.

The state of Arizona declined to administer a  PCIP for Arizonans, so people in our state need to apply through a federally-administered PCIP.  I do not know what the doctor and hospital network is for the PCIP in Arizona.

Lowering the premiums for the PCIP should make it affordable for more people.  The next move should be to waive the six month rule, and then they’d get plenty of enrollments. I have spoken to people paying outrageous premiums for their individual insurance, but they are afraid to drop it, apply for and get denied new health insurance, and then go without coverage for six months so they could qualify for the PCIP.

The website for the Pre-Existing Insurance Plan is http://www.healthcare.gov/law/provisions/preexisting/index.html

Kaiser Health News reports that 600,000 young adults took advantage of a provision in the Affordable Care Act that allows people under 26 to remain on their parents’ employer health insurance.

Wellpoint, the largest health insurer in the country, got 280,000 new clients as a result of the Affordable Care Act. Aetna added close to 100,000; Kaiser Permanente, about 90,000 new clients.

Here are excerpts from the Kaiser Heath News article:

Under the health law, health plans and employers must offer coverage to enrollees’ adult children until age 26 even if the young adult no longer lives with his or her parents, is not a dependent on a parent’s tax return, or is no longer a student.

According to the federal estimates, adding young adult coverage is likely to increase average family premiums by about 1 percent.

People in their 20s have the highest uninsured rate of any age group—about 30 percent, federal data show. Two factors are largely behind this: Young adults are most likely to work for employers that don’t provide coverage and young adults don’t understand the need for health insurance.

The federal government added 280,000 people to its insurance rolls because of the dependent coverage, said a spokeswoman for the Office of Personnel Management.

Before the federal law was passed, many insurers dropped coverage of children either at age 18 or 21 or when the children graduated from college. More than half the states required coverage to continue until at least age 25, but those laws often had several restrictions.

The full article can be read here:  http://www.kaiserhealthnews.org/stories/2011/may/01/young-adult-health-insurance-coverage.aspx?referrer=search