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Obamacare Lives! I’m happy but I’m sad.

Thursday, June 28th, 2012

I was very happy about the Supreme Court decision on the Affordable Care Act. Then I talked to a woman who has no health insurance and was recently diagnosed with cancer.

Dixie is 63 years old. She quit working last year and is living on $1,400 per month from Social Security.  She hadn’t been feeling well for a while, but didn’t see a doctor because she didn’t have health insurance. Then she ended up in the hospital with pneumonia and blood clots. An x-ray showed she has stomach cancer.

If Obamacare were already entirely in effect now, rather than 2014, Dixie would have health insurance. Because of her income, Dixie’s monthly premium would be highly subsidized by the government. Instead, she has a $27,000 hospital bill. The hospital gave her a deal by reducing the original bill from $54,000.

The oncologist has told Dixie she has a good chance for survival if she gets chemotherapy. Without it she has maybe six months to live. Three months of treatment will cost $20,000, and Dixie can’t pay that.

The doctor’s office gave Dixie a number of cancer organizations to call to see if she can get financial help. So Dixie has been dialing for dollars. So far, she hasn’t heard any good news. She feels lousy and she’s scared, but she has to keep dialing.

I told Dixie about one of the programs that is part of Obamacare, called the Pre-existing Condition Insurance Plan (PCIP). This is an insurance plan for people who have been without health insurance for six months and have been denied health insurance. I called PCIP to find out how we can expedite an application for Dixie, and I learned that some of the rules have changed.

Along with a PCIP application, a person must submit a denial letter from an insurance company – or a letter from an insurance broker stating that the person would be declined if she applied for health insurance. So I’ve written a letter for Dixie (after double checking with BCBS of Arizona that a person with cancer would automatically be declined).

Dixie will call PCIP (1-866-717-5826) and a representative will fill out an application for her online. She’ll get a confirmation number for her application, and I will put that at the top of my letter, which I will fax to PCIP.  It takes two to three weeks to get approved, but Dixie’s coverage can be effective as of July 1.

The PCIP will cost Dixie $334 per month and $6,000 between her deductible and her 20% co-insurance. With the rest of her care being paid by the PCIP, she should be able to get treatment – I think, I hope.

So, I’m elated that Obamacare will go forward, but I am very sad that Dixie is so sick and has to beg for money to save her life.  Thank goodness there is a lifeboat on the horizon in the form of the PCIP – which is part of Obamare.

FOR MORE INFO ON THE TRUE COST OF HEALTH CARE, TAKE A LOOK AT A RECENT POST.

Diabetes? No Insurance For You.

Wednesday, January 26th, 2011

I had a phone call yesterday from a woman whose husband wants to change jobs, but the new employer doesn’t offer health insurance. I told her the safest route would be to apply for individual/family insurance before changing jobs so they’d be sure everyone in the family could get coverage before her husband quits his current job and loses his group plan.  Group plans are very different from individual or family health insurance plans.

I asked if everybody in the family is healthy and she said “yes”. We talked some more and she mentioned that her husband has Diabetes.  I said, “Whoa! Your husband is un-insurable with Diabetes!  No insurance company will take him.  Tell him he needs to keep his current job so he can keep his health insurance!”

The wife said, “But I thought the health care reform changed all that!” I told her that some of the health care and health insurance reforms have gone into effect already, but not that one. Her husband will have to wait until 2014 to be able to get individual health insurance with his pre-existing condition. I told her Republicans want to kill the bill and keep her husband from having more employment options.  Sounds like a “job-killing” plan to me!  I hope her husband doesn’t hate his current job.