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| Austrian Seven-League Boots (7Meilenstiefel) , via Vanessa Fire. |
Here we go again with the people who think when Obamacare
outlawed the $5,000 deductible they somehow
ruled a $12,700 deductible in:
MIAMI - Dean Griffin liked the health insurance he purchased for himself and his wife three years ago and thought he'd be able to keep the plan even after the federal Affordable Care Act took effect.
But the 64-year-old recently received a letter notifying him the plan was being cancelled because it didn't cover certain benefits required under the law.
The Griffins, who live near Philadelphia, pay $770 monthly for their soon-to-be-terminated health care plan with a $2,500 deductible. The cheapest plan they found on their state insurance exchange was a so-called bronze plan charging a $1,275 monthly premium with deductibles totalling $12,700. It covers only providers in Pennsylvania, so the couple, who live near Delaware, won't be able to see doctors they've used for more than a decade.
"We're buying insurance that we will never use and can't possibly ever benefit from. We're basically passing on a benefit to other people who are not otherwise able to buy basic insurance," said Griffin, who is retired from running an information technology company.
1. The
average Bronze plan in Chester County, PA (they live in Chadds Ford) for a couple their ages (he's 64 and online evidence indicates Mary Lou is 63) with an income runs a monthly premium of
$1,107, if their income is more than $62,000. The cheapest Bronze is certainly less than $1,275 (I have no idea where they got that number, but it doesn't belong here). If they're down there at just over 400% of poverty, that's a pretty big bite out of your income, but if they could lower their income (e.g. by putting money into Mary Lou's IRA or 401K) just to $62,000, they'd lower that premium to
$491 right away. If they're too rich to do that, then they're rich enough to stop complaining, especially since it's
just a year until Dean goes on Medicare and Mary Lou on a single-individual plan, two years until she goes on Medicare herself.
2. Once again, that $12,700 is NOT A DEDUCTIBLE. It's an out-of-pocket maximum. That is, the couple will pay nothing for preventive care stuff, standard copays for normal stuff, and 50% of everything else (other states' Bronze plans cover 60%, but
these Pennsylvania ones seem to take care of only 50%) until they have paid $12,700 and the insurer has paid the same; after which the insurer will pay 100%. On their old plan they'd have had to shell out $2,500 apiece before getting a penny, whereas now they'll be getting that $5,000 worth of initial care for something like half the price.
Putting it another way, under their old plan, they'd have been paying the $770 a month PLUS the $2,500-per-person deductible for an effective total of $1,187 a month before the insurer ever gave them anything in return, whereas now, with an
almost certainly slightly smaller outlay, they'll be
getting something back every time they go to the doctor.
3. They have access to their Delaware providers, but they have to pay make a higher copay; or they can keep equal access to them by signing up for a Blue Cross Multistate plan (or, as we call it here, the
Infant Public Option). Suck it up, you whiners!
Talk about lies traveling halfway round the world before truth can slip into its Uggs—this stupid story written by Kelli Kennedy of the
Associated Press has been picked up by the
Washington Post, along with God knows how many AP local papers, and
dozens of blogs and propaganda outlets, who reprinted it without even the most minimal journalistic due diligence. THIS MUST STOP!
Update:
A wonderful new tool for calculating premiums is available at
healthsherpa.com (h/t the wonderful
Gotta Laff). It turns out there that the cheapest PPO Bronze plan is in fact $1240 a month, which is not so far off the Griffins' number, though still a far better deal than the high-deductible plan they're losing (looks like the PPO Bronze Reserve, which would now cost $1,107, but it seems to have been withdrawn). The only Multistate option listed is a Gold, for $1,878. These guys may have to decide whether they prefer cheap or Delaware. How often do they go to the doctor, anyway? If that $770 plan was working for them, they must have been paying full price for a very small number of visits, and they could keep doing that for the next year except paying half price for the preventive care.
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