A year ago, we got insurance through the Health Exchange in NJ. It's an Affordable Care Act plan. In 2013 I did this blog post when Ted Cruz shut down the government over the Affordable Care Act. When Josh got laid off in September of 2014, this became a lifesaver!
http://homewithmommy-fran.blogspot.com/2013/11/affordable-care-actclarified.html
He was unemployed a year ago when he broke his hip. Our plan is through Health Republic of New Jersey. We saved thousands and thousands of dollars on these costs through this plan. The only part not covered was the doctor, who didn't take our insurance.
Suddenly, birth control went from $90 a month to free. $1,080 a year we no longer had to spend out of pocket. My birth control isn't just to control family size. I've talked about my PMDD. Severe mood swings at certain points in the cycle. This medication helps control them. It's the only option for me and a necessary expense.
Suddenly, Zach's asthma medication became cheaper too. A $50 emergency inhaler became $25. Instead of $60 a visit for my regular doctor, it became $10 a visit. Instead of $180 a visit for Zach's Pulmonologist, it became $50. We each have to see these doctors at least four times a year to monitor issues. Asthma for Zach and High Blood Pressure for me.
The premium for our plan, before the tax credit is the same as the monthly premium we paid at Josh's old job. That plan was grandfathered in. But I doubt it's much better for those who got it after the Affordable Care Act requirements!!! The coverage was getting worse each year, not better. See above expenses.
Yes, we have a high deductible that will never be met. I took that into account when choosing a plan. I took into account:
1. Deducting reachability
2. Premium
3. Medication costs to us (before and after insurance)
4. Doctor costs to us (before and after insurance)
5. Testing costs to us (before and after insurance)
6. Premium and other expenses to savings ratio
In the end, it just was a better deal. That was determined before we know what tax credit we would get. With our budget, that credit is necessary. It counts as income. The paperwork is printed and ready to go to our Accountant/Josh's sister. But because it was affordable, we have the coverage we need to manage our health issues the best we can.
Health Republic Active Access Spotlight Silver 94% AV Level Plan
That's what we have. The 94% AV Level part is new for 2016. The rest was from last year. I'm not sure what that means. It's not the cheapest plan offered. But, it becomes the cheapest for us when I take our full needs into account. It's important to consider all six of those things.
At first, only a couple of doctors took that insurance. As with all insurance changes not all of our doctors took it at first. Most of them take it now. Two of those doctors have been replaced. The last one, my Psychologist, is too important to change.
When we renewed the plan we had to send in some paperwork. Because Josh is hourly with two jobs, they needed pay stubs. They needed to get a feel for a strong estimated annual income. Zach is currently uninsured. Because of income we had to apply for him through New Jersey Family Care. They are reviewing his file now. At least that's what they told me when I called today. If he's not accepted, we can add him to our plan. But, we can't add him to our plan until they reject him. I blame "Gov." Christie for that situation!
Josh can buy coverage through Fairway. But, it's expensive and not as good. Today it was confirmed. It doesn't matter if he can be covered through work. We can still keep this coverage instead. Because it's more affordable and matches our needs better.
In that blog post from above I said we won't really know if we like the Affordable Care Act until the country has lived with it for a few years. I said ask me in 2016 what I think. It's 2016 and I can write this review with experience:
The biggest negative is that we have to apply for Family Care for Zach. That part might not be a problem in other states. It's how our Governor decided to set up the federally run plan. He will be receiving all medical bills incurred while Zach is uninsured.
Everything else about it is wonderful. Without this option we would have had to file for bankruptcy because of a patch of ice. No coverage means things are worse off for us. It's easier because we didn't have to give up most of our doctors. More and more doctors are taking these plans.
How it was adopted was determined by state so the results will be different for everyone. A lot of states don't offer health coverage through an exchange. They are some of the red states. These are the states with the poorest Americans who need affordable care the most. They might hate the ACA but they are more likely to not realize they aren't helped by it when their Governor passed on enacting it.
I love it. For significantly less money we are getting the care we need. I have a friend from Pennsylvania who doesn't like his health exchange plan. I suspect he just didn't do his research first. He didn't choose what's best for him. He didn't take into account all of the six key factors to consider.
I recommend this plan.
We have been saved by the Affordable Care Act. It's not about the number of Americans insured. It's about what better health means. The real issue is the cost of the care to begin with. Medications, doctor visits, and tests are significantly more expensive then they should be. That's not a new problem. What we needed was a universal plan. This is the compromise that was more likely to be accepted. Something had to be done to lower those medical costs. When you combine those six things to consider, costs get lowered. It certainly did for us! If you can't lower the prices from the greedy sources determining them in the first place, then this is the next best option. I think this has been a necessary step to take in solving a major long-term problem.
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