Obamacare Update

I promised several people to continue to share my family’s experiences with being insured at long last via the Affordable Care Act, AKA Obamacare.  We are coming up on two months of being insured and so far it is an unqualified success.
There was a little sticker shock for us regarding some of the medications we’ve had to purchase, as we have to pay full price until we reach the deductible, and while some of the negotiated prices were better than what we’d been getting with the various discount cards we’d been using, a couple have been quite a bit more.  However, thanks to that, John has now met his $300 deductible and I told him to start making appointments for every kind of doctor he’s ever wanted to see!
Emily, typically, has not used the plan yet, since she has literally not had to visit a doctor for illness since she was two years old.  But I’m encouraging her to get a check up at least.  Jake has visited two doctors and purchased prescriptions.  Here’s a perk:  even though his deductible has not been met, because we HAVE insurance, the doctors file it and then send a bill–they don’t expect us to pay up front.  Maybe that’s not news to the rest of you, but it was a happy surprise to us!  Another happy surprise was seeing our first Explanation of Benefits statement and discovering that because of negotiated rates we will pay less for doctor visits even before we meet our deductible!
As for me, I have now been to the doctor twice and haven’t had to shell out one dime as yet.  The first task was finding a practice, and I couldn’t be more thrilled with where I’ve ended up.  We have a Blue Cross plan, and of course it’s super easy to look for doctors online.  I’m used to looking for TennCare doctors and not finding any, so I was overwhelmed by the choices that were available!  I ended up with Trinity Medical Associates, which is a Christian practice, about five minutes from my house, that focuses on wellness.   I love my doctor, I love her nurse, in fact everybody there is super friendly and helpful.  John, Emily, and Jake are all going to start going there.
My plan covers one free check up and one free gynecological check up per year–no charge.  This practice can do both of those, so I will not pay anything for either of the two visits I’ve had so far.  I went two weeks ago, did the gyno thing, got my tetanus booster, and had blood drawn.  I went back today to go over the results of the bloodwork and to have an EKG.
I’m fat and I haven’t had a check up in six (I think) years.  I was really scared there might be something wrong with my heart, or that I might have to take medicines.  Besides the cost, I’ve avoided having these things checked out for fear of being saddled with a pre-existing condition that would have made me uninsurable too.  But I don’t have to worry about that anymore.  Nobody does.  Because that’s one of the things Obamacare has accomplished.
My doctor recommended a mild diuretic for the swelling in my leg (caused by an unfortunate encounter with my own car ten years ago).  She wants me to take a Vitamin D supplement and a Fish Oil capsule.  My sugar, triglycerides, and cholesterol need watching, but she prefers we try diet and exercise changes first.  To that end, I’ve got a nutritional counseling appointment (covered by insurance) and an exercise counseling appointment (not covered, but only $20).  I’m to go back to the doctor in three months to check my numbers again.
After so many years without insurance, I’m almost giddy about this, y’all.  I highly recommend that you take a look at healthcare.gov and see if Obamacare can help you too.  You’ve only got until the end of this month before open enrollment is.  It wouldn’t hurt you just to take a look, would it?
 
 

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  1. Marta says:

    I’m really glad you’re having such a positive experiment with ACA. It reminded me that I really need to see if my parents got it. My dad is self-employed and my mother doesn’t have insurance through work and previously it had always been too expensive to be self insured. Honestly, insured or not healthcare is outrageously expensive in the US. Unacceptably so in comparison to other countries. But baby steps!

    • lesliesholly says:

      Marta, even if they haven’t gotten it yet I read yesterday that if they even BEGIN the process before the deadline they can still get it this year. Lots of communities are offering free help days because honestly the process is not the easiest. I agree that it’s far, far short of what I’d hoped for but maybe one day we will catch up with the rest of the world in this regard. For now I’m just so grateful and amazed to go pay for one of my husband’s prescriptions and getting charged $1.50!

  2. Clisby says:

    I am so glad it’s worked out well for you. I’m not an Obamacare fan, since I REALLY think the US needs a universal single-payer health care program – but I’m perfectly willing to believe Obamacare is better than what we had before. Not that that’s setting the bar very high.

    • lesliesholly says:

      I completely agree wrt single payer. But since it’s not happening right now I’m just excited to have insurance at all. I’m hoping this is just the first step along the road to something better!

  3. Clisby says:

    I’m also relieved to have Obamacare as an option, even though it’s not financially the best one for us now. My husband is a cancer survivor, so until Obamacare came along there was no question that both of us had to stay employed so he could have insurance. I really want to retire at 62, but I wouldn’t even have considered that if it meant he’d be left without insurance if he lost his job.

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