The Affordable Care Act Works for Me

3 years ago

In July of 2013 our family had to switch from group health insurance to the "individual health insurance market." It took us two months to find a plan. My husband, Tim, and I were both denied coverage and offered a policy with a sky high premium. We considered going without. When we finally found an affordable option it was for the absolute worst health insurance possible. Tim and I spent the balance of 2013 just praying that neither of us would become sick or have an accident. (Thankfully, my daughter, Julia, has her own insurance.) If we did happen to have a catastrophic illness or really bad injury, our policy would have covered it. The real risk was in every day things like sinus infections or the flu or a concussion or any of the other million things that can happen to the human body without being considered "catastrophic."


It was a tense time.


Tim took the lead on navigating last year. He signed up and got verified. It didn't work perfectly, but I've had difficulty placing site-to-store orders on major retail sites. Occasionally, Amazon does something weird and I have to re-find an item and go through the checkout twice. Sometimes the Internet takes a bit of perseverance. It is possible to overcome the glitches.


It was December when I became involved. My husband and I sat down to look at the plans and prices. This required having a lot of different windows open on the computer. We made lists and became quite familiar with all of the Bronze, Silver, Gold and Platinum options. By mid-December we chose a Highmark plan. Though the premium was almost 5x the cost of that worthless individual policy, it was less than half the cost we would have been charged for a comparable Highmark plan in those final months of 2013. Insurance companies really price gouged those of us with pre-existing conditions.


Our new insurance took effect on January 1st.


It was a good feeling to have real insurance cards again. My annual eye exam came around in January and I found I was due for a battery of pictures and tests that my optometrist likes to do every 3-5 years. Even with group health insurance coverage, these tests have cost me hundreds of dollars in deductibles in the past. Sometimes, I refuse all or some of them because of the cost. Then I worry that my eyeballs are going to fall out. 


I had the tests this time. The bill came last week. It was $60. For everything.


With that catastrophic illness policy that we used to bridge our coverage gap I would have paid more than $500 out of pocket.


This is better insurance coverage than we've had in the past five years. Saying so is a bit of a conversation killer. The world would much rather rave about experiences like the one in this recent Forbes' article. But I'm thankful for the Affordable Care Act. Signing up for health insurance through the government's web site was a breeze compared to the two months we spent searching on our own. Coverage, premiums, all of it is better.


Our experience has been a good one. Now if I could only get that published on

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