I just spent the last ninety minutes on the phone with my health insurance broker (1) and the NY State of Health (2) trying to figure out HOW THIS FAMILY WILL BE INSURED NEXT YEAR.
I was going to post a short, exasperated Facebook post about it. Something like, “I feel like a deer staring into health insurance high beams” but this level of anxiety feels too LARGE for Facebook. So I hope Ana doesn’t mind if I hijack the blog to post about this. It is, after all, pretty relevant to the whole “healing” aspect of her life since…well…it means she gets to keep enjoying her medication and any needed treatment in 2014.
So, the good news is that both Ana and Emily are eligible for Child Health Plus and I have promptly enrolled them both via the NY State of Health web site. This is really good. I mean, really, really good – the monthly premium for the two of them is $90 and apparently Child Health Plus covers everything without deductibles, copayments or co-insurance. I didn’t think I qualified for this service. If I had, I would’ve enrolled them years ago. I would just like to take a moment to mourn the loss of $20,000 I paid in deductibles over the last two years under my existing plan with CDPHP.
Jim and I also need health insurance. But if I want to keep my exact same (crappy-ass) high deductible plan, my premium will increase by 47% (so it increases 47% even though the kids are not on the plan). Just for fun, I looked at the 2014 premium for the family plan (e.g., if the kids were included) and it would’ve gone up by 100%. This is the SAME exact plan except it’s actually worse. The new deductible is $10,000 (up from $9000) and the out of pocket maximum is $12,700 (up from $10,000). So apparently my $9000 deductible was a BARGAIN.
So here are my choices:
- Go with CDPHP at the 47% increased premium and basically get no benefits whatsoever, but live secure in the knowledge that if my leg falls off, or if Jim needs to be hospitalized for brain cloud, then we only need to pay $12,700 out of pocket before CDPHP starts paying for stuff. The up side of this is that we know CDPHP will pay because they’ve been great about it for Ana. Also, we get to keep our doctors. Just so we’re clear – that is a total out of pocket expense of just over $21,000 (including monthly premiums – not including the $90/month for Child Health Plus) that we’d need to pay CDPHP before we received any benefits. And stuff is excluded from this! Things like therapy (ahem), dental care and probably other stuff I can’t think of right now due to my current state of incredulous rage.
- Go with MVP which is even MORE expensive than CDPHP for the same crappy, crappy, crappy coverage (until you hit your deductible). MVP also has lower ratings (in terms of customer service and…paying for things) than CDPHP. But it is an option and does include most of the doctors we use…so…yeah.
- Go with the COMPLETELY UNKNOWN yet SURPRISINGLY AFFORDABLE healthcare co-op – Health Republic Insurance. Never heard of it? Well neither has my doctor, or my other doctor, or my therapist, or anyone I’ve talked to about it. But this…THIS is a plan! If purchased through the exchange (and after receiving a $91/month tax credit towards the premium), the premium is just 30% higher per month than what I’m paying now (not including the $90/month for the girls). If you include that $90/month, then we’ll be paying just under 50% more per month for our premium ($747 vs. 500). However, the girls are totally covered (which means all the drugs Ana can eat) and…get this…the deductible is just $500. There’s no charge to visit our primary care physician (even for sick visits), only nominal amounts for emergency room, ambulance and urgent care visits, no charge for generic drugs, and…actually, a ton more stuff. The catch? None (and I mean NONE) of my doctors participate in this plan.
- Close my business and get a job with health insurance (and, believe me, I did consider this option)
But SCREW IT! I’m going with option #3. I’m going to find new doctors. I’m going to take a step into the the unknown and hope that I can get my medical needs met without constantly shoveling money out the door. And at least the girls get to stay with CDPHP for another year. So there’s that.
As much as I’m trying to keep a sense of humor about this, the truth is…I’m worried. It’s just so much money and there are no guarantees about what’s covered or where any of us can go to get medical treatment.