I posted in another thread before, but it is also relevant here, so here is a repost:
I was going to get coverage and then a few things came to pass that caused me to cancel. I paid the first bill. First, as a man I have pregnancy and
birth control coverage I don't need. That is beside the point though. After I got the card and information in the mail, they do not cover pain
management, weight loss programs, and something else I don't recall right now. Right now and for the last many years, my outlay for medical every year
is $5K. That is my pain management doctor and my regular family physician that treats my high blood pressure, etc. Fortunately, I have a couple of
good doctors and they give me great deals for cash.
So, the insurance would take the first payment by credit or debit card, however, you had to put in your banks routing number and account number for
subsequent payments. I knew it was a bad idea to go on, but at the time I thought my doctors would be covered because they were listed in the network
they showed online. The monthly cost was $367 with a $1,500 deductible. Not too bad considering I would meet my deductible rather quickly. The monthly
cost with subsidy was $128. So, it was going to be good for me. I am single and children are grown and have their own children. However, after giving
them my bank info, they wasted no time (10 days) in snaking out the full $367 out of my account. Yea, I get a tax credit to offset my taxes at the end
of the year. I don't like having things deducted out of my account because I am a contractor and work on a 1099 basis. I don't get paid until the
house is built and closed. So, although I make enough to make the payments, sometimes my account gets low due to late closures, etc. So, there are
times I need to wait a few days to make my bills. Fortunately they are staggered through the month which also helps that work out.
Bottom line, I can't afford to pay my doctors and pay for the insurance at the same time that won't cover me. I thought everything was covered,
including pre-existing conditions. So, I called the insurance company about them not covering my doc even though he was in their network for pain
management. The guy told me they don't cover any pain management. I asked if any of their plans do and he said no. He told me if I went into my family
physician and he gave me something for short term pain they would cover that, but not a pain management doctor. I asked why because he was listed and
was told that the in network providers were in there for policies that are still covered by large companies that have insurance programs for their
employees. So, no way, even buying a more expensive policy (mine was Silver btw) could I get coverage for my pain management doctor. So much for that
promise. Basically, I get coverage I will never use as a male, and not get coverage for problems I have to live with, pain management, a preexisting
So, even the numbers that the government is claiming will probably be changing drastically as people realize the load of crap they have been sold.
Most people I know are living paycheck to paycheck and can't afford to pay an additional payment, like a new car payment, and hope to get it back at
the end of the year. I can't do it and then have to pay out of pocket for my meds and doctors, diagnostics, etc. It would be one thing if they covered
the money that was going out for medical care (current spending for pain management, etc.) and you had to pay some additional to have a better
situation with insurance in case you get sick or have an accident not covered by other insurance. I believe that in a few months, once the things are
shaken out, the numbers will be much worse than the government is claiming now. Anyway, that was my surprise experience after trying to do the right
thing and get insurance.
edit on 1/5/14 by spirit_horse because: (no reason given)