His premiums are $500 less per month and there’s zero co-pay for the expensive medicine he needs to stay alive.
When your life depends on taking your medication on time, every single day, it’s not something you take chances with.
As a man living with AIDS, Dan Waszak was willing to pay as much as $1,480 a month for health insurance in the past, because it made his daily medication affordable. Without insurance, he’d pay $4,500 a month just for his medication, and that wouldn’t include any doctor’s visits or other care.
So when Dan got a letter from his insurance company in late 2013 telling him his plan was being cancelled because it wasn’t compliant with the Affordable Care Act (ACA), he was understandably panicked. The first days of Healthcare.gov were chaos, and Dan was worried.
“My major concern was my prescription benefit, but there were so many different plans to compare on the website and it was really complicated. I couldn’t find anything I could afford and I couldn’t get the prescription coverage I needed. I heard Mike Signorile on the radio talking about how it was all going to be okay and I thought, ‘No, it’s not!'” Dan says.
He called into The Michelangelo Signorile Show twice seeking guidance and voicing his concerns. “I told him I was scared,” Dan says. “I told him I’d be dead in six months. I’d be really sick in just 30 days of not taking my medication.”
But for Dan, the third time was the charm. Dan called into the show one more time — this time, to tell Signorile’s listeners he’d been wrong. Because the 62-year-old Michigan man had found coverage that not only let him continue taking his medication without an interruption. It was even better than the coverage he’d had before.
I thought it was important to make that third call to Mike to tell people, ‘Go! Keep looking! It’s out there!’
I found coverage that was better, because it included dental coverage I didn’t have before, and much less expensive. And I got to keep the same doctor who had been keeping me alive for the last 15 years.
Dan’s premium went from $1,480 a month to $915 a month, which included additional dental coverage. His deductible did increase, from $1,000 to $2,000 per year. But here’s the benefit Dan first thought was too good to be true: There is no co-pay for his medications. Zero.
“The first month of my coverage I was really anxious, because I just kept thinking I must be missing something,” Dan says. “I knew I’d have to pay the $2,000 deductible right up front, but to think they’d cover everything else? I couldn’t believe it.”
But after paying his annual deductible, Dan has never had to pay a penny for his prescriptions. His doctor’s visits don’t have a co-pay, either.
I’m not one of those people who can say, ‘I got covered for $200 a month,’ because I didn’t get any tax credits — but it’s still an incredible deal for me. I was worried about them not covering everything because some of my meds are specially formulated, but there has never been a charge after I paid my annual deductible.
Dan’s story demonstrates how important it is for consumers to look closely at the plans they’re considering, and decide what’s most important to them. Perhaps it’s a low deductible or no co-pay for prescriptions or minimal out-of-pocket costs. It is worth taking the time to compare plans, which is much easier now than it was during the first rocky weeks of Healthcare.gov.
During a visit to the White House to share his story, Dan met other Americans who were there to tell Dr. Jill Biden what the ACA means to them. Dan says he was struck by how different everyone’s health insurance needs were.
One woman was worried about getting insurance for her husband, one person was concerned about co-pays, another was a student wanting to stay on her parents’ coverage. There were 10 people there with 10 different stories about why the ACA was important to them.
In more good news, Dan’s premium only increased by $28 a month for 2015, to $943 for medical and dental coverage. Before the ACA, his premiums were increasing by 10% — about $90 a month — year after year.
Dan urges anyone who still thinks they can’t afford insurance under the ACA to take another look. And if they had a plan that was cancelled because it wasn’t compliant with the ACA, they should consider why.
What wasn’t covered? Were there exclusions or limits? If your old plan wasn’t ACA compliant there’s a reason why. You can’t just look at the deductibles or the premiums.
Don’t give up. The right plan for you is out there. Just keep looking. I’ve benefitted tremendously from the ACA.
There’s still time to shop and compare plans before 2015 open enrollment ends on February 15th. Visit Healthcare.gov today. If you need help choosing a plan, visit Get Covered America to find resources including local in-person help.
[CC photo by Will O’Neill | Flickr]