The executive summary is Obamacare needs some work. Too many choices, the carriers are overwhelmed, confusing, frustrating ... but worth the effort in the end ... maybe.
If you listen to the politicians, then America has the best health care system in the world. The World Health Organization ranks it as #37. JFK was quoted saying, "No matter how big the lie; repeat it often enough and the masses will regard it as truth.". You never know what you have until you really need it. I'm reminded of the insurance salesman happily covering you with an umbrella on the most beautiful of days only to scurry away at the first few drops of rain. My first real experience with health care came while being the advocate for my dad as he was rehabilitating from a stroke almost 15 years ago. I remember it as me (& the doctors) against the case workers and the insurance company. The details are in the fine print of your policy.
The motivation to change from Cobra (remember I'm only 4 months into my gap year) to coverage provided by the Affordable Care Act was money. Maybe it's just me, but the cost of Cobra at $2400 per month to cover the 3 of us seemed a little excessive. The other excessive part is big pharma. I innocently went to the Walgreen's and asked, "How much would it cost for me to pay for my wife's 3 prescriptions if I have no insurance?". The answer of $700 per month almost floored me. We actually kept Cobra through the end of the year until we could sort out how to get equivalent drug coverage. As an example, 40 mg of branded Nexium through Walgreen's was over $300 per month. The 20 mg version is over the counter and you can buy over a months supply from Amazon for $20. Take two per day and that drug cost is slashed by more than 85%. Wow. Turned out the pharma was easy.
For the medical plan coverage, we chose to use a highly recommended broker that specializes in plans where you are moving around the country a lot. That fits our situation since we will be away from Austin about half the time. If interested, then read the RVer Guide to ACA Open Enrollment in 2016 which introduced me to a new vocabulary like: on/off exchange, individual mandate penalty, embedded individual OOP maximums, multi-state plans & the lack of PPO plans. What? I've always had a PPO plan and want to keep one.
How did it turn out? Getting a plan for our son in California was easy. About $200 per month with a solid provider (Blue Shield). The Silver PPO Plan has a $1850 deductible which is not very different than what Cobra had. PPO. Check. Took a few minutes and was approved and paid for within a week.
Our plan was a little more complicated and I was finally able to make payment on it about 10 minutes before we headed out for our New Years celebration. It languished for weeks at the overwhelmed insurance provider despite numerous calls from our broker and us. In the end, we have a Silver PPO Plan from Scott & White which is a Texas carrier. The cost is around $950 per month, has a $5000 individual deductible, but has a low cost pharmacy benefit as long as you are on the preferred drug formulary.
Tally it all up and we are all in for under $1200 per month and have PPO plans. A 50% savings over Cobra. This post is just a cautionary tale of our experience. I'm sure next year it will all change again ... but I'll be back on a group plan by then so what will I care? I care because we should take care of our people in America. This needs to be fixed/improved ... not eliminated. I'd like to honestly say that America has one of the best health plans in the world.