October 31, 2013
BUT MYTHS ARE STUBBORN STUFF:
Another Obamacare horror story debunked (Michael Hiltzik, October 30, 2013, LA Times)
I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder. It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year. Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy.As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy.At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.Is that better than her current plan? Yes, by a mile.If she wanted to pay less, Cavallaro could opt for lesser coverage in a "bronze" plan. She could buy one from the California exchange for as little as $194 a month. From Anthem, it's $256, or $444 a year less than she's paying now. That buys her a $5,000 deductible (the same as she's paying today) but the out-of-pocket limit is lower, $6,350. Office visits would be $60 for primary care and $70 for specialties, but again with no limit on the number of visits. Factor in the premium savings, and it's hard to deny that she's still ahead.
Posted by Orrin Judd at October 31, 2013 6:12 PM
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