So, I live in Washington State, which signed up for the healthcare exchange program and rolled out their site October 1, 2013. So far, in just checking plans available – not signing up, just checking, I have experienced no problems with the site. However, in checking out the costs, I am a wee bit dumbfounded.
Inasmuch as I am currently unemployed with no income, they immediately recommended me to Medicare. But, what if I got a job and had to pay for my own policy?
Under the terms, if you make less than $50,000 per year, you qualify for a tax credit of $203.34. For the sake of discussion, never mind my BA and MA degrees which were supposed to add greatly to my annual income. As a legal assistant back in 2009, I made about $49,500 (note: Washington state pays about $10,000 to $20,000 less than California for the same positions – when I left California in 1996, I was making $43,500 and took at least a $10,000 hit by moving to Washington. I spent the next 13 years working my salary back up. After September 11, I knew I wanted to help my country and was too old for the military, so I went for helping my fellow citizens in emergency management.
Washington State’s Emergency Management Division (EMD) requires seven (7) years service without a degree to advance beyond secretary admin OR a Bachelor degree. So, in 2006, I went back to school and back to being a legal assistant to afford it. I worked full-time and went to school full-time. Long story short, I got addicted to school and went onto earn my Master’s degree in Strategic Intelligence – Intelligence Operations and finished it in 2009. In January 2010, I went back to EMD on temporary six month contract and served as a State Emergency Operations Officer (SEOO) in the Alert & Warning Center, and earned the grand salary of about $43,500, for two years (contract extended). Quite obviously, it was not about the money. Mind, the responsibility was easily 10 times that of a legal assistant and, while law has its stressors and time crunch, it doesn’t compare to being the first point of contact for any disaster going down in the state. Here’s a brief description:
“The Alert and Warning Center operates 24/7/365 in 12 hour rotating shifts with two SEOOs on duty at all times. The highly trained professional team of 10 SEOOs and one supervisor are the initiating point of contact for state assistance for local jurisdictions, private industry, state agencies, and other organizations, as well as for federal agencies, responding to an emergency or disaster within Washington State. SEOOs routinely make notifications and coordinate response activities for hazardous material incidents, search and rescue operations, weather events and wild land fire fighting, as well as a wide variety of other emergency situations. SEOOs are prepared to implement contingency plans in the event of earthquakes, volcanic activity, tsunamis, flooding, severe weather, incidents involving the Chemical Stockpile Emergency Preparedness Program (CSEPP), the Fixed Nuclear Facility (FNF) at the Department of Energy in Richland, as well as many other emergency conditions that potentially could impact Washington State. Total Missions for 2012: 4,740.”
So, let’s just say I get a position and at a minimum, let’s stipulate I make $45,000. I qualify for that tax credit and here’s what Group Health Cooperative – my old plan that I paid $35.30 per paycheck for a total of $70.60 per month ($847.20 annual payment) with a deductible of $350.00 ($1,197.20 total for the year) and a co-pay of $20.00 if I recall correctly – will cost me now if I do not receive any coverage from my new employer:
A non-smoker, 58 y/o woman:
Bronze: – $5,000 deductible; $6,350 Maximum out of pocket costs; $200 Emergency Room Visit; $40. Co-Pay = $220.53 per month;
Silver: – $1,500 deductible; $6,350 Maximum out of pocket costs; $150 Emergency Room Visit; $20. Co-Pay = $356.25 per month;
Gold: – $ 750 deductible; $6,350 Maximum out of pocket costs; $100 Emergency Room Visit; $10. Co-Pay = $495.50 per month;
Mind, the co-pay doesn’t kick in until you have paid the deductible – so, I would pay $______ per month premium x 12 months (and the deductible) before my insurance kicks in…. = $2,646.36 ($7,646.36), $4,275.00 ($5,775.00), $5,946.00 ($6,696.00), respectively and that is before I visit a doctor – no vision coverage. Co-pay goes up for a specialist.
A smoking, 58 y/o woman:
Bronze: – $5,000 deductible; $6,350 Maximum out of pocket costs; $200 Emergency Room Visit; $40. Co-Pay = $305.30 per month;
Silver: – $1,500 deductible; $6,350 Maximum out of pocket costs; $150 Emergency Room Visit; $20. Co-Pay = $468.17 per month;
Gold: – $ 750 deductible; $6,350 Maximum out of pocket costs; $100 Emergency Room Visit; $10. Co-Pay = $635.27 per month;
For this sin of smoking, I would pay $______ per month premium x 12 months (and the deductible) before my insurance kicks in…. = $3,663.60 ($8,663.60), $5,618.04 ($7,118.04), $7,623.24 ($8,373.24), respectively and that is before I visit a doctor – no vision coverage. Co-pay goes up for a specialist.
So, let me get this straight: sign up for a medal and pay those fees OR take the $95.00 penalty fee for 2014 and, if something goes wrong, they cannot deny me insurance, so I can sign up after I get sick? Or pay the penalty and sign up with a concierge service – a smaller monthly fee and pay that way. So, it will be an economic decision vs. actual patient care. Huh. “Great little program you got there, kiddo. Shame if something happened to you.”