Saturday, July 23, 2016

ObamaCare's Bronze Plan: ' It really is not affordable care all. When people get sick with an exchange plan, they pay deductibles and co-pays they can’t afford. If they could, they’d get better insurance'


The Sacramento Bee reports:
Richard Sankovich is not happy about the $6,035 invoice he recently got from West Penn Hospital for what turned out to be a pulled stomach muscle, but his experience likely says more about the risks of buying a low-cost health plan than it does about high hospital costs.

In Sankovich’s case, that low-cost “bronze” insurance plan he bought from Virginia-based Aetna Innovation Health through the Affordable Care Act marketplace has cost him plenty.

The so-called “metal” platinum, gold, silver and bronze plans offered through the federal marketplace offer a range of premiums and coverage, and provide a means for previously uninsured Americans to obtain health coverage.

For the most expensive platinum plans, insurers cover 90 percent of the care costs while the consumer pays 10 percent. Those opting for the lowest-cost bronze plan will be responsible for about 40 percent of the cost. With the most popular silver plans, insurers pay 70 percent and the patient pays 30 percent.

But within those general percentages there may be plan provisions that can make a seemingly low-cost option much more expensive. Like most bronze plans, Sankovich’s comes with a hefty $6,500 deductible that he must pay before his insurance coverage takes over.

The plan also holds him 100 percent responsible for emergency room care, which, combined with the deductible, means he’s now going to pay more than a year’s worth of his $473 monthly premium payments for the two-and-a-half hours he spent at West Penn.

What happened to Sankovich “is not uncommon at all,” said Denis Lukes, chief financial officer for the Healthcare Council of Western Pennsylvania in Warrendale.

This is what Barack Obama means "working better than expected" !