Love, Advice, Wellness

This year I signed up for healthcare for the first time. Here’s what I learned

It's so complicated and confusing but I think I ended up with a good plan.

This year I got a friendly reminder from my university that I no longer had health care. Because of that, they’d be adding an additional fee of almost a thousand dollars on my tuition that would serve as my health care for the year. It quickly had me panicked because I had no idea how I was going to pay for this year’s tuition let alone an added fee of Medicare. A thousand dollars may not seem like much to others but to me, it was a death sentence.

[bctt tweet=”It’s so expensive just to live and health care should be a universal right but alas it’s not.” username=”wearethetempest”]

Sad to say that my concern wasn’t really on health at all but on the cost, which really speaks to why we need universal health care. It’s so expensive just to live and healthcare should be a universal right but alas it’s not. So on the last day to enroll in “Obamacare,” with only a few hours until the deadline I put my Christmas vacation on hold and sat down in my best friend’s kitchen to sign up for healthcare for the first time in my life.

Honestly, the first hurdle was finding the right website. There were so many others that claimed to be the signup but really were just scamming and looking to flood your email for the next year and a half. Once I did find the website it started off simple. I filled out all my information like address, bio, and employment information. They determined I had no money, which I already knew, and decided what supplemental help I’d be eligible to receive from the government. Thanks, Obama.

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[Image description: President Obama sarcastically says “thanks obama”]
Then came time to actually pick a health care plan and that’s when it all went downhill. Obviously, I wanted the cheapest plan so I didn’t have to pay anything out of pocket, but I also didn’t want a crappy plan. I had no idea what actually constitutes a good healthcare plan, I just didn’t want to be screwed if something actually happened to me and then I’d be stuck with a really expensive medical bill. There was A LOT to consider, pre-existing condition limitations, mental health coverage because a girl has issues, primary care, prescription coverage, access to a provider who was near me, specialist referrals and coverage, maternal care coverage, copays, and deductibles.

[bctt tweet=”The big kicker is understanding deductibles. What’s a good deductible or a bad one? What the fuck does it even mean!?” username=”wearethetempest”]

Half of these don’t even make sense of how they work, and others we don’t even realize are important and providers will slyly keep them out of coverage to fuck us over later. For instance, it doesn’t help if a doctor can diagnose you for free but then you have to pay for him to write a prescription to fix whatever’s wrong and pay for the actual medicine. No, you want a plan that covers that prescription writing and gets you a discount on medicines from accessible pharmaceutical companies like Walmart and CVS. I tried to be cautious of this as well as mental health and specialist coverage.

Primary care doctors aren’t the be-all end-all, and sometimes you just need to go straight to a specialist without a referral. Why pay to go see your primary care doctor in order for him to refer you to the gynecologist you initially wanted to see? Cut the middle man, cut the processing time, and cut your cost. Now, the big kicker is understanding deductibles. What’s a good deductible or a bad one? What the fuck does it even mean!? Here’s what I found.

list scroll GIF
[Image description: Scene from Aladdin; Jafar unrolls a large list that rolls down and bumps into the Sultan.]
Basically a deductible is the amount you have to pay out of pocket before your health insurance kicks in. For instance, say you break your leg and your hospital bill is $5,000 because you took an ambulance ride to the hospital and underwent emergency surgery. If your insurance plan has a deductible of $2,000 you are required to pay that much of your bill before they kick in. Once you pay that, they cover the rest.

This is different than a copay. A copay is what you pay for “regular” visits, so every time you go to the dentist or your primary care doctor you pay a small fee, and your insurance covers the rest. When I was on Medicaid, I had to pay $20 every time I went into my eye doctor for an annual check-up, but then my insurance paid for the rest of the visit, my prescription, and a free pair of glasses. Some plans also offer certain deductibles for prescription drugs, so if you are a person who needs a prescription every month you want to be aware of that as you choose plans.

[bctt tweet=”This is all a confusing process and I wish it could be less complicated” username=”wearethetempest”]

Healthcare.gov explains that plans with lower monthly premiums – what you pay in the bill – have higher deductibles, and those with higher monthly premiums have lower deductibles. Generally, you want that lower deductible so in an emergency you don’t have to scrounge up $10,000 out of pocket in order to get the care you need.

This is all a confusing process and I wish it could be less complicated, but I think the important thing to remember when signing up for a health care plan or evaluating one provided by your job or school is to evaluate your own health. Do a self-analysis and think of all the things you would need, a low deductible, maternal health care, dental, mental health, prescriptions if you have a condition, etc. Once you have an idea then you can move forward and choose the best plan for you. It’s complicated and reading all the plans can make your head swim, but I luckily had a friend I trust and love by my side and that helped more than anything.