Great reporting by the Charlotte Observer’s Karen Garloch over the weekend. While early frustration with the website showed, the five people she profiled were all getting a better deal on health coverage – much, much better. And to Garloch’s credit, she went into the details of people’s current plans and what they were purchasing now. Just one example:
Simmons was laid off in June 2012 after 30 years with a Suffolk, Va., chemical plant. He and his wife, Briding, both 59, moved to Gastonia to live with their adult daughter. Simmons collects unemployment pay, and both he and his wife are going to school to prepare for new careers.
Today he pays a premium of about $300 a month for health insurance for himself and his wife. That’s a reduced rate. Because his previous employer was adversely affected by foreign imports, Simmons gets federal assistance with expenses for education and insurance.
Knowing that will run out at the end of the year, Simmons went online when enrollment opened Oct. 1 for the Affordable Care Act. He could never get the website to work properly. But in mid-October, he stopped in at Carolina Health Insurance Market in Gastonia, and an agent got through that day to compare plans and view subsidies.
Because Simmons’ current income is between 100 to 150 percent of the federal poverty level, the couple was eligible for a $1,150 premium subsidy as well as assistance with deductibles and co-pays.
For a “silver” plan with Coventry Health Care of the Carolinas, they will pay $17.74 per month instead of the “sticker” price of $1,168 a month. Instead of a $3,750 deductible, theirs will be zero. Instead of a $10 co-pay for each primary care visit, they’ll pay zero. And instead of $75 to see a specialist, they’ll pay $20.
Last week, Simmons made his first premium payment for coverage that starts Jan. 1. If he finds a job in 2014 and his income goes up, the calculations will change. But for now, he said: “I think it’s a great deal.”