Careful questions when choosing insurance

Moderated by Tom Sabulis

Deadline nears for health exchange decisions

Dorothy Leone-Glasser

The race to sign up Georgians for the Affordable Care Act, or Obamacare as it is commonly referred is in full swing. Many groups are spending countless hours to educate individuals about new coverage options available to them under the ACA. I commend the efforts of these groups but want to reinforce to both the individuals signing up for coverage and Georgians, in general, that this is a big decision that will have significant impact on people’s lives.

I am a systemic lupus survivor of over 42 years. However, 26 years ago I was diagnosed with stage 4 cancer and dropped from my insurance plan. Because of my poor cancer prognosis and my poor lupus rating of kidney failure and stroke, I was not able to be underwritten for any affordable health insurance coverage. For the first time in 27 years, I will now be able to get health coverage – coverage that until now, I have been denied because of my pre-existing conditions.

I hope that individuals, particularly those of us with life-changing and life-threatening diseases, will ask the right questions when signing up for a plan through the health exchange:

1. Is my doctor and hospital in the plan? In my case, I go to a rheumatologist and oncologist who ensure that my care is coordinated between all of my specialists which has resulted in prolonging my life and improving my health over the years.

2. Will my prescription drugs be carried on the preferred drug list? In some cases, generic drugs are fine, but I take many brand name drugs that my doctors prescribe that aren’t available in generic form.

3. What will be the cost of my prescription drugs? It’s one thing to have them available, but what will the co-pay be for my current prescription medications?

4. What will be my deductible? For some, who are very young and in good health, a $5,000 deductible is just what they need. But, for people like me who know that I have significant healthcare needs, the cheapest plan will be like having no plan at all.

These are questions that I hope “navigators” are asking people as they make their health insurance decisions.

If you are in the market for any of the plans available in Georgia through the health exchange, please slow down and consider your needs and your options. You have until Dec. 15 to choose a plan for the January 1 start-up. It is important to realize that the health plan you choose today cannot be changed until January 2015.

In the 40 years that I have been battling all the complexities of lupus with arthritis, stroke, kidney failure, seizures and heart attack, 26 years of cancer and 27 years I have been uninsured, I’ve had to make huge sacrifices in order to afford the medical care necessary to manage my health and many times I have been in serious medical jeopardy. To be able to have health insurance coverage is a celebration for me. However, I’m hoping that now the right health insurance plan will not only afford me access to good doctors, therapists and the right prescription regimen, but also allow me to live longer being productive and moving toward wellness.

Dorothy Leone-Glasser is President of the Atlanta-based nonprofit Advocates for Responsible Care.

One comment Add your comment

Bernie31

December 9th, 2013
11:25 pm

If only we Had a WISE Governor and a Insurance Commissioner who supports Affordable Healthcare for ALL Georgians. However We are without the Necessary LEADERSHIP to move this issue Forward and the REAL LOSERS will be the Citizens of Georgia. Just as their Political Leadership.