Endo & ACA – Part 2

On October 5th, I had reviewed the Covered California Exchange and realized that unless I make less than $25,ooo a year, I will be paying $600 a month for an Insurance Policy for Healthcare.  But that’s not all. If I want to actually use the Insurance Policy for Healthcare, I have to pay a Deductible Amount of $2,500 per year before the benefits kick in. So really, the ACA has done nothing to make Healthcare Affordable.

It gets even better. There is no breakdown of what the Insurance Policy for Healthcare actually covers, how much is “Out of Pocket” and how much is covered with a $25 co-payment. If there are any lab tests involved with your Healthcare, there is no clear definition that the Insurance Policy will cover the fees – unless of course you are in an ambulance in which case it’s the Law. So if we have Lab Tests related to Endometriosis Treatment in an ambulance are we good?

So I sent a request for Help through the Exchange. All the relevant auto-replies came flooding in, and then…. *crickets*

Right around the end of October, as the date of my email approached the 30-day mark, I was surprised to see 2 people from Health Net review my profile. What a coincidence – the Covered California Exchange was offering Health Net, I send an email to the Healthcare Exchange, I post on Facebook about the experience and suddenly my LinkedIn profile lights up.

Before I became gravely ill with Stage IV Aggressive Endometriosis, I worked for Health Net. It was the company which gave me my start in Programming, Marketing, Sales and Business Process. In 1998, I left Health Net when the Foundation Health Merger began.  I struck out on my own as a Married Woman with her own Consulting Company. Within a few years I was Consulting in the Technology Industry while building a small Multi-Level Marketing Business with the Young Living Essential Oils Product Line and Training under the April Travis Sales Team through the Top Tier Distributors who worked closest with Gary Young .

When I am critical of the Insurance Industry and the ACA Implementation, it is not without merit. I have experience with the Machine first as an Employee before I was a Patient.  The only reason I have survived the Healthcare Maze as effectively as I have over the years is expressly because of my Employment with Health Net. One of my recent Consulting Contracts involved researching and defining a Cross-Functional Solution for International Privacy Law as it pertains to Electronic Data: what is being transmitted, how it is being transmitted where is it being transmitted and along the way who is accessing the data.  It is complex and confusing but it is one of the only defenses the Average Person has to protect private information.

As I calculate the first year of ACA Implemented Healthcare through the California Exchange and choosing Health Net, the cost is anything but affordable. In addition to the $600/month Premium, there is a $2500 annual deductible – so for the first few visits to a doctor, you are paying for a service you can not use, and in order to qualify to use that service you are bound to the Medical Groups and Doctors listed in the Insurance Policy. For those of us with Pre-Existing Conditions, often times the treatment can be as bad as Remission, so the Financial hit to start the process is a tremendous burden.  Even if you save enough money to get on the Insurance Policy for Healthcare, there is the sustainability. If one can not make the monthly insurance payment one does not have insurance – therefore the Treatment stops and you are left in Limbo – unable to continue treatment due to cost, unable to be gainfully employed to generate income to fix the problem… and the negative downward spiral begins.

Now take a look at the Business Process involved with the ACA and the Insurance Companies. Do you think anyone should trust Health Net right now? Should I trust Health Net right now? Clearly my email was pushed up the chain, my Facebook activity was noted and instead of someone reaching out to provide assistance, I get a LinkedIn drive by …. Really? If the Insurance Industry is going to play this fast and loose with my Personally Identifiable Information in the sales process, what on earth are they going to do with my Medical Records once I become a paying Member?  If the employees at Health Net can not behave professionally during the ACA Implementation, what kind of Medical Fiasco awaits once Treatment begins?

You can see why I should be concerned about bleeding out on the Emergency Room floor while my Insurance Provider does a LinkedIn Social Media check before approving the treatment protocol. You can not trust people like this with Medical decisions.

Still not signing up for coverage. I am steadfast in my determination – as long as the Insurance Industry is involved with the ACA, I will not be participating.  There must be another way.


One thought on “Endo & ACA – Part 2

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s