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Many health insurance plans being canceled weren't worth much

Nov. 6, 2013 at 1:50 AM   |   Comments

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WINTER HAVEN, Fla., Nov. 6 (UPI) -- Many U.S. adults who bought individual health insurance policies and now received cancellations letters are discovering their plans weren't worth much.

Diane Barrette, a 56-year-old woman from Winter Haven, Fla., was interviewed by CBS News and was upset Blue Cross Blue Shield of Florida was canceling her $54-a-month "GoBlue plan 91," but offering to replace it with a $591-a-month "Blue Options Essential plan."

"What I have right now is what I'm happy with," Barrette told CBS News. "I just want to know why I can't keep what I have. Why do I have to be forced into something else?"

However, Barrette didn't know exactly what her GoBlue plan 91 covered and it didn't cover much because it was not what most people think of health insurance -- insurance that would pay for hospitalization for a heart attack or injuries from a automobile accident.

Barrett's health plan, officially known as a mini-med, and also known as a "junk plan," provides limited coverage for lower-cost items such as doctor's visits. They often do not cover higher cost items such as hospitalization, expensive diagnostic tests or maternity care.

The Affordable Care Act requires all health insurance plans in 2014 include: doctor visits, hospitalization and outpatient treatment, diagnostic and screening tests, maternity care, mental healthcare, prescription drugs, home healthcare and rehabilitation services.

ConsumerReports.org interviewed Barrette and analyzed her plan which:

-- Paid only the first $50 of doctor visits, leaving Barrette to pay the rest. Consultations with specialists can cost several hundred dollars.

-- Paid the first $15 of a prescription although some prescriptions can cost hundreds or even thousands of dollars a month.

-- Paid the first $50 of hospitalization only for "complications of pregnancy."

-- Paid $50 for a mammogram that can cost several hundred dollars, and only paid $50 apiece for a imaging scans and only when used for osteoporosis screening.

Karen Pollitz, an expert at the Kaiser Family Foundation, told ConsumerReports.org Barrette was essentially non-insured because if she has made a claim for something serious such as breast cancer or a heart attack, and if she had no other savings, she would have lost her house. The whole time Barrette was paying health insurance premiums she probably didn't realize how little she was covered, Pollitz said.

However, determining what health insurance policies cover is difficult. Barrette's insurance company's summary of benefits is at: https://consumerdirect.bcbsfl.com/sites/default/files/plan-brochures/GoBlue91.pdf.

A person has to apply for coverage when using HealthCare.gov, which is running the marketplace in Florida, so it's difficult to suggest another option under the Affordable Care Act's website, but similar information is available at eHealthinsurance.com.

Barrette, who told ConsumerReports.org her income was about $30,000 a year, qualifies for a federal subsidy of $320 a month beginning in January.

Barrette could purchase a Humana Direct Silver 4600/6300 plan for $165 a month -- or about $100 more a month than she is paying now. Her deductible would be $4,600 a year and her out-of-pocket costs limited to $6,300 a year -- a steep cost for someone making $30,000 a year. However if the 56-year-old woman got breast cancer it's estimated it could cost her some $120,000 to treat and her old GoBlue plan 91 would not have paid for her surgery, chemotherapy, medications or the repeated diagnostic tests she would likely need.

The New Republic discussed Barrette's options under the Affordable Care Act and Barrette said: "With my age, things can happen. I don't want to have bills that could make me bankrupt. I don't want to lose my house."

© 2013 United Press International, Inc. All Rights Reserved. Any reproduction, republication, redistribution and/or modification of any UPI content is expressly prohibited without UPI's prior written consent.
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