As my family sits around the table this Thanksgiving, with turkey and beef brisket and cranberry relish, two types of potatoes, and goodness knows how many pies, we’ll take some time to reflect on our blessings.
Without a doubt, my health will be on our minds. Last March I had major abdominal surgery for probable ovarian cancer. My surgeon, a highly skilled specialist, said beforehand there was a 95 percent chance that’s what I had. And while recovery from the operation wasn’t easy, I lucked out. I hit the 5 percent chance and don’t even need chemotherapy.
And I lucked out another way: Without insurance, I would have over $100,000 in bills. If cancer had been found, those costs would have been much higher. And, of course, while some say that sick people can always get care in an emergency room, that’s not true for someone with my situation and the diagnosis the two surgeons I consulted thought most likely.
When I got this diagnosis, I felt healthy. Pretty much the only time I went to a medical office, it was to get an annual checkup. Then, suddenly, out of the blue, there were high-tech, expensive tests and surgery. My family could have been devastated, not only because of my condition but also financially.
If you don’t have health insurance yourself, or if you have a friend or family member who lacks it, you or they should get it. Feeling healthy now doesn’t protect you from needing care for an accident, sickness or pregnancy.
It’s true the launch of the federal insurance marketplace was a fiasco. The site worked so badly that President Obama apologized for it. Sen. Angus King compared the badly functioning site to 1970s government operations in the Soviet Union.
Now the website is not only working much better, but there’s an easy way for anyone to check how much insurance would cost. You can’t just look at the sticker price, since most people buying through the marketplace will receive financial aid. That aid, a subsidy, will be paid directly to the insurance company.
A new website, thehealthsherpa.com, has information about insurance plans in Maine and most other states.
You start by putting in your ZIP code, then enter the ages of everyone in the household. At the bottom left, indicate household size and income. You’ll see a list of insurance policies, which you can sort by levels of coverage (bronze, silver and gold).
If you do this, you’ll find that a 23-year-old living in Bangor making $18,000 a year would pay between $15 and $78 a month for a bronze plan and between $54 and $124 for a silver one.
A 30-year-old single parent in Newport making $35,000, with a five-year-old, could get bronze-level insurance for between $110 and $215 a month, silver for between $173 and $298.
An Augusta family of four, ages 42, 38, 15 and 10, with an income of $65,000 could get a bronze-level plan for all of them for as little as $195 a month and up to $335. Silver plans, with better coverage would cost between $326 and $506.
And a 62- and 64-year-old in Calais earning $40,000 a year could get a bronze plan covering both for between $0 and $252 a month. Silver-level plans are available for between $206 and $549.
Now, thehealthsherpa.com doesn’t list deductibles and copays, but it provides links to the insurance companies for details, and the federal website shows those. And to buy a policy and get the subsidy, you need to use healthcare.gov or apply by phone at 1-800-318-2596. A local navigator can be found via LocalHelp.HealthCare.gov.
In general, Maine Community Health Options seems to have the best prices and they have an extensive network of providers. But, as they say, mileage will vary.
Unfortunately, because Gov. Paul LePage refused to expand Medicaid, about 28,000 Mainers make too little money to get help buying insurance. LePage’s decision means these low-income working people are more likely to get sick, die or go bankrupt. The Maine Legislature can overturn a future LePage veto and get coverage to these many thousands.
But lots of other Maine people have new, affordable options.
This Thanksgiving, help someone find coverage. The Affordable Care Act isn’t perfect, but it will help a lot of people get care and prevent financial ruin. And for that, many families will give thanks.
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