HealthSherpa.Com — And Why 60% Is More Than It Seems November 11, 2013November 10, 2013 With all the attention rightly paid to “the 5%” who are encountering difficulty and uncertainty with Obamacare — many of whom will ultimately wind up with better coverage for less — let’s not forget the 95%. (Or the 100% who will benefit from living in a healthier country with a healthier economy.) Manish Bhatia: “I’m tired of hearing rants about Obamacare. What is the Republican counter-proposal? Condemn tens of millions to life without medical insurance?” Bob F.: “I purchase insurance from an ex-employer whose retirement health plan I’m eligible for. I’m still working, for another company, and exceed the income levels for any subsidies. However, I wanted to compare the prices available on the exchange to see if I could get a better deal. I was looking for a way to get to a price list without having to go through the entire registration process. When I called the 800 number for healthcare.gov support on Friday, I was told how: On the healthcare.gov home page, there are two green rectangular buttons, APPLY ONLINE and APPLY BY PHONE. Directly below is a grey rectangular SEE PLANS NOW button. It takes you to a page that links to “plans and sample prices” — which takes you here, asks questions, and then gives you a list of plans and prices. These prices do not include the tax credit but for my purposes that didn’t matter. As it turns out, the Marketplace plans and the plan I currently have are close enough that I’m not going to bother switching. Like President Obama said, ‘If you like your current health plan you can keep it.’ I’ll be doing just that.” Bob could simply have used healthsherpa.com — which does include the subsidy calculations. This is so cool. Three twenty-year-olds did it in their spare time over a few nights and weekends. As a public service. Just enter your info and out come your available plans and prices. If you see one you like, click the “How To Buy” button and they tell you how to call the insurance company and buy it. That simple. THE BRONZE PLAN COVERS MORE THAN 60% And listen: we all have a lot to learn about Obamacare. For example, a lot of us know that the “bronze” plan will usually be the cheapest option, covering just 60% or so of the medical expenses you incur. Pretty crappy, no? But as I read this (correct me if I’m wrong), it understates two really important benefits: > First, that your 40% co-pay is based on the dramatically lower fees your insurer negotiates than the full rate you’d be charged if you were uninsured. I go in for an MRI on my own, I might be billed $1,200. I get it via my insurance, maybe it’s billed at $400 . . . of which my 40% comes to $160. So in this example, the bronze plan covers not just 60% of that $1,200 I might have been billed for when I had no insurance (which for many years I did not), but more like 87%. > Second, there is an out-of-pocket annual cap of $6,350 for individuals and $12,700 for families. A huge sum for most families, to be sure. But say you get really sick or injured (God forbid! feh! feh!) and have $670,000 in hospital and medical bills. The bronze plan pays only 60% — until you reach your out-of-pocket cap, but then pays 100% of the rest. So in this example it would be covering not 60% but more like 98% or 99% of your 2014 medical expense. And there are no longer any lifetime caps, thanks to Obamacare, which makes you all the more secure. Which is the whole point of having insurance. To be more secure still, set up an HSA — a Health Savings Account — much like the IRA you’ve been building. Once you’ve amassed a nice sum, even the $6,350 or $12,700 in co-pays you might have to shell out with a bronze plan in an illness- or injury-plagued year would pose no threat to your solvency. VETERAN’S DAY Where would one even begin to express one’s admiration and gratitude? Honoring a hero via the Bob Woodruff Foundation is one idea. Resolving the V.A.’s horrendous disability-claim backlog would be an even better idea.