This post is being submitted on behalf of a friend of America’s Health Care Plans. He knows we work with thousands of agents who collectively sell insurance to hundreds of thousands of households. He hopes his family’s story will inspire some of you to sell even more because the advice and guidance you provide really does matter.
I grew up idolizing my uncle. He was single, never married, had long hair, and, though he never rode a motorcycle, had a “biker look.” He was, in a word, cool. He did whatever he wanted in life and always had the best stories, mostly tales from being a teen in the 60s. He was happy and never seemed stressed. I remember him telling me that he didn’t gamble because he always lost, but that was ok—he was unlucky in gambling but lucky in life. Things always seemed to work out for him, and that proves true in his recent health insurance experience.
This lesson begins a little more than two years ago. After going without health insurance for about a decade, primarily because he couldn’t afford it, back in February of 2015, my uncle asked me what I knew about Obamacare. I told him that the law said he couldn’t be turned down for health insurance and that he would probably qualify for financial assistance based on what I knew about his income. He was self-employed but didn’t make much money, not because he didn’t work hard but because his chosen career didn’t pay very well. He had started receiving social security at age 62, and even with his earnings from working full-time, his income fell well below 400% of the Federal Poverty Level.
I agreed to help and found the application process through Healthcare.gov to be quite easy. That said, I knew a little about health insurance and can see why many people would have difficulty choosing the right plan without some expert advice, primarily because the plans offering cost-sharing subsidies were mixed in with those that did not. It wasn’t immediately obvious which option he should take. Ultimately, we were able to get my uncle a very comprehensive policy for about $50 per month, and the fact that he was a bit overweight and hadn’t had a checkup in years didn’t even matter. Say what you want about the Affordable Care Act, but without it he would have remained uninsured. That would have been bad considering what happened next.
His health coverage began March 1, 2015, and just a couple months later he was experiencing what seemed to be really bad allergies. His voice got worse and worse, and he finally used his fancy new insurance policy to go see a doctor. It took a while to get a diagnosis, but his doctor did discover in the process that my uncle was diabetic. He started taking insulin and began eating better, and today I’m happy to report that his diabetes is controlled through diet; he no longer takes insulin or even oral medication.
By July, we were getting worried. It had been three months and his voice still wasn’t any better. Eventually we learned what we had quietly suspected for weeks: he had throat cancer. A throat scope had revealed a tumor, he had day surgery to remove it, and a biopsy confirmed it was malignant. What followed was several weeks of chemo and radiation. The good news is that by January of 2016 he was cancer free, and throughout the ordeal he didn’t even lose his hair. He saw this as proof that things always work out for him.
To complicate matters a little, my uncle turned 65 in August and his Medicare coverage began August 1, 2016, right in the middle of his throat scopes, surgery, and cancer diagnosis. I called a friend of mine who specialized in Medicare products, and she recommended a Medicare supplement. Though it was more expensive than the Medicare Advantage options he was considering, she pointed out that he’d be able to use the doctors and hospital of his choice without worrying about networks and referrals. I was sold, and it wasn’t difficult to get my uncle on board: $150 per month to have almost all of his bills paid seemed like a bargain. We paired his supplement with a Part D plan that kept his drug costs low.
Long story short, my uncle began 2015 uninsured but in decent health, or so he thought. Over the next ten months, he became insured, switched from private insurance to Medicare, was diagnosed with both diabetes and cancer, received effective treatment for both, and started 2016 with the good news that he was cancer free. Throughout the ordeal, he spent less than $2,000 in premiums, including his Medicare Part B payments, and was out of pocket less than $1,000 total. Not too bad.
In Part 2 of this series, I’ll tell explain how his cancer battle and the time missed from work impacted his income.