Many of you know that I’ve been sick for over a year and recently diagnosed with Hodgkin's’ Lymphoma. Sure, I have Medicare as well as a secondary insurance plan to form Medicare Advantage, but even I didn’t realize how important the Affordable Care Act is in my situation.
The free (no co-pay or deductible) physical exam (primary doctor and GYN), routine testing, and preventative health care which helps all of us is fabulous, but only works for those with insurance coverage/Medicare. Intended to promote annual doctor visits and early diagnosis when disease is most effectively treated with lower costs, it will eventually lead to a decrease in health care spending overall.
Most people also know that people with pre-existing conditions can’t be denied coverage, that children up to the age of 26 can continue on their parents’ insurance, that women can’t be charged higher rates than men, and I’m sure I’ve forgotten something else. All great stuff that moves us in a positive direction (yes, we have miles and miles to go until no one goes without health care).
What is saving my life, though, is the removal of the lifetime cap on benefits. I had good insurance through my employer which continued through my retirement. However, my lifetime cap was always listed on any insurance claim as well as how far I was away from reaching it.
My lifetime cap was $250,000.
I haven’t received my bill yet, nor have I received anything from United Health Care telling me what portion I have to pay, but I will no longer be in a position where nothing is covered because my lifetime limit was reached.
Considering my 15 day hospitalization, the countless ultrasounds, scans, labs and expensive chemo and other drugs I received, the numerous consultations with specialists to address things like kidney failure (improving) and congestive heart failure (gone for now, but awaiting follow-up echocardiogram), I’m sure that “lifetime cap” was crashed through sometime in late December, 2016. I’m grateful it's gone.
And the bill keeps growing because I’m receiving so many services at home (PIKK line care so I can receive infusions and have blood drawn without needle sticks) and Physical Therapy, as well as outpatient services like chemo every 2 weeks with the necessity for lab testing and restorative meds.
Most people forget about the lifetime limit. I’m here with a reminder that all of us will be much worse off if the GOPrs are successful in repealing the ACA. As much as I have groused about the ACA not going far enough, I need to celebrate how much has been done.
The fight isn’t over to expand health care access even if we save the current ACA. It won’t be over until we overturn our current Your Money or Your Life health care system. Thank you, Democrats, for standing up in unity to protect what we have achieved.