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John’s #GetCovered Story: Staying Covered and Staying Alive

Summary: 
Health insurance isn’t just for musicians, and it’s not just for people who are sick today. Nobody plans to be sick or injured—it just happens.

I was diagnosed with type 1 diabetes at the age of 5, and every year since then until the Affordable Care Act, it has been – to put it mildly—a hassle to get health insurance.

I now have excellent health coverage that I can afford through the Health Insurance Marketplace, and I can’t be discriminated against because of my pre-existing condition. That has made a tremendous difference in my life.

I’ve won music awards and acted in national advertisements and major stage productions. From the outside, I look like a very successful performer. But awards won’t buy you groceries or health insurance. And if I don’t get my insulin, I would die within 48 hours.

Before the ACA and the Marketplace, I had coverage for about $450 a month through the former Texas Health Insurance Pool. Risk pools like that were designed for people with pre-existing conditions who couldn’t buy coverage elsewhere. But the pool covered only two appointments a year for me. My doctor needed to see me four times a year or he couldn’t renew my insulin prescriptions.  So he refused, and I was stuck.

Then in 2005, community leaders launched the Health Alliance for Austin Musicians, or HAAM, to help local uninsured working musicians get affordable health care. Austin prides itself on being the “Live Music Capital of the World,” and the founders of HAAM felt that musicians were a community resource that needed support. I got some medical care through HAAM and assistance from the drug company for the two types of insulin I have to take. But it only covered me locally. And once the drug companies changed their formulas for direct assistance, I had to rely on a friendly doctor who gave me samples.

John Pointer meets HHS Secretary Burwell during a visit to the Health Alliance for Austin Musicians (HAAM) at Foundation Communities in Austin, Texas on December 13, 2015.
John Pointer meets HHS Secretary Burwell during a visit to the Health Alliance for Austin Musicians (HAAM) at Foundation Communities in Austin, Texas on December 13, 2015.

It was still difficult to stay healthy.

On the way to the airport for a tour in Hong Kong, I didn’t have my insulin. I had the prescription but no longer had coverage. A bottle of one of the types of insulin that I require costs $812. It lasts about 45 days, and I use two different kinds.

I didn’t have that kind of money, but I didn’t want to die. So I had to put in on a credit card.

Enter the Affordable Care Act, or as I call it, “The Godsend.” As soon as I could, with help from HAAM, I signed up for the coverage I needed through the Marketplace. I was able to compare plans directly, choose the best one for me, and enroll with the click of a button. My premium for 2015 and 2016 is the same: About $30 a month after tax credits and a $0 deductible.

Health insurance isn’t just for musicians, and it’s not just for people who are sick today. Nobody plans to be sick or injured—it just happens. I urge you to check out your options for coverage at HealthCare.gov.

Don’t delay: You need to sign up by January 31, the end of Open Enrollment, for coverage that starts March 1.

Financial assistance may be available to make health coverage more affordable. And that’s especially important because people who can afford insurance and choose to go without it risk having to pay a fee of $695 or more when they file their taxes. For instance, a single person with no dependents and $40,000 income would pay an estimated $746 for 2016.

Just visit HealthCare.gov to sign up today. If you need help or more information about how to enroll, you can contact the 24/7 call center at 1-800-318-2596, or find in-person help near you at LocalHelp.HealthCare.gov, like I did.

Getting health insurance can seem complex and scary for many people. But for me, with personal help, finding the right coverage through the Marketplace was easy. And it helps me stay healthy, on track and on stage.

Health coverage was music to John Pointer’s ears. It was there when he needed it: http://1.usa.gov/1OW3jza #GetCovered

 

Putting Engaged and Empowered Individuals at the Center Two-Minute Drill: Get Covered This Week