#CoverageMatters: The ACA Makes Coverage Stronger For Everyone, Even Through Your Job
What would it be like to fight leukemia on a limited budget?
I had never thought to ask myself that question until my husband, Carlo, was diagnosed with B-cell acute lymphoblastic leukemia, also known as ALL, a rare type of cancer in adults.
We had also never thought much about the Affordable Care Act (aka Obamacare) since we had insurance through my husband’s employer, a suburban Chicago school district.
Then everything changed three years ago. And that’s when I learned that the ACA helped people like me, people who already had insurance.
Carlo was training for a marathon, but felt too sick to run beyond 15 miles. Then, a little while later, he barely got through a field trip with his students, because of some incredible bone pain. The doctors diagnosed him with ALL.
After getting over the shock of his diagnosis, we had questions about our health insurance, because, truthfully, we never had to rely on it before, beyond the occasional sinus infection or strep throat. Then I remembered that many health plans had something called a lifetime dollar limit, meaning there was a maximum amount an insurer would spend on benefits. I found papers stating that our plan had a $1 million lifetime cap. Worried that we would hit the cap because of the rare type of cancer, I immediately called the insurer and asked, Would our health plan be enough to cover all the care he would need?
The insurance rep quickly corrected and reassured me: There are no longer lifetime or annual caps anymore thanks to the Affordable Care Act. And that’s when it hit home for me that the law has made coverage stronger for everyone, even for the 156 million Americans like us who have insurance through their jobs.
So far our insurer has covered 11 hospitalizations, chemo, spinal taps, MRIs, bone marrow biopsies, blood draws, and medications.
Luckily, Carlo, who’s now 46 is in remission. He still requires bone marrow biopsies every six months. He still needs expensive medications. He may eventually need a stem cell transplant if the cancer returns.
Fortunately, I no longer have to look at each bill and worry if this is the one that won’t be covered.
It’s been a whirlwind. Nothing in life prepares you for the stress of a major illness. I can’t imagine what it would have been like if we had to worry about a lifetime cap.
We became panicky again after the election and all the talk of repealing the ACA. We need the ban on lifetime coverage caps and other ACA protections like preventing insurers from denying coverage or charging prohibitive premiums because of pre-existing conditions. Once you’ve got leukemia, you’ve got a pre-existing condition.
Even if you have coverage through your employer, you need the protection that the Affordable Care Act offers. All too often, we don’t know what we don’t have covered until we get hit by cancer, or some other illness, or accident. And by then it’s too late.
It wasn’t until my husband got sick that I realized all the benefits of the ACA. That’s why I urge everyone to be sure they’re covered so they can get the care they need.
If you don’t have insurance offered by your employer, you can now enroll in your own coverage for 2017. Open Enrollment for the Health Insurance Marketplace goes until January 31, 2017.
Check out your options for affordable, quality coverage at HealthCare.gov. Financial assistance may be available to help you get covered. And you can get 24/7 help comparing plans and enrolling in coverage by calling 1-800-318-2596 or finding in-person assistance in your community at https://localhelp.healthcare.gov.
For now, the Affordable Care Act is giving my family peace of mind, knowing that our health insurance is there when we need it.
Carlo recently won a lottery that gives him the opportunity to run in the Chicago Marathon this year. Thanks to the Affordable Care Act and his indomitable spirit, he’s going for it.
I’m sharing our story because our #CoverageMatters, just as it does for millions of other Americans. Share your own story on social media using #CoverageMatters.
It wasn’t until Tracy’s husband got sick that she realized all the benefits of the #ACA. http://go.usa.gov/x9QXq #CoverageMatters
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