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My Healthcare Navigator Is My Lifeline

By: Lori M., Pasco County

I lost my job in 2013. Since my health insurance was through my employer, I lost that as well. I was covered through September, but when that ended, I couldn’t afford the CORBRA insurance. It was simply out of the question. With no job and my unemployment benefits running out, I needed to find health insurance quickly. I have high pressure in both of my eyes which has led to glaucoma. I treat the glaucoma with daily eye medication, and without it, I will go blind.

When I lost my job I did some research and looked up my medication prices. The manufacturers don’t offer assistance with paying for any of my medications. I found out that a one month supply for each of my medications was $400…..and I have 3 medications. Then, when you figure those amounts for 12 months, the price was astronomical. I would have gone broke just paying for the medication. I was nearly in tears. I knew that buying them from Canada wasn’t an option because medications from other places might not be as strong or as effective.

Somehow, I had heard about the Affordable Care Act (ACA) and got hooked up with Michelle, a navigator. I’ve meeting with her every year since 2013 to sign up for coverage through the Marketplace. I’ve been grateful for her because, if I hadn’t meet her, I don’t know what I would do. The first year I was enrolled in a Marketplace plan I had an HMO and didn’t like my plan very much. After that I switched to a PPO which I prefer because, as an established patient with my doctors, I know that each year I am covered with them. I’ve had that plan for the last few years. With the ACA, I can afford my eye medications. Now, my medications are between $2 and $20 a month, which is affordable. I can cover that.

With the Marketplace, my premiums fluctuate each year, but it’s still manageable. My current premium $79.04 a month, which is lower than my premium from 2019. Michele warned me that premiums might go up for 2021, and she was right. My premium went up by $109! So, my 2021 premium will be $188 for the same plan. I think a lot of the increase has to do with COVID. Maybe the insurance companies have jacked up the premiums to cover the cost of people that got sick and people that might get sick. They’re speculating, and we pay the price.

I’ll be the first person to tell you that the ACA needs to be tweaked. Revamped. Does it need work? Well, sure, of course it does. Everybody knows that insurance company prices and rules need work. I’d be lying if I said it’s fine the way it is. But when you hear stories from other people that get a plan through the Marketplace, they say, “I’m grateful that I have it. If I didn’t, I don’t know where I’d be.”

I was thankful that the administration didn’t dismantle the ACA, because they had nothing to replace it with. Once I saw that the ACA was going to stay in place, I could breathe again. When the election came along, I was terrified again. Since listening to all of the talk about getting rid of the ACA again I’ve decided to ask my eye doctor to review my list of medications to make sure that I absolutely need them. If the future of the ACA is still up in the air I don’t’ know what I will do. All I can tell you is that if I didn’t have the ACA I don’t know where I’d be. With no job, I’m living off of my retirement money. I was cheated out of $14,000 of my severance package, which had a huge financial impact!

I’ve had eyesight issues since birth. I’m partially blind in my left eye and can only see light and color out of that eye. I’m nearsighted in my right eye and wear glasses. I also have some hearing loss and have a hearing aid in my left ear. No insurance company covers hearing aids. I’m 62 years old and looking at three years before Medicare. I’ve looked extensively but have been unsuccessful getting another job. My background is in administrative work, and you would think that my experience would help me in any career field. With the ACA in place, I can rest easier and not worry about my health. At least for now, I have health insurance for the time being.


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