Faces of the Affordable Care Act: For couple, a positive exchange

Shopping state's website benefits Meadow Glade husband and wife

By Marissa Harshman, Columbian health reporter

Published:

 

Health insurance profile

Name: Paul Ward.

Age: 61.

Family members: Wife, Susan, 61.

Annual family income: $200,000+.

Current coverage: Kaiser Permanente individual plan ($1,550 per month).

Qualify for federal subsidy? No.

New coverage: Kaiser Permanente individual plan ($1,397 per month).

Examining Health Care Reform

Editor’s note: This is the second in a series of stories looking at how the Affordable Care Act affects residents of Clark County. The Columbian is sharing stories of residents who have found cheaper health insurance through the state-based exchange, are qualified for expanded Medicaid, are opting to pay a penalty rather than purchase a health plan, or are unhappy with the new insurance offerings.

All of the stories also will be available on The Columbian’s Examining Health Reform site.

Paul and Susan Ward have been purchasing their own insurance coverage since they both retired four years ago.

The Meadow Glade couple found a Kaiser Permanente plan that suited their needs and have stuck with it. The plan, which has a $5,000 deductible and an out-of-pocket limit of about $9,000, costs the couple about $1,550 per month.

About a month ago, the Wards got a letter from Kaiser, notifying them that their current plan was equivalent to Kaiser's bronze-level plan under the Affordable Care Act. With bronze-level plans, the insurer pays 60 percent of costs and the policy holder pays 40 percent.

The Wards' policy would be automatically renewed through 2014 unless they took action. Paul, 61, decided to check out the state-based insurance exchange, Washington Healthplanfinder, to see what it had to offer.

On the exchange, which was created under the Affordable Care Act, Paul found a silver-level Kaiser plan for $1,397 per month. The couple does not qualify for federal subsidies.

In addition to finding a plan with better coverage — insurers pay 70 percent of costs for silver plans — for less money, Paul said he's happy he won't face a big premium price hike like he has each of the last several years.

"We've gone through sticker shock the last three, four years," Paul said. "Every fall, we expect to get a big hit."

Their insurance premium went up 20 percent last year when Paul and Susan both turned 60, Paul said.

"I just know this year, too, we would've been hit with another increase," he said.

The Wards have already paid the first monthly premium for their new plan, which goes into effect Jan. 1, Paul said.

While Paul has tried to stay away from the politics of the Affordable Care Act, he thinks it's important people have options. By researching plans, Paul said he now knows more about how plans work, plan deductibles and out-of-pocket amounts.

In addition, using the Healthplanfinder site was simple and made shopping for plans easy, he said. Before using the website, Paul had never shopped around and compared plans.

Since Paul retired from the gas and oil business, he's offered financial help to other businesses in the industry.

He recently helped some employees of those businesses shop for insurance coverage through the Healthplanfinder site and said they're seeing premium costs come down as well.

"I'm a pretty happy camper all around," Paul said.