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29% Rate Hike and 30% Copay to Keep Access to Providers

Richard Hammer - Los Angeles, CA

 

“My total out of pocket expenses for medical care in the past 12 months have been staggering.”

 

I am currently paying $1,584 per month for a grandfathered Anthem Blue Cross PPO plan. I looked at the options offered by Covered California. To my dismay, I discovered that there was not one plan that would allow me to see all the doctors who have kept me healthy and alive for the past 25 years. As an HIV positive man it is critical that I maintain access to  the health care providers whom I know and trust. It is also critical that I maintain the right to choose care from the widest possible group of professionals. And I am paying the price…literally…for this ‘privilege,’

I was accepted by Blue Cross in 1984. My annual premium back then was $875. By 2011 my premium had risen to $1,124. In 2012 it rose again to $1,283. With my premium now at 1,584.00, the increase in my premiums from 2011 stands at 29 percent

The monthly premium is not the only issue however. I have a 30% co-pay on all medical visits, lab tests and medications. I also must foot the bill for chiropractic care which has become necessary due to degeneration of the cervical spine. While Anthem does provide partial reimbursement it is only for a limited number of visits. As you might imagine my total out of pocket expenses for medical care in the past 12 months have been staggering.

I am a freelance contractor in the entertainment industry and currently unemployed. Anthem’s monthly premiums have put a serious strain on my savings. At 62, this is a problem I do not need.

Anthem regularly uses ‘scare tactics’ to persuade me to relinquish my grandfathered plan.  A June 2014 bulletin that was sent to me stated the following ‘New improved health insurance options are available in California. You currently have health insurance that is not required to follow many of the new laws. For example, your plan may not provide preventive health services without you having to pay any copayments. Also, your current plan may be allowed to increase your rates based on your health status while the new plans and policies cannot.” What Anthem fails to say is that all of their new policies come with a restricted and diminished list of health care providers who participate in these new plans. With my grandfathered plan I can be treated at any number of hospitals. This is not the case with Anthem’s covered California plans.

As a person with HIV the quality of my medical care is critical. In fact, it’s a matter of life and death. So, despite the huge cost, I must keep my grandfathered plan in order to maintain the quality of care that is necessary for my well being.