Insurance – Thrifty Patient

Affordable Care Act Faces Uncertain Future

On Wednesday, May 1st 2019 the Trump administration signaled it’s legally challenging the constitutionality of the entire Affordable Care Act (ACA). This marks a shift from their earlier position that parts of the act were good and parts should be struck down. If the entire ACA repeal goes through, then up to 20 million people in the US are in a position to lose coverage.

The Thrifty Patient is an a-political, pro-patient organization. Our mission is to help all patients, no matter how they vote. So, instead, we’re looking at who has benefited from the ACA and how you can prepare for an ACA repeal if you are going to lose coverage.

Who Benefits the Most from the ACA?

There are 4 groups of people in particular that benefit from the ACA. If you’re one of the over 20 million in one of these groups, you would be rightly concerned about what an ACA repeal means for you.

1. People with Pre-Existing Conditions. The ACA ensured that insurance companies couldn’t deny coverage to people with costly pre-existing conditions. Here are some proposed examples of pre-existing conditions. Before the ACA, there were over 400 pre-existing conditions defined by insurance companies, the most common being Cancer, Diabetes, Pregnancy, Mental Illness, and Hepatitis.

2. Young Adults. Under the ACA coverage was extended to the age of 26. You may have noticed young people think they’re invincible. You combine this with the fact that many young people don’t have very well paying jobs until their late 20’s and you’ll find many not affording or thinking they can skip coverage.

3. Low-Income & Lower-Middle Class Families. The ACA allowed states to expand medicaid coverage to so that your household qualifies if the household’s income is below 138% the income level. Check this healthcare.gov tool to see if your state expanded coverage and your household qualifies!

4. People who Need / Use a lot of Care (Via Elimination of Lifetime Caps). One group of people who benefited tremendously was people who have required very costly cares. Before the ACA you had limits to the amount insurance would pay out to cover your bills. For people like newborn Timmy Morrison’s parents, who got a $2 million dollar medical bill – this could quickly bankrupt you. Medical bills are still the #1 cause of bankruptcy in the US, and the ACA was a step towards addressing this.

How to Prepare for an ACA Repeal

If the thought of and ACA repeal gets your heart pounding and your blood pressure skyrocketing…

First, take a deep breath. There are many steps and barriers until that’s a reality. Even if it does happen, we all hope that the politicians have learned how popular at least parts of it are, and won’t want the fallout of kicking everyone off.

Second, start doing research. As the demand grows, options like transparent, out-of-pocket care are becoming more widely available. Also look into what options will allow you to obtain care for free. We have an excellent write up on how to get free dental care. ACA repeal or no repeal, these options are worth knowing about!

Third, take stock of your finances. If you receive care for free now, what can you start saving towards medical expenses? Look into options like High Deductible Plans and Health Savings Accounts. These options are especially important to young adults, who may be aging off their parent’s plans earlier. Don’t let an ACA repeal catch your bank account flat-footed.

Fourth, begin asking about ways to save money now. There are many options out there for drug cards, generic medications, free wellness programs, and so on. Even if the repeal doesn’t go forward, you can only benefit from knowing more about your options.

Fifth, use your coverage now! Take care of those health problems NOW while your coverage is solid. If you’ve been putting off going to the dentist, do it now. If you’ve had shortness of breath, or a sore back or knees that you’ve been ignoring, now might be the best time to get them taken care of. Best case scenario, a year from now you feel better then ever and you still have your coverage.

Finally, if you feel strongly one way or the other about a repeal, take action and contact your representatives to tell them how you feel. At the Thrifty Patient we want to help empower every person to be the best advocate they can be for themselves.

Breaking News: Monthly Cigna Insulin Costs now Capped at $25.00!

Today Cigna and Express scripts took a major step towards driving down the price of insulin for everyday patients. Studies by groups like the American Diabetes Association that insulin prices are rising and people are cutting back due to affordability. For a chronic disease that costs the US more than 300 billion dollars yearly, highly priced insulin is as unethical as it is unaffordable. Insulin is a required drug needed to manage blood sugar levels. Without insulin, the consequences can be life-threatening. In fact, before the discovery of insulin, diabetes was a fatal disease.

Sadly, for many people the cost of insulin can be the difference between if they are treating their disease or just hoping it doesn’t get worse. Insulin too is only part of the problem. Since diabetes is a chronic disease, the cost of testing strips, meters, and regular blood work can be both financially and emotionally draining. With this Cigna insulin Patient Assurance Program, at least one of these factors is being addressed.

Cigna, Insulin, & Express Scripts

Cigna, working with Express Scripts has just announced a new capped price for monthly insulin. For participating Cigna plans, the Cigna Insulin Patient Assurance Program works by bumping down your copay. According to Cigna, this results in an average cost drop from $41.50 for a 30-day supply to $25.00 for that same 30-day supply. All of the savings works out to to about $200.00 a year. Taking into account that Diabetes is a life-long, chronic condition this could result in thousands of dollars in savings.

Who Benefits the Most from The Cigna Insulin Plan?

Everyone who needs insulin should benefit from lower prices offered by the Patient Assurance Program. By the way the press release was worded, certain plans may already be paying less then $25 for a month’s supply of Cigna insulin. People expected to see the biggest benefit will be those on a limited incomes, people who are on high-deductible plans (who may be paying premiums for prescriptions), and people who have been forced to cut back on their insulin due to financial constraints.

How Do I Take Advantage of the Patient Assurance Program?

First, you need to be a Cigna member. At the time of this writing open enrollment is currently closed and will reopen this year from Nov. 1st 2019 to Dec., 15th 2019. There are some circumstances which may allow you to sign up now, you should read about them on Cigna’s website or talk to one of their service representatives (click here).

If you are a member and interested in learning more about the Patient Assurance Program, I’d recommend calling Cigna directly or visiting their website.

Cigna indicates in their press release that they’ll “be activating this new program for participating plans by moving covered insulin products to a lower copay.” You may still want to call to make sure everything is going as planned and to learn when your lower costs will be reflected in your bills.

Tag: Insurance

How to Prepare for an ACA Repeal – 6 Important Steps