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Medicare Resource Center
by Susan Ruiz Patton, AARP Bulletin, June 1, 2010
Artis Perry took two aspirin for the crushing chest pain that woke him up and hoped he’d feel better in the morning.
In a few hours, the pain “was 10 times worse,” he said.
So the 64-year-old told his wife, Linda, “Wake up and get dressed. You’re taking me to the emergency room.” While he was getting dressed, he collapsed and Linda called 911.
That June 2009 heart attack was the first of a half-dozen emergency room trips for the Perrys of Euclid. Those trips and surgery to put stents in his heart cost roughly $70,000.
The Perrys don’t have health insurance. His part-time job driving a school bus offered it, but the rates were higher than he could afford. He went without insurance and took his chances—despite heart problems from a childhood bout of rheumatic fever.
If he’d had his heart attack this year, Perry—who will go on Medicare later this year—might have been able to afford insurance.
Even before President Obama pressed for health care reform, Ohio was in the process of making it happen. Mary Jo Hudson, director of the Department of Insurance, said AARP Ohio was a key player in getting the changes made.
About 1.3 million people in Ohio don’t have health insurance. The Ohio insurance department estimates 109,000 Ohioans will get some insurance over the next three years as a result of two new state laws that make coverage more affordable and available.
One law, which took effect in January, eventually caps rates for people with preexisting conditions at 1.5 times the lowest rate for those without them.
Ron Bridges, AARP Ohio advocacy director, said he knew of consumers with preexisting conditions whose premiums were 25 times more than those without.
The insurance department’s actuaries have estimated that the average rate of $800 per month for an individual plan with preexisting conditions could be reduced to about $285 by 2013.
The downside is that these are bare-bones policies that lack drug coverage. They’re meant to be the health insurance plan of last resort for people who can’t get anything else, Hudson said.
To take advantage of the new rates, consumers will have to change policies and possibly insurance companies. The rates won’t automatically be reduced and insurance companies aren’t required to tell consumers about the new laws, Hudson said.
Companies with open enrollment and some rate estimates are available at the Ohio Department of Insurance’s website.
“What’s important right now is spreading the word about these laws,” Bridges said. “If you’ve ever heard anyone talking about insurance being a burden, they need to know about the new open enrollment program.”
The law is being phased in over three years to allow insurance companies to slowly absorb new customers. Each insurer is only required to take a certain percentage of new policyholders each year. Once that threshold is reached, they will not take any more until the following year.
The other law, effective July 1, allows parents to keep their children on the family health insurance plan until age 28. That is more generous than, and takes precedence over, the federal health reform law, which extended coverage of children to age 26.
In Ohio, roughly 300,000 of the uninsured, 23 percent, are between 23 and 34.
Aaron Nix, 25, of Westlake, is one who may be helped. Nix recently got a job at a company that does not offer health insurance for its five employees. He was shocked when he tried to purchase an individual plan but was rejected because of acid reflux and sinus problems.
“I felt like the system let me down,” he said. He eventually found health insurance for a higher rate, but his insurer refuses to cover treatments relating to his reflux or sinus problems. Under the new law, he could get back on his parents’ plan until he turns 28.
For more information, call 1-800-686-1526.
Susan Ruiz Patton is a freelance writer based in Cleveland.
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