welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Wednesday, November 13, 2013

my healthcare.gov experience

my personal opinion is that we all should have medicare for all
so we would all be on the same plans and this would all
be uncomplicated for everyone and
no one would be left out

if done right and with making the health care changes that
we need to make in the usa
it would be a cheaper and easier system to deal with

that said thats not an option

remember i live in a state where the states administration does not want
this system to work and has done its best to keep it from happening
seems illegal to me

if you have medicare medicaid va insurance champus insurance
or insurance at work or through your retirement or some of
you with a private health policy this all doesnt apply to you
you already have insurance

let me say now if you need insurance
ignore all the stuff you are hearing on radio tv and the internet

if your policy was canceled it was probably because it
was a piece of crap insurance
that does not have the patient protections that we all should
have on our health insurance policies

lets leave politics out of this
you need insurance
these policies that are available are from good stable insurance
they are good policies as good as you can get at work

for me my choices are from $270+- to over $1000 a month
based on the insurance company and what coverage i want

what i did was i looked for coverage that was the same as
what i have now through my wife shes work so i could
compare apples to apples and oranges to oranges

there is a plan for you based on what you can afford
remember over half the people who apply will qualify for
thats half of you who apply
if i was just on social security and my wifes shes salary we
would qualify for subsidies
says something about teachers salaries huh

heres is my situation
im on my wifes plan at work
a blue cross blue shield ppo that recently changed its coverage
and its cost so i wanted to compare our plan to what was

i wanted a ppo since i hate hmos and i wanted to stay with
blue cross blue shield
i also wanted to avoid those companies that i recognized from
private practice that physicians and patients had a lot of trouble
either getting them to pay or getting them to provide care
i wanted a platinum plan since those are usually the best ones to get

the choices are platinum then gold then silver then bronze
as the costs go down the coverage goes down also
but the bronze policies are good safety net policies

also remember there are a lot of protections that are in there now
that were not there before the affordable care act was passed

the platinum plan available in texas the only one is an hmo
my provider i use is on there but when you look at it closely
i realized it was probably going to be too restrictive when it
came to getting care so i avoided it
bad sign was it was cheaper than the lower gold plans
i am considering

about 3 weeks ago after not being able to get on the website
i read an article about changing browsers and the website would
i changed from google chrome to internet explorer and easily got
on to www.healthcare.gov
i was able after answering a few questions to look at what policies
would be available in texas so before creating a log in i already had
my 4 policies picked out to look at

i then created a log in and easily went in and filled out the application
i had to wait a day or two before all the verifications that had to be
done to see if i qualified for subsidies was completed
(thats probably a part they could eliminate if someone doesnt want
subsidies or know they dont qualify)

after a couple of days i went back in and got more information on the
four policies all ppos and all from blue cross blue shield
all i have to do know is check the one i want to purchase and
click on it and im done

remember the hmo versions are much cheaper if you dont mind
dealing with an hmo insurance

my present ppo   $843   ded $500   max out of pocket $2500
my prescriptions for 12 months $400  copay pcp $20   spec $40
a $2000 er visit   i pay $150 + 20%=$150+$370=$520

ppo 1                  $855   ded $500   max out of pocket $4000
my prescriptions for 12 months $0       copay pcp $30   spec $60
a $2000 er visit   i pay $400 + 20%=$400+$320=$720

in a typical year without er visits or other services
present ppo copays $160+drugs $400+pay all labs and xrays to $500
new ppo 1   copays $240+drugs $0    +pay all labs and xrays to $500
so my new ppo 1 would be cheaper if i have my typical year
but my present ppo would be cheaper if i had er visits hospitalizations etc

so really these policies are about the same
the difference is on what my health issues will be this year
note the provider lists and hospital lists are the same on both

be sure and check the lists if you want to keep your doctor

my younger son lives in california and pays $267 a month for a private
policy that has been grandfathered in since hes had it for about 8 years

its a $2500 deductible that pays 100% after the deductible is met
i suspect when it comes up for renewable it will disappear when it
has to meet the new standards

ive gone on the california health care site and have looked for policies
for him in the area where he lives
i looked for a ppo and a blue cross blue shield policy
i will recommend he get not a platinum or a gold policy but a silver one
for $343 a month since he never uses his insurance except for an
occasional illness
he would have a $2000 deductible with a maximum out of pocket
of $6350
as long as he just see drs in the office and urgent care the two
policies basically cost the same in yearly expenses

or he might do ok with just a bronze policy for even less

remember you wont go broke if you have a major health
event because of the protections in these policies

so in summary
dont listen to the naysayers
this isnt about politics its about your health care

go on the website www.healthcare.gov and look at what is available
in your state and especially if you get subsidies which half of you will

fill out the application then pick the policies you may want
consider using your health care expenses last year to compare them
like i did to each policy
hit button buy and youre done

ive found it not as complicated as its being made out to be
consider switching browsers if you are having trouble
i still cant use google chrome to get signed in to the website

take care of yourself and your family
dont miss out on this opportunity to get good insurance

the organicgreen doctor


  1. Thanks for eliminating a lot of the confusion. Your opinion matters greatly.
    Cowgurl friend

  2. finally had time to read this, I am glad you cleared up alot of my questions. My daughter needs insurance this info will help more than you know. Thanks Doc!!