Fountain Hills man says he may soon have to get another job just to pay for healthcare insurance under the new Affordable Care Act.
Michael Cerpok, is a high school drop-out, one of six kids born to a school teacher, and doesn’t come from a wealthy family. He has run two businesses for more than 25 years and says he may have to do more to literally stay alive.
“I've worked hard because I've had to, and I’ve had to, because cancer runs in my family," says Cerpok, who picked his current health insurance based on that family history. His monthly premium is just about half of his monthly take-home pay.
Back in 2006, he found out he had an incurable form of leukemia that requires ongoing treatment until he dies.
In 2012, his treatment bill was more than $350,000. But because of his insurance, his out-of-pocket was only $4,500.
That’s about to change because Michael just got a letter from his insurance carrier saying as of January 1, he would be dropped from coverage because of new regulations under Obamacare. His doctor at the Mayo Clinic may be gone as well.
Then his health insurance plan doesn't comply with the AHA. He'll be able to go into the exchange and buy a policy that, in all likelihood, will be less money than he's paying now. If he's had leukemia since 2006, in those seven years, his insurance premiums have likely risen 50-100% by now.
Yeah, he's losing the insurance that he's got. But, thanks to the AHA, he'll be able to go out and get a new policy. He'll be just fine. You'll note that he says his premium right now is over half his take-home pay. That will absolutely NOT be true with new policies.
And what if he can't keep his doctors with the new coverage? Why should he be forced to get a different plan? ACA needs to go!
The same thing happened in the pre ACA days too. Jeez you guys.
The same thing happened in the pre ACA days too. Jeez you guys.
And what if he can't keep his doctors with the new coverage? Why should he be forced to get a different plan? ACA needs to go!
according to the information provided in the OP post he had to pay 4,500 out of pocket. wish it would have provided his monthly premium cost. but under Obama care he will be paying 6,300 out of pocket so unless his mouthy premiums is 160 dollars less per month then what he did pay he will not get a better dealThen his health insurance plan doesn't comply with the AHA. He'll be able to go into the exchange and buy a policy that, in all likelihood, will be less money than he's paying now. If he's had leukemia since 2006, in those seven years, his insurance premiums have likely risen 50-100% by now.
Yeah, he's losing the insurance that he's got. But, thanks to the AHA, he'll be able to go out and get a new policy. He'll be just fine. You'll note that he says his premium right now is over half his take-home pay. That will absolutely NOT be true with new policies.
"Now it doesn't mean I can't go see my current doctor, but my $4,500 out-of-pocket, is going to turn into a minimum of $26,000 out-of-pocket to see the doctor that I’ve been seeing the last seven years," he said.
There wasn't a 7 foot tall stack of Government regulations in pre ACA days.
according to the information provided in the OP post he had to pay 4,500 out of pocket. wish it would have provided his monthly premium cost. but under Obama care he will be paying 6,300 out of pocket
Sorry, I don't buy that $4,500 out of pocket. I've bought too much individual health insurance in my life to believe that. No WAY. Normally, when one talks about "out of pocket," they are NOT including their health insurance PREMIUM. But, in any case, there's absolutely no WAY this guy was just paying $4,500 for everything with his current policy.
He's in his 40's at least by the OP account. In order for him to only have a total of $4,500 out of pocket including his premium, he would have to be paying less than $400 a month for his insurance with a zero deductible policy. Since we know it's an individual policy, and since we also know he's had it since 2006, that is absolutely impossible.
Edit: Oh, he says he works so hard because his insurance costs half of his take-home pay. That further solidifies that his $4,500 does not include his insurance premiums.
Yeah, you're right.
So without the government as an excuse, insurance companies dumped people all the time. Policies were always rendered old and graced out, people were dropped for various reasons, issues and problems weren't covered in general, and the cost was so high people couldn't afford it, etc.
That's what he's referring to. People are trying to present health insurance as if it's been some stable, reliable, dependable, strong source in our country and it's not and never has been - and apparently never will be seeing as how these new regulations don't address some of these issues.
If he can't keep his doctors? Well, nothing is perfect. ACA's not going anywhere. I'm not that crazy about it. It's got plenty of short-comings that probably won't be known for some time. But they'll fix 'em. For those who think the law is going to be repealed? You've really got to get over it.
The Government forced you to get new insurance pre ACA? And it was completely un-affordable? And taxpayers were footing the bill for deadbeats?
Nope but the insurance companies did, when they dumped your sorry ass because they found out that at age 15 you got special medication for your zits and that may be connected to your leukaemia now, and hence it was a pre-existing condition and they wont cover that.
THAT is how it worked before AHA and THAT killed 100s of thousands if not millions of people... so..
he didn't claim the 4,500 was his premium included now did he. your just trying to make a wrongful assumption he did so to make your you BS sound beleavable
They didn't have to drop them. They priced them out. The old business model was that, as an example, an insurance company would come out with The Sunshine Policy. They'd enroll (example) 100,000 people in that policy and then close it to enrollment. Remember, those 100,000 were all healthy people because they wouldn't insure them any other way. Even high blood pressure would exclude. All young. All healthy. As time passed? Those 100,000 began submitting claims. And the insurance company would adjust their yearly premiums to reflect the change from "all healthy" to "not so healthy." As more time passed, they got even unhealthier. Yearly premiums kept rising on these 100,000. The healthy ones? They shopped for "new" insurance. (Back to the "everybody's healthy mode.) So healthy people cancelled their Sunshine Policies and got new ones. That left sicker and sicker people in the Sunshine Policy, and their rates continued to climb.
I was uninsurable eventually, and I became one of those "unhealthy Sunshine Policy holders." I couldn't change policies. Before I finally went into the Illinois ICHIP health insurance program (subsidized), I was paying American Family Insurance $850 a month for my $5,200 deductible insurance policy. How many people can afford that? But since I had assets to protect? I HAD to afford it.
That's how insurance companies got rid of their sickest policy holders. They priced them out.
Nope but the insurance companies did, when they dumped your sorry ass because they found out that at age 15 you got special medication for your zits and that may be connected to your leukaemia now, and hence it was a pre-existing condition and they wont cover that.
Pfft. You don't know what you're talking about. If you want to debate something, at least be knowledgeable about it.
Your monthly premiums never factor into your deductible or your out-of-pocket maximum. You can lower your premium rates by increasing your deductible, coinsurance and / or out-of-pocket maximum amounts.
so why should the responsible healthy young individuals have to pay for the poor life style choices of the fat asses with health dieses and diabetes or the smoker with emphysema and lung cancer
Maggie it is you who wants to assume something that wasn't stated you want to assume his 4,500 out of pocket included his monthly premium
Read more: What Does Out-of-Pocket Maximum Mean With Insurance? | eHow
so why should the responsible healthy young individuals have to pay for the poor life style choices of the fat asses with health dieses and diabetes or the smoker with emphysema and lung cancer
Oh, and you can't read either. No, I said his "out of pocket" did NOT include his premiums. That's why his story is useless as an AHA bash. If his premiums the old way were $25,000 a year and his out of pocket was $4,500, then if his out of pocket is $6,500! under the AHA, but his premiums are only $18,000 . . . well, which bill would YOU rather pay?
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