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Woman with chronic condition finds affordable health plan

Posted March 27

— Under the Affordable Care Act, Betty Harmon cannot be charged more for health insurance because of a pre-existing condition.

Harmon has ulcerative colitis, an autoimmune disease that affects the colon. She keeps it under control with prescription medications, but the combination of an anti-inflammatory drug, a steroid and an infusion drug add up to about $8,000 a month.

"If I did not have health insurance, I would not be able to afford my medications," she said.

After Harmon was laid off from her telecommunications job, health insurance was too expensive with her condition. She found coverage through the state's high-risk health insurance pool.

The high-risk pool was eliminated as the Affordable Care Act ordered insurers to provide coverage to people with chronic medical conditions. So, Harmon turned to HealthCare.gov to find new coverage through the federal online marketplace.

"The process was very, very frustrating, from trying to get on to the website to sign up for the health care," she said, noting that she finally went to an insurance agent to get a policy.

She chose a Blue Cross Blue Shield of North Carolina plan that includes her doctors and covers her name-brand prescriptions. Her husband found a plan as well, and they qualified for a $100 monthly subsidy, putting their premium at $424 a month.

"With the medications that I get and the procedures I get, I really can't complain about the price," Harmon said. "If I did not have access to health care and health insurance, I probably would have my colon removed because I wouldn't be able to afford my medications – or I very well could be dead."

Harmon also saves $50 a month on co-payments for her prescriptions after contacting the pharmaceutical companies and asking about programs they sponsor to help pay for the drugs.

6 Comments

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  • mark2345678910 Mar 28, 1:03 p.m.

    Six million Americans have now signed up for the ACA. A huge number who would not have had the... View More

    — Posted by Sally1023

    It is because the premiums went up for healthy people and priced them out of the plans they had... View More

    — Posted by girlwonders

    Premiums, for comparable plans, didn't go up for healthy people. Healthy people, who formerly had what was essentially self-insurance and catastrophic coverage, now pay more for actual insurance.

    You complain that we're subsidizing for people with chronic conditions. In the meantime, why aren't you complaining about the rest of us subsidizing for self-insured people who show up at the emergency room and can't pay?

    Oh, because you were one of those who would have gladly used the system if you ever found yourself owing hundreds of thousands of dollars.

  • whatelseisnew Mar 28, 11:03 a.m.

    Ah ms harmon access to health care is completely separate from insurance. Insurance is payment mechanism. Access to health care exists with or without insurance. Interesting that 2people can insure with paying just 424 a month out of their pocket. The ACA policy offered to MY spouse who has zero preexisting conditions was 538 per month with a very high deductible. Unaffordable to us because of the income discrimination built into Obamacare.

  • skeeter II Mar 28, 10:14 a.m.

    Many of the 6 mil that signed up already had health care policies!

    The yardstick that should be used to suggest reaching the goal should be the number that are paying their monthly insurance premiums!

    Administration officials have told Legislators that they do not know how many are paying and will not know until April or later in the year. Seems they will have to get that information from the individual insurance companies.

    Still wonder what will be changed next year for the plans grandfathered this year? Also when the waivers run out what will be the effect on Obamacare?

  • girlwonders Mar 28, 9:21 a.m.

    Six million Americans have now signed up for the ACA. A huge number who would not have had the... View More

    — Posted by Sally1023

    It is because the premiums went up for healthy people and priced them out of the plans they had that they liked. When the insurance company has to cover people with chronic conditions, it makes the rates go up for everyone, whereas the insurance used to cost more if you were sick, and you got a better rate for being healthy, now everyone pays the same, and no one can be turned down.

  • Sally1023 Mar 27, 7:48 p.m.

    Six million Americans have now signed up for the ACA. A huge number who would not have had the opportunity to get insurance. I am thrilled for them all. Cannot understand why the members of the US house are so sad that Americans are getting health care. Guess it doesn't benefit the rich.

  • AliceBToklas Mar 27, 7:39 p.m.

    Very happy for her and her family. It's good to see a positive story about the ACA. I've heard many but few make it into the news.