“I’m getting $196 worth of health insurance for $854.”
I was born and raised in Los Angeles, and now live in the Miracle Mile area. In 2004 I was paying $196 a month for the individual PPO plan that I’ve had for many years. Now, my rate is $854 a month, which means that in the last ten years my premium has more than quadrupled. When I first got the plan I thought the price was acceptable considering the very limited benefits I was receiving, which have remained the same even as my premium has shot up. I pay $45 every time I see a doctor, plus 40% of the cost of the visit, treatment or test. I pay 50% for out of network doctors. My policy only covers generic drugs – supposedly to keep my premium “down.” Not all tests are covered – even preventative ones – even when my doctor recommends them. Last year they would only cover $14 and pay out $7 of a $270 ongoing test that I was required to take because of a medication I was prescribed. My plan is now an example of an absurdly priced plan with low-level benefits.
I’m getting $196 worth of health insurance for $854. The additional $600 a month that I spend on these rate increases add up to $7,000 a year that could have been avoided if insurers were required to get prior approval. Throughout this process I have struggled to pay my premium. I fear that leaving my plan will cause me to lose my doctors, and my “grandfathered” status, and risk me having to pay an even higher premium. This keeps me under their control.
Californians need Proposition 45 in order to level the playing field between consumers and health insurers.