Woman finally gets new hip thanks to affordable health insurance
- on November 10, 2014
The last time Vicky* had health insurance was in 1972 before she moved out of her father’s house. “It's been over forty years since I had health insurance,” she said, “and luckily I managed to stay relatively healthy for the majority of that time.”
That changed on Labor Day in 2009 when Vicky had an accident that shattered the ball in her hip joint. Unfortunately, without health insurance or the kind of income that would allow her to pay $40,000 out of pocket for a new hip, Vicky was left to hobble through life for the next few years. She had to keep working and getting around, so she made due with the pain.
Vicky started coming to Heartland Community Health Center for her medical care several years ago and is well known by many of the staff members. When open enrollment for the Health Insurance Marketplace began in October 2013, Heartland’s Certified Marketplace Navigator, Rosilyn Wells, knew that it would be very beneficial for Vicky.
“Rosilyn tried to tell me about new insurance laws that would help me get affordable coverage, but I thought it would still be too expensive,” Vicky said.
The laws that Rosilyn shared with Vicky are part of the Affordable Care Act or ACA. The ACA makes it illegal for insurance companies to deny coverage to applicants based on preexisting conditions. It also helps those who make between 100% and 400% of federal poverty level afford their monthly insurance premiums by offering tax credits.
Vicky eventually decided that it was worth filling out the application and seeing what she might pay for insurance. She made an appointment to come in to Heartland and fill out the online application through healthcare.gov. She was pleasantly surprised to find that she could easily afford a low-deductible plan, so she did not hesitate to enroll.
Less than two months later, Vicky spent three days in the hospital after receiving the hip replacement she so desperately needed. “When the surgeon looked at it he told me he didn’t know how I could walk on it,” she said.
When all was said and done, Vicky paid $541 out of pocket for her $40,000 surgery. She still walks with a bit of a limp, but she was recently released by her doctor to begin exercising.
“It changed my life. To think my next 30 years was just going to be…” she paused, “I couldn’t have lived in a wheelchair.”
Vicky is still insured and continues to come to Heartland for her primary care, knowing that using her insurance at Heartland helps the clinic afford to help patients who otherwise would go without care.
“I wouldn’t go anywhere else. It’s a really comfortable environment. They’ve always treated me with respect and care.”
This year, open enrollment for the Health Insurance Marketplace begins Saturday, November 15, 2014 and runs through February 15, 2015. More information is available online at healthcare.gov and heartlandhealth.org. If you would like help filling out the online application, please contact Heartland at 785.841.7297 to schedule an appointment with its Navigator
*Person’s name has been changed to preserve anonymity.