Blue Cross/Blue Shield of Texas, having lost too much money in 2015, is no longer offering its PPO plan for 2016—the one in which my parents were enrolled. Instead, they are offering only HMO plans, which does not bode well for the RVing lifestyle. This is a double whammy from Obamacare for my folks. As I mentioned in a prior blog, we had a short-term, catastrophic insurance plan in January 2015, but it was not ACA-compliant, so we are subject to the penalty for 3 months of 2015. We were forced to move from South Dakota to Texas in March 2015 because we could not get ACA-compliant healthcare in South Dakota without a “permanent” address. Fortunately, Texas recognizes our mail forwarding address as a permanent, physical address, thanks to Escapees taking that battle to the Texas Supreme Court several years ago. So we were able to get an ACA-compliant plan off the exchange and obtain subsidies. Ironically, we never used the services. We are a pretty healthy family and have no medical conditions for which we require regular doctor visits. Anyway, back to losing our plan…
Feeling we had no other options, we are now enrolled in Liberty Healthshare, which is faith-based health sharing. As members, we are exempt from the Obamacare penalty. Liberty Healthshare emphasizes they are NOT an insurance company. Funny though, they sure act like one! They would only accept Mom on a provisional basis. They looked strictly at height and weight, and based on the Body Mass Index (BMI), deemed my Mom obese. This set Mom off royally and she began her rampage. They asked her no questions. How did they know that she wasn’t a body builder and the weight represents muscle, not fat? (trust me, she ain’t no body-builder). How did they know if she had a temporary medical condition? (Again, not the case, but Mom’s battle is all about principle!). Mom is the first to admit she was packing more weight than she should have. But she is very active and always has been. She donates blood regularly, exercises regularly, does not eat fast food at all. Cholesterol levels, Hba1c levels, blood pressure—all A-OK. She is probably the healthiest fat person you will ever meet! But her arguments fell on deaf ears. If she wanted coverage, she must get “counseling” for her “overeating disorder”, consisting of one phone call a month, at a cost of $80 per month (on top of our regular premium), for a minimum of 3 months! WHAT! She can join Planet Fitness gym for 10 bucks a month! Well, nothing motivates my Mom more than saving money. The minute they told her about this requirement she started to diet, losing just about half of the required pounds before January 1, when the counseling and enrollment in Liberty Healthshare began. She just reached goal, so she is hoping for an early “release” from the "fat farm food police" to save some money. Wish her luck!
The good angel on my right shoulder said, “Your Mom did the honest thing by reporting her actual weight at the time she applied for coverage.” But the little evil devil on my left shoulder said, “Honesty—forgetaboutit! It’s over-rated! If she understated her weight by just 2 pounds, she could have avoided this whole dilemma! Two little pounds would have brought her BMI under 30, making her just overweight (instead of obese), for which they do not require counseling. A little white lie never hurt anyone.” I’m still deciding which one of these characters was right!
Which one would you listen to?
Rambling RV Rat Stress Binging