Lake Charles man with cancer shares Obamacare experience - KPLC 7 News, Lake Charles, Louisiana

Lake Charles man with cancer shares Obamacare experience

Posted: Updated:

President Obama celebrates 7.1 million people signing up for healthcare before the March 31 deadline.  If you missed the health insurance enrollment deadline, your next chance to sign up for coverage is not until November 15, unless you meet certain criteria.

Inside the health screening room at SWLA Center for Health Services in Lake Charles, 51-year-old Charles Delafosse is getting his new insurance plan sorted out.

Charles never thought he would need to sign up for the health insurance marketplace.  "I always worked and always had health insurance," he said.

But that security changed when he was diagnosed with prostate cancer in January. His employer cut him from his job and the insurance that came along with it.

Plan B was COBRA, something Charles simply could not afford while unemployed.  "It was going to be $620 a month," he said, "with not being able to work from my surgery, I couldn't have done that."

Desperate for help and with a cancer surgery already scheduled for April, Charles came to this health center last week.

CEO Sheik Bacchus explains how navigators assess each patient.  "They determine if there are pre-existing conditions, what meds you're taking, what is covered and not covered relative to the four commercial-based plans," said Bacchus.

Charles said the computer connection on www.heathcare.gov was not working properly, so he went the route of a phone call to pick out a plan. It took about 20 minutes, but he got a plan that starts April 1 - and one that is within his budget.  "It's only going to cost me $19.20 for the health plan," he said, "and for the dental, it's only going to cost me $14."

So how affordable is the Affordable Care Act?  That depends on the plan you select. Overall, premiums are low, but out-of-pocket expenses can be high.  Insurers are required to cap those costs at $6,350 a year per person.

There are also subsidies, but they do not cover every penny of care.  Robert Laszewski is the president of Health Policy and Strategy Associates.  He says, "A family of four making $59,000 a year still has to pay $5,000 a year net of subsidies. How many people making that kind of money have that much money in their checking account?"

Charles says it is about more than money right now. For him, it is about stopping his cancer.  "I was worried about my surgery and how I was going to survive and have this done," he said, "now I have a lot of peace of mind and a lot of stress off of me."

Special enrollment periods extend through April for those that started an application and did not complete it, as well as people dealing with "special circumstances," like family problems or technical difficulties.

Penalties for not signing up this year are $95 per adult or one percent of your income.

Copyright KPLC 2014.  All rights reserved.

Powered by WorldNow