The COVID-19 pandemic has highlighted the importance of quality and affordable healthcare coverage. Open enrollment to sign up for coverage in 2021 through Healthcare.gov runs from November 1 to December 15 in most states.
Having affordable and reliable healthcare is of the upmost important for Tim S., who suffers from asthma. “I consider myself lucky in that I don’t require constant medical attention. However, when problems arise, I need access to a doctor and prescription meds, and I need them quickly. Urgent care doesn’t offer a comprehensive understanding of my background or needs to be effective,” Tim explained.
Working freelance as a theater director, he unfortunately isn’t always able to set aside money to cover emergencies or even copays for doctor visit. “The times when I have been without healthcare coverage have added a great deal of anxiety to my day-to-day life. I felt as though I was rolling the dice with my own health and any symptom that popped up, no matter how minimal, I panicked while hoping my symptoms didn’t escalate. The stress alone was likely degrading my physical health. I ended up missing more days of work since I was only blindly treating my symptoms.”
Despite this anxiety, Tim wasn’t willing to give up his work in theater for a job that offered more secure healthcare benefits. Unfortunately, while he was working consistently, he still didn’t qualify for health insurance through the director’s union. Luckily, The Actor’s Fund provided a seminar on applying for coverage through the Affordable Care Act which Tim attended.
The Affordable Care Act created a healthcare marketplace, Healthcare.gov, where individuals who need health insurance could purchase quality and affordable coverage. All plans on HealthCare.gov must cover the 10 essential health benefits (including hospitalizations, emergency care and prescription medications), cap your out-of-pocket costs, and won't charge you more for a preexisting condition, like asthma. “I signed up for a plan through the NY Health Exchange and remained on that plan for about a year and a half. I was able to maintain regular screenings, doctor visits, and testing to keep on top of my general health,” he explained.
When signing up, Tim was pleasantly surprised by how easy the process was. “Honestly, I had always been intimidated by the system and the prices. But once I was educated on the tax rebates/discounted rates available based on my income, that intimidation was gone, and the process was simple. I didn’t require any assistance signing up, but I found there was a bunch of help and that resources are out there. Based on my income level, my premiums were reduced to a level that I could afford, even in the ebbs and flows of a freelance world.”
Tim’s experience is not unusual – more than 80% of people who sign up for coverage on Healthcare.gov will get help paying for their health insurance.
Healthcare and COVID-19
This year, in mid-March, Tim developed COVID-19 symptoms. Since it was the beginning of the pandemic, there was very little information and getting access to care was challenging. “My symptoms came during those initial few weeks where new infections in NYC were so great that experts were telling people not to go to the hospital unless you felt you required emergency care, and testing was not available outside of hospitals. I have a doctor in my family who I was in daily contact with, and who helped me weigh the pros and cons of going to a hospital. I got close one night, and under different circumstances I know I would’ve at least gone to see a doctor.
“I remember lying awake in bed, anxious over my breathing and whether or not symptoms would get worse. For some reason, my instincts told me to roll over and lay on my stomach to ease my breathing. I never sleep that way, but it did seem to offer relief. It was weeks later that doctors began reporting they were ’proning’ patients like this and rolling them over to allow them to breathe.”
A few weeks after recovering, Tim tested positive for antibodies. However, he still struggles sometimes with the aftermath of the virus. In addition to the health consequences, Tim was laid off from his full-time job in mid-March and the three theatrical productions he was directing were cancelled or postponed until next year.
Luckily, even though he lost healthcare coverage through his full-time employer, Tim qualified for health coverage through his stage director’s union, SDC, and was able to get a new plan right away This coverage is short term, however, and he is sure he will need ACA coverage again in the future.
Tim’s story is a great example of how the Affordable Care Act not only allows those with pre-existing conditions like a chronic lung disease to have quality and affordable healthcare coverage, but ultimately can help us all lead a full and active life.
To learn more about signing up for healthcare coverage, visit Lung.org/openenrollment. We have answers to many frequently asked questions about healthcare coverage, information for individuals who recently lost healthcare coverage as a result of the COVID-19 pandemic, new Spanish-language resources, and many other materials. Remember the deadline to sign up for healthcare is December 15.
Blog last updated: November 2, 2020