Diabetes Patient Finds Affordable Care with Community
Up until last year, Sophia had been uninsured and long struggling to manage her diabetes. After initially considering going uninsured rather than pay over $650 to be covered under her husband Bennie’s plan from work, she decided to sign up for a Community Health Choice plan. Sophia renewed her plan this year, and her and her husband sat down with us to talk about her time with Community Health Choice.
Why did you pick Community?
Sophia renewed her plan this year, and her and her husband sat down with us to talk about her time with Community Health Choice.
Why did you pick Community?
Bennie: “Mainly it was the premium, as well as the copay, because you don’t know how many times you’re going to have to visit a doctor or specialist, or how many appointments you’re going to need to make.”
Sophia: “Especially with my diabetes. When I was going to the clinic, I was having to go every two or three months to give them my results – when I would check my sugar and what my levels would be and all that – to see if they needed to adjust it, what they can do. So it was like I was just constantly going to the clinic.”
"What I like is when you call customer service, they’re not rushing you."
Are you also making preventive care appointments?
Sophia: “I’ll be going, because my family has a whole line of cancers and stuff. And it’s always good to get the one year check-up, because you never know what’s going to happen. Or what’s building up to happen you. So you need it.”
What did you do before insurance?
Sophia: “Before we had insurance, I would just go to a doctor and pay the regular fee. And then see if they could just give me a prescription for however long they could and just kind of stretch it out. But even just on that, it’s kind of scary. My sugar levels were really high, so going to sleep, you’re kind of scared not knowing if you’re going to go into a little sugar coma or what. So it’s more a relief now.”
Did you skip doses?
Sophia: “Oh yeah, all the time. And use over the counter insulin. It was pretty crazy.”
What have you liked about having Community Health Choice?
Bennie: “Just knowing she gets everything. Because in the past, she’s had to be admitted to the ER for mismanaging and not being able to keep up with a primary care physician or anything like that. So it’s been good to go ahead and have someone to monitor it and keep on top of it and make sure everything does go good. Because with the kids it’s like we have to watch ourselves, we have to take care of ourselves.”
Did you shop around for health plans this year?
Bennie: “Actually the plan she was on already was pretty much the best one. Like I said, the premium went down and the copays went down, but it was pretty much the same coverage. Sophia: “We looked at the one from my job also, and it wasn’t…this one was better still. You figure going through your company will be a little [better]….but this one was still better.”
What would you tell someone considering buying a Marketplace plan?
Bennie: “To first of all shop. Just shop and look at the benefits of all the plans if you want to be smart about it. You want to shop everyone. It just so happened Community Health Choice did offer the best benefits for what we were looking for, and that’s why we went with them. “But there’s too many uncertainties – you don’t want to go uninsured. Because we did debate that. When they were going to pass the health care law, we said, ‘if we don’t get insurance, how is that going to affect us?’” We were looking at that more than what kind of health care we could get. But after I just said, ‘okay we need to look at all of this,’ and finally did, I saw that, yeah it’s doable and the help is there. And it’s a lot better that we have it than trying to think of if we didn’t get it at all. “Well basically after we’ve gotten to know Community Health Choice by having the plan and talking to people we know, they are local and the customer support is way better. As far as when you need answers, you need help, guidance, anything like that, you give them a call and they’ll point you in the right direction. And they’ll let you know how you’re covered and where you can go and how to get to it – how to get to the best care.”
What are your next steps with Community?
Bennie: “It’s been real busy since the end of the year. We’re catching up, and then we’ll be able to really dive into making the appointments, doing the managed care – things like that. We’re really looking forward to another year with Community Health Choice and taking advantage of the benefits. “We’re about to start looking for another provider through the insurance now. It’s been a lot better, since the premium did drop significantly from last year, which is really great, as well as the copay dropped, I’ve seen. And other than that we’re just doing a lot better.” Have you had any trouble finding providers in network? Bennie: “Since we’re gonna go to Kelsey, I’ve seen the locations and they’re pretty convenient to us. We have one that’s really close to where we’re at, so it should be easy for her to get to her appointments, in and out. Other than that, when I’ve had to search for providers, either for diabetes or just for other purposes, it had a pretty extensive list of providers that were in the area or even if we happened to have been somewhere else, I’d say a good number of providers are available.” What is the one thing you would want people to take away from hearing about your experience? Bennie: “I would basically reiterate what I said about them being local, them being affordable, them being helpful – being able to give them the tools you need to be able to make an informed decision about either choosing them, or choosing a provider to help you out with whatever your condition may be, if you just want to do preventative care as well.”