Health Insurance: The Eternal Battle
Health insurance is a subject that weighs on me and keeps me up at night. Every once in a while my insurance situation is sorted out and the worry briefly lifts, then something happens and the anxiety falls on me once again.
In my early 20s, I often went without health insurance. At the time, I knew it was a risk, but I was broke and did not know how to get health insurance when I was between jobs. Thankfully, nothing more serious than a sprained ankle occurred during these uninsured times.
My late 20s were mostly insured. I went a few months here and there between jobs without insurance, but spent most of these years with health insurance. Keeping myself insured did not become a huge problem until my early 30s. At that point some major things happened…
I was old enough to understand the incredible cost of not having health insurance.
It wasn’t until a few years ago that I began glimpsing the high cost of medical care. The simplest ailment, such as seeing your primary care doctor about a sore throat, is more than $100 per appointment. Having warts removed is considered outpatient surgery and will run you close to $1000. An hour with a therapist is $160. Getting shots and stitches when you cut your foot is around $1200. Simple, everyday ailments and accidents cost incredible amounts of money. A recent trip to the emergency room due to unexplained chest pains totaled $4198. None of these costs are chump change. They add up to huge figures and for some people, are absolutely insurmountable.
The laws in my state changed. It was now illegal not to carry health insurance.
The changing of Massachusetts health insurance laws happened in 2006. This change was meant to be a good thing. Yes, everyone should have health insurance. Yes, lower income people should be able to have subsidized insurance. Those are two topics I agree with. However, making people pay a tax penalty if they are uninsured is not something I stand behind. To me, it seems like another way of penalizing the poor for being poor. Even with the subsidy, the cost of health insurance is simply inaccessible for many.
This law influenced me because I could no longer go for a few months here and there without health insurance. Even if I wanted to, regardless of whether it was a bad idea, I had to carry insurance.
I got laid off. Twice.
When I was first laid off in 2007, the company ousting me paid for my health insurance for an extra month. I tried to finagle an additional six months, but that did not fly.
I had the option to continue my health insurance through COBRA, a government program that gives workers who lose their jobs the option of continuing their health insurance at full cost (without the employer paying part). The premium was $457 per month. That is a whole lot of money for someone who has just lost her job. Continuing with COBRA was not a viable option.
For people in my situation, Massachusetts offers something called the Medical Security Plan. If you meet certain financial guidelines, the state will reimburse you for up to 80 percent of your COBRA or individual premiums. I was excited about this option and applied for the program. I was a few thousand dollars above their financial limits and was quickly turned down.
A program called the Commonwealth Connector was recommended to me. This is the state’s way of offering “affordable” insurance to individuals. “Affordable” is a relative term. I ended up with a terrible health insurance plan for $256 a month. It was the type of plan that would partially cover my hospital stay if I was hit by a bus, but would not pay for anything else. It felt like I did not have health insurance at all because I could not really use it.
When I got a new job, the company was too small to offer a group health insurance plan. They handled this by asking me to get an individual plan that they would reimburse me for. I chose a good plan that kept me happy. The premium was $412 per month.
I only worked for this small company for a few months. When they laid me off, I was once again in a pickle about what to do about my insurance. I remembered the Medical Security Plan and reapplied. This time I was accepted.
I was able to stay on the Medical Security Plan for six months. This was a glorious time for me and my health insurance. After my reimbursement, I was paying around $83 per month for fantastic coverage. I was able to see my therapist, chiropractor, and nutritionist without any problems. My visits to the gynecologist and primary care doctors cost me only a $15 co-pay. This level of coverage pleased me to no end.
This went on until I got a new, full-time job. My eligibility for the Medical Security Plan was crushed.
My new era of health insurance.
Right now, I miss the glory days of the Medical Security Plan. I work full-time and am eligible for my employer’s health insurance program. This sounds like the answer to my problems, but has two huge issues. The first is that the plan offered is terrible. The second is that I have to meet certain quotas and hour requirements to stay on their plan. If I drop below these quotas and requirements, I get kicked off and become uninsured again. This is a new system for me; I have never been insured under such strict terms before.
I am currently fighting to keep myself insured. My plan has many $50 co-pays and a high deductible. Only basic medical needs are covered. I can no longer go to the chiropractor or nutritionist. My therapist and psychiatrist are considered “out of network.” The plan is highly confusing and the insurance company wants me to change many of my doctors.
I anticipate that my employer will soon kick me off of this plan. Next month, my work hours will change. It will be much more difficult for me to meet their quotas and I am not sure I can do it.
I am trying to figure out what I will do when this happens. I am investigating becoming part of a group health insurance plan that covers freelance writers. This sounds like a great idea, but my sleuthing so far has revealed that this only works well if you are a resident of the state of New York. My main option is to get a new, individual plan. I could go back to the type of plan I had when I was reimbursed through the Medical Security Plan. However, the plan I had is no longer offered and similar coverage would run me around $450 per month, post-tax. I have found a plan that would cover most of my basic needs for $313 per month, but that is still a large number. I make little money right now and $313 is almost a week’s paycheck for me. I am eligible for lower income subsidized insurance through the state, but feel strange about applying for it.
When, and if, I get kicked off my employer’s health insurance I will figure out what to do. Until then, I will continue with my confusing, high co-pay plan. Keeping yourself properly insured should not be as excessively difficult as it is. The whole issue makes me a little ill. Good health care should be a right, not a privilege.
Goldstein, S. (2016). Health Insurance: The Eternal Battle. Psych Central. Retrieved on February 20, 2017, from https://psychcentral.com/lib/health-insurance-the-eternal-battle/