Health careless.

Hello.
My name is Paige Worthy, and I’m a statistic.
I’m a casualty of the U.S. healthcare system.

I got a letter from COBRAsource, my former employer’s provider, last night saying my health coverage had been terminated. One very, very short week after I found out it had been reinstated.
Terminated for nonpayment.
(Even though, as of Tuesday, November 2, I had sent them nearly $1,200 for three months’ coverage.)
Apparently my former employer did open enrollment for some new plans, which were sent my way but never explained to me, and no one told me that my premium had gone up.
In fact, I was told it had gone down. I had a jubilant conversation with a sweet — and, in retrospect, ill-informed — woman just last week about how it never happens that rates actually decrease after open enrollment.
I thought I was the exception.
Turns out I’m the rule. And I have been broken.

But let’s rewind.
To a month before my last day on the job.
That’s when I started looking for a health insurance plan for myself.
I worked with Gizmo Health to help me wade through the process — before my first call with Michael, my agent, I didn’t even understand what a deductible was; no lie — and was quickly denied by not one but two major insurers: Aetna and Assurant.
I was told not even to bother with Blue Cross Blue Shield, my group provider, because they are notoriously tough on patients with pre-existing conditions.
It would seem those conditions, two health factors that made me a normal paying customer under my previous group policy, have magically transformed me into a high-risk case now that I’m seeking an individual policy.
This is just…ridiculous.
My yearly well-woman exam came back with irregular results earlier this year. The biopsies showed no cancerous cells. My doctor cleared me for another year.
It was good enough for her.
Why isn’t it good enough for them?
I’m living with mild depression, for which I take 10 milligrams of an SSRI every morning. So I can, you know, contribute to society with more energy and fewer grumbles. I also go to therapy once a week — which I’ve dropped back to twice a month now that I can barely afford a box of Macaroni and Cheese, let alone an hour in a cushy doctor’s office.

Both companies knew about these conditions because I’d described them in detail on my application’s health history form.
Still, Aetna and Assurant both called me at odd hours. A woman whose English I could barely discern through a thick Middle Eastern accent called me to have me explain again, in detail, what was wrong with me, so she could recommend in person to her superiors not to insure me. I knew when I spoke with her I didn’t stand a chance: If she couldn’t even understand the words I was saying, how could I expect her to read between the lines and find the nuances — that my lady parts are clean and healthy despite a bad test; that I’m of sound mental health even though I’m seeing a psychologist?
She couldn’t.
No one could.
Because that’s not what health insurance companies do. They aren’t actually out there to ensure good health.
I’m not really sure what they do besides make money.
So, that happened.

There’s also a state-supported plan called ICHIP (Illinois Comprehensive Health Insurance Program), which is essentially subsidized under Blue Cross Blue Shield for high-risk patients who can afford health insurance but have been otherwise unable to get it.
Sounds great.
Except that “state-run” ends up meaning “miles of red tape” and “labyrinthine bureaucratic nightmare.”
After a six-week ordeal of back-and-forth snail mail — because God forbid anyone with the government should do things efficiently and electronically, see also: voting —many, many copies of my personal health information sent and resent, and a trip to the DMV to update my physical drivers license with my current address (which isn’t required by the state to drive legally but, go figure, apparently is to get health insurance), I found out that I’d have a six-month waiting period for any coverage of my pre-existing conditions.
Which is why I was trying to get insured in the first place.
So I could go to therapy and get my prescriptions refilled.
I turned down that tempting offer and sucked it up. COBRA it was.

For about $400 a month.
Fourrrrrrr hundred.

My first payment, by cashier’s check — because obviously everyone who loses their job must be a deadbeat who can’t be trusted to write a personal check — was $807.64.
Seriously.
For two months of coverage.
And it took them until the last week of October to reinstate my benefits. Because they do everything via snail mail, too. And a feather pen. Math with an abacus.
When I was finally switched back on, I started the long process of getting reimbursed for the prescriptions I’d paid for out of pocket: $120 for my crazy drugs and $45 for a necessary lady medication that prevents me from becoming a “proud breastfeeding momma” before I’m ready for that. Which, obviously, is a long way off. So keep the meds coming.

So I’ve given them almost $1,200 based on the statements they’ve sent me. And now my premium has gone up instead of down, and I’m being punished for their mistake.
They tell me I’ll be re-reinstated after my payment comes in.
But seriously.
The system is down.
And I am enraged.

Imagine if I’d lost my job instead of leaving it by choice. Talk about cast out in the cold.
I shouldn’t have to take a job that doesn’t make me happy just to have benefits. If thinking it’s right that people should have reliable insurance regardless of income or employment makes me a Socialist…
I guess I’m redder than all those assholes who just got elected in part because of their platform to block it.

Hell.
I don’t know.

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23 Responses to “Health careless.”

  1. TurnJacson Says:

    Can someone say…. CANADA! LOL

  2. Rachel H Says:

    This is why I screen my dentist’s calls now.

    I’ve also been dropped from COBRA for non-payment due to a misunderstanding. Trying to appeal it was a joke.

    Too bad I’m a pinko. I think that might be considered a pre-existing condition in this country.

  3. wafelenbak Says:

    I’m sorry to hear you had such a bad experience with the ICHIP program. I’ve been very happy with it since my COBRA from my last job ran out and I am self employed now. Though, I’m not happy about the prices I still have to pay for prescriptions ($150 a month for Zoloft WITH coverage). BCBS turned me down for individual coverage due to pre-existing conditions and then ironically I ended up covered by them through ICHIP. :p

  4. Tweets that mention Health careless. | paigeworthy.com -- Topsy.com Says:

    […] This post was mentioned on Twitter by Erik Deckers and Erik Deckers, Paige Worthy. Paige Worthy said: BLOGGED: Health careless. http://paigeworthy.com/?p=503 (This could have been twice as long. #twss) […]

  5. Gabriel Says:

    “I shouldn’t have to take a job that doesn’t make me happy just to have benefits.”

    Can our Paige Worthy get an “A-men!” here, people?

    It’s this happy horseshit that made me at once embarrassed and proud to be standing inside a voting booth on November 2nd or whenever it was.

  6. Helena Says:

    I studied in France for a year (enough to be covered by their government social systems) so I have a direct comparison for how much better it can be. I believe I once had to wait in a government office for 2 hours to fill out paperwork, but other than that, everything was smooth (and free!) sailing.

    The idea that so many people here are “stuck” in jobs they hate because of insurance concerns is both sad and infuriating.

  7. Erini CS Says:

    “If thinking it’s right that people should have reliable insurance regardless of income or employment makes me a Socialist…
    I guess I’m redder than all those assholes who just got elected in part because of their platform to block it.”

    AMEN.

    While uninsured, back in July we found a cyst — so now I’m finding out if I have endometriosis… the bills are insane… So I was ecstatic when I got a job with benefits. Now I’m learning that I might not be covered… So much for having the surgery to remove the painful cyst and to complete my diagnosis.

  8. Philip L Says:

    Its time to move to Europe, Paige. Almost every other ‘civilised’ western country has a healthcare system which is free at the point of need. So are we all socialists….tell that to our new right wing government who got in on a promise to improve the healthcare system not dismantle it.
    I have so many American friends who have been brainwashed by the propaganda disseminated by the insurance companies and so believe that socialised medicine is evil and communist.
    So spread the word Paige …its America that is out of step on this.

    • Paige Says:

      Uh.
      Read for tone, Philip.

      The comment you left?
      Exactly the point I was making.

      Pay attention to a little bit of news from the other side of the pond…anyone who’s educated here knows y’all have it better.

  9. H Says:

    Sounds about right. Now take all of those stressors and add them to the humiliation of being suddenly (and without warning) fired–for no reason that anyone was willing to tell you–and also not being able to get unemployment.

    God bless America.

  10. Brian D. Says:

    As a person who works in the health care industry, i have to say, this happens, alot. alot more than it should. I see on a daily basis, DAILY, where this exact thing has happened, or the plan has changed, or the co-pays increased….
    A few other points. Some, alot, most(maybe not most) people have not a clue how their insurance works. You’re an exception Paige. You seem to be very knowledgeable, and that’s great.
    The part that makes me mad is that health care is being dictated by the insurance companies…what they will pay for services, prescriptions, whats covered or not. Its really not a good idea when an insurance carrier calls me( im a pharmacist) and asks me what drug i would use to treat a certain patient, when all I know of the patient is his name, address, birth date….i know NOTHING of his medical history. yes, this has happened to me, on several occasions.
    on the other hand, im not sure a purely socialist medical system is the way to go either. in my expericace there are some very easy, common sense fixes to this problem, but as long as blue votes blue and red votes red i fear this will continue…

    and yes, this sucks, and yes, id be mad too….

  11. Philip L Says:

    @Paige
    I was agreeing with you Paige and really just emphasising for your audience.
    Cant agree on your other point though. Too many highly educated American people that I know don’t think we have it better.

    As for tone I had hoped that there was a little subliminal ironic humour in there but I recognise that I am not as skilled a writer as you so I must admit failure in that department 😦

  12. Wardell Says:

    @Philip L I got what you were saying but I also see how it could have been missread .
    I totally agree with you on this as well Paige.

  13. Philip L Says:

    @Wardell
    As George Bernard Shaw once famously said ‘Britain and America are two nations divided by a common language’
    The nuances of our different versions of English are sometimes misread and I apologise to anyone who thought that I was in conflict with Paige. The fact is I have almost always agreed with her opinions

  14. Laura Scholz Says:

    Preach it, sister! What kind of freaking backwoods nation do we live in where benefits are tied to either 1. employment by a large corporation or 2. marriage (but only if you’re straight). Totally been there, and it beyond sucks. And the scary thing is that people die every. single. day. Because we’re crazy socialists for thinking that health insurance is NOT optional.

  15. Philip L Says:

    @Paige
    At the risk of sounding like a mutual admiration society Paige, your blog is one of the first things I look at each day. You always have something interesting to say and a way of saying it with originality.

  16. Sam Sarbinson Says:

    The scene from “Booty Call” comes to mind where one of the guys is mistakenly shuttled to the ER for castration. Jamie Foxx is outside screaming at the doctors that they’re going to ruin an innocent man’s life forever. They ignore him and talk about playing a few holes after they finish the job.

    Jamie gets the brilliant inspiration to yell “He doesn’t have any insurance” and the surgeon instantly says “fuck” and slams his instruments down.

    Also to paraphrase the dean in “Accepted”: Let me tell you kids how insurance works. You got sick on a Monday? Sorry, we only cover on Tuesdays. Want us to pay for psych meds? Sorry, we only cover sane people. Got a problem with your penis? Sorry, we only cover vaginas.

  17. doniree Says:

    This makes me so frustrated – not only for all that snail mail and red tape you (we) have to cut through, but at the whole system in general. Talk about broken.

  18. Mrs. Apron Says:

    I have ALWAYS thought it absurd, since when I first learned about health insurance, that it was tied to employment. It makes no sense to me. The people who can’t work because they are sick are the very ones who need it the most. Then we get punished for treating manageable conditions with “pre-existing condition” clauses. I had to turn down my ideal job in the past year because it was only 28 hours/week and there was no opportunity for benefits. I’d have had to take a 2nd job not only to make up the discrepancy in pay, but also to pay for the additional cost of trying to be self-insured.

  19. Mrs. Apron Says:

    I changed jobs back in September, and my old health insurance (which is almost identical to my new health insurance — same HMO) finally sent me a letter this week to let me know my coverage had expired back on Sep 30, but I have until January 2011 to tell them I want to opt into COBRA, which would give me the same crap coverage I’ve had for 2 years for a monthly premium of $611.

  20. leyla Says:

    This happened to me a year ago. It’s OK. don’t worry. I was able to find adequate insurance for $187 a month. I have a huge deductible ($5K) but I’m ok with that since I’ve never once needed it. I’d rather pay less a month and keep money in my savings for emergencies rather than pay $400 a month for insurance.

    If you need the name of my broker, let me know. Also Nicole Yeary is an insurance broker and can help you too.

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