Wednesday, May 23, 2012

The Unemployment Diaries- Health Care



Snoozefest, right? Or, at the very least something we all take for granted. However, the possibility of being uninsured should be enough to get, not just into your gut but into your bones and your dreams at night (if you can sleep). At the end of this month my COBRA will expire.

When you’re a spry young thing your attitude towards health care is likely to be a fit of pique over having monthly deductions from your paycheck because you never get sick (unless it’s from too much tequila and the medical establishment has not made many strides in a cure for that). Then you hit midlife and well, you’ve been to the doctor a few times. Maybe for: an out-patient procedure, physical therapy, or for the athletic among you- knee surgery, a torn rotator cuff, back sprain. It’s life and it happens. Suddenly, insurance isn’t such a big deal and you pay your premiums, co-pays and drug costs and it’s all good. If you’re lucky this is your situation until your last breath. Mazel! However, if you’re one of the 55% of Americans who are employed but without benefits, the 17% who are uninsured, or, like me, currently have a COBRA plan you’re not so lucky. Add to that the ominous sounding “pre-existing condition” factor and even if you are insured you cross yourself and pray. 50% of non-elderly Americans have pre-existing conditions. Pretty much any problem you’ve encountered in your life, whether it was treated or went away on its own counts. High blood pressure, asthma, bad back, depression (no matter how temporary- if you used the word to your doctor, it’s on your record) and even allergies are all pre-existing conditions. By 2005, 1 out of 2 American adults had one chronic illness and 75% of people with a chronic health condition are under age 65.

If your current health care coverage is ending don’t panic; easier said than done because the information out there is so conflicting and dire. People in the MEDICAL profession will tell you that you won’t be able to get coverage. The word “denied” comes up a lot. And, if your disease du jour is like multiple sclerosis then using online health insurance search forms to find coverage will make you queasy as it’s one of the top major chronic conditions for which you can be denied. Are you starting to feel a knot in your throat? So was I but I worked through it (thank you wine and klonopin- see, now I can say that because I’m insured) and here’s what I learned.


1. If you can only read this far so be it, but pay attention. This is critical: DO NOT WAIT UNTIL THE LAST MINUTE. If you have COBRA or other insurance then you need to think about what’s next a good 2 months before your coverage expires.

2. Educate yourself on your state’s health care status. Yes, Oregon is almost a socialist country but in this instance it worked in my favor. Your state may be the same way. One, most states provide coverage for uninsured minors so your children should be protected. As for you, if you have no income and no other resources (savings, a 40lK) then many states have emergency relief. It’s like an HMO in that you won’t get to pick your doctors and it’s bare bones but it is coverage. Two, depending on your status, your state may offer coverage to you if you have a medical condition that makes you undesirable to private insurers. In Oregon it’s called the High Risk Pool. It’s NOT cheap but again it means you will continue to have coverage.

2. Don’t go it alone online. This is just going to scare and depress you. If you know anyone who’s been in the same situation ask them if they know an insurance broker. I was hesitant, thinking this person was going to push a high cost plan on me but instead she was very pleasant and knowledgeable (even after hearing about the MS which she did admit “narrows your choices almost completely”). She was the first person to tell me to call my current provider and ask them if they had options. So…

3. Call your current health care company. You want to know if they have portability or continuation plans (every company calls it something different, of course). When I did this I learned that Regence had two portability options and they would send me an information packet. What this means as you’re already a member? NO interview or questions about pre-existing conditions. The downside? It’s not cheap. Money I’d earmarked for retirement fun is now going to pay to keep me insured. The upside? I have insurance and no changes with my providers.

4. If you have options, take the time to think carefully about the best one for you. It may be painful but if you can bear it, create an excel spreadsheet and compare costs. It may make your ears bleed from crunching numbers and gathering old pharmacy receipts but you’ll learn a lot. For me, I have 1 or 2 doctor’s visits a year – at most - so I don’t care so much about their cost. What I do have is an insanely expensive drug ($5,000 a month which is beyond bullshit) but I’ve found other ways to manage that. I opted for the lowest monthly out-of-pocket and will hope for good health.

Not the most exciting post and, hopefully, for most of you, one you’ll never need but maybe a few people landed here via Google. If so, you do have options and, while its cold comfort, you’re not alone. It’s a sad state of affairs in this country right now and not likely to change anytime soon.

3 comments:

Annabelle said...

It's scary stuff, no question about that. I'm covered at the moment but I certainly do have preexisting conditions, so I am not looking forward to my next change of status!

JD @ Honest Mom said...

I was laid off four times in four years back in the early 2000s. One of those times I was single and I had to rely on COBRA. It was *just* about to run out when I got a job. I was freaked out about it, even though I was healthy and in my mid-20s. I live in Mass. so no one is without health insurance here - technically - but I wouldn't want to deal with worrying about health insurance again, that's for sure...

PS - here via WOE!

~Julia said...

I'm sure many people will find this information useful. Thank you for putting it out there. Insurance is definitely one of those things you think about- until you're without.

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