My Frustrations With Health Care

This is one of those topics that is really difficult for me to write about, simply because I feel so uninformed. Health insurance and all things related are way over my head. I do my best to read and understand the fine print, but the important big picture question, “what should I do?” is the one that stumps me. I just don’t know. I read about all the controversy about this health care reform bill and I wonder, “how will this affect my situation? Will it even help me? Will it be too late?”

Four years ago, I had great coverage. I worked for Walgreens and my insurance (Blue Cross Blue Shield) covered everything with a very small copay. My decision to leave that company was complicated, and because ties haven’t been cut altogether, I really shouldn’t delve into it, but as a result, I lost that incredible coverage. My next job was at a small company that could not afford to provide group insurance. (Moving to a job without group insurance was probably my first mistake.) My husband worked at the same company and was still a student. At that time, we decided to look into private insurance. We didn’t have a lot of money to spend on insurance, so we chose a plan with a large deductible through Assurant Health. The premium was still $175 or so each month with a $5,000 deductible. We tacked on maternity coverage since we planned on starting a family.

A few months later, my husband got a new job which provided group insurance. I chose not to apply for his policy at that time because we were told I would have to pay my own premium – that his employer did not cover the whole family’s premium, only his. The coverage was considerably better than our policy at Assurant, so naturally we assumed it would be too expensive.  My premium at Assurant went down to $120 a month. Midway through my pregnancy with Micah, we reconsidered (I can’t remember why – I think we planned on reorganizing our budget) and I tried to enroll with his insurance. I was denied because I was coming from a private insurance policy. Apparently I could have been added if I had applied in the first 30 days of his employment, but that was my only chance under current circumstances. I wasn’t about to get fired just to get insurance. I immediately regretted my decision to go with private insurance. Would I have been better off uninsured at that point? It’s possible but I’ll never know, I suppose. The next blow came when we added Micah to Eric’s policy and realized his paycheck stayed the same. So… we weren’t being charged extra for additional family members? Were we misinformed or did we misunderstand? I still don’t know. The third blow came when we got the bills from the hospital. Everything was charged on separate accounts, meaning the $5,000 deductible was barely met and Micah’s treatment costs were applied to a separate deductible. Some pregnancy/delivery related treatments were billed as non-maternity. Essentially, our “insurance” covered next to nothing. We racked up nearly ten grand in medical bills. I looked back on the thousands of dollars in premiums I had paid and wondered, ‘what was the point of all that?’ Nearly a year later, we still haven’t paid Micah off (though I’m hardly worried he’ll be repossessed, hehe).

Last month, my policy with Assurant was due to expire and I had the option of renewing, but at a 68% increase in premiums. Given our current financial situation, I had no choice but to not renew. Considering how much that insurance helped me, I did not mind dropping it. Especially because this past time around, I would have been better off as a self pay because I would have gotten those discounts. As it stands, I am currently uninsured. I’m not necessarily worried because I’m healthy, but we want to have more kids and can’t afford to take on any more medical bills at this point. Even if we could come up with 8-10K, if I ended up needing an emergency c-section, the bills would devastate us. I’m not sure how long it would take to recover from that. We would probably not be able to afford a third child then, and that would break my heart.

At this point, my only shot at getting insurance is through Eric either getting a new job, or his employer buying a brand new group policy with a different company (and even that is not a sure thing, I suppose). There is no way we can afford private insurance. Any plan that we can afford will end up costing us more than not having any insurance at all.

Why must affordable health insurance (that is worth anything) be tied to a job (at a larger company) and why is it so hard to get? Why are there so many exclusions? What are people like me supposed to do?

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7 Comments

Filed under Family, Finances

7 responses to “My Frustrations With Health Care

  1. That is so tough, Kim. I am not sure how I feel about all of this either. I also don’t really understand it. All I know is that we switched from military insurance to BCBS in January, and that was a huge blow. BCBS is great insurance, but our deductible is 10x what it was on Tricare and our monthly premiums are 2.5x as much. I just wonder what would happen should Rob ever become self-employed. What would we do? What if one of us gets sick and is labeled with a “preexisting condition”? I have a really hard time with one particular argument that I hear from some people who are vehemently opposed to health care reform. They say that good health care is a privilege and that if you don’t work for it then you don’t deserve it. On the one hand, I agree that people shouldn’t mooch off the government. On the other hand, I don’t work! What if BCBS dropped me for some reason, and I needed to figure something out for insurance? Do I not deserve that “privilege” because I made the choice to stay home and raise my children? What about small companies like you mentioned that can’t afford to provide health insurance for their employees? Do those employees not deserve proper health coverage because they didn’t take a job with a large corporation?

    Bottom line, this is a complicated situation, and I don’t think anyone REALLY knows what is going on with this bill.

  2. Wow, I think this story says a lot about the situation. I know that medical insurance is one of the main obstacles I think about when wondering/wishing that I could go into business for myself. And that same reality for most Americans has got to put a damper on the US economy too, (not to mention the “American Dream”) when you consider that small business is the engine of the American economy. David Morrison sent me to your blog. Thanks for sharing.

  3. You are not alone, that’s for sure! I was with a company that was union and for just $5.50 a week I had great insurance! Aly and Aidan cost us just a few hundred dollars but then I left the company (which eventually went bankrupt anyway) but we didn’t consider our health insurance until afterward and were shocked to find out how much it would cost through Gary’s employer…so we didn’t. It wasn’t too bad until I got pregnant with Garrett and then a friend joked that we should have him at home to save money. Well, we looked into it and did hire a midwife and had him at home…he was our only baby that was totally bought and paid for before he was born :o) I would have had Rachel at home (we were uninsured again that time) but that midwife had sold her practice. Gary actually lost his job a month after we found out we were pregnant with Rachel. When he got another job a few weeks later we both decided we didn’t care what it cost we would take their insurance and were very relieved to find out that my pregnancy was covered. His company changes insurance companies just about every year and makes me crazy. Sometimes it’s good and sometimes not so good…right now it’s excellent, when Emily was born last year, not so much (in fact they dropped her after she was born and we still don’t know why!) Anyway…to make a long story short (or not) all that is to say that God provides. Always. He will let you know what route to take with insurance and He will provide just what you need to cover it. I can’t imagine trying to navigate any of this life without Him!

  4. This blog is great. How did you come up witht he idea? 3 3 6

  5. Jaime

    My husband and I are in a very similar situation! With our first child my husband was still in Law school and we qualified for Medicaid coverage in the state of Michigan. Now he is working for a company that not only doesn’t pay that great but also only covers a portion of HIS insurance! I had never heard of that before! So to add myself and daughter we would have to pay 1,000 a month in premiums! On his salary that is impossible. Now we want to have another child and unless he changes jobs and gets better insurance we don’t know what to do. There is also no way to get any kind of decent maternity coverage through an individual plan. I never thought that the government would inevitably end up essentially dictating how many children I have and when! It is so sad but we what do you do? I also had a c-section the first pregnancy and I know if we paid on our own it would be massively expensive. Ughhh…so frustrating isn’t it? I thought the reason we spent all that money on law school was NOT to ever be in this kind of position!

    • Kim

      That is so frustrating! Does your state offer insurance for moms and babies? I have been looking into Illinois’ moms and babies program. It is based on what you can afford in terms of what you have to pay for the premium – but it’s something like $30 and the insurance covers everything for your pregnancy, delivery, and the baby’s first year of life. I don’t even know if we would qualify, but if we do get pregnant before I am able to get insurance, it’s definitely something I’ll apply for.

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