Saturday, August 1, 2009
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My Experience with Private Insurance
There was a long period of time from my late thirties and into my mid to late fifties when I had to buy my own health insurance as a self employed individual working as contract labor. Sounds very glamorous doesn't it? If you're an actor or model or voice talent or make-up artist or stylist working in Utah with an agent you're contract labor. If you get a part in a movie or on a TV show that's a union production, for that brief time when you're on set, you're covered by the production company should you be injured or become ill while actually working. But really, the bottom line is you're responsible for your own health insurance.
When I first signed up for coverage in the '80s there was only one insurance company offering individual coverage in Utah, and that was United Healthcare. My premiums started in the $300 range. I thought that was high but it was the only game in town. As long as my internist proscribed my antidepressant, United Healthcare covered my treatment. It was when my depression wasn't responding to the antidepressant I was on, and my internist referred me to a psychiatrist, that United Healthcare began increasing my deductible and co-payments at an alarming rate. I began to see my insurance provider as my adversary. Every year my premium went up close to $100 a month. My copay went from $5 to $10 and then $20. I knew I was bipolar, but my primary symptom, or at least the one that made working impossible, was severe depression. Until I started seeing a psychiatrist I had been able to keep the word "bipolar" out of my medical records. Once that diagnosis started appearing in my records, my premium doubled. In one month it went from $500 a month to $1,000 a month. At that point I had to give up coverage.
It was just prior to that last doubling of my premium that my biggest client went out of business. This decreased my income 80%. So, I had to drop my insurance; I simply couldn't afford the premium anymore. Then I discovered that my mother had vascular dementia. As her only living relative I became her only caregiver, the one person responsible for her. So she became my full time job, a job that is depressing even for those not inclined to depression.
Without my medications, caring for my mother drove me over the edge into psychosis. I was hospitalized at the University of Utah adult psych ward for two weeks. This was the beginning of the precipitous plunge into bankruptcy. I couldn't afford the drugs I was on. At this point my drug bill was almost $1,000 a month. I couldn't afford to pay my medical bills. So next came the slow process of applying for disability. Within one year I was bankrupt and disabled. And then I started getting the help I needed to stay somewhere close to the balance point of the seesaw I was living on.
Once I started getting a monthly check from Social Security Disability and getting 80% of my medical bills paid, I was able to hang on by my fingernails. Without that public option I don't think I would have survived that terrible time in my life. It is one thing to have an illness that is expensive, incurable, and tricky to treat; it is another thing to be treated like a deadbeat who can't pay her medical bills and doesn't deserve to live.
Even with the public option of Medicare, I have to make difficult choices regarding the allocation of scarce dollars. My illness is still expensive, but as long as I make a good faith effort to pay my bills, I am treated like a person with value and dignity. I'm never refused treatment. I choose my own doctors. My drugs are now affordable because of Medicare part D and the extra help I get with drug costs because of my low income--no donut-hole for me, thank god.
I can't work anymore. But I can tell my story. And it's a common story. I am not alone. Anyone who has lost benefits when they lost a job, knows what I'm talking about. If you have children, insurance is an absolute necessity. Children cannot go without some kind of health insurance. And we should never have to choose whether we get the medicine we need or buy food. It's that basic for a lot of our citizens. We have reached the bottom line. We need single payer healthcare. But if that's off the table, we must have a public option for those of us most at risk. Healthcare shouldn't be a choice, it should be a human right.
When I first signed up for coverage in the '80s there was only one insurance company offering individual coverage in Utah, and that was United Healthcare. My premiums started in the $300 range. I thought that was high but it was the only game in town. As long as my internist proscribed my antidepressant, United Healthcare covered my treatment. It was when my depression wasn't responding to the antidepressant I was on, and my internist referred me to a psychiatrist, that United Healthcare began increasing my deductible and co-payments at an alarming rate. I began to see my insurance provider as my adversary. Every year my premium went up close to $100 a month. My copay went from $5 to $10 and then $20. I knew I was bipolar, but my primary symptom, or at least the one that made working impossible, was severe depression. Until I started seeing a psychiatrist I had been able to keep the word "bipolar" out of my medical records. Once that diagnosis started appearing in my records, my premium doubled. In one month it went from $500 a month to $1,000 a month. At that point I had to give up coverage.
It was just prior to that last doubling of my premium that my biggest client went out of business. This decreased my income 80%. So, I had to drop my insurance; I simply couldn't afford the premium anymore. Then I discovered that my mother had vascular dementia. As her only living relative I became her only caregiver, the one person responsible for her. So she became my full time job, a job that is depressing even for those not inclined to depression.
Without my medications, caring for my mother drove me over the edge into psychosis. I was hospitalized at the University of Utah adult psych ward for two weeks. This was the beginning of the precipitous plunge into bankruptcy. I couldn't afford the drugs I was on. At this point my drug bill was almost $1,000 a month. I couldn't afford to pay my medical bills. So next came the slow process of applying for disability. Within one year I was bankrupt and disabled. And then I started getting the help I needed to stay somewhere close to the balance point of the seesaw I was living on.
Once I started getting a monthly check from Social Security Disability and getting 80% of my medical bills paid, I was able to hang on by my fingernails. Without that public option I don't think I would have survived that terrible time in my life. It is one thing to have an illness that is expensive, incurable, and tricky to treat; it is another thing to be treated like a deadbeat who can't pay her medical bills and doesn't deserve to live.
Even with the public option of Medicare, I have to make difficult choices regarding the allocation of scarce dollars. My illness is still expensive, but as long as I make a good faith effort to pay my bills, I am treated like a person with value and dignity. I'm never refused treatment. I choose my own doctors. My drugs are now affordable because of Medicare part D and the extra help I get with drug costs because of my low income--no donut-hole for me, thank god.
I can't work anymore. But I can tell my story. And it's a common story. I am not alone. Anyone who has lost benefits when they lost a job, knows what I'm talking about. If you have children, insurance is an absolute necessity. Children cannot go without some kind of health insurance. And we should never have to choose whether we get the medicine we need or buy food. It's that basic for a lot of our citizens. We have reached the bottom line. We need single payer healthcare. But if that's off the table, we must have a public option for those of us most at risk. Healthcare shouldn't be a choice, it should be a human right.
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