Health insurance is kind of backwards. If you are extremely wealthy, then you might be able to get through life without having health insurance coverage. I mean, Bill Gates is unlikely to have concerns about being unable to pay for an extended hospital stay or the cost of the ambulance that took him to the hospital.
What if you aren’t extremely wealthy? You are simply not going to be able to pay your medical bills out of pocket. The only way you are going to be able to pay for your health care needs is if you can get insurance coverage. Theoretically, health insurance is supposed to be there to help you pay for (at least some) of your medical bills.
Which brings me to an obvious problem. Health insurance is expensive. We aren’t going to be able to access the Marketplace system until at least October of this year (where we should be able to find affordable health insurance). In short, this means that the people who are most in need of some financial assistance to pay for their health care needs are the least able to buy health insurance coverage.
In April of 2012, I spoke with an insurance broker who was able to help me find affordable health insurance coverage. The premium was about $130.00. It was a comprehensive plan that covered the “if I get hit by a bus and end up in the hospital” type situations as well as the “if I get yet another sinus infection and need to see a doctor and get antibiotics” scenarios.
About a month before I got the policy, I picked up a gig that turned out to be a very steady, regular one. I was able to figure out exactly how much writing work I needed to do for that one gig in order to pay my health insurance premium. Suddenly, access to health care seemed like something I could get when I needed it (without having to eventually file for bankruptcy due to unpaid medical bills).
A few months later, the cost of the premium went up a little. It now would cost $138.00 per month. After consulting with my insurance broker, we came to the conclusion that this slight cost increase was because of my age. I turned 39 in May of 2012, which my insurance broker said pushed me into a different “bracket” than the one I was in when I purchased the policy.
Ok, fine. I would need to do a little bit more writing work for the gig I considered to be my means of paying for health insurance (in addition to all of my regular writing work) in order to pay for my health plan. It looked like I would be able to keep it, if I could manage to stay well enough to work a little bit harder than expected. This seemed possible, because if I got sick, I would be able to afford to see a doctor now that I had health insurance coverage.
I think it was during the summer of 2012 that my health plan changed. It now included coverage for maternity (which, if I recall correctly, was required by a California state law). It also covered treatment for autism (another California state law). Not long after that, it started covering birth control, (because of a federal law that was part of the Affordable Care Act). The cost of my premium didn’t change.
A few months later, I got a letter from my health insurance company telling me that my policy had been discontinued. Of course, I panicked. I presumed that this meant that I no longer had health insurance coverage. Instead, after talking with my broker I learned that wasn’t exactly correct.
The health insurance company was pressuring me to leave my current plan, that had an affordable premium and nice coverage, and jump into one of three plans they highly recommended. My broker made it clear that I didn’t have to leave my current plan, and noted that the plans they wanted me to move to were more expensive and with less coverage. She suggested I stay with the discontinued plan, so I did.
I got more than one notice from the insurance company suggesting that I should switch plans. They pointed out that if enough people left the discontinued plan it would mean that I was suddenly in a smaller pool – and as a result, my premiums would increase. This seemed incredibly unfair. I didn’t do anything to cause this to happen. I’d been paying the premiums on time. Why were they picking on me?
In November of 2012, I got a letter from the insurance company informing me that as of April 2013, my premium was going to increase. My new monthly premium would rise from $138.00 to $166.00, (which they noted was a 20.2% increase). This certainly felt as though the insurer was punishing me because I didn’t leave the discontinued plan – that was affordable and had good coverage – for one of their crappier and more expensive plans.
This news meant that it was highly unlikely that I would be able to afford to keep my health insurance coverage. Again, I figured this was the insurers way of forcing people out of a plan that they wanted to stop offering. This, too, seemed incredibly unfair.
Once again, I spoke with my insurance broker, hoping she could help me. In short, she suggested I stay with the plan for now, and then use the Marketplace in October of 2013 to find a better, more affordable, health plan. All I had to do was somehow find a way to pay for my health insurance between April of 2013 and January of 2014, and I would avoid having to pay a fee for not having coverage. She offered to help me to use the Marketplace when it opens, which I intend to do.
In April of 2013, I got another letter from my health insurance company. This time, there was “good news”. It wasn’t really good news, but it wasn’t horrible news, either. They decided not to raise my rate as high as they threatened to back in November.
Instead, as of April of 2013, my new premium was $160.00. So, instead of paying an extra $28.00 per month, I would be paying an extra $22.00 per month. I’m still going to have to push myself and do some additional work each month for the gig I consider to be my “I can pay continue to pay for health care” gig. In the meantime, I had a different gig dramatically reduce the amount of work they wanted from me. I’m starting to pick up some stuff, here and there, to replace what I lost (but am not there yet – not even close).
Will I be able to afford to keep my health insurance between now and when the Marketplace (previously called “health insurance exchanges”) opens? Can I hold out long enough to make it until January of 2014 when the plans purchased in October will go into affect? There is no way to know, but it doesn’t look good. If I were healthier, I would have the option of dropping my health plan and spending the cost of the premium on some of our debt. Unfortunately, I have serious, chronic, allergies, so this is just not possible.