My Health Insurance Crisis
February 18, 2010 in Health Care Crisis
I’ve got a minor health insurance crisis on my hands, one that I learned about a few days ago when I tried to have a prescription filled. The following is a tale of bureaucratic tedium and frustration for only the heartiest of souls.
My Blue Cross HMO New England plan, unbeknownst to me, was canceled on February 12, retroactive to January 1. The prescription medication I take to control my asthma normally costs $50, the price of my co-pay. Without insurance, it’s $250.
My last employer laid me off in October, 2008. I worked as a financial writer for an investing newsletter publisher, and our subscribers fled in droves when the markets tanked in September of that year. I spent most of my last few days of employment fielding calls from irate investors who had followed our advice straight into penury.
After my severance ran out, I enrolled in the Commonwealth of Massachusetts’s Medical Security Program when I applied for unemployment. I have never received or paid a bill for my health insurance premium, which is (I found out today) $387 a month. Single guy here, no kids.
After I paid $250 for a little purple plastic disk full of steroids, I called Blue Cross. The first time, they told me that my policy was “inactive.” I was puzzled, but then I thought it might be because my Medical Security Program benefits had lapsed when my initial claim for unemployment insurance expired in December. I am on extended UI benefits, thanks to the federal government. So I called the Medical Security Program to see if I still qualified.
Here’s the thing about the Massachusetts Medical Security Program office: Sometimes they are so swamped (are you hiring, BTW?) that they won’t even put you on hold, they just tell you to call back and then hang up. After my third call, I finally got some harried woman who told me that I needed to ask my employer what was going on and that “it’s your responsibility to make sure you have health insurance.” Oh really? Thanks, lady. It turned out that my benefits had indeed lapsed under the MSP and I needed to call them to have them reactivated. I didn’t mind this mild bureaucratic scolding, because I got my Medical Security Benefits back during that call. Good! That was Tuesday.
Even though I was and still am terrified at the thought of not being covered if I get into a car accident or the cat finally succeeds in making me fall down the stairs, I decided to let the system’s gears grind away for a couple of days. The Medical Security Program needed to call Blue Cross, right? I mean, they must talk all the time. They’re probably friends.
In the meantime, I called Ecu-Healthcare, a local non-profit that helps MA residents get the best deal on health insurance using the MA state system. I called hoping to speak with or even go in to see someone, but they were swamped, so they called me back about 5 hours later. The harried woman who helped me this time told me that as long as I was covered by the Medical Security Program, there was nothing they could do for me. If/when my unemployment benefits and Medical Security Program benefits ran out, I could come to them for help. Okay. Fair enough. That was Wednesday.
I called Blue Cross for the second time today to find out if through some magical operation of “the system” my health insurance had been turned back on. Did Blue Cross get a call from its BFF the Medical Security Program? I had reason to be hopeful because the Medical Security Program told me that my benefit had been reinstated retroactive to January 1. But no luck. My insurance was still canceled. I hung up, frustrated and a little bit scared. Who could help me with this?
So I called the Medical Security Program again. After trying twice and being told to call back later, I finally got through. Apparently, my Premium Assistance benefit under the Medical Security Program only covers 80 percent of my premium of $387/month. It’s my “job”–again, with the job! I didn’t realize I had a job!–to pay that, and the state will reimburse me 80 percent once I submit my paperwork each month.
The problem is, I have never once received a bill for my health insurance premium and have never submitted proof of payment to the state for reimbursement. I have seen my doctor and had prescriptions filled during the 14 or so months of my unemployment. I have paid the co-pay for office visits and prescriptions, and everything had seemed to be working just fine. I thought this was the Massachusetts system doing its job.
I was wrong.
It turns out that for some reason my former employer has been paying my health insurance premium up until February 12. Possibly by mistake. When I called my former employer to talk to someone in HR to find out what was going on today, I found out that the person I need to talk to is on vacation until Monday.
I just submitted an application for something called Direct Coverage insurance to Blue Cross of MA. The premium is about $400/month. For just me. But I won’t know if I have been accepted into this plan for many, many business days, and coverage wouldn’t start until March 20. And I won’t be able to find out if I can continue my old insurance on COBRA or under some state law or regulation until I talk to HR at my former employer on Monday.
In the meantime, I HAVE NO HEALTH INSURANCE. AT ALL. Just getting to this point of figuring out the known unknowns, as Donald Rumsfeld might say, has taken several hours of my week. And I still have to make it through the weekend without some kind of health care emergency. My insurance, I found out today, isn’t so much “coverage” as it is a chance at coverage. And my most recent roll of the dice came up snake eyes.
Moral: Our health insurance system is appallingly broken. It has taken me hours–hours I could have spent productively looking for work–to wade through the dementedly fractured system in Massachusetts that is supposed to protect me in the case of a catastrophic illness or an accident. Even in my “universal coverage” state, apparently, one’s health insurance rug can be pulled out from under one with no notice. Cancellation can be retroactive.
Our system is immoral and almost shockingly stupid in its construction. We have got to fix this.