10 January 2012

Equation for Screwed

(C+I)x(U+N)= Screwed
 where C= Chronic  I= Illness U= Under/unemployed and N= No Health Insurance.....

Ok, so I have never been that good at math but I AM an unfortunate expert in the mathematics's of no health coverage.  I have been uninsured before, and unemployed/underemployed before, it was tough ESPECIALLY since when I got sick.  Then I did not have a chronic illness, such as Meniere's, as I do now.  Back then it was just the standard stuff that went wrong.  Fast forward a few years and I'm looking at a new equation, and prices have only gone up.

I get asked things like "why didn't you COBRA?" It was because we were not sure there would be any disability insurance income before the deadline, and to COBRA would have been literally more than 3/4 of my husband's take home.  That would have left us with exactly enough to eat, but no other bills. And it would have been rice and beans at that.

The next question I am asked, "Why don't you just go get a private insurance policy?"  Because I am "uninsurable" with my condition for most companies, factor in my weight and PCOS, and no company will insure me for any price. I did have one quote for 1200.00 before the Meniere's was diagnosed, but I figured with the 3000.00 deductible and 60/40 co-pays we'd be broke even if we could have afforded it just from the deductible.  (the 10,000.00 deductible plan was only about 350.00 a month but it, like all the rest, wouldn't cover pre-existing conditions)

Only a few ask about the plan for pre-existing conditions that is out there now.  The "state health pool" was the first we looked into.  It was as much, or more than COBRA.  The new federal plan covers a lot.  It has about a 1000.00 deductible and would run about 350 a month.  Doesn't sound too bad, until you look at the whole picture.  I would qualify for that plan because I meet the criteria, but the question of how to pay for it is still on the table.  We can afford ONE of us to have this policy, not both (that's 350 each and separate deductibles).  And with that ONE, we can afford the premium or the deductibles.   Let me explain:  The doctors offices now have signs up stating that "If you can not afford your co-pay, you will have to reschedule."  Upon further investigation, this goes for the amount up to the deductibles as well. So if I don't have the 125.00 for each visit when I get there, I don't get to see the doctor.  Well if I pay 350 a month for insurance, I'm NOT going to have the money for the visit.  It's a great plan for someone that brings home 2000.00 a month or more, but it isn't going to help me if the only stable income we have is less FAR less than that! How do you afford a deductible that is about what you bring home? 

We opted not to get this insurance because my disability insurance policy will run out in the fall, and we would no longer be able to afford the set up.  We thought, at the time anyway, after I graduated with my degree in special education I would find a job right away.  Due to the state making some poor choices even the special education market dried up.  A job that has a 5 year burn out rate on average, a job that needs more teachers than there are to fill the slots, a job with benefits.

So I'm among the ranks of the "underemployed".  I sub when I am called, and pray for a long term slot where I can have a steady income.  With any steady income, however, we run the risk of loosing the disability insurance policy that keeps us afloat when I'm not working.  It's a risk I have to take.  Now I paid for this policy, so I'm not cheating the system, let me clarify here.  It is for exactly what its doing here, and that is to help someone "retrain and retool" when they can no longer do the job they are doing when they got sick.  For me it was being a firefighter. When I was too sick to work anywhere, (and I still have times where this is the case) I applied for Social Security Disability.  I was denied.  I want to work, don't get me wrong, but there are days and weeks where the whole idea of working is absurd because I'm so sick.

Ok, back to health care.  I only go to the doctor when I can afford to pay up front. We don't use credit, so if we don't have the cash, we are screwed.  The doctors office ever so nicely told me, if that happens, just go to the ER.  They HAVE to see you, and you can make payments on the bill for as long as it takes. I'm not going to the ER for some trivial thing like an ear infection or a sore throat. If its stitches or a broken bone, sure, but its not for cold and flu.  Its not.  And if it were something scary, like say chest pains (God forbid), and they "found nothing" they are going to refer me to a doctor I couldn't afford anyway for a follow up.  So this heartburn I've been having, which the doctor will want to run tests to see why, isn't going to get treated anytime soon because the tests are unaffordable.  Sure I can afford a doctor visit, but not the tests needed for a proper diagnosis.  Go to the ER, and they refer you out to a doctor for a follow-up you can't afford. 

We go to the local Urgent Care for a number of reasons.  Its inexpensive, they take a 75 dollar payment towards the total, and the hours are great.  They don't like people like us using it as a regular doctor's office. Not much is said, but its the questions and comments that imply as much.  "Why did you decide to use urgent care and not your regular doctor?", "Don't you have insurance to cover that?" and so on.  My regular doctor's hands are tied because I can't afford his tests, and I have to be available to work at a moments notice so scheduling is always a challenge.

So I look for a job that has good pay and insurance. In the meantime, we find ourselves on the "pray" policy.  Pray you don't get sick or injured.  A scary proposition when you have a chronic illness.

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