Tuesday, October 13, 2009

At least I have my health.

As anyone who has been following this blog for any amount of time knows, I lost my job about ten months ago. Since then I have been either unemployed or underemployed, and while I'm now working a 40-hour full-time job, it's a temporary position and I don't know if it's going to amount to anything other than having paid for the Wii I bought a few weeks ago.

The first thing I did after starting to do freelance work in March was to look for health care. The coverage that was provided by my former employer was great. It covered just about everything I could want it to cover, and my prescription copays were always very low. I decided that I wanted to stick with the same insurance company that I'd been using for years. I found a website through which I could apply, filled out the application, and sent it in.

A few weeks later I heard back: my application had been rejected. The reason had something to do with some doctor's visits I had made almost a year prior, and it didn't make any sense. I wasn't seeing that doctor anymore, so why should it affect my coverage now? So I applied again. This time I tactfully and skillfully left those previous visits to the doctor whom I was no longer seeing off of my application. Was this wrong? Maybe. But I needed insurance, and since I was no longer seeing this doctor, I didn't think it would be a problem. And again, a few weeks later, I received another rejection. No mention was made of the doctor whom I was no longer seeing. This time the reason given was my height and weight. Fun fact about me: I'm 6'5". I carry a little extra weight around my midsection, but I am by no stretch of the imagination obese. I'm a big guy, and I'm built like a big guy. My weight has never been an issue before medically, so why should it be an issue now? I was convinced that, if they could see me, they would have accepted my application.

Now I was frustrated. I had seen an ad in the paper for a local insurance agent with the company that I had been applying for coverage from, so I called him. We talked for about an hour and I filled out yet another application and he sent it in for me and told me he would let me know what he heard. So I waited for about a month, maybe more, I don't remember exactly, and then I heard back. Rejected yet again. This time, it was because of a prescription that I've been taking on a daily basis for a while now. In other words, I have a pre-existing condition. I don't see a doctor for this condition. I don't have to undergo expensive medical procedures because of this condition. Once a month I go to the pharmacy and have my prescription refilled, and that is the extent of the care that this pre-existing condition requires. The cost of the prescription without insurance is a little over $100. That's just over $1,200 a year. The premium that I would've been paying to the insurance company would probably have covered most of that. And yet, they wouldn't give me insurance.

So I decided to go a different route. Referred by a friend to another website, I filled out another application and was soon contacted by a very friendly woman who helped me compare my options and choose a plan that I could afford and that would cover what I needed. My prescription copay was a little more expensive than it had been before, but I wasn't paying anywhere near the full price so I was fine with it. All was fine with the world. Until this past weekend. I went to pick up my prescription, and my copay had almost doubled from $45 to $83.30. That's just $20 less than the cost of the prescription. Monthly the insurance costs around $140, plus the now $83.30 copay for the prescription, which makes the monthly total around $223.30. It would actually be cheaper for me now to just drop the insurance and pay for the medication out-of-pocket than to continue with it.

Since this past weekend I've contacted the woman who helped me set up the insurance, and after doing some digging she informed me that the copay increase wasn't a mistake (as I thought it surely must have been). It's just a tactic of the insurance company's in an attempt to get me to sign up for a mail-order program that is supposedly cheaper than going to the pharmacy. She also mentioned that her own insurance company has been pressuring her to make the switch from pharmacy to mail-order service.

I just really don't know what to say about any of this, nor do I pretend to know everything about the current health care debate that is going on around the country. I do know, though, without question, that the current system is broken and that something needs to be done to fix it, and soon. I also know that I hope I don't get sick any time soon.

3 comments:

  1. I bet Wii Fit would tell me I'm obese right now. And then it would yell at me. Which is why I don't use Wii Fit anymore.

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  2. Honestly, I think having a Wii Fit would be really good for me, precisely because it would tell me I'm obese and then yell at me. I need that.

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  3. Shit, you don't have to waste money on a Wii Fit. I'll yell at you and call you obese as often as you want me to. I can even send quick texts every 6 hours and really defeat your self-esteem to the point that you're crying and huddled in the shower while fully clothed. It's the least a friend can do. :)

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