Thursday, October 21, 2010

The One Where I Lose My Insurance

Note: I'm not looking for sympathy. I'm also not looking for ridicule (those of you who should know better than to use the same IP address all the time.) I'm just telling the story here, the way it happened.

I have never in my life understood insurance. I understand the purpose of it and how it works and yes, I understand that it's a business, but I don't understand why insurance companies can be so damn cold when it comes to helping people not die.

I had Blue Cross/Blue Shield of North Carolina, and I'll tell you. . .when I called to try to get my situation worked out, the guy I talked to, whose name I desperately wish I could remember, was really nice, but ultimately, BCBSNC doesn't care.

(Again. I UNDERSTAND that it's a business. That's what D keeps telling me. "They don't HAVE to help. They're a business." I get that. But while you're sitting there with your nice insurance industry job and benefits, there are a ton of people out there who need help, and you just don't care.)

The main thing that gets me here is the Pre-Existing Condition clause. Yeah, I've got The Diabeetus. Have for 21 years now. Not my fault. Not anyone's fault, but I don't feel like it's fair to make me pay hundreds of dollars more because of it. The coverage I was paying for? Cost me $400 a month. That's what I paid in rent when I was living in the mountains. Because of that and prior diagnoses of depression, mixed in with some anti-depressants (which, God only knows I wish I had access to at this point in my life), I'm a gold mine for insurance companies.

Apparently, I lost my coverage at the end of August, due to being behind on payments. That, obviously, is my own fault. I chose to have a little bit of extra money in the bank "just in case" (which was awesome to have when it came to paying rent last month) rather than paying the premium. My own fault. Not trying to blame anyone for that.

My question is, why does it have to be SO DAMN HARD to stay healthy? We're America for God's sake. We're supposed to have all these opportunities and all that bullshit here, but instead, what we have, is a medical system that can only be paid for if you've got insurance through your job or if you have a lot of money to buy your own.

Which I do not.

I keep getting off track. Apparently, I lost all coverage August 31st, and the insurance company didn't feel the need to tell me that. They didn't feel the need to be like, "Hey, you're not going to be covered after this date." I'm not even asking that they gave me an opportunity to do something about it. That would have been nice, but it's my own fault the coverage expired. All I'm asking for is a form letter saying, "Hey, we're not covering you anymore."

Because then I wouldn't have gone to the two doctors I did, and then I wouldn't owe the almost $300 that I now owe.

Again, I digress.

The problem I have here is that, when I called the company to figure out what the hell was going on (Oh, I found out about this when I sent D to the pharmacy to pick up my insulin for me, and they were like, um, you're not covered. So instead of paying $35 for two bottles, which would last me a month, I instead, over the phone, crying to a pharmacist, payed $123 for one bottle.) the guy I talked to was nice. I cried again (this is not a sympathy ploy. I just have a very loose grasp on the crying mechanism in my head. I cry a lot, not only when I'm upset, but also when I'm angry, frustrated, whatever. My emotions manifest themselves in sloppy tears.) and he was nice about it.

He told me that what he'd try to do for me was to see if I could pay $800 by the end of October (this was about a week ago, so I had about 3 weeks to somehow pull this off), and then I'd be caught up and could continue coverage. The problem was that, for one, I didn't know where I was going to come up with $800, and for another, I'd still have to pay the rest of how far behind I was (a total of about $1,130) and still make a payment for November.

I didn't care. I was desperate, and I was sure that somehow, some way, I could pull all this money together. I'd bake dozens and dozens of cupcakes and sell them to unsuspecting strangers. I'd help D do his selling. I'd ask for help from Mom. Whatever. I'd do it.

So I'm feeling cautiously optimistic, thinking, as I sometimes do, that everything's going to work out for me, and that I'll be OK. That I'll pull through.

The guy puts me on hold for about 10 minutes while he "talks to someone" about it. His supervisor? I don't know. For all I know he went and took a pee and got a donut. Hopefully not at the same time.

He comes back and tells me that "he" (whomever he "spoke" to) is concerned about me making payments (as he has a right to be) and that the only way I can fix this debacle is to send, by overnight mail, $800 that day.

Wait, what?

I was scheming and planning how to get $800 in about two and a half weeks, and I was half convinced I'd be able to pull it off. But now I needed $800 in less than 24 hours.

That wasn't going to happen.

I cried some more, told him thanks for his help, asked him to tell his company to go eff themselves and hung up.

And cried some more.

And then added up the expenses in my head. $240 a month in insulin is less than the insurance itself would have cost. But when you throw in my insulin pump supplies (about $700 per order, every 3 months or so) and my dreams of a new pump to replace mine that is 7 years old (um, thousands upon thousands), I'm pretty much screwed.

My therapist (who, incidentally, I can't afford to see anymore) suggested I try to get on Medicare (or is it Medicaid? I always get the two mixed up. The one not for old people.) but warned me that it was going to be really difficult, "because I'm white." She did say it would be better since I'm a woman, and would be EVEN BETTER if I were pregnant.

That? Is screwed up, you guys. Screwed. Up. These illegals are swarming in and getting free healthcare, free this, free that, and me, an American-born citizen that just happens to be in some hard times right now, like so many of us are, might not qualify because I'm an American-born citizen that just happens to be in some hard times right now. There is NOTHING right about that.


So we'll see what happens from here. But for now, I'm not completely broke, but teetering, unable to get a new insulin pump before mine dies, paying a week's pay for the medication I need, not even mentioning anything else I might need. . .

God bless America and our laws and systems.


  1. Oh no!! That realyl sucks!

    I actually have Medicaid (the one you want to try and get). For the most part, it sucks (at least, here in NH) because the state doesn't want to pay the doctors, so the doctors have begun to not take the Medicaid now. So, some of the doctors that I need to see, I can't.

    It does have benefits, like not having to pay for a doctor's visit; but then again, some of the doctors I need to see, won't take it... It's a vicious cycle.

    Either way, I hope you're able to get coverage from SOMEONE. :-\

  2. I know this is an older post, but I've been a bit behind on my blog reading.

    I have also had quite a go-around with insurance companies in my life. I was born with scoliosis, and major surgery was required to make sure I could live past the age of, oh, 14-ish. My surgery was actually scheduled for May the year I turned 12, and then my father was laid off and lost his insurance. They tried to pick up new insurance so we wouldn't have to reschedule the surgery, but no insurance company was going to cover a kid that they knew was about to have major surgery in three months. Luckily, my dad got another job pretty quickly, and we just had to push the surgery forward about 6 months to make sure it was covered. And as you can imagine, this "pre-exiting condition" (even though it was FIXED) has made obtaining insurance a challenge as an adult.

    Medicaid is definitely your best option. Like the commenter before me said, some providers won't take Medicaid, but that's their right. There are still plenty that will take it. And just FYI, I above all others enjoy a good "illegals" rant, but it isn't their fault (this time). As much as we yell about illegal immigrants taking our resources without paying in, that typically applies to public schools and hospitals -- not Medicaid. I interned as a tax attorney this summer (THRILLING, I assure you), and I learned a lot about what our country/state is and isn't willing to pay for when it comes to illegals. State sponsored healthcare is most definitely NEVER covered. Now again, they can go to the hospital and get treatment whenever they want, but so can you. You just have to be willing to completely destroy your credit score with the knowledge that you will probably never be able to get a loan/mortgage/health insurance later in life.

    And since I'm already bordering on a political rant, can I please say that one of the major issues you're facing right now is "Obamacare"? The healthcare bill didn't do anything to help your premiums, all it did was say that a company can't DENY coverage based on pre-existing conditions -- so they raised premiums across the board. Let me tell you what kind of legislation we DO need: we need to outlaw companies providing health insurance as an incentive. That's what is saturating the healthcare system and causing premiums to be so high (even without all the government regulations). A major company can afford to pay millions of dollars a year for health insurance; you and I cannot. It is currently illegal for a company to cover your own personal auto insurance, so I don't see why they couldn't do the same with health insurance. Prices across the board would drop dramatically, and it would be much easier to obtain affordable insurance.