Health Care Horror Story #3

The following story is true.  It was told to me by a Florida woman who wishes to remain anonymous.

“I knew I was going to watch my son die.  I didn’t know I was going to have to pay to see him suffer while he did it!

My son has cystic fibrosis.  He is 22 years old.  With good medical care he can live a relatively normal life until he’s about 25.

When he became an adult, since he was uninsurable, the State of Florida had a health plan which covered him.  Under the state’s program, health insurance companies doing business in Florida must offer plans, at a reduced cost, to people who were unable to obtain insurance on their own.  To be covered by this plan, each year, all we had to apply for insurance,get rejected, and then apply to the state’s program, which required a copy of the letter of rejection in order to insure us. Because of his illness, getting this letter each year was no problem.

The state plan is still expensive, about $500 per month.  Its best feature is that it has a $10 co-pay.  Since the monthly breathing treatments that keep my son alive and active are more than $2,000 per treatment, a $10 co-pay per month is a great deal.

Once the new healthcare law goes into effect, my son will no longer have this state option.  Since insurance companies must offer him insurance, we will no longer be able to provide the letter of rejection required.

To prepare myself, I  spoke to several insurance companies in our state.  I wanted to get an idea of what my son’s insurance will cost.  All of them said the same thing.  There are no price controls limiting what they can charge to cover my son.  The lowest price I heard for a policy was $1,300 per month.  Worse, all plans offered were going to be 80-20 plans.  This means that we would have to pay at least $400 for my son’s monthly breathing treatment instead of the $10 co-pay we pay now.   And, of course, on top of that, I would also have to pay 20% of the bill for doctor visits, tests, medication,  treatments, etc., for which I now pay this same $10 co-pay.

Even worse, since, under the new healthcare law, lifetime maximums are now eliminated, most plans also plan to eliminate the annual caps on the amount out of pocket expenses.  Now, after we spend a certain amount in a given year, for us it is $5,000, the insurance picks up 100% of the rest of our son’s medical expenses.  Every year, we hit this maximum.

I spoke to the people at the state’s Department of Health.  I was told that they are planning to dismantle the state’s program.  I won’t be able to get the policy my son has had since he was 18.

The cost of my son’s care will ruin us.  We have two other children.   I don’t know what to do.”

Since people will no longer be able to provide letters of rejection, states across the country are planning on dismantling their programs requiring insurance companies to offer lower cost programs to insure the uninsurable.  Under the new law, insurers can charge any price they want for individual high risk plans.  Let the buyer beware!

Health Care Horror Story #2

Imagine that you are a 32 year old divorced woman with a 2 year old child.  Your husband is gone. You don’t know how to get in touch with him.  The idea that he might come up with child support makes you laugh.

Each day you work in an office.  You get paid $32,000 per year.  You take home about $2200 per month.  Your rent is $600.  Daycare at the cheapest place you don’t really love is $350 per month.  If you pack your lunch every day for work and never buy any treats for your son, food costs at least $100 per week for the two of you. You have your car payment, $300 per month, your cell phone payment, $50 per month, and your utilities, $110 per month.  This leaves you less than $55 per week to pay all your other expenses, including gas for the car, clothes for you and your son, diapers, furniture, repairs, credit card bills, medical expenses and maybe even cable for the TV.  Every month you feel you just get by.

You know times are hard at your company and times are tough in general.  You know you are fortunate because the company you work for still offers a health plan that pays almost all your medical bills.  However, business is bad!  The company can’t afford to pay the $20,000 a year per person the health insurance premium will cost beginning in 2014.

The company has given you notice that, as of the first of the year, they will stop offering this plan.  They informed you that, for about $5000 per year through your state’s exchange, you could obtain a catastrophic health plan for you and your child with a $3000 annual deductible.  In order to have the money to pay for this plan, beginning right now, you would need to set aside about $414 per month.  In addition, to meet the deductible, you would have to put aside an additional $250 per month.  The idea of coming up with an extra $660 per month is mind boggling.  It represents 30% of your take home pay.  What are you supposed to give up? Eating? Even that wouldn’t be enough!  You are not expecting a raise any time soon.   How are you going to pay for medical care for your son if he gets sick?  Even with the proposed tax benefits, there is no way you could put aside an extra $6000, this year or any year, with your current salary.  You will just have to roll the dice; take the chance that you and your son will be healthy; hope and pray you can make it through the year uninsured.  Maybe next year things will be better!

Health Care Horror Story #1

Imagine that you are a 19 year old Hispanic boy working at a fast food restaurant.  You are trying to make extra money to pay for your tuition at city college, hoping someday, if you work hard enough, you will be able to go to university.  This year, you think, if everything works out, you will earn at your $8 per hour job, about $10,000, to support yourself and pay for your expenses for college.  You know your take home pay is only about $710 each month.  You live on a very tight budget.  Since you work every day, you are able to eat at your job.  You’re lucky to live in a place that offers very cheap rent.  School costs you about $2,000 per year, if you take one class each semester.  You’re young and have never been sick; so why buy health insurance with money you don’t have.  BUT, things have changed.  Now, in order to attend city college, you MUST provide proof you have health insurance or you MUST purchase it from the school.  The college offers a plan for $984 per year or $82 per month, not including coverage over the summer. And, you must pay the money up front for coverage.  Where are you going to get $984?