The health insurance we’ve been purchasing through COBRA ran out at the end of May (you only get 18 months on COBRA). That means Mike and I spent the last six weeks researching our options. Since we are both independent contractors, that meant we had to purchase a private plan.
We applied for a plan with Blue Cross/Blue Shield (who we were with previously). Because we had exhausted our COBRA options, we qualified for something called Guaranteed Issue. Very simply, that means that if we couldn’t be underwritten for a regular plan because of pre-existing conditions, they still had to offer us coverage. I filled out our family application online while I was on the phone with an agent. We discussed that my pre-existing conditions are all pregnancy-related, and decided it would be best to waive maternity coverage.
The decision came back a few days later. I had been denied underwritten coverage because of c-section rehab, postpartum depression, and gestational diabetes. Mike had been denied because of his hospitalization last year. We weren’t worried, though, because we still had the guaranteed issue option…at least, we weren’t worried until we saw what that plan entailed:
$1,266 monthly premium
$4,000 deductible per person or $8,000 maximum family deductible
I had to bust out my calculator, but I figured out we could potentially spend $23,192 out of pocket in the next 12 months. I don’t expect my health insurance to be cheap, but I don’t expect it to be out of reach, either. I believe that you get what you pay for, but for $23,192 I’d think we’d have the best insurance in the world.
It turns out that they have to insure you, but they can charge whatever they want. When I called to be like WTFBBQ you denied me for all pregnancy-related conditions even though I waived maternity coverage, I was told it didn’t matter – I showed a “pattern of health problems.”
The new health care reforms don’t kick in until January 2014. There is a “temporary high risk” pool for people like us, but unfortunately (at least as far as Mike and I understand it), you have to have been uninsured for six months to be considered – meaning, this isn’t even available to us for half a year.
It looks like we have two options: either go into debt to have insurance for all of us, or just insure Annie. We are leaning toward just insuring Annie, but that terrifies me. The last three years have shown us how important insurance is. Our health can turn in an instant.
We’re extremely frustrated. This is another example of just how broken the health care system is and how many people get left out in the cold. Hopefully, by 2014 this won’t be the case anymore. I’m worried though. There is still opposition to reform…could it be derailed by 2014? Also, as this “temporary high risk” pool exhibits, the reforms still aren’t perfect. People (like us) are slipping through the cracks.
I spent hours on the phone today exploring other options (and don’t even get me started on how Blue Cross took money from our bank account three days early). We’re afraid to make the wrong decision. I am so stressed out about this. GAH. And the fact that we are still better off than many only makes the entire situation more despicable.
Becca_Masters says:
good grief!!! thats a heck of a lot of money. sometimes I have to thank my lucky stars that in the UK we have the NHS (even if it is sometimes a bit hit and miss!)
I can’t imagine having to shoulder that kind of burden!
my fingers are crossed for you in that you find a decent plan that fits your needs.
p.s. who picks your ad’s? are they just random, cause I find it ironic that the ad under your blog is for healthcare cover! (in the UK no less!) or perhaps not everyone has the same kind of ad??
Becca_Masters says:
nope it’s definitley all Health Care ad’s for the UK…… it changed to a different provider when the page refreshed!
Heather says:
A lot of my ads are through Google, so I think they search the page for relevant terms! Still, that’s ironic, don’t you think?
Becca_Masters says:
most definitley!
Kandi Ann says:
Mine is for Red Lobster restaurant.
Emese says:
Mine is Verizon??
Shalini says:
I really do think.
(sorry…I had to)
Diane says:
Mine was Red Lobster.
Tiffany says:
Ditto on the Red Lobster.
And as far as the health insurance scandal, cause that’s what I feel like this is currently, it’s absolutely HORRIBLE!! My sister and her husband have had to wait almost 2 years in order to be able to get maternity coverage (and for it to actually work) because she was born (27 yrs ago) with her intestines on the outside of her stomach & thus doesn’t have a belly button. She’s never had another problem in her life and hasn’t ever suffered from her initial problem. Her husband is in perfect health. It’s sad that the health care providers have such a hold on so many americans and their finances.
I hope things get better for you all in the future, even if it is 2014.
Kate @ UpsideBackwards says:
I am sooo glad we don’t have this problem! We have plenty of problems with our health care system, sure, but I think it is still way less stressful than yours for most people. Best of luck, fingers crossed for you!
Caroline says:
Heather,
I am so very sorry… that’s awful. You are in such a difficult situation here, and it’s sad to think that insurance companies wouldn’t realize that and do what they can to make your life better.
I know that this is just another post in the middle of the night, but please let me know if I can do something to help you, alright?
Em says:
God I’m glad we have the NHS , it may have its issues but everyone gets treated. A small payment out of our wages each month for a lifetime of knowing there is another option.
Fiona says:
Despicable indeed.
I think myself lucky to come from the UK (even though the NHS has it’s own problems) and now live in Germany – which has an excellent health care system. I have never in my life had to think about how to afford heath care. I always knew the US had a private health care system and this could be expensive, but you have brought it home to me how truly unfair this system is. It is unfathomable how some can be against the health care reforms due in 2014. These people must obviously easily afford their premiums.
Never again will I take for granted my access to free and comprehensive health care. Thank you for helping me to count my many blessings.
I hope you find a solution to this terrible problem. Keep us posted.
Fiona x
roshan says:
Fiona,
Your health care is not free, your taxes pay for it. Yes it’s comprehensive and not discriminatory because providing health care to everyone is the most human thing to do. The rich pay a little more and the poor a little less but everyone pays nonetheless and make it affordable for everyone.
Becca_Masters says:
it’s most certainly free for some people in the UK (I can’t comment on Germany having never lived there). It’s the people that don’t work, won’t work who get it free. They don’t pay taxes as the government pay their taxes for them.
and in some cases it can be discriminatory, the UK government have lottery postcodes, where some people can have life prolonging cancer drugs, but then there are others who need certain drugs and have to spend months fighting the system to get them, which is a shame.
at the end of the day, no health care system is perfect, some are better than others and some are just downright unfair.
roshan says:
Becca,
Yes of course there are folks who are able and won’t work and get free health care. I have heard numerous scare stories about such folks but have never known definitely how many of such folks are there exactly. These folks are unnecessarily made the bogeyman against every constructive piece of reform that comes up, be it health care or immigration or any other. People can rage against their money going towards killing people in case of wars and/or against saving folks who don’t pay taxes. For some reason there is not much protest in case of wars which are funded endlessly but people put their foot down if there is talk of providing comprehensive health care.
No health care system is perfect as you said but that is not a valid argument against having a comprehensive one.
Fiona says:
I am well aware that nothing in this life is for free apart from love and family.
My point was that irrespective of my previous health problems or my income I receive health care in both the UK and Germany. Of course taxes pay for it – it has to be paid for some how – I think we all know that. The NHS is ‘free at the point of use’ which is where my ‘free’ statement came from.
You don’t go into hospital and get asked for your insurance card before you get treated.
Sally says:
Well, we’ve been living in Ireland for a year and I believe that the US system is superior to what we have experienced here. In spite of the problems that people have with the US system and all of the complaining that US residents do (b/c they/we are for lack of a better word, spoiled), the fact is that you cannot be denied treatment in the US either. Additionally, I don’t know about the UK, but in Ireland, the national health care is not really free – you still have to pay premiums, and they are higher than in the US (but only about 25 percent higher – at least for the ten appointments that our family has had so far).
Like I said, we’ve only been here a year but two of our neighbors who are completely capable of working live off the system (the government pays for everything – even their premiums). Additionally, another neighbor with a family claims that if he stops working he will actually make MORE money than if he keeps working. Additionally, we have several friends (families) who sacrifice a lot to shell out over 1K euros per month for private insurance (in addition to the “free” national insurance) because they have such low respect for the national system. My friend’s mother’s heart is currently at 15% of what it should be – in the US this would be grounds for immediate emergency heart surgery, but here, they don’t even offer it.
All this, and there has been talk in the past year of closing hospitals and clinics – which for us would mean that the closest clinic and urgent care would be two hours away (instead of what it is now – one hour). For a country the size of Missouri – that’s pretty far away! I’m sure in Missouri you can get to a clinic or urgent care from anywhere within 30 minutes or less.
Admittedly, when I think about the grand scheme of things, I don’t know the ramifications of either system in terms of finances or overall health (here in Ireland, the Americans I know who have moved here seem to be of the opinion that any health care is better than what things were like 100 years ago, anywhere) – however one thing I do know is that the EU system promotes less personal responsibility, more abuse of the system, and causes a huge dependance upon the government. To me, dependence on government is to be avoided at all costs b/c then they have the power to manipulate citizens.
Cute~Ella says:
That is just terrible! Just another example of the insurance companies getting away with highway robbery.
I’m not sure you were asking for suggestions or just venting, but I’ll toss this out there just for the heck of it…I know a lot of independent contractors in various fields and some of them have opted to work the minimum hours at various places just for the insurance benefits for themselves/families. One works at a local grocery store, one works at Target and one works for a local YMCA. Yes, they’re working for little more than minimum wage and out of the home 30 or so hours a week, but the group plans of a hundred/few hundred dollars a month for them/family to be covered is worth it to them.
Jack's Mom says:
I work for a large global defense contractor and have for the last 15 years. After I had my son, I was able to work part-time with full benefits (health, life insurance), and that’s the only reason why I still work. My husband decided to start up his own brockerage firm, and purchasing insurance for a family was outragiously expensive, so I continue to work part-time, mostly for our health insurance. Pretty ridiculous that the only reason I’m working is for health insurance, but hey, this is the American way. Our insurance is tied to our employment-pretty much sucks. Some companies offer insurance even if you only work 10 hours a week….something to look into. Better than paying $23K out of pocket. We aren’t given many options when it comes to health care.
Jamie says:
Yes I was going to suggest the same, I know Starbucks offers a phenominal plan to PART TIME employees!!
Gabriella says:
I work for Starbucks and yes, the health insurance is the only reason I am still there. I pay $127 every two weeks for Myself and my two sons, and thats FULL medical, dental and vision. You only have to work a combined equivalent of 20 hours a week. It has saved us a lot of heart ache.
Emma says:
$127 every 2 weeks?? Is that supposed to be good? My basic healthcare through my province is free (though I used to have $22 taken from my cheque once a month until the gov’t made it free for all Albertans) and my Blue Cross averages about $60 a month. I can not even begin to imagine paying $250 a month for coverage. Yikes.
Catherine Lucas says:
It is so totally unfair that people have to cash out a months wage for health care insurance. In Belgium, you pay 20 dollar a month for insurance, and that covers 90 percent of medical care.
You can take extra coverage, but I have never heard it reaching the amount they would charge you in US.
Having said that, I do worry about health care a lot, as my husband is an american and we might move to the States next year.
It is very troublesome to realise that people at times have to choose between selling their house and being insured for other solutions do not come in the equation…
My husband says that the new health system will take care better of people who need it the most, but hey, why wait till 2014… What if you need it now???
It haunts me that only people with more then good incomes in the States can have good health insurance. Insurance companies are the richest companies in the world, and we all know why…
They live on the backs of people who could use their money for better things. I often wonder why nobody tackles those insurance companies… the same bad lot as banks if you ask me!
Sorry, ranting! I hope Heather that you can work this out! If you do, please share as lots of people need that info but are not as smart as you to figure it all out…
Sarah says:
Good luck, hon. That insurance situation is terrible! It’s hard to understand how some people can be opposed to health care reform.
jo's comment says:
In Aus we pay a 1.5% levy on our income tax to get free public health care, sure its not perfect but sounds much better than your situation. I can’t understand all the opposition to BO’s reforms from what we hear & read. Hope it improves for you.
Lindy says:
Oh Heather that really and truly sucks! As an American living in the UK I have experienced both systems and can say that for all it’s faults the UK system works. I pray that the US stops treating people who are unable to afford heathcare like they’re losers. The pull yourself up by your bootstraps mentality might have worked 100+ yrs ago but it’s a different world. How are average families suppose to compete w/ multi-million dollar companies w/ powerful lobbies working for them? Still find it amazing that people think Health insurance COMPANIES and pharmaceutical COMPANIES have their best interest at heart. From this side of the pond it sounds like Americans are becoming heartless and are only out for themselves. I KNOW this isn’t true as I’ve seen the generosity of Americans (especially here on your blog).
Lindy
PS sorry for the long comment
gnimaerd says:
Gotta agree with what was said above – cases like this make me so thankful to live in the UK. Our NHS may not be perfect, but no one will ever, ever be in your situation here. Whoever you are you can absolutely gaurentee that if you need a doctor you will get one and get whatever treatment you need and never have to worry about the cost. Your newborn needs heart surgeory? Not a problem. You have a pre-existing condition? No issue. You need IVF? Our NHS will cover that. In all honesty I think it’s a wonderful, merciful, compassionate thing – just about makes me proud to be British. As a tax payer, it’s something I’m happy to contribute to because it saves lives. I mean, our infant and maternal mortality rates are lower than America’s – yet you guys, by all accounts, have access to better medical technology than we do and your surgical techniques are usually way ahead of ours. That’s just messed up.
I really hope you guys can sort something out so that you all stay safe and financially stable.
Lynn from For Love or Funny says:
Oh, Heather… It sounds like you are doing lots of homework and thinking deeply about this. I hope a solution presents itself soon!
IrrationalDad says:
There are sooo many people that think health insurance is only $50 week because they don’t realize how much some of our employers are paying. I know one couple where the husband works on his own, so the wife got a job strictly for the health insurance.
You could always move to Canada until 2014, eh?
Tracey says:
Canada is a great place to live, eh!!!!
Sue says:
Just the act of TRYING to get insurance is enough to make one so sick that they desperately need it!!!
Lori says:
Hi Heather!
Sorry you’re going through this! I can’t believe how expensive your quotes are! Have you tried any other insurance companies besides BCBS?
From what I hear Starbucks has awesome benefits for their employees working at least 20 hours per week. A aspiring actor friend of mine worked as a barista in LA for a few reason just for the benefits.
Good luck to you all!
Jamie says:
I thought of starbucks too when I read this. My husband worked there in school just for insurance. They have awesome benefits. Good luck!
Lori says:
Oops..somehow I typed reason instead of years. Close enough?
karen says:
I agree with all the posters from the UK – it might have it’s faults but you can always see a doctor for free.
I found it nice to see Lindy’s comment. The view from this side of the pond is very strange sometimes
I hope it works out for you.
ps thinking of your Aunt and family!
Barb Howard says:
Oh Heather, I’m sick about your insurance situation! This issue is the reason I voted for Obama. I am stunned that so many (otherwise) reasonable Americans so vehemently oppose health care reform, even now. I too have fallen into the pre-existing condition black hole, and the only solution available to me was to stop work all together and apply for disability. Yes, my illness will eventually cause illness that makes working impossible, but I remain far from that situation on my good days, and would love to be working now. However, I can’t afford to risk giving up my medical coverage in order to do so, and possibly losing my disability. What’s wrong with this picture? EVERYTHING! And this is the system perpetuated by those who are fighting tooth and nail against reform. It’s sad. However, I do urge you to steer clear of BC/BS. They and the parent company, Anthem, (located in my fair city), are the absolute worst abusers of their insured. I hope you can find an acceptable alternative to paying the equivalent of a new car every year! This system remains broken, and it makes me furious.
Megan says:
I just wanted to point out that many people are opposed to the health care reform in it’s current state – they left a lot of important things out – namely pre-existing conditions (which I think should have been #1 on the list), but put a lot of pork in. We’re not against REFORM, just THIS reform.
Jill says:
AARRRGHH! I am so enraged for you. This makes me so mad. We have insurance through a small business, and that is exactly the kind of plan our insurance has worked out. It is maddening.
Tristachii says:
This plain stinks. As a Canadian I have never had this issue but I can feel where you are coming from. My mom has recently been very sick (full recovery though) and I couldn’t imagine my parents having to go into debt to her treated (if she were American she would have been denies insurance due to pre-existing conditions). I agree with the commenters that our healthcare does have it’s few issues but it works. I do not mind paying for everyone to have access to the care they need through my taxes. It’s a basic human right that surprises me that the states has only just began to believe in.
Hopefully you can get this figures out because you and your family deserve to be treated like living, breathing humans.
jean says:
I completely understand your pain. My husband was without work for 4 months and I was horrified how much insurance cost for our family during that period. What we ended up doing is getting a short term policy which is normally fairly cheap because it does not cover any preexisting conditions. They usually last 6 months or so. I realize it is not a permanent solution.
Another thing I did was increase the medical coverage on our auto policy. For about $6 monthly, I got $100,000 coverage for all of us in the event of an auto accident.
It’s hard for me to believe that there are people that think the system we have is the best we can do. You know what really frustrates me? People like you and Mike will pay thousands of dollars each month because you are being responsible while so many go uninsured without a thought and when a catastrophe occurs, they often get it written off because the hospital knows they will never get any money, so they don’t pursue collection.
I am sorry, Heather. Good luck
Jen says:
I am so sorry that you have to go through that! Living in a free country you would think that if you get sick that someone is there to take care of you and that it’s something you can pay for! IT’s just insane to me! I wish that I had better advice for you and that I could tell you the right direction to go! I my self don’t understand the whole health insurance thing and I to am hoping that it will be all straightened out by the time the new reform takes place! I hope that you come to a good decision that’s right for you and your family and that everything works out!
Anna says:
Or one of you could, you know, _get a job_. I’m sorry, and I’m sure that there are injustices in how the US healthcare system is set up, but honestly, for two people who are apparently being supported full-time by a BLOG– both enabled to hang out with their daughter 24/7 and support a family on the proceeds of writing, like, two paragraphs per day– well, excuse me, but complaining about the expenses of daily life strikes me as a little rich when there are so many people out there working ridiculous hours just to get by.
Healthcare is not some magical gift that comes for free. If the chances are above 25% that you and Mike will end up consuming $100,000+ of healthcare in the next year, how is it not fair for the insurance company to charge you $~25,000/yr accordingly? I guess they could decide to award you coverage as a gift in consideration of your fame and special circumstances, but in that case the money would have to be made up by raising the premiums for other hardworking families. Or by cutting back dividends that investors (many of them retirees, on fixed incomes) had counted on.
Here’s the thing: Stuff costs money. I’m so incredibly sorry for the misfortunes you and Mike have faced so far, but I hope you wouldn’t argue that your past experiences entitle you to be freed from obedience to the basic rule that things bought, have to be paid for. And frankly, I’m a little embarrassed for my sex when I read all the outraged comments here that suggest that a lot more moms out there don’t really understand that principle, either.
Best of luck to your family in trying to figure out its finances.
Heather says:
It is funny to read your misguided assumptions about how we earn our money because as I write this Mike is in the classroom. He earns his living as a substitute teacher servicing inner city children. As for me, I do not make my living simply off this blog. I wish! There are a number of other things I do as an independent contractor to provide for my family.
As for Healthcare being “some magical gift that comes for free,” you should know that Mike and I, in the two years we have subsisted as independent contractors, earned and paid taxes on income comparable to the average American family. No more, no less. The rub is that by working as independent contractors and not for a corporation, we cannot afford insurance. That is the problem.
The issue of whether we have a 25% chance of consuming 100k+ in healthcare in the next year is an interesting one. The reason we have had high needs for healthcare in the past has been entirely due to Madeline’s prematurity and subsequent death. Prior to these horrible last couple years we have paid far more for insurance than we used. Since we are not requesting maternity this time, however, the odds are low that we will consume 100k plus. But what if we did? Are you saying that families that will face tough times should just be left out in the cold?
We are very aware of the concept of “things bought have to be paid for,” and we are not abusing that concept. Of course, the problem here likely is people like you who make assumptions about people in our situation. We are freeloaders who should just get a job, right? Well, that isn’t us, and that isn’t the majority of people who are suffering under our current health care system.
Kat says:
How nice would it be to be able to live off writing ‘a few paragraphs a week’ and the only worry being healthcare? I didn’t know blogging was so well paid!
God some people live in cuckoo land.
I hope it all gets sorted soon, insurance companies are hideous to talk to aren’t they?
xx
Beverly says:
It’s a bad assumption on the part of many that if you work, you have healthcare. It’s also a bad assumption that if you don’t have healthcare you’re lazy.
My son is in a position, as an upcoming college senior, of needing his own healthcare plan. As his life plans include graduate school, he is in the need of purchasing a private healthcare plan.
With a genetic cancer syndrom, that’s impossible.
I hope this healthcare reform isn’t changed. Steven, and about 11 million others who have battled any form of cancer, need it.
I’m bold enough to say that if any change to the reform is made, I hope that the change is an addition of a public healthcare option.
Jeannine says:
wow, you’ve made a lot of assumptions here. Pretty bold.
Nik says:
Anna is just another misguided Republican
Blaine says:
Ummm….isn’t that also an assumption I guess coming from a Democrat???
Just because someone believes the gov’t needs to stay out of healthcare doesn’t mean they are a Republican. The gov’t can screw anything up (both parties) so why do I want them to have anything to do with my insurance?
Kate says:
ANY organization (private or public) can screw anything up – hello BP!?!?….and I think we ALL know that the current system is not working under private insurance – plain and simple. The difference is that if we don’t like the way government is working, we have a say. We can vote, we can run for office. There are ways to get involved. You could argue that ‘we can also shop around for insurance to get the best rate’. Well as Heather clearly states throughout her wonderfully written piece here, she HAS shopped…..and no dice. I am not affiliated with any political party, however I view health care as a basic human right, not something only the rich are privy to.
roshan says:
Aha, the quintessential “get a job” comment. It comes in handy while trying break ice in social situations or shooing off hippies. It can only be used by the “real” salt of the earth Amuricans who are so resilient that every time they bend it’s to pull up their bootstraps.
These are the folks who assume everyone other than themselves is a freeloader and show up at protests to keep “gov’t out of their medicare”.
Their IQs are such that if they got any dumber you would have to water them (hat-tip Molly Ivins).
Nina says:
Roshan, I think I love you.
Karen says:
In fairness, though I think Anna’s comment was not quite appropriate, it *is* reasonable to suggest that there’s a certain cost/benefit analysis to be done here. The benefits of being an independent contractor include being able to stay home with your darling baby, and being able to exercise greater creative control over your projects/project choices. One of the costs is the necessity of finding one’s own, private health insurance. It looks as if the cost/benefit relationship might be changing for the Spohr family.
Before my husband or I could land a professional job, he worked the required number of hours per week at a local employer that offered reasonable health benefits to part-time employees. It was not great pay, but the benefit to us of having health insurance was reason enough to stick with a coffee-pouring job. We don’t need it anymore; we have better benefits and more income now, 5 years on. But it’s a reasonable thing to point out to Heather that she and Mike might do well to revisit their job situations. I’m all aboard on health insurance reform, but they need something to work for them in the interim. A job that has blah pay for 20-25 hrs per week but ALSO saves them from having to pay out $20-30K for health insurance is worth considering. If independent consulting gigs aren’t providing what they feel their family needs, maybe they want to look around at other (part-time) options as a stopgap solution.
Marisol says:
This comment really upset me and so I felt the need to reply.
Just because Heather and Mike write a lot about their personal lives on this blog does NOT mean we (blog readers) know EVERYTHING about their lives and especially personal things like how they make a living! Do not assume things!
Also, I totally understand what Heather and Mike are going through. My family has always had their own business and it is very hard and expensive to get insured! Just because someone does not have a “conventional” job does not mean they do not work. And it does not make them any less worthy of anything. It also does not mean that they do not pay taxes! I truly hope the new laws will help EVERYONE get the health care they need.
I may have gone off on a tangent, but i just had to say something. Best of luck to the Spohrs!
Meg...CT says:
“My family has always had their own business and it is very hard and expensive to get insured! Just because someone does not have a “conventional” job does not mean they do not work. And it does not make them any less worthy of anything. It also does not mean that they do not pay taxes! I truly hope the new laws will help EVERYONE get the health care they need.”
…exactly! I don’t think people quite understand how difficult (ie expensive) it is for the small business owner to insure themselves.
Dawn says:
Holy Cow, well thank you, if the family only knew that things costed money!!!!! Now all of their problems are solved.
No kidding things cost money! Do you think they are stupid! They have jobs, just because they are independant contractors doesn’t mean they should have to sell a kidney to get insurance!!!!!!!!!!!!!!!!!!!!!!!!! How ignorant of you, you should ashamed.
Adrianne says:
Wow, I’m really embarrassed on your behalf, Anna. And a little stunned that Heather took time out of her day to reply to the likes of you in an intelligent, rational way. I wouldn’t have been able to be so kind.
“Best of luck to your family in trying to figure out its finances?!” How generous of you.
As far as healthcare not being free, where in Heather’s post did you get the idea that she wanted or expected FREE healthcare?! She obviously fully expects and intends to pay for it and completely out of pocket. But she’s allowed to vent her frustrations that the cost is going to be completely, ridiculously high and that it is going to be a challenge for her family.
I realize that when people criticize others, they are just projecting their own issues onto that person. So with the same sincerity that you wished upon the Spohr family, I’d like to wish you the best of luck with YOUR issues….like being rude, judgmental, assuming, etc to a perfect stranger on their personal blog.
Shalini says:
You’re probably not going to reply back seeing that you made a really embarrassing guffaw with your comment, but I hope you learned a lesson. Judging others based on very limited information is hurtful, not to mention completely erroneous.
Jamie says:
Wow. Unbelievable. So you read someone’s blog, mainly focused on her children, and that makes you fully aware of all aspects of her life? Including how both she and her husband spend all of their time and make all of their money? You spent a lot of time, writing a lot of words, without actually thinking any of them out. Weird.
Kate says:
Uh, regardless of whether they have jobs or not, $23,000/yr is a huge premium. That’s way more than a lot of nonprofits and small businesses could afford to subsidize.
Lindsay from Florida says:
Anna, I know I could reply eloquently if I had it in me after a long day, but others (most notably and amazingly, Heather) have done that already.
So let me just congratulate you on being the epitome of the phrase about what happens when you ASSume. Seriously, what a brazen, ridiculous, embarrassing thing for you to have written.
Ashley says:
Wow. I echo the above statements- I was cringing for you (Anna) as I read your incredibly insensitive, asinine response, and am impressed that Heather took the time to respond to your comment.
Just saying, the founding fathers of this country did not have “conventional jobs”. That conventional job you so clearly have and hold as the standard of employment and entitlement for basic human rights was in fact built upon those “unconventional” jobs like small businesses, independent contractors/people starting out for themselves, etc. Nobody plopped down on this continent with a publicly traded company and staff of 200+.
Also, the “conventional job” that you hold as the gold standard often leaves many people in the same exact position as Heather: expensive, shitty, gaping health coverage, because it is all insanely expensive, not just for families but for organizations and companies.
Also- have you tried to get a job lately? Even at a Starbucks? Not such a piece of cake, my dear.
Eric says:
“Healthcare is not some magical gift that comes for free. If the chances are above 25% that you and Mike will end up consuming $100,000+ of healthcare in the next year, how is it not fair for the insurance company to charge you $~25,000/yr accordingly?”
Anna, it isn’t that people are opposed to the concept of risk/reward. However, it’s an unbalanced equation, because the insurance companies make obscenely large profits. And they make those profits by denying healthcare to those who need it.
In fiscal 2009, United HealthCare (just to use one example), made 3.8 BILLION dollars in profit. Not total sales, but PROFIT.
Think about how many lives that 3.8 BILLION dollars could have saved. Or how many premiums that could have paid.
Quality healthcare and profitability are mutually exclusive goals. Because the only way to make profits is to ration services.
And when you do that, people die.
Cynthia says:
Heather,
Sorry if you receive an incomplete post, but my computer (actually my husband’s laptop) went wonky earlier!
I know that you have alot of comments to review, but please let me know if you would like some information I have in regards to Health Insurance/Blue Cross and primary lung cancer w/metastasis to the brain.
My insurance broker recently alerted me to the fact that many Universities have health insurance coverage (or connections) available via their Alumni Association. Both my Husband & I are USC Alums as well (Architecture ’92 and Nursing ’90), so I’m looking into it.
In addition, I am an NICU RN (not Oncology), but I have been helping my Aunt, who was diagnosed with primary lung cancer/metastasis to spine in 2007. She started with Tarceva , and it wasn’t effective, but further chemo modalities were. She was doing great until last October when neurological issues popped up & it was discovered that she had mets to the brain.
I was able to convince her to get another opinion from an awesome practitioner I know in Whitter this April. She loved him and switched insurance to work with him. He also has her working with a new Radiation Oncologist (Whittier Presbyterian Hospital) and a new Oncologist (Hoag Hospital, Newport Beach). She is responding clinically while looking great & feeling stronger! You can also see that her HOPE is coming back! My Uncle, who has been so awesome and positive as well, was really beaten down when the brain mets were discovered, is getting his hope and optimism back too, hooray!
I am praying for your Aunt and your entire family. I have empathy for you & your family thinking, “Okay..what now? What’s next?” From what you have shared with us, I know that your family is a force to be reckoned with and your Aunt will never be alone in this awful and most unfair fight against those stupid cancer cells that just don’t know who they are messing with!
Again, please let me know if I can be of any assistance to you, okay? I know this is redundant, but again, hang in there, okay?
Cynthia
JoAnn says:
This situation DISGUSTS me to the highest degree of being disgusted. I cannot, for the life of me, imagine why anyone would be against healthcare reform. There are so many stories like yours that underscore why it’s necessary. And typically the people who complain about it are the ones who say “I don’t want my taxes to pay for people’s insurance”. Well- to be frank that makes me pose the question: “What kind of a person are you to have a response such as that when millions of Americans don’t have coverage because they CAN’T afford it. Millions of EMPLOYED AND TAX PAYING AMERICANS!!”. Heather, I am really sorry to hear that you’re in this situation, and I really wish there was something that could be done…
rachel says:
Hi, I am on a cell and can’t read all of the messages, but here is what I did: 1) incorporate. Make a Spohr Entertainment LLC. Then, hire an outside h.r. Firm to admin your wages. (Follow me here…) Then, you can give one of your employees (ie you) health insurance. Like, 300 a month. Ihad to do the same thing or risk 1400 a month premimiums. Good luck!
Jeannine says:
i second this idea.
Chris says:
Heather,
This is a really good suggestion. My husband and I owned a small business in So Cal a few years ago, and I have a preexistinng condition that makes me a candidate only under group insurance. (Which is also ironic since all the medical bills for that beyond regular see the doctor every 6 months) are now 15-20 years behind us, and it’s not treatable or curable so I’m certainly not racking up medical bills anymore. My husband with run of the mill doesn’t knock you out of medical insurance coverage ASTHMA has higher medical bills than I do just by virtue of having to go every 3 months for medication refills. (Sorry tangent, but you hit a subject that I have battled and been frustrated by since I was a teen).
Anyway, we owned a business and were incorporated as part of the business for other legal reasons, but we then purchased group health care insurance through it with the caveat of offering it to only full time employees. At that time we only had a couple of teenagers working part time for us after school besides us, and they weren’t interested in the insurance anyway still on parents plans. It worked out great for us giving us “normal” premiums and was through BCBS. It might very well be worth calling an insurance agent–preferably one that handle a lot of plans/companies and seeing what they could do for your business and what the exact requirements for an incorporated business are for it to meet their guidelines.
Also, as far as part time jobs that offer benefits, I know that at least some of the work at home call center positions do. The company I work for are all IC, but the last company I recruited for had employee benefits. There are also a lot of sales from home positions which sound like they might be a fit for you and some of them offer benefits–they probably aren’t great, but they would be group, ergo cheap. Biggest problem with jobs like is the need for a quiet background, but there might be some options out there. I’ll try to dig up some more info if you’re interested.
Amanda says:
Haven’t posted a comment in a while but still read daily and think of you family!
The comment made by Rachel is third’ed.
(Yes, I know it’s grammatically horrible but thought I’d through in alittle laugh for Mike too).
Seriously.
Check it out.
Kristen McD says:
When my husband separated from Active Duty in the Air Force, we went through a similar shock. Luckily, we qualified for Kid Care Medicaid – and obviously opted to enroll our then 6m old son. Our income was just over the line to disqualify us for coverage ourselves, but somehow the kids portion is different. I wonder if there’s not a similar program in California. We just sort of crossed our fingers and hoped that neither of us would get sick or hurt – but man was it a relief to have the baby covered.
A year later we made $130/year over the income requirement, and had to buy insurance for the first time ever. We would up going to a broker, overwhelmed by plans. We adopted the idea that ANYTHING would be better than nothing – and chose a bare bones policy we couldn’t really afford to use (exception being well visits/immunizations for our son) and again, crossed our fingers. It was not ideal obviously, but the broker was amazingly helpful.
I grew up in Canada with Universal Health Care, and then married into the military – and found TRICARE to be much the same as Universal, so long as you followed their rules. Paying for health care seemed absolutely ridiculous.
The Daver says:
When I had my consulting business, I was under COBRA coverage as well, and one month I was late with a payment…
Next thing I knew all coverage had been dropped and I had to BEG and GROVEL to the COBRA administrator to get my coverage back. I was *lucky* that the person on the other end of that phone call had a heart and reinstated me.
You shouldn’t need to be lucky to have health coverage!
You guys are in our thoughts — here’s hoping you can find a better alternative soon.
rkmama says:
I just don’t get it. I mean, I get that capitalism is one of the aspects that this country prides itself on but situations like yours and so many others just make me sick. Our health should not be a privilege. It should be right. I’m so sorry you’re going through this.
Jenny @ http://motherlawyercrazywoman.blogspot.com/ says:
WOW. Just wow. Good luck figuring it out.
Alexis says:
And when you apply for just Annie, they can deny you for random ridiculousness as well. I was in the same position you are in when my first child was born, and when we applied for coverage, my infant daughter was denied due to her, ‘low birth weight.’ She was 6 lbs 9 oz, had 9 and 9 apgars, and was perfectly healthy.
amanda says:
This is just one of the many reasons I love living in Canada. Our healthcare isn’t perfect, but we have healthcare.
For the life of me I cannot see why people in the United States are actually opposed to the healthcare reform. It boggles my mind!
And I cannot believe your healthcare would cost THAT much, oh my goodness!!!
Between this and what Mocha Momma is going through with her mom (uninsured so she couldn’t get a bed…) I just don’t get it. Who gets to and why do we place such a crazy value (or lack of it I guess) on a human life.
I hope that this gets resolved for you guys sooner and later and hopefully with a much cheaper option!
Beth says:
my in-laws used to have ‘major medical insurance’ because they were small business owners. not sure about all the in’s and out’s of it or how much it costs.
http://www.major-medical-insurance.org/
SarahB says:
Gah!
That’s all I have to say. Other than, at least get catastrophic insurance for you and Mike…but I hope that’s an issue of last resort.
Jennifer says:
This baffles me.
I’m an American who lives in Asia most of the time, and I have global health insurance. It pays 100% (with a $200 annual deductible) and includes things like Medivac to other countries that have better hospitals. What do I pay? $550 per month!
It is infuriating that this insurance company could charge so much more for your coverage! I’m sorry. I wish I had a solution, a magic answer to make it all better. Thank goodness there are some legislators in our country who are trying.
Barbara says:
I feel like the Lone Ranger here. Heather, I feel your pain. I am in a similar situation. I have a husband who was carrying us through his employee coverage, he lost that job and now he works for a company that does not offer coverage. I am an independant contractor as well. I was finally able to get my son and I coverage, but they will not cover my husband. He is a cancer survivor. My point to all who are saying that we need reform and they can’t believer the people who are against it…Most people want reform, but don’t like what the current adminstration is offering. The people who don’t work will get their ins for free, while the hard working people will be the ones to fund it. To me this is the worse situation…you work, you get benefits, you don’t you get nothing (accept for the few who truly cannot work). That’s what I think needs to happen.
We can debate this to no end, but I just wanted to make it clear to those out there that yes we do need reform. Let’s start with tort reform and go from there. I for one want the current Healthcare coming down the pike repealed and something more sensible put in it’s place.
Best of luck to you, Mike and Annie finding something affordable.
Stephanie says:
Sorry, Barbara, Tort Reform will not make a dent in the cost of health care.
And I’m sorry you don’t have compassion for others. Do you know how little you have to make to qualify for Medicaid? With the new HCR it will be 133 % of the federal poverty line. Currently, that’s $24,000 a year for a family of three. Can you imagine how hard it is to live on that? In California, it’s almost impossible. Couple that with buying health insurance on the individual market, and you’d never be able to afford to eat, pay rent, etc. You don’t think that people making that little should have health insurance?
I work on health policy and advocate for the poorest among us.
And when health care reform kicks in, you, as someone on the individual market, will benefit. Your husband will benefit.
C says:
I think people forget.
People who don’t work ALREADY are insured. When you have no assets and no job, medicaid, medicare or charity care are easy peasy. And if not, then who cares, because in America, we as a society have already decided we WILL treat everyone who walks into an ER, regardless of INS. But if they have no assets, then the hospital has no recourse.
The problem, and what the bill addresses REALLY are those that work, but don’t qualify for ins still. Either because they’re just under full time, or they work 3 small jobs, or the work for themselves.
Let’s not kid ourselves. The people who will “mooch” off the rest of us (My husband and I each make around 6 figures, and my husband works for a hospital..we’re good to go on ins.) already DO. It’s the people in between that get lost. The people who work hard but can just not get a break with pre-exisiting conditions etc.
That said, I can’t lie. I voted for Obama, (I actually volunteered for the campaign and everything.) and I adore some of the things in reform. But he didn’t do a THING for doctors, and without that we’re all going to suffer. Tort reform sure as HELL would help considering more and more doctors who have no suits on their record keep retiring because it’s just not worth practicing anymore. OBs are getting harder and harder to come by. In CA, primary care physicians are hard as hell to find.
What Obama did was Ins reform, not healthcare reform. And since costs are still going to stay high, now we’ll all have ins, but I’m not sure ANY of us will be paying any less. If doctors are going to fined for any tests the gov’t finds unneeded, but still have to practice hardcore defensive medicine, more and more are going to stop working. And having recently been, like Heather, in labor at 27 weeks, gestational diabetes, had a horrible post partum, etc. I want the best doctors.
Anyway, that went on a tangent, but I hate to hear people talk about “those lazy people who won’t get a job.” in connection to Obama’s reform. I won’t deny those people exist. Thing is, they’re ALREADY set.
Amanda says:
Actually, I work for the State of Tennessee’s Department of Human Services, and know that your assumption that *everyone* who won’t work is eligible for health care is wrong, at least in our state. I work with clients every day who have no income, and the only ones who are eligible for insurance are children 21 & under, and *single* parents with a child under the age of 18. Oh yes, and pregnant women who meet the income requirements. I have many clients who are single men and women over 21 who apply and are completely ineligible.
I would be interested to know which states do offer Medicaid for adults w/out children.
C says:
I feel as though maybe you missed this:
“or charity care are easy peasy. And if not, then who cares, because in America, we as a society have already decided we WILL treat everyone who walks into an ER, regardless of INS. But if they have no assets, then the hospital has no recourse.”
The poorest of the poor can get care without being driven into the ground…maybe because they’re already there. But they can walk into the ER without a thought about how to pay for it. Nothing to lose. Maybe not every treatment…but they can walk into the ER and be seen. In NJ at least, Charity Care covers a LOT for people who can claim hardship.
But, the guy who makes 50k and has 80/20 whose child has cancer? That guy who always goes to work? He’s fucked.
Even us. We make over 6 figures…when I went into labor at 27 weeks, we had 80/20. We worried about the baby of course. But we also worried about how we would survive financially if he came early. 20 percent of a NICU bill? It’s not the 2 million dollar bill that kills you. You just hand them the keys to the house and car and start over again. It’s the bill you CAN one day pay…the 100k bill that you’ll spend every free penny paying off, and maybe you still wont make it.
My point was simply that people always complain about the bill, as if the bill is the one thing that’s going to get poor and non working people the ability to see a doctor. That’s just not the case. The people who suffer the worse, IMO, under our current healthcare system are the people who work, make money, and are underinsured or can’t get ins.
Kati says:
oh my god, that is really terrible… i can’t even image what it is like to be in your situation. i never thought of insurance being so expensive!
i hope you find a way of insuring all three of you without going broke… there has to be a way!!!
Fernanda says:
OMG…I cannot believe how CRAZY is the health care situation in the US! For people from another countries, like me, it is really hard to get. The stress people go through to get health coverage it’s cruel.
In France the Government pays 70% of your medical bills. I do have a private insurance who pays the other 30% (it costs me 70 euros/month) but most people prefer to pay from their pockets because it is not that expensive. We do indeed have to pay a LOT of taxes, but I NEVER had to stress about paying medical bills. So, I am fine with it!
I also lived in Brazil and things are a little different. The Government pays 100% of your bills, but the system is overcharged (long wait for consults, operations) so middle class people often choose to pay for private health. And is expensive. The difference from US is that there is a strong government regulation on the private insurance companies so the private health it is not bad at all. Way more fare than in US, for sure! This is just to show that there are other alternative out there (and private companies still make money on this, believe me). To me, there is no logical explanation that a poor country like Brazil can have a better health care system than USA.
I do really admire the american people. I have been following the health care reform debates since last year and it is impressive to see how people commit with the discussion. You really gave the world a lesson of democracy, but there is a long way to go.
Heather, I really hope you find a decent solution after all. You all deserve it!
Momma Uncensored says:
oh sweet girl!! i’m so sorry you are dealing with this utters BS and it is exactly what is wrong with the health care system and profits!!!!
the fact that mike’s hospitalization is seen as a medical liability makes me sick to my stomach. can you even imagine? you reach out for help after the most tragic event in your life and months later you are penalized for it. unreal.
our coverage is also blue cross.. it is terrible. we have a $10,000 family deductible. can you stand it?!
the fact that you possibly pay out of pocket what some american’s make in a year is an injustice.
Java says:
Don’t opt for no insurance…that might come back to haunt you…I didn’t know you were both independent contractors…what do you do?
Is it possible for either of you to get a part-time job with insurance?
Good luck! I hope you come up with a solution!
Heather says:
Mike is a substitute teacher and copy writer, and I do freelance writing and ad sales for other websites (and about a million other tiny odd jobs, too!).
Midwest Mommy says:
I have to say I stopped by to read the comments. I am all for the healthcare reform and was just curious how the comments would pan out. How anyone could say this is fair or right I just don’t understand, everyone deserves health coverage.
Holly says:
You need to follow up on your COBRA information. COBRA coverage was extended under the new health bill and was effective immediately. Go to the government site and research it. I think your 18 month statement is incorrect and the new COBRA laws would favor you. Just something that could potentially save you time and trouble. Good luck!
J+1 says:
Holly, the cobra subsidy was extended– they didn’t lengthen the amount of time someone could be covered by COBRA.
Unfortunately.
Jennifer says:
Yikes! That is just plain ridiculous! It seems to me that a person who could afford that price for insurance probably wouldn’t *need* the coverage. You know, because they are probably rich. That amount is more than half of my annual salary!
Gretchen says:
Can you get insurance through a professional association or trade group? Or check into this: http://www.costco.com/Service/FeaturePage.aspx?ProductNo=10166086 I don’t have any personal experience, but it’s worth checking into. Or this: http://www.california-health-insurance.com/self-employed/ Good luck!
nancie says:
ugh…i know (personally) how hard this can be. i too was covered by bcbs – for 20 years + …then got a divorce in 2006. i too held onto cobra as long as i could, then just assumed i could get ‘individual blue’. i was turned down because of back ‘pain’ i was having (which began in 2006). i had been to a doctor about some sciatic nerve problems – nothing requiring surgery for sure..i appealed bcbs’ decision – and my doctor even wrote a letter to include in my appeal, that my condition did not require surgery and it certainly shouldn’t have caused me to be turned down by bcbs. but nonetheless, i was turned down again. since then i have had to turn to ‘united healthcare’ – i was scared to death of being turned down again, but i wasn’t by them. BUT, i do have very high premiums – that seem to increase ALL the time..plus a $1,900 deductible..it’s very hard financially – but for now, it’s pretty much my only option. i do work full time, but the place that i work (a small law firm that does not have enough employees to be required to carry insurance for their employees) does not offer any insurance. i feel your pain!! but do try other insurance company’s…while they are still expensive – they might have something cheaper than the bcbs option you have. good luck!
Jill says:
Heather – you have just described exactly what is wrong with the current “health care system”. How can any insurance company, or any government reasonably expect you to be able to pay that premium?! It’s ludicrous.
I am a Canadian living in the US, and as bad as the Canadian system can get, people have access… I just can’t wrap my mind around “for-profit” health care.
I truly hope that you can find a solution for your family… don’t give up!
Tracey says:
I’m a Canadian that was thinking of moving to the US. But when my daughter was born with a cleft lip and palate we knew we had to stay here. She has required many surgeries, speech therapy, as well as routine hearing tests.
I don’t think we could have afforded to live in the US
Jill says:
I didn’t read all comments, but have you thought of making you and mike a company and buying small group coverage? Time might be an issue, but it’s worth a try. Either get it straight through the company and try to join a purchasing group or see if your local chamber of commerce offers something for small businesses.
Jackie says:
Heather, I read your blog every day religiously but have never commented before. I think about you guys all of the time and pray for you (and now your aunt)…you seem like an amazing family.
Anyway, I’ve been going through the same thing for a few months with insurance. It’s AWFUL to say the least. We are either looking into what another commenter suggested about incorporating an LLC or something else that may be helpful to you…some trade associations offer insurance to members. Maybe if you or Mike belong to one or could join one, that may be an option. I’m so sorry you are going through this on top of everything else.
Kristen says:
I am right there with you on the insurance issues. My husband carried our insurance and when he got laid off just before Christmas, they dropped us. They did offer COBRA, but at a higher cost than what he brought home in unemployment benefits. We ended up applying for the state run health insurance. We were approved, but now can’t find primary care physicians that will take the insurance! In the event of something as mild as a case of pink eye, we will have to go to the ER…the only place that HAS to accept the insurance.
Krissa says:
To say I’m sorry you guys are going through this would be putting it mildly. Years ago I had a job as an “Underwriter Communicator”. That was my title. I spoke with applicants from all over the country on the phone asking them questions the Underwriters came up with based on the answers they gave on their applications. To do that job I was given basic underwriting guidelines and knew what the underwriters were looking for. I knew what conditions would be automatically declined, what would get a rider, etc.. I walked out on that job I was so disgusted. No notice, nothing. I couldn’t take it anymore. And that was way back in 1990 and 1991. All the companies are the same. That industry needs such a major overhaul in a way that I wouldn’t even begin to know what the right answer is. I hope you guys find something fair and decent soon. My grandfather, may he rest in peace, worked for Prudential his whole life. So I am not against people who have jobs in insurance, but I really do not have anything good to say about that industry. There needs to be a change and I’m not sure the current health care reforms are the way to go or not, but something needs to change. Ok, end of rambling. Good luck!
Jenn says:
HI Sweetie,
This the EXACT reason why my husband and I have had to turn down so many positions in the USA. Even though it would make my quality of life 100% better if I were able to move to a warmer state, your e-mail just proved this would be impossible for me to do this!
I don’t know how you guys do it in the USA. The sad things is, since we’re neighbours, there is talk from my government to copy you guys in one way or another!
I was in awe to hear woman have to go back to work when their babies are only 6 weeks old. How in the hell do you guys do that? In some cases, people are STILL healing! Up here, we get a whole year off with at least 55% of our salaries. (if you are self employed you don’t get any leave).
I don’t know what to say! I wish I could give you the $23, 192 and know my friends are well protected. Since I’m not, this is not an option…yet.
Good luck with your research and decision making.
Love,
Jenn
Michelle says:
I’m so excited that the US is moving towards a new health care system. I know there are problems with public health care – but I’m so grateful to be Canadian, so that I can go to the doctor when I’m sick and not have to worry about money. That situation is ridiculous, and I’m sure there are millions more like it.
Jenny says:
Your situation sucks. I’m sorry.
When I was growing up my Dad farmed and my Mom stayed home. So they had to buy their insurance privately too. Eventually this drove my Dad to get an off the farm job for the insurance. No one can afford $2000/month for health insurance. As an aside, before that they had dropped their maternity coverage since they were finished with having kids. About 6 months after they dropped it, my mom got pregnant with twins. She was very high risk—history of miscarges, gestational diabetes, and she was 38, so she was on bed rest and had weekly doctor’s appointments for most of the 9 months. Which, of course, was a lot of money. It took them years to get out from under that. But they were blessed with two healthy girls and one doctor who was the babies’ doctor after they were born that just charged them $90 for the whole time they were in the hospital—he was an older doctor who knew our family and knew that they were getting hit with thousands of dollars in bills from the birth.
Anyway, I hope this healthcare reform doesn’t get sidetracked and you guys are all covered soon.
Mahala says:
First of all, it’s a shame we can’t get affordable health care in this country. Ridiculous.
Second, another option you might check into is joining a small business organization or other group. Dig around, maybe there’s an “internet entrepreneurs” or self employed women’s group. Usually you can pay a small yearly membership fee and in return get group rates on insurance.
I have to qualify this by saying I’ve not tried it myself, but I took a small business management class a few years ago and it was one of the subjects we covered. Maybe try the Small Business Administration? I mean, if you run ads, your blog is a business, right?
Hannah Hawley says:
Hiya Heather,
Have you tried applying through your state for state insurance?
Its what my boyfriend has because his work doesnt offer him health insurance.
I live in VT.
Hannah
Lindsay from Florida says:
It is despicable. The system is beyond broken … just the other day, I was told that a preventative exam would not be covered … specifically BECAUSE it’s preventative (and thus not “necessary”). It does not compare in the least to your situation, and I don’t mean it to, but it’s just another illustration of how backwards/flawed the logic is. People who have had physical or mental health struggles can’t get coverage b/c it’s pre-exisiting, and people lucky enough to be in health cannot get preventative care to stay that way because it’s not “necessary.” It makes the head spin.
I wish with all I have that there’s a solution somewhere out there and that your diligent searching will find it soon.
You desperately deserve peace of mind when it comes to the health of your family.
Michelle H. says:
I’m so sorry. Healthcare is always one of my biggest worries as a parent. Its so sad the decisions so many people are faced to make as they cannot afford healthcare and are employed! (whether it be through a company or on their own!) I know we aren’t a socialist country, but I’m ok paying a little bit more so that more people can have health insurance.
Meg...CT says:
BELIEVE ME..I understand your pain. My husband is also self-employed and we pay a TON for insurance for our family. We recently just changed our policy to Oxford…we went with the health savings plan which has a very high deductible (so our premium is lower)…but, wouldn’t bankrupt us if, God forbid, one of us had a hospital stay. (There is a spending cap for the year that we can live with)
The HSA part helps in that we can pay for everything with pre-tax dollars. Also, with this plan we get the benefit of the contracted cost (for prescription and sick visits…well visits still covered 100%) vs the “joe off the street” cost.
We were told we could not be denied coverage with this plan…though, (knocking on wood), we are all very healthy, I have had easy, uncomplicated pregnancies and do not have any long-term illnesses. I on’t know if that makes a difference…unfortunately, it seems like it does.
Maybe a similar plan is avaiable to you?.
I agree that the health-insurance in this country is outrageous…don’t know what the solution is. Not sure the health care reform is the answer…but, I hope it is a start. I am sure that not having insurance is not the answer though.
In Connecticut, we have something called “huskies” which insures children and mothers…does California have anything like that available?
I hope you find a suitable solution…NOBODY should have to be without health insurance…
You should NOT have to go without the medicines that help you nor should you have to put off the doctor’s visits that are imperitive to your health (physical or mental”).
Maybe through these comments today, you will find another option…Good luck
Deborah says:
I’m so, so sorry that you are having to go through this. I just can’t imagine. I hope you find a workable solution soon so all three of you can be insured without having to break the bank! What an absolute shame this all is.
Kelly says:
i could be wrong, but I thought the health care reform bill didn’t control costs. They just make it mandatory that the health insurance company offer you a policy, at whatever price they decide on. I could be wrong though. I am so sorry about your situation. My mother was turned down everywhere for long term care insurance because she’s had breast cancer and a few other issues. I live in fear of losing my job because I know I can’t afford COBRA, and I have pre-existing conditions as well.
To comment on a previous poster’s post, state-run health plans, aka Medicaid, isn’t accepted at many doctor’s offices because the state won’t reimburse them properly. The state often reimburses for less than the minimum cost of the care. For example, the state won’t pay the doctor the same amount of money it took the doctor to purchase a vaccine from the pharmaceutical company. So the doctor takes a loss.
The whole system is screwed up.
Stephanie says:
Although we won’t know for sure, it’s likely health care costs will go down or at least hold steady. Many more people will be insured, spreading out the risk and lowering costs.
At the very least, the new law will place limits on how much a health insurance company can charge based on someone’s income. It’s not perfect, but it’s an important step.
Bob says:
?
leslie says:
UGH my COBRA ends in October and we are so stressed. We still have HUGE deductibles but at least we are covered. ACK!!! I better get on the ball, I feel your pain!
Ms. Moon says:
You are singing to the choir.
rachel says:
It’s so frustrating that honest people trying to do the right thing cannot afford insurance because, shockingly, in the past they had to use their insurance coverage. It makes no sense and I cannot imagine how frustrating this must be for you and Mike. I wish I had a great idea for you…
Hang in there.
yvonne says:
When my husband lost his job in Nov. of 2008, we were unable to afford COBRA at that time – it was astronomical! We got BCBS for the 3 of us, and it is about 1,300 every other month, with a $5000 deductible. Are you sure the price they quoted is EVERY month? The insurance that his new job offers, is ridiculous – crap HMO that costs way more than BCBS – it would take about 2/3 of his paycheck which is just crazy….best of luck to you…
Susan says:
I’m think this is ridiculous as well. I am for health care reform but there is still problems with the proposed reform for 2014. Everyone needs to read very closely. Don’t believe what you hear coming out of the crooked politicans mouths and yes, I don’t believe any of them anymore. However, I hope for the best because very soon we will be in your situation as well. As far as Canada’s health care, there is another side to that as well. The health care system sounds great when you go for routine visits or at least nothing real serious. But come down with a termainal disease….and everything changes. I have a lot of Canadian family and my aunt tried to be treated for bladder cancer but the wait was horrid and she would have been dead if she did it the Canadian health care way. Thankfully she had the funds that she was able to come to Michigan and be treated. So, there is always two sides. I wish you and your family the best in trying to find coverage. Like I said, I am researching my options as well. Annie is a doll.
Tristachio says:
That’s unfortunate that your Aunt had to way so long to get care. Like you said there are two sides to the Canadian Health-care, but my family has never had any problems with it so I can give it nothing but praises. My grandfather needed a quadruple by-pass surgery and got in within a week, while my boyfriend had to get an MRI for potential risks and had it within a few days. But I know there are cases of taking long (i.e knee surgery etc..) but I love the fact that we don’t have to go bankrupt for something that is our right.
But I think it was a smart thing that your Aunt did — being able to attain better care for herself because she had the funds too do it. So there are options atleast!
Whit says:
I hate our health care system. I have family that works in health care and of course can tell me the cons of the health care reform, but then I have my parents, who cannot afford to insure my dad because of his history of mental health problems. You tell me what is more important? A long wait at the doctor’s office, or the people who really need it getting help?
Yeah.
That’s the sad part. The people who REALLY NEED health insurance are the ones who do not qualify, or qualify with huge premiums. Like my dad, or you guys. It’s so broken.
MM says:
It is incomprehensible that anyone would vote for representatives that are not for healthcare access for all. This is a really big reason I cannot go back to Texas where I’d have to watch outwardly reasonable people shoot themselves in the foot by continuing to vote Republican.
I grew up in a family that had a crappy insurance plan w/ an outrageous deductible and I remember how sick we had to be before a doctor’s visit was warranted. I’d never want that for my children, but even if I wasn’t a parent, I wouldn’t want that for any children!
Kim says:
I feel you pain! I am a teacher and will lose my job this year. My husband is an independent contractor and we have twin girls-both who were born 3 months early. We can COBRA for 18 months but as you know it’s not that cheap. I have such anxiety over this and haven’t been sleeping. The sad thing is that if I continued to get pregnant and have babies then I could be on state insurance. I just couldn’t work because then they’d take away my benefits. There are no options for people that aren’t “living off the system” but also aren’t independently wealthy! It sucks!
Molly says:
Blargh. I feel you. Now that I’m not in college anymore it’s $1000 a month for just me. just medical. Not dental or vision. Not to mention what my parents pay for themselves and my sibs. It’s SO expensive! That’s just wrong.
Health Insurance is absurd. I’m sorry you’re dealing with this.
Karyn says:
look into CHIP for Annie. And if something does happen to you or Mike (and ER visit, etc) and the charges are out of this world, there are always income based programs that hospitals offer. They don’t advertise them, and they don’t come right out and tell you about them. But i had to have an emergency surgery and had no insurance (granted this was in PA) and the whole thing was paid for by the hospital. Its out there, you just have to ask and get the right people to help you. Also your doctors office may work out a deal with you for routine visits for you and Mike depending on your relationship. They may let you pay over time for visits etc. It never hurts to ask. the worst they can say is no.
Lyndsey says:
So, sooo sorry to hear about this. American insurance blows. I went through a similar thing when I graduated from school and came off of my parents’ insurance. I was going to be an independent contractor and no insurance would cover me because of preexisting conditions. I called the state insurance agency for advice and the counselor told me: get a new job or marry someone with insurance. those are your options. (that and, of course, going into the high risk pool and paying 1000/mo for myself alone!).
What I did was find a high risk insurance broker. He was able to find me (albeit, kind of crappy and non-maternity) insurance at a totally reasonable cost. It isn’t the best insurance out there, but it is the only insurance I can get, it covers the big stuff, and I can afford it.
Lisa says:
This just sickens me. It should not be this difficult for a family to get healthcare coverage. To try to rob you of every penny you have in order to provide you with incomplete coverage because of some pre-existing conditions is just unconscionable. I hope you guys are able to fine an option that works for you family that does not involve you guys being without coverage for 6 months.
See, all you healthcare reform nay sayers, this is a perfect example of why we need reform.
I’ll be thinking of you and hoping beyond hope that something works out.
Love and hugs.
flhs says:
I am against the new health care plan. You can’t give BETTER care to MORE people for LESS money. It’s math. And the government doesn’t pay for anything, people do.
I am glad that we have drug companies & hospitals doing research to save lives. I believe people who find cures should reap the rewards, otherwise there is no incentive to do the research.
Insurance companies are bad, but government control is worse.
JoAnn says:
I work in the pharmaceutical industry. And I negotiate what Pharma companies pay to Drs who are “researching to save lives”. I know first hand that this industry is just as crooked, if not moreso than the health insurance industry. At the end of the day the majority of the pharma industry is looking to capitalize off that research, while mitigating the number of adverse events or deaths they encounter.
I’m sure we’ve all read the news. Pharma companies will find ways to skirt the system to ensure that their drugs are sold and they are making money.
Regarding the Drs… Of course there are a number of Drs out there that are interested in the science and the health benefits that discovery can provide. But there are JUST as many (if not more) who are looking for a way to turn a buck. And many of them leave private practice and solely focus on pharma research. Why? Because that’s where the money is, and there is very little liability involved as long as they follow the Protocol. Because if they do- and someone is injured or dies, the pharma company will offer them indemnification from the situation.
My point is, I wouldn’t put much faith in an industry that’s just as big of a culprit for looking to turn a buck. And quite frankly, a citizen should not have to turn to risky unproven science to ensure that their medical condition is treated.
amanda says:
Girl, it completely freaks me out – I feel for you guys – it just plain sucks.
J+1 says:
I’ve actually been wondering about what you guys were doing with insurance; you’d mentioned it a while ago, and I worry about random things like that. I’m sorry this is such a hot mess.
I have to echo the comments above relative to taking a part-time job in order to have insurance. A while ago I worked at a bank, and we offered health insurance as long as you worked 20 hours a week minimum. We had a number of people that worked as tellers who had home businesses, or were independent contractors. We even had a woman who was a professional musician. It worked well for them, and we got great employees.
If that’s something you consider, though, you may have to buy a few months of the horribly overpriced BCBS plan until another plan kicks in. You do not want to let your coverage lapse! Reforms to the preexisting condition laws for adults won’t take effect for ages.
Good luck with all this.
Kelly says:
Have you looked into a high deductible health plan for yourself and Mike? You pay a small premium, and save your own money in a Health Savings Account for the deductible, if you have money left in the account you can use it kind of like an IRA. This may be a more cost effective option, and still get you some kind of coverage.
Heather Pina says:
My husband is thinking of starting his own business and Im a SAHM. So We might very well be in your shoes soon. I heard that Starbucks offers good insurance for part time workers??? Sounds better than paying 23,000 for insurance. Hope you can find something reasonable soon!!
mjp says:
Unfortunately the health care bill does mandate you have insurance, but doesn’t give you any real help paying for it.
MBKimmy says:
I know that Ohio will allow you to form company with like compnaies – maybe you and your husband could form a free lance compnay that would put you in a group of more than 20 and it woudl lower your costs dramaticly – if you could do the insurance they suggested until you could form it it would only be a few months ?!
I will be thinkign about you and I am so sorry!
Amanda says:
Does Annie qualify for a state child insurance plan (KidCare here in Florida, don’t know what CA has)? Usually they have a program for children who don’t qualify for normal medicare, but who’s family cannot afford health insurance.
If you could get a program like this to cover Annie, that would free up you and Mike to find coverage for only the two of you, which should *hopefully* be cheaper.
Kat says:
This is why my dream of staying home and doing creative things is just that… a dream. DH and I both have some health issues, and I shudder to think of where we’d be without insurance. Sadly, that means I continue to work for The Man. Good luck!
Snickrsnack Katie says:
I don’t think Obama’s health care plan is good at ALL but I do agree that something needs to be done regarding the EXORBITANT cost of healthcare for people such as yourself. That is asinine that you would have to pay that much. I hope that you are able to figure something out!!!!
Virginia says:
I’ve been dealing with BlueCross BlueShield recently for our insurance because they randomly jacked our rate up an absurd amount. After figuring out it was because hubs turned the big 3-0 I found out that I could get my doctor to fill out a form that declared me with a clean bill of health from gestational diabetes (had it with my first pregnancy really bad) since I did not get it with this pregnancy and hubs is getting a vasectomy in August or Sept so our chances for any subsequent pregnancies are going bye bye.
See if you can get this form for your diabetes at least. They said once approved it will lower our rate considerably. (Now given I’m also working with BlueCross BlueShield of Tennessee so I don’t know how the different states do things)
Kelli says:
I feel your pain, Heather. Both me and my husband work for small offices that don’t offer insurance. The private insurance I have is a joke. The deductible is ridiculous and we are having to put off starting a family because of it. It’s not like we don’t have savings…but having to pay my deductible would drain it enough to make us uncomfortable, so we are holding off until we can cushion our bank account a little more just to be safe! It’s so sad…especially when I see very young women in the office I work in everyday (law office) that are hooked on drugs and living off the government that have 2 or more children and my husband and I can’t try for children of our own because of INSURANCE. It’s just really depressing!
Just wanted to sympathize with you!! I hope you guys can figure out an affordable option!
Leanna says:
I think this situation sucks and is unfair. No one should be in the position that you and Mike are facing of potentially having to go into debt for your own health care, or forgoing health insurance and god forbid something happens then you will surely be in dire financial straits.
I hope you don’t mind, but I linked to this post from my own blog.
Evelyn says:
Wow. Yesterday when I picked up some prescriptions I was thinking how lucky I am to have benefits through work as it would have cost me around $100 otherwise. In Canada most things are covered, except prescriptions.
I really don’t understand how people can be ok with the system there! Hopefully something works out soon and that stress disappears! If not, Canada is super nice this time of year
Neeroc says:
I am so sorry. I’ve never understood the American model, or why people are so opposed to extending healthcare to everyone. To me it’s not about the extra $ out of my pocket, and if I’ll ever have to use it, it’s about treating people with dignity. But then again, I guess that’s because I’m a pinko socialist Canadian
J from Ireland says:
Oh my God, those prices are scary. I know we complain about the health system over here but at least its free or feck all in comparision to America. My heart goes out to you.
The adverts on your blog is for Irish Pet Insurance!!
BethT says:
I’m sorry you have to go through this. Have you looked into Kaiser? A friend lost insurance and had troubles due to preexisting conditions (a lung transplant!) but Kaiser accepted her.
Jen says:
I totally get where you are coming from. My job doesn’t offer insurance, so I have a bare-bones individual plan that doesn’t cost much but also doesn’t cover much. I dread going to the doctor anymore for fear of the bills that will result from the visit.
LD says:
Man- I feel your pain. My husband has Crohn’s and he’s totally uninsured. Thank heavens he has a job with benefits or our family would be totally screwed.
Sue says:
I have not posted before, but have been following your blog for quite a while.
You probably have already considered this (and I did not read all other comments), but what about a Catastrophe policy for you and Mike and regular insurance for Annabel. My uncle does this because he is self imployed. He basically pays a flat premium for a plan that only kicks in if a major health problem happens. All other doctor bills he pays out of pocket. Since he is generally healthy this ends up costing him less money, yet is covered for major events (like when he had a heart attack a couple of years ago).
Laura says:
I know how you feel. I have been deemed un-insurable by all insurances. I had complicatinos during pregnancies (all three-last one ended 3 weeks ago with a birth) and after my daughter 2yr ago I got thyroid cancer, so therefor I am no longer insurable. It would cost me over $1,000 a month in costs, plus out of pocket, and deducibles. however, if it comes down to it, and you still have medical issues and what not, you should check in to your counties MIA program. Each county in CA has one, its called Medically Indigent Adult, it like Medi-Cal, but for people with chronic health problems. That was going to be my last option before we moved out of CA.
I wish you the best of luck, and hope you can find a plan to workfor you for now. (that doesnt break the bank)
Smoochagator says:
It’s stories like this that make me wonder why the heck people are so opposed to health care reform. I mean, everyone who shouts, “America is not a socialist state!” think that their tax dollars are going to pay for health care for lazy bums. What about the people who are working hard and can’t afford health insurance? What about the way insurance companies penalize you for actually USING your insurance? I could go on and on but you don’t need me to clog up your blog comments with me ineffectual ranting I hope you find a feasible, affordable option SOON!
CASI says:
I am not sure of your financial’s or if Cali even has the program, but here in Wisconsin we have a medical card. I was on it with my first daughter my husband had ins. but was not very good so I got on the medicAl card and it covered me baby and husband!! I really dont like to use goverment funds but I figure I pay taxes so in the long run I paid for it!! I HAD A JOB AS WELL AS MY HUSBAND so I WAS NOT WORKING THE SYSTEM. So if u have something of that sort u might want to check into it,because you do have baby they should except whole family. (Sorry about my horrible writting skills!! never one of my best skills)
Mrs. Bro says:
My husband and I are also both independent contractors, so I’ve been in your boat before. Check with Kaiser if you can. Their premiums are on average about 20% cheaper. Additionally, since you are self employed, you can buy health insurance as a business owner – small group of one is what they call it. I’m eligible to buy the insurance this way because I claim my income via 1099 forms. My husband & I are about the same age as you, with a 2 year old. We have her on a separate policy (also through Kaiser) which offers better coverage for a lower premium than having her on our plan. She’s $113 a month. For my husband & I, I have 80/20 insurace with a $3600 max out of pocket, $1200 deductible. Office visits are $30 and I have a $100 presciption deductible. For the two of us, I pay $363 a month. Kaiser is also more lenient about pre-existing conditions. Just a thought – for what it’s worth.
Emily says:
There are so many bloggers that work from home full time now…I wonder if you could form a group. Small businesses frequently band together to get group coverage rates from insurers. Perhaps you could get 50 or more interested bloggers and form a group. Once you get group coverage, the rates stay the same despite pre-existing conditions and they can’t deny you coverage. It’s just like getting insurance through an employer. Might be worth a try…
Kim @ Beautiful Wreck says:
O, what a horrible predicament to be in. I wouldn’t know what to do.
Nicole says:
This is why I am all for the new health care bill! I am in a similar situation. Since I am not married to Tim I get left out for health insurance. Tim and the kids are covered, but I have nothing. When I got pregnant I had to apply for medicaid and then find a doctor that took it. That ended when I had my baby.
Now I have nothing again, and we can’t afford to buy a private plan for me. So I am stuck just suffering when I get sick. I pray to go nothing major happens to me.
I hope you guys get things worked out! It SUCKS not having insurance.
Kerry says:
Heather, your post makes my stomach turn because it is so close to my insurance situation this year (right down to BCBS withdrawing money from my account early). I have 3 boys under the age of 2 as I just had identical twins at the end of last year and my employer cut my benefits. After MUCH sleeplessness and research, what has worked for us with the kids is a state program called Florida Healthy Kids which was available for the kids and I know another commenter mentioned it, I hope CA has a similar program of great insurance for kids. My husband and I have the BCBS FULL of exclusion riders leading to increases (WTF?) and rate hikes just last month. So we do our best to get by. The system is broken and it is beyond heartbreaking for our family and I am sorry to see anyone else go through it too.
Leslie says:
I am so sorry you are going through this! My parents have been going through the same thing for the past few years, and since they are older and with a few preexisting conditions, their choices are to not have insurance or pay 2000 a month, which is double their housing cost! Anyway, what I would suggest would be to combine Mike and your subcontracting work under a corporation or an LLC and use that enterprise to get insurance. I know that in MD, there is a small business arrangement with Blue Cross, where businesses with fewer than 10 employees can get a group plan. Maybe CA has something like that? Also, I would check with the Chamber of Commerce. They offer health insurance to their members and I believe membership is pretty inexpensive. Again, you could do that under a corporate structure. Just a few thoughts… Good luck finding a solution.
Jamie says:
Have you looked into just getting you and Mike catastrophic coverage and covering Annie fully? That wasy, God forbid, in the event of a major accident, you will be somewhat covered? Good luck on your search! I hate insurance companies!
mar in the mn says:
We faced a similar problem last year after my husband lost his job. We purchased a policy from Assurant through our car and home insurance agency, State Farm. It was about $350.00 a month for my family of five. I don’t know if you have State Fram Insurance for your condo and cars, but maybe your home/car insurance provider has a similar offer? The coverage we got with Assurant was okay, not great, but it was very reassuring.
Have you seen Sicko, that film by Michael Moore? It made me want to move to the UK, Norway or France where I wouldn’t have to fight for quality healthcare.
binkytowne says:
I know a lot about this: Research limited benefit plans or short term plans for you and Mike to cover you for the next 6 months until you can be covered by the high risk pool. Limited benefit or short term plans DO NOT cover anything that is pre-existing but will provide coverage if anything should happen in the short term until you can get full coverage. It’s not ideal, but it’s better than nothing and more affordable since the benefits are somewhat scaled down or just for something catastrophic. Please email me if you want to ask any ?s. Good luck.
Joy says:
I’ve been hoping for universal coverage since Clinton promised it to us in the 90s. I’m still waiting. I’m not very hopeful about the reforms coming in 2014 as they require that everyone have insurance but they don’t require that the prices be reasonable. The only good things that come out of it are that no one can be denied and that your children can be covered to age 26.
Honestly the only way I was covered by an insurance plan with reasonable rates was by lying. I’d moved to a new state and I decided to pretend that I hadn’t seen a doctor or been to a hospital other than to give birth to my children. I lived in fear for the first two years because the plan had a clause that said if they had a claim that gave them reason to suspect that I’d lied they could drop me or go through all of my medical records. As more and more of our records go onto databases it will get harder and harder for anyone to lie like I did.
I was lucky and the two years passed without any problems. My preexisting conditions were so minor that I wanted to laugh that no insurance company would accept us.
In the fall when my children go back to school I will be looking for a job with health benefits because right now all of the money I earn goes directly towards paying for my insurance.
Rebecca says:
I don’t know if anyone has already suggested this (cause… too many comments to read through!), but we are in the same situation, and here is what we have done, if it helps:
Every member of our family has health issues that preclude us from being eligible for insurance: for me, celiac disease, diabetes II, PCOS, and PPD, for my husband depression, and our son GERD. We are magnificently uninsurable!
We pay cash to see our doctors and for our prescriptions, and amazingly enough, it actually costs us less to pay cash than our copays cost when we had insurance. Our GP (bless her soul), only charges us $35 a visit. Doctors and hospitals are VERY gracious to cash patients, and will almost always give you a 30% – 50% discount on services.
Our son is insured through healthy families, which only costs us $17 a month (though there is an income limit to qualify). I love this program, and I have found him a fantastic doctor.
When I was pregnant with James, I joined the AIM program, paid a $600 copay, and they covered my VERY high risk pregnancy (similar to yours), and the $40,000 delivery.
Other than that, you can buy “catastrophic” health insurance, which will cover your family in cases where you encounter some sort of very expensive medical issues: hospitalization etc.
We have been doing this for a couple of years now, and it works surprisingly well! To my way of thinking, if you are going to spent $25,000 a year on medical expenses anyway, why not just pay cash and get a discount?
Amanda says:
I am SO thankful to be Canadian! We may pay a wack load in income taxes and have long ER wait times but I won’t ever have to go into debt for my health. What an aweful situation to be in, I hope you find something that works financially for your family and not have to opt for no coverage.
Catherine says:
I guess I spoke too soon about how lucky you all are for great medical coverage. That’s scary! Doesn’t seem right that you have to work for big business in order to get affordable health care. Thanks for opening my eyes.
Jenn says:
I seriously don’t know how people sleep at night. It’s unbelievable that someone cannot get coverage for something completely out of their control! There should not pre-exisiting conditions…period!!!
So sorry that this is yet another thing you must contend with.
Hugs
Angie [A Whole Lot of Nothing] says:
Nauseatingly frustrating.
Katie says:
Perhaps one of you could try working for a company that provides group coverage?
Kelly says:
It stinks that people can’t work for themselves in this country and still get decent medical coverage at a decent price. And even if you have an employer-sponsored plan, it can be really expensive, and there can be huge deductibles and not everything is covered.
I know people working for companies that offer health insurance who have spouses who are uninsured because the spouse+1 health plan is way too expensive. Many spouses of public school teachers run into this problem.
Katie says:
True. However, that is the situation we have now. I was throwing it out there as an option. I mean you gotta do what you gotta do.
Other options… live in a smaller house… sell a car… give up private school…. work more…cut your expenses.. consider moving to a more affordable region to afford healthcare, etc, etc.
I don’t want to get into an argument about the way things should be when right now, in the present, we all have to deal with the way things are. : )
Cheers!
Adrianne says:
This seems like an obvious suggestion, and several people have made it. But you really have to think about the added costs that this option would have. So Heather goes to work somewhere with benefits. Lots of people have suggested Starbucks, part time. Sounds reasonable, but now you’ve got child care as an added expense. And here in Texas, child care for an infant can cost as much as the insurance premium that Heather quoted. And most places don’t lower the costs that much for “part time” care.
So she’d have to be making pretty good money (not gonna happen part time at Starbucks) for them to break even with the added expense of child care. You really have to weigh the pros and cons.
Katie says:
So that option, working parttime at Starbucks isn’t going to happen. It won’t work. And honestly, methinks Heather is pretty smart and pretty educated and methinks so is her husband so probably working at Startburks is not the only option they have.
I am arguing that people have to do what works for them. If working from home as independant contractors doesn’t work because of the cost of healthcare is prohibitive then maybe they should do what does work.
It sucks. No doubt. I am not arguing that. But lots of people change their lifestyle to deal with present challenges.
If you want the present challenges to change then you work to change them (voting/coming up with solutions/being an activist/running for office/whatever), but you still deal with them.
You still assess what you do have and adjust accordingly.
JoAnn says:
I think the entire point of, and the genesis of, the discussion was that it sucks that someone who IS working, and IS doing what they need to to pay the bills (or even trying to be successful), can’t afford insurance.
I pose the question: Why should they have to alter their lives to be able to afford insurance?
This country was driven to greatness partly on the sweat of the backs of people who struck on out on their own. What we’re doing is forcing those people with a like mind to shuffle themselves back into the corporate line because they can’t afford to be free thinkers- which I think just drives the greed of this nation and stifles any hopes we might have of creative, independent thought.
Listen, I get the whole “you gotta do what you gotta do” attitude. And I myself am a subscriber to that way of living (likely out of laziness- which essentially makes this post quite hypocritcal right? There- I called myself out). But being apathetic and throwing one’s hands up to say “Oh well, it is what it is!” isn’t going to resolve this country’s current health care situation.
(climbs off soapbox).
Katie says:
Being defeatist and throwing up one’s hand to say “Oh well, I guess I will just go without insurance!” isn’t going to resolve one’s financial problems in regards to healthcare. Particularly if one were to get hurt… or sick…
JoAnnU1978 says:
You’re right. It won’t. But the point of my response is that what is broken within the healthcare system is that it doesn’t seem to want to allow middle class people, people without a trust fund or an inheritance or some sort of financial assistance, the ability to work independently.
The poor get financial assistance, the rich don’t necessarily need it. The middle class, small business owners , entrepeneurs,(correct me if I’m wrong, but the largest class in this country) are the group that need this assistance the most. And as Heather said,. those people are falling through the cracks.
Rebecca says:
Have you heard of Cal-Cobra? When my insurance ended with Cobra before, I got a letter stating I might be eligible for Cal-Cobra which would let me continue my Cobra coverage beyond the 18 month limit.
(I’m sure you’ve probably researched everything but just in case you haven’t…)
http://www.healthhelp.ca.gov/dmhc_consumer/hp/hp_cobra.aspx
Katie says:
Yup. It’s why I can’t be without group coverage via my employer (or my husband’s). What I find hi-larious is that I would be denied because of my infertility issues…none of which were covered under my insurance and none of which would be covered under any other policy. So I’m denied because of something that doesn’t exist to them.
Angie M. says:
Hi Heather,
That situation is so upsetting
I work with COBRA for several companies in the Bay Area. When a participants 18 months are coming to an end they are offered what is called Cal-COBRA or an extension of coverage, which would be an additional 18 months of coverage through your current carrier. I think your current carrier should have offered an additional extension.
Perhaps contacting them and asking would’nt hurt?
Anyway, good luck to you. I know how important health care coverage is.
Jean says:
Well. There was a lot of opposition to what some people are calling Obamacare. I’d love to know how many opposed have health care through their employer or their spouse’s employer. One very vocal woman who was totally against health care reform who I spoke with was a stay at home mother who had health care through her husband’s employer. Okay. Won’t even get into what’s wrong with that picture. If she had to pay for it herself, she would probably think differently.
I did not have insurance for years. I lost it after COBRA ran out, 18 months after my divorce. My children are on my ex husband’s insurance. I have insurance now. I hate to tell you but if you just insure Annie, it’s not going to make that big a difference. I pay for one person, and it is close to what you were quoted for three. I am in CT.
This is the calculator for what we are going to get in 2014. http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/ Put your income in. It’s not promising. The poor will get it for free. Some in the middle class with get a small discount. Some in the higher bracket won’t see any difference. And the break will come at tax time. So people who live check to check are going to feel it.
My oldest, 22 years old, is engaged and living with his fiance. My first grandchild is due in two weeks. He can’t get married. I told him he had better not get married or he is screwed. And I would absolutely love for him to get married. A year ago, his work cut his hours to right under the required full time. They cut everyone’s hours to right under full time. The pay is good, but no one has health insurance. He is under his father’s insurance. He needs to stay under that until he finds another job with insurance. His fiance and the baby are under CT’s health insurance program. Her work cut her hours too. She lost her health insurance two weeks after she found out she was pregnant.
Wait until 2014 when employers are going to be dropping people’s insurance left and right. The penalty for employers is cheaper than what they have to pay for their employees insurance. I hope the people opposed to universal healthcare are happy with themselves. Karma is a bitch and it’s going to come back around in 2014 when employers drop their employees insurance and opt for the penalty instead.
Kelly says:
My issue with the health insurance reform bill is that I believe that while the insurance companies will no longer be able to drop people from coverage, they will be able to limit what care they cover and they’ll still be able to charge whatever they want for it.
So you could have insurance and still not be able to get a mammogram, because your insurance company may suddenly decide that no one under age 50 needs one.
roshan says:
So the health insurance reform bill needs to add one more regulation that will make the insurance co’s cover preventive care and still keep premiums affordable. I am not sure if its not already in the current reform bill. If anyone thinks that the insurance co’s are going to do that on their own without outside pressure then they must also believe in the tooth fairy.
OTH, the mammogram issue is real but it was a gov’t report that stated that women under 50 don’t need one. It was criticized by most folks including HHS Secretary Kathleen Sebelius and has not been codified yet.
Jessalee says:
We’re going to be in your shoes come December when the COBRA coverage from my husband’s job he lost runs out. The COBRA subsidy though is the only thing that is allowing us to be able to afford COBRA, which is about what BCBS offered you guys for your monthly premium.
We have two kids, my husband is an insulin dependent diabetic and ever since I started making babies, I’ve had problems. Plus I have sleep apnea, PCOS and fibromyalgia. Our chances of getting a decent plan, even though I very, very rarely use my existing coverage, is going to be slim to none.
Plus, I’ve been an independent contractor for five years, and my husband, following his job loss, became one. So I run my own business because I can make more money this way. Husband runs his business to avoid losing his job again an in iffy market. But that sacrifice to up our quality of life is insurance. I don’t think it’ll last.
All of it is terrifying.
Vicky says:
I don’t know how helpful this would be but have you tried looking into receiving at least primary care at a community health center near you.
Check the link of the National Association of Community Health Centers to find the closest one.
http://www.nachc.org/findahealthcenter.cfm
And good luck!
Stephanie says:
I second this. There are hundreds of sites in the Los Angeles area, and they’re really great. I know that health centers have a certain stigma, but as someone who works on behalf of them (and on health policy), I can tell you that they give great primary care. And they definitely cost less than a regular trip to the doctor, believe me.
Alexa says:
There are a few companies out there who provide reasonable insurance for part-time work. Assuming that they haven’t changed their requirements, Starbucks used to offer insurance to all employees who work just 20 hours per week. I believe there are some restaurants like this too. Perhaps there’s a list of such companies out there on the internet.
While I know that you’re self-employed and aren’t looking for more work, picking up a part-time job to avoid over $20,000 in insurance costs might be a viable option. If it isn’t for you, maybe someone else who has left a comment is interested.
Lynn says:
My prediction is that our health care system is going to cripple our economy sooner rather than later. Because if people are spending $24,000 every year on their health, guess what they’re not buying? Cars, vacations, clothes, meals out, all those little things that our consumer economy is totally dependent on. And costs are going up (for a plethora of reasons, not just ins co greed), and employers will have to cover less and less to break even. Wait for. it. I hope that by 2014, the current reforms will be seen to be what they are — not nearly enough. Single payer is the only way.
Meg...CT says:
totally agree
Laurie SL says:
i’m so sorry that you have to go through this. I take for granted when we have health insurance. When my husband was applying for medical school 2 years ago one of the questions he got was something like, “what do you think would happen if universal health care was passed in the US?” He said, “Revolution”. He meant that it would be a huge change and affect everything in the US (for the better), but the doctors on the review board gawked and laughed because they thought he meant that people would revolt, insurance companies would be brought down, etc – very different reactions to “revolution” in terms of universal health care.
After reading your story, I am even more in favor of health care reform/universal health care. I sincerely hope everything works out and pray for the right decision and peace after that decision.
Jean says:
Kelly, I agree with you. But Obama did not want it this way in the beginning. He had opposition every step of the way. Changes kept getting made until we have this. Personally I think what we’re getting now stinks, and I am for health care reform. But this is the result of a lot of opposition. His original plan should have been embraced.
When Bush changed the bankruptcy laws to make it harder for people to file a Chapter 13 bankruptcy, the majority cheered. They said “Way to go! That will teach these people not to file bankruptcy! I’m not paying for their mistakes!” A small minority said “This is bad. In a couple of years, there will be massive foreclosures and the economy will plummet.” Chapter 13 bankruptcies allow a person to stay in the home and pay the back balance over 5 years. I was one who said bad idea. Look what happened. The small minority was right. I just read an article the other day that blamed the bankruptcy laws for the housing mess. A little too late now. Sometimes the vocal ones don’t think of all the ramifications down the road.
Amanda M. says:
Ugh, I hate health care. While I’m against the socialization of health care, it’s better than what we’ve got going on now. I sprained my ankle a few months ago, and WITH health insurance it cost me over $2000. They charged me $487 for the nurse to velcro the little plastic (and $73) brace around my ankle. It’s infuriating.
Stephanie says:
I was just in the same situation. Broke my foot so I had to see a podiatrist, got a weird rash on my neck so i had to see a dermatologist, was having recurring headaches and back pain so i got referred to a chiropractor…ALL IN THE FIRST WEEK AND A HALF IN JUNE!!! I didn’t have to see a specialist but I couldn’t find any primary care physicians that were “accepting new patients.” I am paying a buttload and that is WITH insurance. Thank God this didn’t happen 6 months ago because I didn’t have insurance then (and for an entire year for that matter) because I was unfortunate enough to graduate from college in 2008 and was not able to find a “real” job so i was stuck working at some restaurant that didn’t offer insurance. Funny how things work out. The current US health system can suck it.
wordygirl says:
Thank you for this post – it makes it clear to me just how awful the health care system is in the US. I live in Canada and I’m very grateful. I really hope that a solution makes itself apparent soon, for you and for all the others in this painful situation. Love to all of you.
Nina says:
I have no advice to offer, but just that my heart goes out to you and Mike. This just SUCKS.
And because the personal IS political, this is exactly why I voted for Obama and supported health care reform, even in the imperfect form it was passed.
The sad thing is, you can’t just WAIT until 2014 for health care. It’s good to know that Annie, at least, will be insured, but it seems to me that a part of child health depends on having healthy parents to care for him/her.
I wish there was something I could do for you guys.
Rachel says:
Heather, I am so glad you wrote this. Having just graduated from college, heath insurance is becoming a worry for me. I can stay on my parents plan until I get married…but I am planning a wedding for next year. I haven’t been offered a job yet so that terrifies me. My fiance owns his own business and is currently uninsured, which scares me in and of itself, but due to some pre-existing conditions that I have, going without is not an option for me. It is a really scary thing, and like you said, it’s all the worse that we are so much better off than so many other people. I’m glad our president is trying to fix this, but it scares me that it’s not totally a done deal yet….health insurance should be a right, not a privilege. I’ll be thinking of you all and praying that you can find some more affordable coverage.
Jean says:
Rachel, I am going to tell you the same thing I told my oldest. Don’t get married yet. Not until you have a good job that offers health insurance. Take it from someone who has gone through divorce and had (and still has, I have one minor child left) to raise her kids as a single mother. The stress of money matters is horrible. The worry is 24/7. I am past that time in my life, thank God, but going through the stress was horrible. If you get married you won’t be on your parents insurance any more. One thing can put you in a financial hole. Your new marriage doesn’t need that kind of stress.
Rachel says:
I know this has been nearly a year ago now, but I just wanted to sincerely thank you for your advice. My fiance and I have chosen to hold off on tying the knot until we are a bit more settled! I have a rocking part-time gig that doesn’t offer insurance, but it is putting me on the path to one that does! Your advice really made me think.
Nanette says:
I feel ill just reading that, mama.
I’m sorry.
Kristy says:
Heather,
Oh man! I can relate. After our son, Ethan passed away, I was perscribed ONE perscription of Ambien to help me sleep. I never had it refilled. Never was on any other medication and when I applied for medical insurance through HeathNet I was denied for my ” dependecy on sleeping aide’s” . They too were gracious enough to offer me insurance at a 60% increase in my monthly premium. It was really eye-opening to me to see just how damaged our health care system is. Sad. So sad!
I haven’t read all of your responses…and I’m sure you have already been given alot of ideas..but..have you looked into Healthy Families for Annie?? We have our son on Healthy Families and we only pay $41 a month. He has 100% coverage for just about anything….even braces! ((You know, just in case you feel like getting her teeth squared away early). I know the income guidelines are kind of high for the first year but once she turns one year old , the amount YOU and MIKE need to make goes way down and she should qualify. SO maybe you pay for her coverage for a few months and then switch her to Healthy Families when she turns one??? Not sure if this will help you at all but just a htought.
I wish you lots of luck in your search. I know how much it can suck!
http://www.healthyfamilies.ca.gov/Home/default.aspx
Marti from Michigan says:
We have that in Michigan as well, called MI Child (supposed to be My Child – MI for Michigan). I sure hope there is something like that in the Spohr’s area.
Meg...CT says:
“when I applied for medical insurance through HeathNet I was denied for my ” dependecy on sleeping aide’s” . They too were gracious enough to offer me insurance at a 60% increase in my monthly premium”
I think this is criminal…
so very sorry for your loss.
Karen says:
Sadly, I understand exactly what you’re going through. While my premium isn’t (yet) as high as yours, it’s inching up there and my POS insurance company keeps raising my rates hoping we will drop them. Unfortunately it will be another couple of years before another company will insure us due to too many recent medical events. My husband and I are also both self-employed, so our options are also limited.
I am also sad that since I’ve had a c-section I will likely not be offered maternity coverage (if I even wanted to obtain it) and will have to wait til my son is 6 years old before I’m able to conceive again under the new reforms in 2014. if I can stand waiting that long. Otherwise I’ll have to pay $15k out of pocket while people I know who are not contributing to society are getting FREE MATERNITY because they are on Medicaid. Disgusting.
Anyway, just wanted to lend you some support. The insurance situation in this country makes me SO mad. Big hugs to you and your family.
Cynthia Woodmansee says:
My husband lost his job of 26 years! We had been with Blue Cross the entire time. Because our children are adopted through foster care, they have medi-cal coverage until 21. Thank God. We were blessed to be included in one of our private doctors plans. We now have Health Net, which is a HMO, not used to that, however we are blessed to at least have something. WE pay 842 a month for the two of us. Have you tried Kaiser? I know if you are used to a ppo, switching is terrifying. You and Mike do need insurance. I even applied at Gap and Costco just for ins. Good luck. I love your family! Cindy
Lisa says:
Hi Heather — Have you looked into the CA Healthy Families insurance? Not sure what the qualifications are but here is the website. http://healthyfamilies.ca.gov/MyHealthyFamilies/Open_Enrollment_2010.aspx
I enrolled my son when we moved back to CA from HI, and it was perfect for him. I was unemployed at the time. Hope it helps.
K says:
Heather I am so sorry. I’ve commented before that I am so grateful to you for your honesty and courage in discussing health care and your personal trials with obtaining coverage.
During the reform debates I actually had people tell me that we should just leave well enough alone because “there was a reason those people didn’t have insurance ” and “I like my insurance. I don’t want some politician telling me what I can have and who I can see.”
Each time I heard this crap (which seemed like endless ingnorance) I thought immediately of my gorgeous 22 year old son and of you and your family. Who are these “others” so many are afraid will take something away from them? Are we not all in this together?
How incredibly heartbreaking that after all you have been through you must make such difficult decisions and face financial jeopardy just to obtain a policy that will only kick in in some catastrophic event. IMHO it is a shameful reflection of our values as a nation.
I guess those who oppose reform of our system have never tried to imagine what health security feels like. Nor have they faced such excruciating decisions or watched a loved one suffer or die due to “rationing” health resources or forgoing medical care for lack of money.
I hope that you are able to find a solution and again, I can not thank you enough for your willingness to discuss the topic. The way we care for each other speaks volumes. And you speak for so many so eloquently. Thank you.
TN working mother says:
“Each time I heard this crap (which seemed like endless ingnorance) I thought immediately of my gorgeous 22 year old son and of you and your family. Who are these “others” so many are afraid will take something away from them? Are we not all in this together?”
My feelings exactly! [I mean it — almost “word for word”.]
My additional thoughts were “so the proposal is not perfect, get going whatever we can get congress to agree on now, then elect people who promise to tweak it in whatever ways we think will improve it”.
Sarah P says:
I’m not a party-liner, at all, so please no one scream at me.
Recently, I heard a candidate for Congress giving a campaign talk. He said it was important to oust as many Democrats as possible in November, so Congress could refuse to fund health care reform until they could get a Republican president in 2012 and overturn the whole plan.
Of course, he went on to say Republicans have a better idea (which is always what the party out of power claims), but if that were the case, Republicans would have reformed health care when they were in power.
I hope you can all get coverage.
roshan says:
Yes they do have a better plan. Everyone is going to get a moose hunting license under President Palin and chickens can be exchanged for heart bypass surgeries. Not only that you can drill for oil under your house and sell it to the Saudis.
Sarah P says:
Your reply was the funniest thing I read all day.
Jessie says:
Yeah, I wonder how many of those older republicans would be willing to give up their Medicare to go out and find their own private insurance elsewhere? Not many.
TN working mother says:
I heard on a real news program a few months ago (i.e., not a “talk radio” type of show) that Nixon tried to get a national health care initiative passed that was actually very similar to the one we have now gotten (or at least similar to Obama’s original proposal — I can’t recall now exactly) and at that time it was the Democrats who blocked it,
Marti from Michigan says:
Sounds stupid maybe, but how about writing a letter to President Obama and explaining all that? He may not see it, but some of his aides will and if it is important enough to them, they give it to him.
I have no health insurance and have not had since August 2006 when I lost a good job due to downsizing. I am 59 years old, have hypertension and a kidney condition that needs to be watched. I take vitamins galore, calcium because I am postmenopausal, vitamin D because I have a proven deficiency. I also visit a free clinic here in my town, called Oasis of Hope. They keep an eye on my health, and I don’t have to pay them a dime for anything. I just had a slew of blood work done, not a penny out of my pocket. I do donate to them when able, as I only work part time.
I am wondering if there is something similar in your area – a free clinic, or a sliding scale clinic?
There are also other health insurance companies besides BCBS – BS is the greatest name for them by the way!
I am so sorry you guys are experiencing this, it sucks.
In Michigan, if an uninsured person has to be hospitalized, Medicaid picks it up and that person gets Medicaid until they are all better. Perhaps there is something like that as well in your area?
The system plain and simply, sucks, however.
Marti from Michigan says:
I did not mean that you guys should check out Medicaid, please don’t take it that way. I’ve been reading all the responses tonight, and I’m learning all these things I did not know.
Michelle Pixie says:
This frustrates me on so many levels! I am sorry you are have to deal with this.
Pamala says:
My hubby lost his job last week and this is my number one fear. First off I’m obese so that excludes me. My husband is BiPolar and that excludes him from that coverage and my daughter has a genetic medical condition which gets her excluded. So none of us can get private insurance under the current system.
Luckily we will have Cobra for the time being, and luckily we won’t have to pay full cost for it. But it scares me, what if it takes my husband over a year to find a job? Or what if the job he does find doesn’t provide insurance? What do we do?
That’s why I find it amazing that people can be so against providing everyone with proper health care. I mean seriously, I’m not some lazy person mooching off the system. My hubby isn’t someone who isn’t trying to find work. But apparently our family and many like us deserve to be punished because a few abuse the system.
Anyhow that’s my rant for today.
Caren Drink says:
Heather-
i’ve been in your shoes. My solution was to find a job with benefits. it took me a year to get one locked in, and in that time we insured only our child. It was horrible, and we are lucky we didn’t get sick.
I feel you, and I feel FOR you.
Hang in there…. Caren
Debbie says:
I understand your situation. My husband and I are both self employed. We made me an employee of my husband (paperwork) which then allowed us to get group insurance. Group insurance cannot turn you down based on pre-existing conditions. Our premium is still high but the coverage is better. We are in our late 50’s and pay about $1300 for both of us. Yours should be cheaper. It is with Blue Cross of California.
I am Jenelle Flittner Hogues mom so if you would like to hear how we did it just get in touch with her or e-mail me and I will give you my phone number.
This is an ongoing issue which I hope will resolve itself soon but in the mean time we need insurance. You can also check into Healthy Families for Annie. It is also with Blue Cross and very reasonable.
Deenuts Dana says:
So, what you’re saying is, health care is inexpensive if you don’t get sick? Nice.
Kathy Riches says:
That’s why my husband, daughter (20) and myself have not had health care for 3 years. This is terrible to say but I guess we will just fall into the hands of the state if something bad happens like everyone else here in Arizona….if you get my hint.
Sarah says:
I always feel so terrible for my neighbours to the south when it comes to health care. My cousin in laws are having a real debate about when they should have kids and I never really understood, I thought they were waiting for the perfect moment. Then they told me their insurance would go up an additional $700/month. I know canada’s health care system isn’t perfect but its one less big thing that we never have to worry about…if my child gets sick we don’t worry about whether or not we can pay for treatment…i couldn’t imagine what it would be like if we couldn’t afford treatment it breaks my heart to think people have to make that decision everyday. Th
Sarah says:
Opps accidently sent when I wasn’t finished my rant…all I really had left to say was I really hope that things start improving in your health care system and may be even a little before 2014! But in the mean time hoping things work out for the 3 of you in a good way you definitely are due for a little break.
Mandy says:
Yup. My husband and I only have insurance for our son. It’s all we can afford. I had an ear infection earlier this year and they wanted $350 upfront before the doctor would even see me because I wasn’t insured. Needless to say we couldn’t afford that so I left. I still can’t hear out of this ear.
Marti from Michigan says:
Mandy – you need to have that examined. This is not good. Can you go to an urgent care center perhaps? Is there a Catholic hospital or a hospital in your area that is run by Trinity Medical? We have one in Grand Rapids, Michigan which is where I live – and they work out payments for you if you are uninsured or low income, and they’re very reasonable, even $10 a month.
You should not have to lose hearing in your ear just because you can’t afford to be seen. Please check this out. Please check out free clinics and sliding-scale clinics as well.
If you take a teaspoon of raw honey every day (not the stuff in the grocery store, real raw honey), it acts as a natural antibiotic. I do this. Hope you feel better.
Amy Collen says:
I agree with Marti, Mandy. You really need to have that checked out. When it comes to issues of ear infections and such, you really should get them looked at or at least get some antibiotics. If you are still not hearing that is very worrisome. Sorry, don’t mean to lecture you, I just hear a lot of horror stories from my PA hubby. Please get it checked out….
Maria says:
Marti & Amy – I agree that Mandy definitely needs it checked out…but I’m pretty sure that is obvious to her as well. Who WANTS to lose their hearing voluntarily?
The point is that no matter what your income, job status, etc…we should ALL be able to see a doctor without worrying about the cost. Why is there an expectation that we need to have low cost, high cost, free clinics, etc? If you’re sick you should be able to walk into any hospital and be taken care of. Period. AND without the worry of it putting you into bankruptcy. I’m not saying it should be free. What I’m saying is that every hospital should be required to fully take care of a patient and charge them accordingly. Got a job with health care and can afford the care? Great. Pay your bill. Laid off and are barely making enough to make it week to week? Great. Here’s the sliding scale for your income range and a payment plan if needed. Happy to see you’re healthy. I’ll bet that if hospitals and clinics were rated and received financial incentives based on the number of patients that get BETTER/HEALTHIER we’d be living in a whole different world when it comes to health care.
Nicole says:
Have you tried Scott & White? I’m not sure if they’re available in your area or not (I’m in Texas) but it’s worth looking into. I have a friend who went through a very similar situation and they were able to insure their family, at a “reasonable” cost (much less than $23k/year!!!).
Keeping you all in my prayers, as always,
Nicole
Kristen says:
I also have Scott and White Helth Insurance. They are only in the Central Texas Area.
A. says:
Move to Canada!
Jannette says:
SInce I have rheumatoid arthritis and my husband is an independant contractor, I had to go to the high risk insurance pool in Texas.
My premiums are $17,000 a year with a $2500 deductible. Luckily, our kids are covered by husband’s private plan; however their premiums are $1,000 a month. So in total we pay $29,000 a year just in premiums. Without insurance, my medication alone would cost $6,000 a month!!!
I agree we need reforms, but even with such a high cost for my family, I am still against the health care reforms that will go into effect. First, the reform will do away with pre-existing conditions. This is great until you realize it will not control the cost of the premium or if the cost is controlled then the benefits will be cut. So in actuality, this reform already exists with the current high risk insurance pool. Lawyers and lobbyists are writing the reforms when doctors and patients should be writing the reforms. Think about it: Why did the stock price of insurance companies soar when the changes were signed into law.
Here were the options for us:
1. Create a small business of two and get health insurance for the small business. For us, the cost of creating a samll business and tax implications did not work.
2. Look into trade associations health care. The benefits with these associations were too limited. My medication would not be covered which was my biggest expense.
3. Either my husband or me had to become an employee with a company that offered benefits.
4. Go into the high risk insurance pool.
5. Not get insurance for me.
In the end, we chose option 4. Yes it is expensive and painful, but we do what we have to. Eventually, we may have to choose option 3, and I hope we will be able to find a job with benefits.
Sadly, I do not believe the health reforms will help you Heather, but we will see.
Allison says:
My husband and I were both self-employed for a while and we risked it and went without. We bought it for our children though, like you mentioned.
It was a scary time, I hated worrying about if anything happened to us! Medical bills are the number one reason for bankruptcy, they can be devastating.
Now my husband has an office job and we have coverage. But I agree, our health insurance in the US has some major problems!
Barnmaven says:
Our family premium even on Cobra when I was between jobs in 2007 was over $1000. I don’t know how people can live and have non-employer sponsored health coverage. One of my BFF’s has terminal cancer, and has state-sponsored coverage, which is horrible. Everyone should have access to quality medical care, regardless of their income. My friend is on disability, which pays her barely enough to live on as it is, and the state insurance plan has horribly high deductibles. Dealing with that kind of financial stress certainly isn’t helping her fight her cancer.
It boggles my mind that people continue to oppose health care reform, that some people believe that letting private insurance companies dictate premiums and levels of care is somehow better. Its the kind of stuff that makes me crazy. And sad.
Lynn says:
After reading your blog today, I was so irritated at BCBS that I talked with my husband about it. He wondered if it would be worth getting in contact with one of your members of Congress about it. Have you considered this? My husband’s thought was that perhaps a little pressure could be put on the insurance company this way. The costs they are giving you just seem outrageous. It may not work but perhaps it is worth a try.
Insurance companies seem to have a formula they follow and there is basically no room for any sort of exception based on individual circumstances. We experienced being put in one of their designated boxes regarding coverage for fertility. I am almost 40 and yet we had to wait and wait for coverage simply because we got pregnant naturally one time, despite the fact that I miscarried at 10 1/2 weeks. Anyway, our fertility issues are obviously not the same circumstance that you are dealing with, but it demonstrates that these insurance companies put everyone in a box, even though there is no way people have the same circumstances. It is very sad. Hang in there!
Krista says:
Your situation highlights everything that’s wrong with our health insurance system. It’s the people in the middle who really struggle: people above a certain income level are able to afford good private coverage or are provided it through their employers, and people below a certain level get charity care or medicare/medicaid.
Skye says:
That is just awful. Thank you for writing about this. I really hope that the more people who share their personal health insurance stories like this, the fewer people will lobby against health care reform. I just don’t get how anyone could be against reform- I have to assume all of those people have never witnessed an unjust situation like yours.
Trisha Vargas says:
I have been blessed to have continual health insurance through my employer for the past 10+ years. We’ve switched providers and the weekly premiums have fluctuated a lot over the years, but I’ve always had it.
I cannot imagine the stress you are experiencing in making this tough decision. There is definitely peace of mind there to have it just in case you need it.
I hope you find a solution that works for you and Mike and Annie, so that you all can take care of yourselves without worries of coverage.
(((HUGS))) from Florida
Beth says:
ug – how awful. this issue makes my blood boil!! my parents struggled without health insurance – my mother battled bipolar disorder and severe anxiety without it – i can’t even get started on prices of medications – especially back then when prozac was new. lost coverage when she lost her job because of her illness – not a new cycle. and no happy ending with her death at age 47.
enough about me :)!…are there any inexpensive (ha) catastrophic/hospitalization only plans you could get for you and your husband? I am so scared that this reform will be gone as soon as some legislators get the chance – my state is already trying to pass state legislation to opt out of federal requirements…ug!
Nadine says:
I’m a South African living in the US – I was only ever eligible for “student health insurance” through whatever university I was attending at the time and that was for emergencies only – everything else had to be paid out of pocket. Once I graduated and started my one-year temporary work permit, I was no longer eligible for anything. So for the last year I have ignored any ailments I have had because I can’t afford to get it checked up. I haven’t been to a dentist in 5 years. It’s ridiculous. Hence, I am moving to Canada, where not only are they more receptive to me establishing myself there (I can go to school for one year and become a canadian resident, and then after 3 years apply for citizenship) but their healthcare is funded by higher taxes that people don’t mind paying because you can go see a doctor for free, whenever you want. I cannot wait…and my aching teeth can’t either!
Janelle says:
I haven’t had health insurance since 2006! We’re a family of four and we pay out of pocket for drs visits, which totals less than $1,000 a year for all four of us (we pay completely out of pocket, no gov’t assistance). It is scary to be uninsured but 1) we live in a US territory, not a state, so that makes things more complicated and 2) our only real option would cost us close to $2,000 a month for a family of four and again, that’s still crappy coverage.
amy says:
Very interesting to hear how other countries deal with providing health care to their people. Let’s hope the US gets its act together and SOON.
As a Canadian I am frequently bewildered by the stories I hear from US friends. For such a large and rich country it seems quite unreal the way health care is dealt with.
(And don’t get me started on how much is spent on WAR…)
Molly says:
Ug, that’s awful. I never would have believed in “socialized medicine” until I lived in the UK for a year. Now I can’t understand why the US doesn’t get its act together. Ug, ug, ug.
No advice here–just lots of luck. I’m sorry you have to deal with this stress right now.
Marcela says:
It’s crazy and sad that this is something we have to stress over. You are doing the right thing by researching and exploring all your options.
Sending good thoughts your way for this to work itself out.
LB says:
So sorry you are going through this on top of everything else….maybe you could share your story here?
http://www.health-access.org/shareyourstory.aspx
I know you have a lot of blog readers but getting your story in front of an advocacy group like this could be even more powerful.
lisa says:
http://www.uhc.com/home.htm
i realize your situatioin is different but, we’ve been taken well care of. it’s worth a shot to see what’s available.
Lisa
C says:
This is probably stupid, but I’ve always wondered why a group of people can’t just decide to group together and go to the INS company with buying power.
I’m a photographer, and work for myself, and I’m lucky that my husband works for a hospital, but we talk about him quitting and just working with me. The thing that holds us back is insurance. I’ve always wondered why a whole lot of us independent photographers can’t get together and get ins at better rates since we’d have a large group.
That’s not so helpful, just thinking out loud.
Good luck, Heather. I know this is so so stressful.
Anita says:
C,
A few years back my small company got a better rate on dental insurance by joining a group put together by our neighborhood Chamber of Commerce. There are rules about putting together a group — I remember when we first got insurance for our staff we had to confirm that we were not a company that had been established for the sole purpose of buying insurance — but it’s possible.
Cinthia says:
Healthy Families is good (I used to work for a non profit community clinics coalition in Orange county), if not, try Kaiser Kids (their income limits are higher).
Kaiser has a steps program as well, which charges less than usual, but it is a pain to have to only go to their hospitals, etc.
I tried getting a job last year, but jobs are few and far between in CA.
I ended up going back to school at a UC. They’re coverage is pretty extensive, but getting the family covered can be pricey! Probably not as pricey as Blue Cross…
Mary says:
I have the same problem, I choose to insure only my son for now, and pray God every night to be healthy .Its really an nerve-wracking situation.Hope you the best ….
Mary
mythoughtsonthat says:
Same situation in my family and my husband hasn’t worked in nearly a year. Tough times. Of course, I don’t know your income, but any chance you could apply for Healthy Families? It would only be for your girl but its worth a look. Also, look at Kaiser’s income based plan (again, for your girl only) if you don’t qualify for healthy Families. Good luck. Peace.
CorningNY says:
When I Google the Kaiser Steps insurance program program, it says it’s not accepting new members.
mythoughtsonthat says:
Its not the step plan, its the child health plan.
kristen says:
I have to say that for all its faults (and they are huge), health care reform has helped me and my family. Specifically, one of my sons was born with a congenital heart defect, corrected with 3 surgeries, and he also has epilepsy. However, a child’s pre-existing conditions can no longer be considered for insurance purposes.
That being said, a major reason why I work, especially a corporate job, is for the insurance. My husband owns our own business, and any insurance we would get would have much less coverage and cost us a huge amount. There are so many days when I wish I could stay home or do consulting or even work for a risky start-up. But, because of the insurance situation in the US currently, none of that is possible.
As a country, we have to do more to ensure that everyone has access to high quality, affordable health care.
Heather, I really feel for the position that you and Mike are in, but I wouldn’t recommend being without coverage for yourselves…
Lex (@laprimera) says:
Oh man, Heather! That sucks so hard.
My Ex and his new wife (I know.) just had a baby girl. She was in the NICU for 10 days. The insurance for the baby covered none of the NICU. WTFBBQ.
Erin says:
Hi Heather,
I’m so sorry to hear about your family’s situation. We feel your pain.
Our example isn’t ideal, but ít illustrates how difficult it can be to get health care. We both have pre existing conditions. Mine surround pregnancy, my partner’s is juvenile onset (Type 1) diabetes.
My partner, who would love to focus on his independent business and be one of the proud “small business owners” held up as political trophies during election years, has had to get a job for another company. For health care. I hate that he has to do this. It doesn’t seem right.
I have gone back to school and taken on a slightly heavier courseload to get health insurance through my University’s group plan. It was the only way for me to get maternity coverage. No self-paid insurance plan offered maternity coverage in my state. And I still have to pay out of pocket for a host of expensive prescriptions.
You and Mike aren’t alone. I’m sorry it’s frightening and you have every right to feel that way. You guys work hard, I know you do. Both as parents and as contributers to our social good as a country.
You’re in our thoughts!
Rachel says:
That’s crappy. I have been paying $420/month for my insurance through Cobra for the past couple years since I turned 25 and got kicked off my mom’s plan (I’m a grad student). I applied for my own plan when I turned 25, but got denied for my “seasonal allergies” which I do not see a doctor for or take prescription medication for. I’m trying to find a job with full benefits because this payment is killing us! I’ll be thinking healthy thoughts for you guys. Hang in there!
Lisa says:
You have described the situation I was in when I lost my job (I carry the insurance for the family). I could be an independent contractor but out premium would have been more than yours-with at least that ,much of a deductable because I have (mild) asthma, allergies and mild High Blood pressure. My husband has anxiety and a back issue. I would not have made enough for us to live on after the insurance-we ended up moving from where we loved back “home” where I finally found a good job but we are miserable in the “where we live” department.
Liz says:
I don’t want to sound like a smug Canadian but this boggles the mind. I recently read a heart-breaking blog post by an American woman who lost her baby due to complications at birth. In the post, she expresses her guilt for choosing a home birth (despite a previous complicated labour and birth) because it was less expensive.
To be clear, I have no objections to home birth at all. I have good friends who have had safe wonderful births at home. But to have to make that choice for financial reasons and live with the guilt this woman does? I can’t imagine it.
I had multiple miscarriages, extensive testing, two succesful pregnancies with literally countless ultasounds, a NICU stay for my oldest who was early, etc. My care was top tier as far as I’m concerned and I paid exactly nothing, except prescriptions. How can that system be worse? I don’t get it.
Anita says:
Hi Heather. I haven’t read through all the comments, so perhaps I’m repeating someone, but have you considered just having catastrophic coverage for you and Mike? Paying for your regular healthcare (annual, etc.) out of pocket sounds a lot cheaper than this plan, and if, heaven forbid, anything big happens, the catastrophic would kick in. I could go on and on about how wrong it is that insurance companies are among the most profitable in the country, as they continue to cover less and charge more. Good luck!
Tracey says:
Hi Heather,
Long time lurker, first time commenter (came to your site via Matt and Maddy). I have laughed and cried reading your blog and keep you and your family in my heart and thoughts daily.
I work for a health insurance broker in NorCal and fully understand your frustration. It’s very easy for people to assume that you can just contact another carrier and magically get coverage if you have pre-ex conditions. Let’s not forget about the money tree you have growing in your backyard……
I have several suggestions (some of which you’ve heard). First and foremost, see if you qualify for Healthy Families http://www.healthyfamilies.ca.gov/Home/default.aspx so you can get coverage for Annie. If you don’t qualify for HF, just get an individual plan for her right now. Children under 1 year are a little more expensive, but once she turns 1 the premium does go down considerably.
Secondly, see if you can apply separately (i.e., you and Mike on different policies). They may rate you up at a higher rate (Mike, too, depending on medical history) but it’s worth a try.
Try Aetna for a quote. We’ve been able to get some of our clients covered who were turned down by Anthem Blue Cross and Blue Shield (they’re separate entities up here since we don’t have HMO’s).
If you and Mike start a business, you only need 3 months payroll (both of you as employees). Mike or you can waive coverage which would give you the eligibility requirements (minimum 2 employees). Group coverage is higher but it IS guaranteed issue so they can’t turn you down for any reason. There’s more to the group coverage but if you can find an insurance broker who knows his/her stuff they can point you in the right direction.
Don’t even get me started on health care. We deal with people day in and day out who either can’t get coverage or can’t afford coverage, and those who do have it get reamed by the whores (aka insurance companies) for their premium payments. Unfortunately those issues weren’t addressed (along with many others), but for those of you of the mentality that “I’ve got mine, screw everybody else”, you have NO idea of what TRUE health care reform can mean to you and millions of other Americans. (Stepping off soapbox).
Good luck, Heather – email me if you have any questions.
Bridget says:
It’s the double-edge sword to working for yourself – you have to make more than what you thought was a “good” income to cover the benefits that are paid for by employers in a typical job. And obviously you’re being looked at individually instead of through a pool where they can’t single out your history. You do have the perfect storm of health insurance woes! Too bad all the independent contractors can’t form a union…
Tamara S. says:
Insurance sucks! I haven’t read all the replies but have you considered catastrophic coverage? I think you could get a high deductible plan for yourself and mike (something like 10K) so at least if something major happen that would kick in. I’m sorry your having to deal with this. Love reading your blog. Your little sweethearts are adorable.
Jackie says:
Heather,
I know there are a lot of comments to look at, but I suggest checking to see if your university’s alumni association has a health plan or if you can join a professional association that has a health plan. Best of luck to you! Also, for Annie, check to see if you qualify for the State’s healthy kids program (although I know CA is tight on money for right now).
You are correct that everyone deserves healthcare. I can’t believe someone told you to get a job. Horribly horribly rude! We all deserve affordable healthcare!
Cristin says:
I could rant and rave about BCBS (Blue Cross Bull-Shit) for HOURS. Heck, any insurance in America. But I’m sure everyone knows that they are screwing us. It’s disgusting.
Thanks for putting this out there. Help us “little people,” Obama!
I recently had to purchase my own crappy plan because I am now self employed. It’s a joke.
Someone please tell me who DOES qualify for a private plan. Who has a “clean” health history, free of pre-existing conditions?
My blood pressure goes up just thinking about it. OOoohh, another pre-existing condition!
Issa says:
220th whoo hoo.
Sorry couldn’t help it.
I pay 1k a month to insure me and the kids. And it is crappy Kaiser. Which I despise. But I can barely afford this. No way i can afford anything better. I am considered high risk or whatever. For teh crazy. And asthma. As is my not yet six year old. Asthma. That she’s had since four month old. Is awesome, let me tell you. Then again, our prescriptions alone, without insurance would be $820 or something. Shrug.
It has to change. It just has too.
Until then…man Heather, I hate to say it, but can you put Annie on a really good plan and get something suck ass like kaiser for you and Mike? Or maybe just Mike? It sucks but gah, 20k a year? I can’t imagine. Then again I personally think 12k a year is way too much. Makes me almost want to go back to working a corporate job. But with that comes the 14 hour days and my time with the kids is already limited.
I have no answers. Obviously. But SUCK. That is all.
Ashley says:
This is just ridiculous. I hope you get it figured out quickly, without going broke.
By the way, this will sound strange since I don’t know you, but I had a dream about Maddie last night. I was on a boat and you guys were all there and we were sailing. She was having a blast, with that goofy smile.
becky says:
Heather, have you thought about incorporating as a writing biz and then pursuing ins that way? From what I have read & understand, it’s completely different if you have a small corp w/a couple of employees because it’s then group coverage. Taxgirl has mentioned this multiple times, so it might not hurt to check w/a CPA about your options down that avenue. Even with doing an LLC here in Cali, it may be cheaper than that other BS. (Also, check into California’s Healthy Families program for coverage for Annie – it’s a great, low-cost program if you qualify for the income limits.)
PrincessJenn says:
This makes me ill. And the number of comments chiming in with ‘me too’ breaks my heart. You should not have to be rich to be healthy.
I may not always agree with our Canadian health care system, but at least our basic care is covered.
So the only solution is for you to move to Canada and be my neighbor.
Love you guys lots. Really hope that you’re able to figure out something that will work for you. xoxo
Molly says:
Have you checked out Cal-Cobra. In some cases after you’ve exhausted 18 months on Federal Cobra, you are eligible for another 18 months on California Cobra before you have to do guaranteed issue. I believe the cost of COBRA was 102% your insurance premium & Cal-cobra is 110%. Not as expensive as guaranteed coverage. I hope you qualify, it’s worth checking into.
the following is from this link: http://www.disabilitybenefits101.org/ca/programs/your_rights/cobra_obra/cobra/program2.htm
Cal-COBRA is a California law that expands on COBRA. It allows 36 months of continuation coverage for employees of businesses with 2-19 employees. For employees of larger businesses who only have 18 months of COBRA, Cal-COBRA also provides an additional 18 months of coverage, bringing their total to 36 months as well. The Cal- COBRA premium is up to 110% of the premium for current employees with the same plan. Unlike COBRA, Cal-COBRA does not apply to self-insured plans, and those already on Medicare cannot qualify for Cal-COBRA. If you are switching from COBRA to Cal-COBRA, the health plan must send you a notice explaining the change in premiums and what you need to do to keep your coverage. If you don’t get a notice, and think that you should have, contact the health plan.
Good Luck!
becky says:
I totally forgot about Cal-COBRA. It was offered to me when my COBRA coverage ran out, but at that point I was able to get on my husband’s coverage, so I opted not to take it. Whoever administered your coverage should have told you about that.
Denise says:
Oh Heather, that sounds horrible. Amazing how insurance companies can just use some random formula to screw patients. We have insurance and I still have to fight tooth and nail for the most basic coverage, not to mention scour every bill to make sure they aren’t overcharging us (which happens a lot).
Overflowing Brain (Katie) says:
I hear you so much on this one it’s not even funny. Though I am one of those people who does use $100,000 of medical care a year (already at $96k for this year), it doesn’t mean that I should have to go bankrupt for it. In 2007 I paid almost $20,000 out of pocket for just me and my salary as a teacher was $28,500.
It’s criminal. Good thing you have a friend who’s married to a doctor…
Brooke says:
I’m so sorry to hear that you guys are facing this kind of decision. It is tragically unfair. No one should be without health coverage. And you shouldn’t have to wait until 2014 for it be affordable. I wish I could offer more than sympathy…
Amanda says:
Heather, I hope you understand that people can support you and your family without supporting you views on healthcare reform. I have a chronic health condition and dealing with health insurance is practically a full time job for me. The proposed reforms would benefit me more than most as it would allow my husband to become an independent contractor which would drastically increase our income. However, allowing us to work the job we want and make more money does not, or should not, give us the right to spread our healthcare costs to others. I know many, many people who will be hurt by the reforms. Frankly, when you needed a net to catch you, COBRA was already in place. You’ve had 18 months to evaluate your options and have another plan in place. To the people who have posted previously: before the claws come out, YES, I understand what the Spohr’s life has been like for the past 18 months. Believe me, I hurt each and every day for what has happened to the Spohr family. Again, I can totally support Heather and her fammily without agreeing with all of her views.
Heather says:
If you don’t think the system needs to be changed, that’s totally fine. I actually HAVEN’T had 18 months to have another plan in place, because once reforms passed, everything changed. That’s kind of an insulting thing to say. Do you think we’ve just been sitting around, doing nothing?
I don’t like a lot of the reforms, believe me. But I’m not going to be freeloading here. We work hard, pay our taxes, and yet, we can’t afford health insurance. Don’t you think that’s a problem?
Amanda says:
Heather, I’m in no way implying that you’ve been sitting on your thumbs for 18 months. As someone who follows your blog, you seem to have been exceptionally busy, both personally and professionally, actually. I understand the reforms have passed but, as you well know, they won’t have an immediate impact for many of the people who are counting on them. You said in your response that “once reforms passed, everything changed” so I guess it would be more accurate to say you’ve had 18 months of coverage but not 18 months to evaluate what options the new reforms will make available. I know the time frames of reforms vs. COBRA is affecting many in our country and adding to an already stressful situation.
Just to clarify, I have never implied that you are a freeloader and certainly understand how frustrating it is to work hard, pay taxes, and still not be able to afford health insurance. Been there, done that. I’m not saying the system is or ever was perfect. I agree that reforms are needed – I do not agree that the reforms we are getting will adequately address the issues causing the problem.
Claire says:
Jesus!! Reading things like this makes me:
1. Extremely thankful that I’m Australian
2. Wonder just exactly HOW logically minded people could have been opposed to healthcare reform?!?!
I think that people in countries with “SOCIALISED OMG?!?!? WON’T SOMEONE THINK OF THE CHILDREN!!” healthcare hear senarios like this and have trouble fathoming the correlation between careing for your being and big companies making BIG money. Even the most hardcore conservatives here in Australia would never argue that this system is the right way to go.
I’m in my late 20’s, a full time uni student who earns too much to qualify for aid/welfare and have very poor maternal health prospects such as yoursef. Last year I sat in a public hospital bed for a week while they tried to figure out where my ectopic pregnancy had disappeared to. They did this because the doctor did not want me to leave the hopsital on the off chance that something could happen in the interim. I seriously live 5 minutes from said hospital. I could see my house from the room I was in. This did not cost me a cent and I can’t imagine the stress of having to pony up the funds for such a thing. Because it would be absolutley impossible for us to pay that sort of money for insurance. It just wouldn’t happen. I can’t wrap my head around how people get by?!
Amanda says:
One of my best friends is Australian. She works very hard and makes a decent living. She also pays 45%(!!!!!!!) in income taxes. Once you’re out of uni and doing well professionally, you may not feel that your medical costs “did not cost me a cent.” Trust me, it cost someone.
roshan says:
45% is the highest bracket for personal incomes over 180K in Australia. Below 180K the tax rate is 31%.
Marie says:
Well then your best friend earns a HELL of a lot of money Amanda. I don’t pay that much. I’m also getting surgery in a few weeks that I don’t have to pay for. And I’m more than happy to live in a society where our taxes go towards helping each other, instead of letting the less fortunate go without.
The attitude of “Let the rich get richer while the poor die from lack of healthcare” makes me sick. Honestly, and America wonders why the world hates it.
Amanda says:
Marie, my friend does earn a lot of money. She’s also one of the most generous and genuine people that I’ve ever met.
In America, the very rich AND the very poor get the absolute best medical care. It’s the middle class (people like me and Heather) that struggles so your comment about all the poor people is unfair and inaccurate.
I’m sorry that you are one of the less fortunate and hope things turn around for you soon. Then, nearly half of YOUR income can go to the society you are happy to be a member of. I wonder if a change in circumstances would change your outlook?
roshan says:
Oh, look at all these poor folks getting the absolute best-est medical care.
LA
http://www.msnbc.msn.com/id/36813750/
http://www.scpr.org/news/2010/04/28/weeklong-free-medical-clinic-heads-day-2-la-sports/
Kansas
http://www.kansascity.com/2009/12/09/1621898/free-health-clinic-draws-hundreds.html
Texas
http://abclocal.go.com/ktrk/story?section=news/local&id=7034143
West Virginia
http://wowktv.com/story.cfm?func=viewstory&storyid=64178
Arkansas
http://www.arktimes.com/ArkansasBlog/archives/2009/11/26/got-health-care
Tennessee
http://www.oakridger.com/health/x985821960/Free-Medical-Clinic-opens
And look there are pictures too of all these poor people.
http://news.bbc.co.uk/2/hi/in_pictures/8653700.stm
Somehow arguments which have “generous and genuine” preceding “let me keep all my money” give a certain kind of vibe.
Jean says:
The attitude of “Let the rich get richer while the poor die from lack of healthcare” makes me sick. Honestly, and America wonders why the world hates it.
———-
Marie-Not sure where you got that impression from, but the poor have free health care. It’s the middle class that suffers the most.
Marie says:
“Marie, my friend does earn a lot of money. She’s also one of the most generous and genuine people that I’ve ever met.”
I don’t see what her generosity has to do with anything?
“In America, the very rich AND the very poor get the absolute best medical care. It’s the middle class (people like me and Heather) that struggles so your comment about all the poor people is unfair and inaccurate.”
Have you ever been to a free clinic? The poor do not have the same access to healthcare that the rich have in America and I don’t have to live there to know that. And yes, great point about the middle class and it doesn’t make it any more fair that they have to struggle for healthcare either.
Great links btw Roshan, exactly my point.
“I’m sorry that you are one of the less fortunate and hope things turn around for you soon. Then, nearly half of YOUR income can go to the society you are happy to be a member of. I wonder if a change in circumstances would change your outlook?”
I’m not less fortunate thankyouverymuch. I work and pay my taxes. You think if I had more money I would have a problem with paying tax? 180k is a LOT of money. And from what I understand you have similar high tax brackets for such high income? My friend Lisa in the USA said she got taxed 47% one year so let’s get off our high horse that Australia has high taxes shall we?
Claire says:
I worked 10 years full time in the financial services industry before uni. The maximum medicare levy is 1.5% and it’s just not a problem. No one thinks of it. It just gets taken from your tax return every year. It’s not taken directly from your paycheck every week … you don’t notice it! I still got thousands back every year after the levy. And even if I wanted private cover it’s no where NEAR what Americans pay.
I’m currently trying to be a nurse and I see a lot of heartache and worry but it is NEVER anything such as “how the hell am I going to pay for this?!?!”
Tam says:
I am also a born and bread Aussie, and have also used well and truly over my fair share of taxpayer funded medical aid. My last pregnancy I had over 30 ultrasounds to keep an eye on our terminally ill unborn daughter. But you know what? I pay taxes as well. While I don’t work right now, due to my high risk pregnancy, my husband and I have both held full time jobs since leaving school. We both pay taxes.
Our healthcare system is not free. The taxpayer funds it. And as broken as it is, it does help any australian citizen who walks through those doors without demanding a single cent.
The rich and the homeless all have access to top notch medical care.
I can’t believe that a country as advanced and developed as the USA doesn’t have a scheme similar in place. Who cares if some people bludge and dont pay there way. They still deserve to live and be healthy – its a human right.
Claire says:
You hit the nail right on the head Tam. It’s not free. But on a day-to-day basis you don’t notice the cost and it’s not a huge stress. It could be better, but at the same time it’s much more effective than a lot of other first world countries. And no matter who you are, what you earn, what you do, where you live you get looked after no matter what. In busy areas there are waits (up to 7-8 hours for non emergencies in ER depts in certain cities) but you do get looked after without out-of-pocket costs.
I’m very lucky. I’m an hour from Melbourne if I need any specialist care and in a well funded regional area with short wait times and a very well equipped hospital.
If I didn’t believe in the Australian healthcare system I would not have become a nurse at 30 years of age. It’s not perfect but it’s much better than the alternatives.
Carolyn says:
Do Australians also have state taxes and local taxes and property taxes? 45% is a lot but if you don’t have all of the taxes Americans have, and you don’t have to save for your child’s education or get huge loans for education, or worry about health insurance, I’d think you’d be better off than under our system.
Tam says:
Carolyn – We do have all those taxes. I don’t get taxed at that high of a rate – because we are middle class income earners. But yes, we have Property taxes, Land taxes, Rates, Water Rates, and this thing the government conned us with a few years ago now called the Goods and Services tax (GST) a 10% tax on almost EVERYTHING that was meant to be ‘the tax to end all taxes’, except that we still pay other taxes on some of that stuff as well. We have to pay for university although we do have something called HECS – sort of like your student loans I believe? I think a lot of what our system entails is similar to yours – but we deffinately seem to be on a better thing compared to your health care system at present.
Ray says:
$23,192 dollars for the year = devastating blow! WOW! I don’t know much about health insurance, and 232 comments in I’m sure everyone gave you all the advice that you need. So I have nothing to say there. But…GOOD LUCK in finding a plan for not only Annie, but for you and Mike as well.
thenextmartha says:
I’m pretty disgusted at the whole thing. You are TRYING to do the responsible thing and it’s like the system wants to work against you and A)make it such a paper ordeal that I bet many don’t even get as far as you did but just give up and if they do then Make it so unaffordable that those who are TRYING can’t do it in the end. So sorry this is happening. Ugh. (This is where if I was on Twitter I would use the hashtag #Assholes. Can I do that here? Sorry, I know you run a clean operation around these parts.
megryansmom says:
When my husband lost his job 4 years ago we couldn’t even afford the COBRA. It took him all of that 4 years to find a full time position that offered benefits. We were self pay for medical incidentals for that entire time and thank God neither of us became seriously ill. Now that we have coverage the insurance won’t cover my husband’s office visits because of pre-existing conditions, he has diabetes. It’s a bunch of crap. I’m hoping something better comes along soon, we’re a ways off from medicare, if that’s even around in 20 years.
twingles says:
And how much do you think it will cost in 2014? Health insurance will be guaranteed, but it won’t be any cheaper. IN fact it will more expensive, because everyone has to be insured, no matter what.
The health insurance reform most closely mirrors NY states’ health insurance laws (my home state) and we pay the highest rates in the nation because NO ONE CAN BE DENIED. I just shelled $300 for medication for my son today and $45 for the doctor visit, despite paying $1100 a month for health insurance (my DH is self employed like you guys).
DOn’t hold your breath for the next 4 years.
Rebecca says:
Agree and agree! That “no one can be denied” is what is dangled before people and dazzles them. Then, too late, everyone is going to realize what it really means….not good. Reform is needed but NOT the Obama version of it.
CorningNY says:
The point of mandating insurance coverage for EVERYONE is to drive down costs by making healthy people get coverage. They pay premiums but need less care, thus making it less expensive for everyone.
As for NY: are you saying you would rather have a system where anyone can be denied for any pre-existing condition? That’s just wrong.
Kathy says:
Hey Heather, has MIke ever looked into teaching for an online school? I did that when my kids were little and it was great. I live in Ohio so don’t know what CA offers in the way of online charter k-12 schools…
There is also K12 Schools (http://aventalearning.com/) which is nationwide. Just a thought…
Good luck with all this.
Marie-Christine says:
Poor girl, that is one sucky situation… I hope you find a good solution… I live in Canada and I try not to complain about our slow health system because it’s FREE and I get how important that is.
I wish you all the luck on this!!!
Karen says:
My husband and I will be in the same boat soon. After I was laid off, I went to work for my husband who was previously covered under my company’s insurance. Self-employment rocks and sucks all at the same time. Good luck to all of us.
Maria says:
Heather I’m so sorry.
Is there any way Mike can pick up a lame job that has insurance coverage? I know Starbucks has insurance for part time employees.
AJ says:
I don’t know about CA, but here in MI, the state aid insurance only goes to people who don’t work at all ( you have to make under a certain amount, and when I waited tables and had to claim $2.65 an hour and that was it, I made too much to get it…AYFKM with that shit?). So that’s probably not an option for you.
After reading these comments, I want to quit my job and work part time at Starbucks. Yum!
I hated BCBS when we had them for a year.
AJ says:
also, I have Aetna and love it. I checked out their website, and they have a link for buying plans for indivduals, I have no idea the terms or conditions, but here’s the link:
http://www.aetna.com//members/individuals/health/plan_details/California/
I’ve been happy with their customer service as well, it might be worth a phone call. Hope it helps!
Marti from Michigan says:
I live in Michigan too AJ. I work part time after losing a good job with good benefits in 2006. I don’t qualify at all for Medicaid because I make too much money. Yeah, sure!
Arial says:
We went through this, and the answer was the we had to find different jobs that provided benefits. In the here and now, it’s just what has to happen to get by unfortunately.
It does seem that you are able to take a lot of trips and stay in hotels, that is not something we can do, even with our good insurance. It’s also extremely expensive to eat out constantly. So maybe there is some cash in there somewhere?
Heather says:
Not that I have to explain myself to you, but 95% of the travel I do is work related. As for eating out, that never happens unless my inlaws are in town. We certainly aren’t reckless with our money, as you are implying.
We live a very simple lifestyle. Our cars are paid off, we don’t go on vacations, we shop at costco and use coupons. If I could find a job with benefits that paid as much as I make freelancing, PLUS enough money to cover day care, I would do it. I look all the time.
I’m glad you were able to get insurance. It’s a shame you had to find a different job to get it.
Jenny says:
I agree with you, Heather. You don’t have to explain yourself or your finances to someone else. Kudos to you for handling that comment with grace. That definitely deserves a “You go, Girl!”
Kristen McD says:
I was going to say… I don’t remember a lot of talk about eating out. I do remember cereal being mentioned a few times.
roshan says:
Oh, all that talk about eating out is on her other blog http://www.thespohrsarerich.com
There you can get totally blinged up photos of Annie too.
Jennifer says:
BWAHAHA. I wonder how many people are going to click that.
Adrianne says:
Heather, that’s exactly the point I was trying to make on one of my other comments here. People keep saying to “get a job with benefits”. Well, duh. If it were that simple, I’m sure you would have done that a long time ago. What they don’t seem to realize is that getting a job outside of the home adds plenty of other extra expenses, the biggest of which is child care which is very expensive for an infant.
Then on top of that, you’d have to have to pay for at least SOME of your insurance premium. I work for a huge company with excellent benefits. My costs are covered, but if I want to add dependents, it’s taken from my paycheck. I think that’s pretty standard.
So when you consider what it would cost to get a job outside of the home, you have to take everything into consideration. That includes child care costs, insurance costs, time away from Annabel, commute time (i.e. extra gas costs), etc. Add all of that up and you’ve probably got that insurance premium only you might not be making as much and you’ve lost irreplaceable time with your daughter. So what does that solve?
Anyway, I’m really sorry you’re going through this. I know exactly how you feel because my husband and I are talking about trying to have our first baby and one of the biggest factors is insurance. We need my job for insurance because it’s over $1000/mo for him to add me and a baby to his work plan!! So my dream of being home with my kids cannot be a reality at this time:( Good luck to you.
KT says:
Even if Heather DID take vacations and go out to eat, that still doesn’t validate the exorbitant amout of money insurance companies charge for premiums. Especially in Heather’s case where all her pre-existing condidions were pregnancy related and she opted out of maternity coverage. Your argument is weak.
KT says:
conditions.
mrs chaos says:
I don’t know all your personal/business details, but I’m wondering if you’ve tried the “group” insurance route since technically you own your own businesses. Sole proprieters should have several options. (Business license and tax returns are required, though. Again, I have no idea of your situation with regards to that.)
I wished you lived in NORTHERN CA. I would have more options for you.
Lisa says:
For about five years my husband and I were in the same boat. We were both self-employed (he was an insurance salesman (irony), I am a writer, both highly educated, hard-working people) and had to purchase individual insurance plans. We started out around $1200/mo with not so great coverage, copays, and huge deductibles, just like you are finding.
My husband had an unexpected surgery that cost us, in addition to our premiums, nearly $14K out of pocket. We paid all of it, but it HURT. Then Massachusetts passed its health care reform. We didn’t qualify for the state plan, which isn’t free, but is reduced (we made too much money), so we continued to purchase our plan, this time at $1k a month. We dropped dental insurance. My husband takes medication for a chronic health problem, which, with insurance, cost us in the neighborhood of $200/month.
I know I’m not laying this out as neatly as you did, but suffice it to say, it was a lot of money every year. More than many people make in an entire year. After five years we were just flat broke. We’d gone through all our savings and then some just to keep health insurance. And then the economy tanked and so did my husband’s income.
After a great deal of consideration we gave up and opted to take the corporate path. He just took a full-time job at a low, low salary just so we can get affordable health insurance. Our premiums are down to $400/mo, and should go lower once he hits a certain milestone, but I’ll tell you, he won’t be giving up this job anytime soon. Without it we would have lost our home.
I don’t know why people don’t understand that health care reform is going to help hard-working, income-earning, tax-paying individuals get access to health care, and preventative health care, which should ultimately save money in a multitude of ways.
I don’t want free health insurance, but I would like affordable health insurance.
Thank you, Heather, for bringing it to the fore, and for explaining it simply and well, so that others have a chance to understand exactly what a lot of us are facing every day.
Kim says:
HI Heather,
It is just outrageous what people who can’t get group coverage have to pay! I haven’t read through all the comments to see if this was suggested but my husband was self employed years ago and joined the National Association Of The Self Employed:
http://www.nase.org/Home.aspx
They offer group type benefits to their members. Good luck to you and Mike! I hope you can find a solution that works for your family!
Hugs,
Kim
Sue says:
My kids and husband have insurance. My husband through his employer, and my kids through the state of PA because his employer charges too much for us to afford financially.
But me? I cannot be added to my husband’s policy without sacrificing nearly my entire paycheck to the premium Gods and my employer is too small to offer insurance.
For $23K a year, you could probably afford paying out of pocket. That is, if you actually HAD that much to spend on healthcare.
I was dismayed to learn that I cannot get free care for a few years, too. That bites.
Hope you find a much more affordable solution soon!!!
Danielle says:
Hey there! Health insurance is ridiculous! Both my husband and I work, and we get our insurance through my company that I work for. We pay just under $900 a month for our insurance! This is even with my employer paying some!!! Over $200 a week comes out of my check,
My vote is definitely if you can swing insurance for all of you then you should. You just never know what tomorrow is going to bring…
Erin says:
i so feel for you !!! i know how awful it is to deal with insurance companies. my husband once worked for aetna and we were covered on my policy from the hotel i worked for because it was better and cheaper aetna policy the he got as an aetna employee (go figure) my other personal fav. was when i was going throu ivf treatments because i had blocked tubes from an appendix when i was a child, anyway the women told me they would not pay for ivf but that if i wanted stairalazation they would pay for that. then last week i was informed from our current provider cigna that we could not us either hospital 15 miles from our home, but had to travel 45 min. away to go to a hospital. and we have a top of the line policy now. Please let me know if you need any help. my husband and i know our way around insurance companies.
Amanda says:
I started reading this and wanted to scream, but honestly, and I feel awful saying this aloud, I am so tired o being angry at government and indestructible corporations that all I really want to do is cry. Numbers, unimportant numbers, and yet behind every number is a Maddie, or a Mike, or another impossibly precious person. Sorry, but sometimes the world just deserves a big WTF?!$%^&#%
Michelle says:
The only sure solution I can think of is for Mike to join the military so you can get TriCare. My husband has been in the military for 13 years and we have an 8-month-old daughter. This might sound ridiculous, but it will surely get you insured.
Michelle W says:
I find it completely outrageous but at the same time I would advise that if you can, insure all of you. As much as Annie is so precious to both of you, you are precious and vital to her too. In the meantime I hope a better solution presents itself.
Susan from PA says:
Heather I am sure you looked into something like this, but my husband and I joined a local Chamber of Commerce and were able to get Blue Cross Blue Shield PPO through them…Not sure if someone already commented on something like this for you, or if you have one locally. BUT, Mama has to take care of herself before she can care for everyone else. Remember who is supposed to put the oxygen mask on first on the plane???? Keep looking. Your situation and our health care options suck, but there has to be something. I’m keeping my fingers crossed.
Marie says:
Thank God I live in Australia that’s all I can say. I feel for you.
Yes, health care sometimes goes to lazy people who refuse to work. But it also takes care of people like Heather and Mike, genuine hardworking people who have had health misfortune in their life. That’s why we need it. It’s up to the government to get stricter on the unemployed and push them into the workplace. But to say they deserve to die is another thing. Or their children, who didn’t choose to have non working parents.
Jenny says:
I hope that you and your family find a solution. This is a miserable problem for so many people. I am always amazed when people don’t realize that health insurance through an employer is a benefit (in every sense of the word) and not necessarily always a right. I heard this on NPR and looked up more information on the web (so it must be true *smile*).
“Offering insurance policies to employee groups not only benefited insurers, but also benefited employers. During World War II, wage and price controls prevented employers from using wages to compete for scarce labor. Under the 1942 Stabilization Act, Congress limited the wage increases that could be offered by firms, but permitted the adoption of employee insurance plans. In this way, health benefit packages offered one means of securing workers.” This was further advanced by allowing the employer and employee to deduct the expenses for tax purposes but not requiring the employer to add payroll taxes since this is a “benefit” instead of a “wage”. However, if you ask someone how much they make they never add in the employer paid piece of insurance… even though some of these same people would be in the $20-$30k boat with you if they did.
I’m very grateful for the insurance coverage that I have. I wish you success in finding something that will work. It looks like there are a lot of great suggestions listed above.
Michelle says:
If any of you come up with the perfect solution to “pre-existing conditions” … let me know.. YOU HAVE MY VOTE in the next election !
As the mother of a preemie with a form of primordial dwarfism , I have my share of insurance woes!!! Stuck between working to my full capacity and having my son disqualified from his current disability healthcare OR living well below the poverty level so that he can see his 5+ specialists as needed and receive his medications which alone cost over $50,000 a year!!! I hear alot of rants concerning people who receive (or MOOCH as it was gracefully referred to ) government funded healthcare yet no realistic solution to those (especially children) who have no where else to turn !
Heather, I do pray you find a better solution for your family !!!! You have all been through so much and to have a healthy family without breaking the bank just seems like the very least you deserve! Just my opinion anyway! good luck mama!
Jennifer says:
Ok, first… what the heck is c-section REHAB?!
Heather,
I’m so sorry. I’m sorry you’re dealing with this BS on top of everything else. I’m sorry well meaning families like you are falling through the cracks in our health care. I’m right there with you. Hey, I wonder if they have take-out down here… cuz, ya know, you eat out all.the.time. ; )
Keeping my fingers crossed that you find something that isn’t so terribly high.
Vanessa Jordan says:
Heather,
I can’t believe what they want to charge you, that is so outrageous! I know what it like, I don’t have insurance, I can’t afford it. My husband had a heart attack and is in congestive heart failure. When he was in the hospital for two days after the heart attack, the doctor came in and told us his heart muscle was completely destroyed! He said the only way he would live was to have a heart transplant, so we asked what we needed to do, he said well where Mr. Jordan doesn’t have medical insurance… then I would tell you to get your things in order within the next 6 months! I thought I was hearing things, I just stared at him with my mouth open! I said wait Tommy is only 49 yrs.old, you can’t just let him die! Apparently they can, after searching everywhere, I found a hospital that had a program that would cover him getting a defibrillator because it was a life of death situation, now the doctors said when his heart stops, I have one hour to get him to an emergency room! I’m sorry its just all so cold and heartless! He worked all of his life. Now he needs constant care, I can’t work and can’t afford insurance on me. I had pneumonia and had to tough it out for over a month, I couldn’t lay down my lungs were so full, I would smother and choke, I really thought I may not make it, I woke up sitting up against my headboard with my 7yr.old holding the phone, crying, she said mommy I thought you were dying I was going to call 911, do you know how scared that child was, for her to feel better I let her call nanny to come over and check on me. She probably saved my life, I might have been dying, I sure felt like it!
I started a business at home where I can’t leave my husband, its by no means insurance, but it will save you money on dental,vision,medical, and chiropractic! Its a savings plan, its what I have, if you do have to go 6 months without any insurance at all, you may want to consider looking at it, it can really make a difference if you have to go in and pay all of that, its saves you anywhere from 25% to 80% on your services, that can really add up when it comes to some services that cost thousands, if you can save a couple thousand thats a couple thousand and thats a lot of money! A friend has it and she saved $100.00 on glasses!
The best part is they turn no one down, even people with pre-existing conditions, the only thing they won’t give you a discount on is dental work that is already in progress.It cost $14.95 for a single plan up to $39.95 for more benefits and coverage for everyone in the home!
I just thought I would let you know, you can go to my website and read all about it! I hope you get some coverage that is affordable, this may help if you do have to go uncovered, or with high deductibles! check it out see what you think!
http://www.mybenefitsplus.com/v.jordan
Betsy says:
Welcome to my world and why I have been fighting like a crazy person for HCR for the last several years. It absolutely makes my head implode.
Rachel says:
As a Canadian living in the States (and paying for American healthcare insurance through my employer), I will NEVER understand why so many Americans are against healthcare reform. I don’t see how it’s even remotely acceptable in “the best country in the world” for an individual or family to go bankrupt to be insured. And never mind the fact that even with coverage, the copays and deductibles can be astronomical. I don’t think anyone should have to go into severe and unmanageable debt just to remain or become healthy. And before anyone jumps on the “but how long do you have to wait in Canada?” bandwagon – do you not wait here in the ER? Yes, you may have to wait for some (many) elective tests and procedures in Canada but if you’re health and/or life are on the line, you’re not going to be forced to wait. I’m currently expecting and would give anything to receive a Canadian maternity leave – 52 full weeks. Instead, I get 12 weeks (which of course is better than nothing) that I essentially have to pay for myself by clearing out my earned PTO and EIB hours. Don’t get me wrong; America offers many wonderful opportunities – that’s why my husband stay here legally and pay our taxes. But healthcare is definitely something that needs to be reformed for all, and not just made into a Democrat vs Republican issue.
PM says:
as someone who lives in a much less well-off nation than the USA (Greece-enough said!) I can’t beleive that there are people, hard-working normal middle-class people who can’t go to the doctor for simple things such as ear infections, dentist visits, even have to count a certain number of years to be able to get pregnant!! (All things I have read right here on the responses to this blog post). Not to mention the other more serious health issues. Americans??? that can’t be! We see America as being not only the richest country of the world, but also that it provides the best of the best to its’ citizens. While we here indeed have our share of problems, no doubt about that, however I will say that ANYBODY can get treated, wether they are insured (because we DO supplement with private insurance, if you want to) or not. The public hospitals may not be the “best of the best” and trust me when I say they have their share of problems but at the end of the day if you need to be treated you will be! Suffice it to say that my son had to have hernia surgery a few years ago and we paid a total of 75 euros. Now, if we could get rid of all this national debt AND raise our salaries then things will be great! Good luck Heather.
chandan says:
Good to see another nice article on your blog
KT says:
Have you looked into limited insurance plans? I don’t know if they’re available in every state. I had to get on one recently because my regular insurance didn’t cover pregnancy (boo). It’s not major medical, so if something big happens, you’ll still pay a ton out of pocket, but from what I understand, the plan discounts your bill up to 70%, then depending on the plan you get you may get paid a benefit for everyday you’re in the hospital. I’m not a health insurance agent, so I don’t know the exact details. With my pregnancy I’m covered $150 for my first five doctor visits, then my hospital bill will be reduced up to 70% (50% is standard) and I’m paid a $750 beneift per day I’m in the hospital. I’ll still be out of pocket about $2000 when all is said and done, but it’s WAY better than nothing. I know limited insurance covers a lot of people with pre-exsiting conditions. You’ll have to see if there’s a company that offers it in CA.
Ug, insurance issues suck.
KT says:
Or, I think the plan will insure you if you have a pre-existing condition, but won’t cover that condition.
Julie Q says:
What a scary system. Luckily I live in New Zealand, where most of the health care is free. If you end up in hospital in the ICU, Emergency department, NICU – all of it free. Our tax is around 33% and with a population of only 4 million, we can still sustain it at a reasonable level or care.
Two of my sweet friends had their wee daughter in the NICU here last year for 8 months. Sadly she passed this time last year, but there were no charges involved in her care.
We know the transition must be scary, changing health care systems, but we hope that the US can lead the world in healthcare reform, and let average families know that their healthcare needs will be met without the treat of losing their incomes or homes.
Best wishes
Julie Q
New Zealand
PS – I love your blog – your story has touched many hearts.
Olivia says:
This issue suddenly became very real for me yesterday as I lost my job. Even though I am eligible for COBRA, it is still exorbitantly expensive for a new member of the unemployed.
The COBRA subsidy put into place by congress expired on May 31st. In many ways, I wish I would have been let go 10 days earlier so health insurance was more attainable. Pray that congress extends the COBRA subsidy long enough until they can find a more permanent solution to the health care crisis the country is currently facing.
Tara says:
I tried to scroll through to see if anyone mentioned this …
What about the government controlling the outrageous amounts the healthcare industry has been allowed to charge Americans for care/drugs? Healthcare is simply not affordable without insurance … and sometimes not even affordable WITH it. Even routine care (annual visits, vaccines, etc.) cost outrageous amounts … God forbid you get sick, pregnant or seriously injured. Insurance is charging crazy premiums in anticipation of having to pay 80% (or whatever) of an individual’s medical bills. However, if the medical bills were not so exorbitant, then maybe insurance wouldn’t have to be. Does that make sense?
I mean, come on …
– It does NOT cost $800 to insert a catheter
– 5 cc’s of Versed does NOT cost $540 to manufacture
– A 3-minute renal ultrasound does NOT cost $670 (not to mention the $250 radiologist fee)
– A 1-month supply of a cancer drug does NOT cost $5000 to produce (yes, I understand there is a lot of research that goes into developing and testing a new drug – but I think it more than pays for itself once it approved and goes into mass production/distribution)
– One NICU isolette does NOT cost $2045 a day to function … nor does it cost $1700 just for the space where it sits in the NICU
– A 15-minute consult with a specialist does not cost $550 ($2,200 an hour rate, really?)
(And the list goes on and on and on – I’m sure all of you have plenty more examples of the ridiculous & nauseating charges you have seen on your bills.)
All I am trying to say is that MAYBE the government should think about stepping in and controlling what the healthcare industry charges (and capping their profit margins)… and then MAYBE insurance premiums wouldn’t cost so much (for anyone/business) because healthcare itself would be more affordable – for EVERYONE! Hospitals are businesses run by CEO’s (not doctors) to make money … and as long as they are allowed to charge such outrageous & shocking fees, they will (duh). It’s shameful & despicable.
Tara says:
We need healthcare reform as a WHOLE – not just health insurance reform.
Sara says:
I wholeheartedly agree. My c-section 6 years ago cost $22,000 and the one last year cost $37,000. I don’t know of any other industry that is so ridiculously inflated and pumped up beyond all reality. What we need is monitoring and regulation of the healthcare industry, or we’re all going to be screwed.
blue says:
This is why I’m so pro health care reform.
The US does not like entrepreneurs.
People who work for anything other than a big company get hosed when it comes to insurance.
I would like to start a business. I can pay the startup costs. I can feed myself and my family and take care of every other bill until I can turn a profit. But I don’t have 23 thousand dollars to pay for insurance, nor can I risk the health of my family to pursue a dream when I’ve got stable income and insurance right now.
Entrepreneurs and other go-getters are better off in any other English-speaking country, and that embarrasses me as an American.
Christen says:
I work in Healthcare- Patient Accounts no less- and I can say I’m so torn up about healthcare reform. I don’t like what my patients that have Medicare or Medicaid have to go through. I would never want to be totally dependant on either one of those programs. The Medicaid program only allows for 12 physician visits a year. 12. Do you know how many visits someone who is sick can go through? And that’s not 12 per doctor, that’s ONLY TWELVE A YEAR. After that, in the state of MS, they refuse to pay for any more visits for a patient so patients have to pay out of pocket for their visits. If they could afford to pay $80-150 a visit, then they might not need the medicaid! Sigh. And do not get me started on the coverage of medicines in the Medicare program. So, I look at those programs and say no way. I don’t want government help.
But, then I look at the Tricare Military Program. Its ran by an insurance company, but funded by the government. That program is better and if we could guarantee a Tricare like program, then it would be great. I just don’t think the politians even know what kind of insurance they’d be giving people. That’s scary to me.
There has to be an answer. If BOTH sides could shut up and really come up with a solution, it could be great. I think the problem with the current reform bill is that it was a “My way or the highway” type reform and that is never good for anyone.
I like the idea of being able to create a company for you & Mike’s freelancing. I would think that could be a real way for you guys to fix your problem now… although it would take time. Good luck girl!
Lo says:
I was unemployed for about 4 months after my son was born. I applied for Blue Cross but was denied. I had no other option than to get Medicaid for those few months.
Now I have insurance through my job but I still can’t afford to insure my son. It was going to cost 6 x what I’m already paying for me. He is covered under Medicaid which has been a lifesaver considering several health issues he has.
I never thought I would be in this position but here I am. Good luck to you and your family. I hope you can find something affordable.
Emily says:
Hi Heather –
your post really hit home for me as well, and reading thru these comments has stirred me up even further over this issue.
my husband and i are in a similar situation, both independent contractors (he a dentist – does not own his own practice, i am a freelance classical musician). we have both worked tirelessly over the past few years to build our careers and buy a home and now are looking to start a family.
of course that is difficult when you are self-employed and have to pay for your own insurance – this past january i worked with an agent to find a maternity plan and found one with a 90 day waiting period (much better than most plans which are 6 mo to 1 year waiting period). in april, when the 90 days was up, i called to make sure i was covered and also to let them know about a change of address (we moved from Chicago to the suburbs – to the Indiana side, still considered a Chicago suburb).
well, they tell me that since we are crossing a state line, i will lose my maternity coverage, because it will be considered a “new plan” and they no longer offer maternity for new plans. i was so angry. i have been paying $360 a month for this plan (that has a $5,000 deductible for me and a $2,000 maternity deductible – this was just for me, my husband has a separate plan for him) to cover our future pregnancy. so they told me if i get pregnant in the next 90 days while the plan is being converted, they will cover it. needless to say, we’ve been trying very hard! but it’s horrible to have this deadline over our heads, and it has really put a damper on the fun and excitement of conceiving our first child.
while my husband and i make decent money and feel lucky to afford our health premiums at all, we don’t make enough to risk not having maternity coverage – especially if there were complications. i feel very angry that the health insurance industry gets to dictate my family planning in this way. my husband and i are also lucky to be young and healthy and not have to worry too much at the moment about exorbitant health care costs, but i worry a lot about the future.
i am going to look into a lot of suggestions from these comments – my husband currently doesn’t own his own practice but once he does we may be able to look into small business insurance, although i’ve heard the costs are exorbitant.
hang in there heather. know that you are not alone!
Sara says:
Honestly? If you have any way of getting a job at a corporate entity even at an entry level position, it’s worth doing for the benefits alone. When my husband earned only $500 a week just starting out in his current career, we had excellent health insurance because it’s what big companies have.
When he decided to go freelance to earn more money, we went on Cobra and it was $800 a month for a family of 3 with no health issues. Still, that was continuing our awesome coverage, so we did it for 6 months and it almost broke us.
Then, we went without insurance for two years while only insuring our daughter, G, and it was the stupidest thing we’d ever done. I broke my wrist and it cost us $2000 out of pocket for a trip to LA County. It’s not really an option, especially for someone with health insurance.
I’d say aim for a job that can give you benefits, even if it’s not a big shot career, since that’s what it sounds like you guys need right now.
Monique says:
I didnt know they had a guaranteed coverage plan. i just signed up with them for my state. i havent had coverage for almost 2 years due to being cut off at 25. i have back problems and had surgery for it in 2008. they granted me coverage but added a rider exclusion which means i will never be covered for my back even after the preexisting condition period. that my main concern knowing that i’m in pain and have been in pain for 3 years and i need treatment. i would like to have babies i dont want my back to be an issue when i do. i dont know if i can wait till 2014 for the new law. i am thinking about appealing their decision or canceling it all together. however the out of pocket expenses have already equaled up to 10000 this year. there has to be something out the for high risk people that starts now not years from now.
defendUSA says:
I am not so sure the new health care is all that, myself. But, have you considered this: Put aside whatever you have been paying for your current insurance. Go to your docs and tell them your situation. Many will gladly accept cash for the office visits(mine charges 55.) because they do not have to file for you. And that rate is lower than the contracted rate with any carrier…and better than what they are reimbursed in most cases.
And should you need a script or other stuff, ask about the availability of samples.
Join the Wal-green or CVS RX program for a fee, and if you know what drugs work for you, check the list. You’ll get away cheap. Annabel is generally healthy, so you could take her to your local health dept for her immunizations, cheap.
When enough time goes by, and they ask questions again, you can legitimately answer no to hospitalizations which may help.
I personally would fight the decision if you can, because technically, PPD, C-Sections, and even Mike’s hospital stay were all manageable conditions and not indicative of future risk over the long term- even the GD.
For example, we have depression and Mitral VP’s in the house…meds successful for depression, no job loss because of it, and no other issues that were not resolved in the kids.
I do not recall being asked about pregnancies, or anything related. But, it’s worth a shot if you can buy a little time with giving the “correct answers” !
Sometimes volunteering too much can screw the pooch. My husband did it with life insurance and now we can’t raise what the policies are worth should something happen to him.
Oy on that one. Just my two.
huv123 says:
I cant imagine what it would be like to make that decision. In Australia, I spend a little more than $2000 dollars a year for the top health insurance that covers private care and gives a rebate on most extras like dental and chiro. Since keeping the insurance is only dependent on my ability to pay the bill (and is not for ex. tied to a particular job) I will continue to keep it as long as I pay for it.
As a side point, it is very important to commit to health insurance early and continue to pay it (in Australia at least) – it is much harder for them to deny you once you are already member than if you are trying to get a new membership.
Tara says:
There should be low cost health insurance available for at least you and Annie through the state. Annie can get Medicaid. I’m sure others have said this. Keep calling, keep checking. You need to be insured and I hope you find a solution soon!
Tiffinie says:
Dear Heather: I have thoroughly enjoyed your blog. I wanted to give you some advice. I can surely understand your predicament as I also suffer from the same blood disorders as yours and am required to take blood thinners while I am pregnant (Lovenox). I noticed on your blog you mentioned a 4,000 deductible and your paying a very high price for the insurance, which sounds like to me you have been bamboozled by someone. Your paying for a “catastrophic plan” with a so called “health care plan” title. I learned some tricks along the way and thought I woulld share. We pay for a catastrophic plan (5,000 deductible) for each member or $10,000 for the family, 100% coverage thereafter. I’m sure your thinking that’s a large deductible! and it is. Not to mention no maternity coverage. There is no SUCH THING AS materinity coverage on a self pay insurance plan. However we only pay $270.00 for 6 people…6. Then we carry 3 supplemental plans in addition, a hospital indemnity plan, and 2 sickness plans. So my last 2 babies. I received $7,200 from my supplemental plans, which paid for all of my hospital and OB, you can carry this on everyone in your family and it hardly costs anything. Total we pay a month for everything is $350.00 (approx.) Look into, there’s Conseco and Aflac and several more and an insurance agent can help you for the state of California.
And I just have to say, I totally disagree with you that the Government is going to make healthcare all better. It’s too expensive, we’re broke and after watching this oil spill….we’re screwed. Just saying.
Kate says:
Oh dear! How on earth do you keep the plans all straight??…I have one plan – my Provincial Health Insurance Plan which covers me in the event of all illnesses requiring hospital stays, doctors visits, midwifery and/or obstetrical care, as well as community health needs such as homecare nursing or a personal support worker to assist with personal care at my home if I need it), and the list could go on. No worries about pre-existing conditions – I’m covered, no questions asked! When I need to see my doctor, I call the secretary, book an appointment, present my little health card and get seen – no doctor has to call my insurance company to make sure I am covered for a specific test – if it is deemed clinically necessary, it is ordered – plain and simple. Just a few bucks each month in income tax….I don’t even miss it on my paycheque.
Remind me again why people in the US do not want this system??
Mimi says:
Tiffinie good info. Thx.
Heather: I’m in the same crappy place you are re. insurance.
Anna: Wake up, 30 years ago my Dad, an independent contractor, took out loans & 2nd mtg’d his house to pay his employees hospitalization & union costs when the large big name company they did contract work for did not pay them. ONE MAN took care of 8 families. This health care system has been in the crapper for 30 plus years. Dad also had 8 kids at home to insure, he was a good moral man.
Mimi says:
Anna, and another thing…independent contractors don’t work when they want, or stay home and play 24/7. OH, I have so much I could respond to, but you’ve all said some pretty intelligent responses.
In this difficult world, we are all suffering.
I just wish people like Anna, could just be tolerant, understanding, open and compassionate.
Peace & good health everyone, love Mimi
Steph says:
My mom and dad are in a similar position. My mom has a serious back injury that happened after a fall at work. Her private insurance has never paid a penny for it. She had COBRA coverage through her work for the allotted time and now it’s expiring and they are forced to look at the Wyoming Insurance Pool which sounds exactly like what you’re looking at. It’s criminal and disgusting.
Janelle says:
I’m going to echo the advice to seek out a “major medical” or “catostrophic” plan that has a high deductible but lower premiums. It is what we have to do – I work 30 hrs/week and have no benefits, and my husband works full time for a small business that doesn’t offer insurance. Although we would potentially be looking down the barrel of $10,000 before our deductible kicked in if something happened to both of us, our monthly premiums are low enough that we take the gamble we’ll stay healthy, and just pay out of pocket for office visits. We carry a separate, more comprehensive insurance for the kiddos.
And, in my experiences, hospitals will work with you on a payment plan should something catostrophic happen that causes you to reach your deductible. (we negotiated our bill down by 30% just by coming in and stating that we wanted to pay).
Good luck, I hope you find a plan that works for you!
laura says:
Hi Heather,
Last night on eyewitness news here in LA they did a whole segment on health insurance and options after COBRA! I immediately though of you! Here is the link to the segment:
http://abclocal.go.com/kabc/story?section=news/consumer&id=7493592
and here is the link to a helpful website that helps people in each state explore their options.
http://www.coverageforall.org/
I hope everything works out for you guys. Good Luck!
Al_Pal says:
UGH.
The suggestion about alumni insurance was a good one!
I’ve gotten catastrophic-care [not preventative] through my alumni association before, and [for me, at the time, in my 20s] I got 6 months coverage for… less than a thousand, for sure. Closer to the mid-hundreds I think?
A lot of people seem to like Kaiser. I’m sure you checked them out though.
Good luck & hugs!!!
Robyn says:
Like the other Brits, I have to say this makes me so grateful for the NHS. I can’t imagine what it would be like facing a health crisis and having to worry about how we’re going to pay for it or what it will do to our premiums at the same time.
I went to a conference in the US with a some (british) friends and their daughter who has a rare genetic condition. I just couldn’t believe that some of the kids there had not been able to have necessary treatment because the insurance would not cover it (one farming family where paying a quarter of their wages and still had inadequate cover for their child).
I had an uneventful pregnancy and started out having a homebirth (on the NHS) until severe preeclapsia struck during labour, resulting in quite a complicated birth and recovery. Yes the food was a bit hit and miss and the decor pretty shabby but the care for my daughter and I was excellent, and it didn’t even occur to me how many thousands of pounds it probably cost until after. I truly believe a civilized society looks after all its members, particularly those most in need. I really hope that your family can find an affordable solution and thing change for you all over there soon.
VDog says:
We are paying $1266 for BlueShield Cobra for the three of us. It’s REDONK.
Moving is going to cut our health insurance by at least half. CA is REDONK.
I’m sorry this is sucking for you guys, too.
Two Makes Four says:
Holy shit. I don’t know what to say, but my eyes are still bugging out of my head at those figures.
I don’t know how on earth freelancers/independent contractors afford health insurance on their own. We rely BIG TIME on my husband’s Big Corporate-y Corporation benefits, which are AWESOME but we’d NEVER be able to get anything remotely close to it on our own.
Good luck.
Liz says:
Blue Cross is Evil. They denied me as well.
After exhausting my COBRA option, I was accepted by
California’s MR MIP program (major risk insurance).
Not sure if any of the previous 350 commenters
already suggested this to you as an option.
I pay just over $300/month for an individual plan.
It might be worth your time to do the application process.
As I recall it took a few weeks, even months, for MRMIP
to approve me/sign me on.
Best of luck, it can be frustrating, I know!
gorillabuns says:
we pay around $1000/month. only because I didn’t ask for back premium from BCBS for Thalon. We aren’t covered for shit except for you know, the big one.
We are self-employed and I don’t go to the doctor unless very necessary and my girls go to the doc in the box because we can’t afford to be cancelled since Thalon cost our insurance company around $100K after three days.
Terri says:
Heather after reading your experiences I have changed my mind on Obama’s healthcare plan. Like many people I’m afraid of change so I think that was a major part of my hesitation, but something HAS to be done. It is ridiculous the amount of money you are being charged!! My inlaws live in Turkey and I got sick there once with a horrid kidney infection, my father in law took me to the hospital where I had to wait an hour or so, but I got to see a urologist, who was actually the head of the department. That, and the medicine was around 10.00. They never asked if I was foreign or if I had insurance or anything, they just took care of me. My mother in law’s fear of getting sick while she is here visiting us is huge. She always says this is a nice place to visit but a horrible place to get sick in! The hospital I went to is the same one my nephew was delivered in. My sis in law had a c-section, she stayed for 3 days and the bill for her and the baby was 35.00. (not 3,500 or 35,000 or 350,000) but 35.00. The room wasn’t fancy, but it was clean, just a bed, small bedside table and a hideabed. They brought their own comphy pillows and blankets from home, and her husband brought a little tv in since one wasn’t provided. But for only owing 35.00 at the end I would have gladly given up the jacuzzi shower and flatscreen tv I had when my daughter was born. I hope you find a solution Heather, that sucks! And it sucks even more to be denied maternity. Every pregnancy is different, who knows what will happen. I hate it that insurance companies are taking over our lives and lining their pockets. It’s really not fair.
Rhonda says:
Greed…UGH!! I hate big government and every damn program they have doesnt’ work, healthcare probably wont either…but, we can hope. : ) Good luck, girl.
Tanya says:
We are fixing to be at our 18mth on cobra also and we tried to get back on our b/c and b/s policy also and i was denied for preclimpsia (which is pregnancy related) my husband was denied for sleep apnea (which is under control) and our daugther was denied for Agne….no joke! It is horrible to think that u can deny people for things that are beyone their control and especially things that are resolved issues….we are in the process of trying to get an 11mth extension because our micropreemie is on SSI so we can apply for it and b/c and b/s has denied the standard documentation which is the SSI Award letter stating when he became elligible saying it doesnt tell enough. they want the SSA office to hand write the date he became elligible…..what! Give me a break that is just a way to delay the process…..so hubby called the dept of labor and the governors office here in Louisiana and they are working on getting this resolved. ….if they don’t we are in trouble and it makes me very scared also…..this world is going crazy!
lucy says:
Wow your health system sucsk so bad!! How does such a big country get it so wrong.
In Australia we have free healthcare for all no matter what your health history is. Also you can buy insurance to use the private system so it won’t cost you so much if you want to see a private dr/hospital etc and once you’ve waited the 12mth waiting period it doesn’t matter what preexisiting conditions you have, your covered. (how much your covered depends on what level of inusrance you buy) It’s like no more han 2000 a year or something for middle range cover.
The insurance companies you have over there are criminal! And hospitals not treating you unless you have the right one is worse then criminal. I sure hope this health reforme in 2014 mkes things better. I mean how can they punish you for the things that go wrong with your health. it’s not like you caused it by smoking or drinking etc. Just wow!
leigh says:
i am just seeing this, but i wanted to tell you that i was denied by bcbs for the exact same reasons and then given a second option (like you) with extremely high, high premiums. we ended up going with goldenrule through united health. they took me, even though i had gestational diabetes and hyperemisis. no maternity coverage – but a premium i could handle for myself and my daughter. just a suggestion. hope you found something. i definitely sympathize. all my best.