Tuesday, March 23, 2010

It's Never Too Late To Make Something Right

I'm one of those people who got fucked by the health insurance industry. At the time, I was in my forties. I had a decent income. But it turns out I had a pre-existing condition, as defined by the healthcare peeps. It wasn't cancer. It wasn't diabetes. It wasn't MS, Parkinson's, or Lupus. It was my job. 
      When I was still working for a big ad agency, I went to see a counselor because the stress of my job was making me crazy. [Okay, crazier.] 
      Coincidentally, a rep for a production house came in to screen a new director and we got to talking about health insurance. She said whatever you do, don't ever put in a claim for therapy sessions, because if you lose your job or go out on your own, you will be denied health insurance. 
      So I began to see a counselor about my crazy-making job, but paid for everything out of pocket.  After leaving the agency, I applied for sole proprietor insurance. I was eligible for a good package with Prudential, $200 a month, only four times as much as I was paying when I was covered by group insurance, but manageable. 
      Around the same time I had a physical. During a conversation with the doc, as he's taking my blood pressure, hammering my knees, and thumping my back, I mention that I had been going to therapy sessions because my job had been causing me so many problems, but when I left, the problems went away, so, ta-da! I didn't need a therapist any more. 
      A few weeks later I get a call from the insurance company. "Are you still seeing a therapist?"  Holy crap, how do they know that I even went to one? Because my doctor wrote down our conversation in my records. Which were sent to the insurance company when I applied for the new insurance. "Am I seeing a therapist? Not any more. But I paid for that out of my own pocket." "Well, we're still required to pay."  "But you don't have to."  
      It didn't matter. I was denied insurance through Prudential because I had done what a lot of people are told to do -- I sought help for a stressful situation. Not schizophrenia. Not drug, alcohol or sex addiction. Or re-hab. Something temporary, that went away when the source of the stress was gone. Something I paid for by myself, hoping not to draw the attention of the healthcare companies, based on the warning I got. Something they didn't even have to cover, since I never filed for reimbursement.  
      Except my doc ratted me out -- inadvertently, he claimed -- and when I told him the disaster his allegedly innocuous notation on my record had caused, he was stunned. 
      Now the only sole proprietor insurance I could get that had reasonable coverage would cost me over $600 a month. Those dollars are from 20 years ago. I didn't have that kind of money.  So I settled for such a high deductible that my insurance coverage didn't kick in until I had forked out enough for a new car. Not just the down payment for a new car; the whole car. 
      As a result I had to wait almost a decade before I could afford to get new hips through Medicare, our government run medical insurance plan. If the reform bill had been in place, I wouldn't have wasted ten years of my life wondering if I would ever walk right or feel normal again. 
      So thanks, Mr. President. Even though the reform bill is not perfect. It's a damn good start. 

4 comments:

EmcogNEATO! said...

I had seventeen years of Baptist training, so forgive me if the only way I can think of to register my agreement is, "AMEN!"

Here's to starts!

Donna said...

Thanks for the info; Cliff and I will avoid any and all counselors. I'm just glad I got my new improved boobs.

Paula said...

Yes, THANK YOU OBAMA!
It's about time we did something about our shameful health insurance system.
I'm an expat RN living and working in Sweden - land of national health care. Happy that we have finally begun the journey back home too!

Chris said...

"I'm one of those people who got fucked by the health insurance industry."

Avoiding any comments about the new hips....promise :) ;)

What? You set me up for that one!