Posts Tagged: health insurance

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12
Jul 10

Health insurance

I am sick as hell this week.

I suffer from severe allergies, which means that I am sick pretty much all of the time. Except, I’m not “sick” as in “contagious” or “diseased”. I’m just severely allergic. Those of you who have friended me on facebook might recall a few times when my status read “…is having a good day”. This usually means I can breathe fairly easily, my eyes aren’t itching, my sinuses aren’t on fire, and I have a slightly larger range of food that is safe-ish for me to eat that day than usual. My version of “I feel pretty good today” would make the rest of you cry, and call in sick to work, and sleep all day long.

This is my reality.

As a result of having so many severe allergies for…. well, forever, I’ve become an expert about what is going on with my body. This means that when I have a few days in a row where my sinuses hurt, I’m exhausted, my throat is sore, my stomach is bothering me, and other non-allergy related symptoms, I know without a doubt that I am actually sick.

I’ve been really really sick since Wednesday, July 7, 2010. After days of drinking lots of fluids and sleeping more hours than one would think the human body was capable of doing, and trying to “fight it off”, I’ve realized that I’m going to need medical attention this time around.

As I may have mentioned before in this blog, I have no health insurance. I live in a country where only those people lucky enough to be employed in jobs that not only offer health benefits, but also give a person enough hours to be eligible for those benefits, is allowed to have health insurance. I had health insurance when I worked full time in a bookstore. I had health insurance when I was working as a teacher’s aide in Special Education. When my job as a teacher’s aide disappeared, so did my health insurance.

Shawn and I have been living since September of 2009 without any form of health insurance. None. Zero. Every medical expense, every doctor’s visit, every prescription for medication since than has been out of pocket expenses. Yes, I did receive information about the COBRA plan that was supposed to, potentially, extend my health insurance benefits after my job ended. However, the amount of money COBRA wanted was more than we could afford to pay. It was more than I was getting from my Unemployment Insurance Benefits. It was not an option.

Today, we went to the MedStop, which is one of those walk in, no appointment needed, medical clinics. Some people who had insurance didn’t have to pay one single cent to the MedStop. Most people paid ten dollars. One guy had to pay fifteen dollars. How much did my doctor’s visit to the same MedStop cost? One hundred and fifty dollars. Out of pocket. Or, I should say, out of credit card.

I remember hearing President Obama talk about health care reform, but have yet to personally experience anything relating to health care that actually helps me. Perhaps help is on the way. There is a now an official website put up by the U.S. Government that has information about health care.

Now, I haven’t read through this entire site yet. I’m not sure how much of it I would understand, as sick as I am right now. But, I am of the impression that somewhere, in all those links, is a way to get affordable health insurance.

At least, this is my hope. If anyone who reads this blog has managed to get affordable health insurance as a result of using that government website, please leave a comment, and let me know. I’d like to see some evidence that this is helping people, instead of just looking as if it might, possibly, potentially, help some people.

Also, excuse the typos and strangely formed sentences that may appear in this blog. I am too sick right now to do much in the way of proofreading. Hopefully, I wrote coherently enough so that those of you who read this blog can find the health care link I embedded somewhere in there.

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21
Mar 10

Help is on the way?

In case anyone was wondering, I did, finally, recover from the sinus infection that I had when I was writing my last post. I decided to just stay home, drink lots of water, and sleep, instead of making an incredibly expensive doctor’s appointment that I would have difficulty paying for. I got lucky, and this worked, this time around. I am all better.

In the news lately is talk about Obama’s Health Care plans. While it seems to me that nothing is set in stone just yet, I am excited by what I am hearing so far. An article titled : “A look at the health care overhaul” , by the Washington Post, does an excellent job of explaining the changes we can expect to occur if Obama’s Health Care Plan happens.

Here are a few key points that make me, a person who lacks health insurance due to the loss of a job, very happy:

* “HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.”

Yay! Finally, most of us are going to be able to get health insurance! More of us will be able to go visit doctors when we get sick, and afford the prescription drugs required to make us healthy!

* INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.

In my opinion, if you are so poor that you are using Unemployment Insurance benefits in order to survive, you are “low-income”, and will be exempt from paying a fine. Few people are getting enough money from Unemployment Insurance to entirely pay all of their monthly bills. No one is living well on Unemployment Insurance.

* “EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers’ coverage. The $2,000-per-employee fee would be assessed on the company’s entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.”

Oh, how I love this idea!

It has become common practice for large corporations to intentionally keep their employees just a couple hours under “full-time”, so that the big corporation can refuse to offer these employees health insurance. It has also become common for large corporations to take more and more work hours away from their full time employees who do have health insurance, so that these workers will be forced to seek a job someplace else, if they want to be able to keep paying their bills. I’ve seen this happen, and I’m certain that at least some of you reading this have seen it too.

These same large corporations would claim that they simply couldn’t afford to offer all their employee’s health insurance. Somehow though, these corporations think it is acceptable to insist that the employees who are too sick to work, and financially unable to see a doctor, come into work anyway, if they want to keep their jobs. Making that “sales plan” is more important to these corporations than the well being of the workers whose efforts make those sales happen. It’s disgusting.

I love that the government isn’t forcing these nasty, greedy, selfish corporations to provide health insurance to it’s workers. Nope! Instead, the government is going to fine these corporations if they decide not to do so. Each worker, even the part time ones, who select the government’s health insurance plan because the company they work for isn’t offering them one, or because the one their company offers is too expensive, means one more fine placed on that company.

I have always believed that one cannot legislate morality. People who do not give a damn about other people are not going to suddenly grow a conscience, simply because a law was created. The people who make the decisions at these large corporations aren’t suddenly going to say “Oh my goodness! I should have been providing health insurance to all of our employees all along, because it’s the right thing to do!” It just doesn’t work that way.

All these people care about is money. The government is offering a choice. What costs less? Offering ALL of your workers affordable health insurance? Or paying a fine for ALL of the workers you refuse to offer affordable health insurance to, who are turning to the government to provide what you refuse to? It’s called “negative reinforcement”. You provide a negative, uncomfortable, undesirable stimulus whenever someone chooses a behavior that you don’t want them to repeat. In order to avoid experiencing that negative thing, a person will instead do the good behavior that they should be doing in the first place.

That noise that sounds when you start your car without clicking your seat belt is an example of negative reinforcement. You don’t hear a verbal suggestion from your car that says “put on your seat belt…. put on your seat belt”. You hear an annoying noise that you want to make stop, and so, you quickly click your seat belt to make it go away. It doesn’t matter if you wanted to put on your seat belt when you entered the car, or if you think that seat belts don’t really save lives. You made the wise choice anyway.

I love the idea that soon, (perhaps sometime in 2014), no one will have to stay in an awful, soul-sucking job, simply to continue to have health insurance for themselves and their families. There will be another option.

I love that soon, big corporations will be prevented from playing the games with people’s lives that they do right now. How many of you have been in a job interview where you were assured that this company offers it’s employees health insurance, only to later find out that you are not eligible for it, and there is nothing you can do to change that? Anyone else been in a job where the manager entices you to work harder, so you can get full time hours and be eligible for health insurance, when in reality, the manager has no intention of ever giving you enough hours to make that happen? Anybody else transfer from one store to another, and lose their health insurance in the process, even though you were told that would not happen? Have you ever panicked because, suddenly, the company health plan will cost you more than you can afford to spend? Have you had the experience of suddenly discovering that the employer offered health insurance plan will no longer cover, or even provide a discount for, the prescription drug you need in order to stay healthy?
This is the kind of nonsense that has to stop!

It is my hope that this new way of providing health care will actually help people, so that more American’s can have healthier, happier, longer lives. We are all going to have to wait and see what really happens. For now, I have hope for a better future.

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23
Oct 09

A COBRA in my mailbox

I’m starting to develop a phobia involving mailboxes and important looking documents from places with acronyms instead of names.

In a recent blog post, I mentioned COBRA insurance. This is basically a supplemental insurance you can purchase if you lost your job, and as a result, lost your health insurance along with it. In the previous blog, I was talking about how these plans are too expensive for unemployed people to be able to pay for.

This is why so many Americans have absolutely no health insurance right now. Perhaps the government expects us to all start praying to St. Jude, Patron Saint of lost causes, that we don’t catch H1N1, get hit by a bus, or have a stroke from the stress involved with being unemployed, and wind up in the hospital. If this happens to me or to Shawn right now, there is absolutely now way we would be able to pay the hospital bills. We would lose our (Mobile) home.

COBRA is supposed to provide help for unemployed workers. A fat envelope from COBRA arrived in my mailbox today. Let’s see what it has to say, shall we?

* “The cost of COBRA is 102% of the rate upon loss of coverage.”

* “You should pay the entire premium due at the time you send in the Enrollment Form.”…. “The COBRA benefits will not be activated until the payment and signed enrollment form have been received by SCIC”.

* “Rates are subject to change due to benefit modification and/or October 1st renewal”. This is written in bold. I have received this letter on October 23, 2009, and it was dated October 21, 2009. Does this mean that the rate I see on the next few pages is correct, or is that now subject to change? I became unemployed September 25, 2009. Should I assume that since I have been sent this COBRA information pack that I am actually eligible for the health insurance benefits it is talking about, or, are my benefits already gone because I wasn’t able to pay them anything on October 1, 2009, because I was no longer employed there?

Why am I getting this letter nearly a month after I lost my job? Shouldn’t they have sent this to me right away?

Here is a paragraph that makes me question the integrity of the whole deal:
” To help keep Californians informed about their health care options the California Legislature has required that the following wording be included in this letter: “Please examine your options carefully before declining this coverage. You should be aware that companies selling individual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely.”"

Translation: “We are only telling you this because we are required to by law. You better pay us the 102% of what you were paying before you lost your job. Other health insurance companies might not take you at all!”

I am warned that this COBRA rate is only for health insurance, and it excludes dental and vision care. If I want dental and vision care along with the general health insurance, I have to pay extra.
* “Premiums for State Continuation of COBRA will be at 110%.”

This is all on page one of the packet of information I got in the mail today. Page two is called “Summary of the COBRA Premium Reduction Provisions under ARRA”, and is nicely centered at the top of the page, in bold print. Two governmental looking symbols appear on either side of it.

The first paragraph informs me : “President Obama signed the American Recovery and Reinvestment Act (ARRA) on February 17, 2009. This law gives “Assistance Eligible Individuals” the right to pay reduced COBRA premiums for periods of coverage beginning on or after February 17, 2009 and can last up to 9 months.”

Who is an “Assistance Eligible Individual”? If it’s you, then you:
* “MUST be eligible for continuation coverage at any time during the period from September 1, 2008 through December 31, 2009 and elect coverage:”
Check.
* “MUST have a continuation coverage election opportunity related to an involuntary termination of employment that ocurred at some time from September 1, 2008 and December 31, 2009:”
Check.
* “MUST NOT be eligible for Medicare AND”
Umm… I’m not eligible for Medicare myself, but my husband is. He gets disability benefits because he is legally blind. Does this disqualify me now?
* “MUST NOT be eligible for coverage under any other group health plan, such as a plan sponsored by a successor employer or a spouse’s employer.”
Um… I haven’t even started working my ten hour a week part time job yet. I don’t have any idea if I qualify for health insurance through them.

Nowhere on this page does it tell me how to find out for certain if I qualify for the ARRA discount in rates. How do I prove to my employer that I qualify for the lower rate?

Page three is a form to fill out called “REQUEST FOR TREATMENT AS AN ASSISTANCE ELIGIBLE INDIVIDUAL”. Here are a series of questions for me to check “yes” or “no”. If I can honestly check “yes” to all the questions, it looks like it gets sent to my former employer, and then they have to fill out the bottom half of the form.

Their part of the form says “REASON FOR DENIAL OF TREATMENT AS AN ASSISTANCE ELIGIBLE INDIVIDUAL”. They can check any of the boxes next to the four questions to deny a person the discount Obama offers. There are four questions.
1. Loss of employment was voluntary.
2. The involuntary loss did not occur between September 1, 2008, and December 31, 2009.
3. Individual did not elect COBRA coverage.*
4. Other (please explain).
The * connects to something called an “ADDITIONAL ELECTION PERIOD”, which means something like “second attempt to get COBRA and the discount”. I don’t like this “other” question. My former employer can check “Other” and write “Failure to complete the Probationary Period” or “Didn’t have Specific Skill Set”, and can legally screw me all over again, for the same event, twice. They will save themselves money in the process of denying me a discount on the cost of continuing their health insurance. I don’t trust them NOT to pull something like that.

Somewhere beyond more pages of forms to fill out is a page that tells me what, exactly, COBRA is going to cost me. If I would like to continue to have health insurance, and dental insurance, and vision insurance, it will cost me $634.34 a month. If I ever see a check from Unemployment Insurance, it will be for about $720 each month.
$720 – $634.34 = $85.66 to “live” on. I can’t afford to do that. Now, if I qualify for the ARRA discount, then I would be paying only $222.02 a month instead. This is still way to high a cost!

The last page starts with a paragraph I find threatening.
“Because the COBRA law does not allow for any break in coverage, your coverage will be retroactive to the date you became ineligible due to termination, retirement, death of the employee, divorce, or loss of dependant status. Therefore, premiums must be paid back to your qualifying event date (see page 1), even if services were not used.”

Translation: Pay us, right now for the month we sat on our asses and neglected to give you this form. We know that your doctors office and pharmacy denied you use of the COBRA insurance you hadn’t had the chance to sign up for yet for this month. Too bad! We don’t care! Pay us right now for the month we sat on, and the month about to start.

Now, remember earlier, where it said that “The COBRA benefits will not be activated until the payment and signed enrollment form have been received by SCIC”? Check out this little scheme:

*Amount Due if Enrollment Form Signed And Received In Our Office: 10/ 31/ 2009: $634. 34

* Amount Due if Enrollment Form Signed And Received In Our Office: 11/ 30/ 2009 : $1,268.68

* Amount Due if Enrollment Form Signed And Received In Our Office: 12/ 31/2009: $1,903.02

* Amount Due if Enrollment Form Signed And Received In Our Office: 01/ 31/ 2010 : $ 2,537.36

The longer I wait to give them the money they demand, the more money I have to pay. I got this letter on October 23, 2009. It will be impossible for me to fill out these forms, let the US Mail send the form to my former employer, and assume my former employer is going to get right on helping me out with that. If they stall, then I owe more money, AND I cannot use the insurance until they get paid the entire owed amount FIRST!

There are phone numbers I can call, and websites I can visit in regards to this, but I’m not intending to. I, like many Americans, cannot afford to use the COBRA insurance, even if I do end up being able to prove that I qualify for the discounted rate. Let’s hope I don’t get hit by a bus before I am able to qualify for whatever health insurance plan my new employer will offer.

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20
Oct 09

Scarier than Halloween could ever be

I am starting to question if I should continue to read the random news articles I accidently come across as I browse the internet. I know it’s not a good thing to intentionally decide to bury my head in the sand, and strive to maintain ignorance about what’s going on in the world right now. I just wish the news wasn’t so incredibly depressing and scary for the unemployed.

Here is an MSNBC article I came across without wanting to. The title, in red print, the color of blood, screams out at us: “High jobless rates could be the new normal”. Shocking!

In short, this article is trying to tell us that the job markets that got America through previous recessions simply don’t exist anymore, and therefore cannot save us now. The auto industry, for example, has been decimated. The construction industry can’t hire more people because the housing market collapsed, taking away all the construction work that they would be hiring people to do.

It goes on to say inspiring quotes such as:
* “The job market is caught in a vicious circle: Without more jobs, U.S. consumers will have a hard time increasing their spending; but without that spending, businesses might see little reason to start hiring.”
Translation: No job for me, and no job for you either. Or for you… or you… or you… or the rest of you.

* “Many of the 7.2 million jobs the economy has shed since the recession began in December 2007 may never come back.”
Never? Should I begin making plans to leave the country right now? Could you point me towards the countries you shipped the jobs to a few years back?

* “So far, they’ve been unable to win even a simple three-month extension of unemployment insurance for people in states with jobless rates above 8.5 percent.”
Right, because all those people in Congress have jobs. They have jobs that will give them a nice fat standard of living when they no longer have the job, so they have no reason to care about extending unemployment insurance for the less fortunate.

Oh, right! All us unemployed people are sitting at home on our couches, watching Oprah, and eating bon-bons. We all must be out of work because we are lazy, and it’s got nothing to do with some states having “jobless rates above 8.5 percent”. How could I possibly forget that! When I think about what must be happening in Congress when these types of financial aide plans are considered, I see them sticking their fingers into their ears, and singing “I caaaan’t hear youuuu! I caaaan’t hear youuuuu!”

This is another MSNBC article. If you get laid off, you generally lose your health insurance, in the blink of an eye. (Yay, America!) There is something called COBRA, which is a way to extend the health insurance that you lost because you no longer have a job.

“Officially known as the Consolidated Omnibus Budget Reconciliation Act, COBRA allows workers to remain on health insurance plans offered by their former employers by paying 100 percent of the cost, plus 2 percent in administrative fees. But for many, COBRA insurance is too expensive, costing thousands of dollars annually. “

President Obama signed a new law called the “American Recovery and Reinvestment Act” in February. This is supposed to offer people who got laid off a 65% discount on the COBRA insurance. It sounds like a good thing, but, this article points out, it’s not working so well in reality.

Why? Most people do not know that the discount exists, or how to go about getting it. It turns out a lot of employers are not telling their employees about it, so the employer can avoid paying extra on health insurance for an employee they no longer want. Either these companies are stingy, or evil, or a heady mixture of both.

Some companies have yet to train their Payroll departments in how to give former workers this discount. We all know that the excuse “but I didn’t know any better” always goes over well in court, right! Perfectly acceptable!

The woman in the article had a different problem. Her former workplace “accidently” had her in their system as “leaving the job voluntarily”, and so, she was denied the discount on the COBRA health insurance extension.

One can only qualify for the discount if you left the job involuntarily, and not because you did something completely egregious and inane. You can’t, for example, smack your boss upside the head with the expense reports he wants you to duplicate in triplicate, get fired for it, and expect to get the COBRA discount. But, if you get laid off, due to budget cuts, or due to the company deciding to downsize, or because they simply don’t want to continue to pay somebody who earns as much as you do anymore, you should be eligible for the COBRA discount.

It’s no longer acceptable, in legal terms, (we all know that “morality” and “workplace” don’t usually meet), for stingy employers to fire somebody, and then inform that person that they should go preform an impossible sexual act upon themselves when it comes to paying for health insurance. It’s good to put a stop to that kind of behavior.

Oh, except for when the more vile companies find little loopholes that allow them to cheat. The woman in the article was “accidently” entered into the system as “left voluntarily”, not as “fired” or “laid off”. She had to put up a fight to get the COBRA discount she deserved. How many companies across America do you think are playing that little game right now?

Both of these terrifying articles are ones I found on MSNBC. Maybe MSNBC is something I should avoid reading. What about something more respectable? How about Forbes dot com, for example.

Blogger Loses Unemployment Benefits After Making $1 A Day in AdSense Pay. Oh, crap!

It says here that “the New York State Department of Labor, which recently declared a laid-off attorney ineligible for unemployment benefits because she was bringing in $1.30 a day from blog ads through Google AdSense.”

Seriously! She was making a whopping $1.30 a day. Yes, that decimal point is in the correct place. What’s that come to, if you work the typical five day work week? The calculator on my computer says it comes to something like $32.50 a month. (Do correct me if I got that wrong). The New York Department of Labor thinks someone can live on about thirty bucks a month? They have lost their minds!

Now, if she picked up a “regular” part- time job, (ahem, flipping burgers), she wouldn’t have completely lost her unemployment benefits. Instead, they would have reduced her benefits, to compensate for the pittance she was making at her part-time job. So why is she being punished for the sin of blogging?

This article says: “The state, it appears, can’t decide whether the income from the blog was residual or was daily employment. If the former, it does not reduce jobless pay; if the latter, it does.” Wonderful. States are having problems dealing with the changing job market, now that they have cut away damn near all the “regular” jobs. States don’t want to allow people to make a few pennies online, no no no! Clearly, the government thinks it’s more beneficial to America if people such as this former lawyer, who has a college degree, and has passed at least one bar exam, is flipping burgers somewhere, instead of writing something for people to read, for free, online!

Are you a blogger making a few pennies? Are you unemployed? Watch out! Big Brother may decide to punish you for it. Thou shalt not blog!

Reading articles like these is making me feel like being on Unemployment Insurance is like being forced to play a game with your older, mischievous, brother, on a rainy Sunday afternoon. You would much rather be outside, doing something you enjoy, but you can’t do that now. This game looks complex, and dull, and in your gut you are certain that you won’t enjoy playing this game one bit. You found the rule book, but it’s not written in English, and it’s missing a few pages, causing you to rely entirely on your rotten older brother’s word in regards to the rules. Your chance of winning is nearly non-existent, but you have no other choice, except to play.

I think I’m going to avoid reading random news articles for a while.

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28
Sep 09

Nice Timing!

The day after I got the “Letter of Doom” in the mail, (the one that informed me that my job was gone), I got mail from Anthem.
Anthem

Anthem is the name of the insurance company I had before I lost my job. Employees where I used to work were able to have some of their paycheck taken out in exchange for the ability to have health insurance. No job pretty much means no more health insurance. I am going to have to figure out what to do about that sometime soon.

Irony: Brand new health insurance card from the health insurance I get through my job arrives in the mail the day after I get a letter in the mail informing me I no longer have a job.

The universe is laughing at me.