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25 July 2013 @ 04:49 pm
My Life According to Health Insurance  
Since childhood, health insurance has been in the passenger seat, co-piloting my path in life.

First off, let me say, this is not a tragic case. I was a kid with a serious pre-existing condition, and I never had to go without necessary medical care. My parents were often un- or under-employed, but they are educated, resourceful and lucky. They made a lot of sacrifices to get me the care I needed (with the bad jobs they stayed in for continuing health coverage, with putting medical costs above everything else in the budget, by countless other things), but they were able to get me care, which is more than many families who have to sacrifice more and are left with less.

I was on state-assisted health care through most of middle and high school, which didn't cover prescriptions. My parents spent untold hours on the phone haggling with insurance companies for treatment coverage, and I had to ask every doctor I saw for samples. I learned to fill out Proof of Hardship forms and wrote a lot of pleading letters to the executive offices of Pfizer and Glaxo-Wellcome, telling them what a good student I was and an athlete and how hard I worked to manage my severe asthma and how my parents are unemployed, which was the way to request complimentary "compassion" meds in the 90s. I fucking hated constantly having to justify my worth to powerful strangers, and I always had in my head — if I convince them to send me a $200 or $400 or $50 inhaler that I need, it won't be sent to another person who also needs it, and what if that person is sicker, poorer, or a more promising human being than me?

I got it drilled into me: You can never be without a job that has healthcare. Never have a gap in insurance, not even a day. I needed a career that was always in demand by corporations, and insurance was always much more important than pay.

I'd always get angry when people told me I could be the author I'd wanted to be as a child, or should start my own business based on a good idea, because I knew I was forever handcuffed to an office desk by Advair, Albuterol and the looming possibility of hospitalization, no matter how talented or diligent I was. I was so jealous of my healthy sister, who just walked into Kaiser Permanente and paid $95 a month for independent health insurance. She could do ANYTHING she wanted with her life!

I did all the right things — got a job with benefits, changed to in-network doctors every year, chose less expensive medication options whenever I could, and I still racked up a ton of debt from co-pays, coinsurance, and those fucking deductibles that hit at the beginning of every single year (When I was 24, I had a $2K individual deductible plus a $1K prescription deductible, and at 25 my monthly premium cost was over $500). Out of pocket medical stuff was like a mortgage – over a third of my income. (Not gonna lie, I was actually proud of that at the time because I was taking care of my own medical costs, if on credit. LOOK AT MY HARDSHIP AND INDEPENDENCE!)

Fast-forward to this month. I made the terrifying decision to resign from my Good Corporate Job when my FMLA ran out to take care of my mom while she goes through Ovarian Cancer 2: Chemo Boogaloo. I'm happy that I can pay her back for some of those times she drove me to the emergency room. One of my admin friends who got laid off from my former company in December told me that the COBRA option they offered cost $2,200/month, which is way more than our monthly take-home pay was when we worked for them. So I stocked up on my prescriptions (thank goodness the company took out a cheapo health insurance policy for this year with required mail order pharmacy!) and prepared to have that insurance gap I was never supposed to have, and crossed my fingers that I'd be able to buy insurance in Massachusetts with a pre-existing condition and a coverage gap of however many months it would take before residency and insurance would kick in. (I also hoped that coverage would cost less than $2,200, or, you know, more than I will ever make in a month.)

Part of MassHealth (the state-level model for the Affordable Care Act before congress got through with it) is a patient advocacy office in every hospital to help people get signed up for healthcare. It's a state requirement that almost everyone be insured, and these people help you find and apply for the right plan for you. I trooped to my cute rural hospital today with a notarized letter stating I live in Massachusetts now and my final pay stubs, proof of insurance, utility bills, and my pitch (like those old Glaxo-Wellcome letters): I grew up in this town! I'm such a good person! I'm here taking care of my mom, who has paid Massachusetts taxes for decades! My dad is friends with a guy you went to high school with!

The lady asks if I'm making any money now. "No, but here are my final pay stubs from May." She doesn't need them, just asks what I made in 2012. I tell her – I think it's a lot for this area, since I was working in a city with a higher cost of living – and she types it in and starts printing final forms for me to sign. "Should I tell you about my health history, or will I write it on the application?" That doesn't matter. Nobody needs to know. Unless I'd like to tell her about it so she can give me moral support, she jokes. Sign here, and here. I do. "How long until I know if I've been accepted?"

She smiles, and says that just by signing the form, I'm already covered for emergencies. In three weeks, I'll receive a note in the mail – she shows me what it will look like, minus my ID numbers – and then I'm completely covered. Pick a doctor, call a toll-free number. I won't have to pay premiums. It's free.

She adds, "Welcome home."

It's free. I'm covered right now. FOR FREE.

I didn't have to show proof of hardship, or write a begging letter to showcase why I'm more deserving than other applicants, or read out my whole medical chart, or even show my history of on-time insurance payments.

On my way out of the hospital, I pulled over and cried. The gardener nearby probably thought I was in the hospital to visit a dying relative. They're giving me health insurance, just for being a human being.

Thank you, Massachusetts.

(For those not from here and wondering about my lj-cut text, schoolchildren have to learn John Winthrop's City on a Hill speech. He was one of the Puritan founders of the Massachusetts Bay colony in the 1600s. All the eyes of the world are upon us, if we shall fail to do justly, love mercy, and walk humbly in the eyes of God. I loved it so much I put it up on my wall as a teenager.)
A.j.: hugsaj on July 25th, 2013 09:14 pm (UTC)

That is amazing. SO glad for you! SO HAPPY. *more hugs*
Little Red: aw - cj/d *hugz* - natushkamylittleredgirl on July 25th, 2013 10:00 pm (UTC)
A.j.: hugsaj on July 26th, 2013 03:35 pm (UTC)
*GLEEFUL BOUNCING* Happy freakouts are okay! They are of the good! *clings forever*
Human Collaborator Flunkie Pool!fic Muse: Wonder/Beauty (by Matilda7)joyfulfeather on July 25th, 2013 09:21 pm (UTC)
I am trying not to cry because I'm at work and am wearing mascara, but. Wow. Wow.

This is the way it should be, and I am so so glad you're in a place that does it.
Little Red: aw - cj/d *hugz* - natushkamylittleredgirl on July 25th, 2013 09:59 pm (UTC)
Don't cry!! <3 *hugs* I just hope that by Massachusetts doing it and not fucking it up (with all eyes of the world nation upon us) that the rest of the US will stay the course and get on this soon. Even if I had to pay money, which I will once I start making money again, the fact that this was the easiest, least confusing sign-up process with a state-provided helper-office is just amazing. Omg, America, we could all do this! It can be done!
Human Collaborator Flunkie Pool!fic Muse: sisters (whelan)joyfulfeather on July 25th, 2013 10:13 pm (UTC)

God, I hope so. My sister is uninsured, and her job is cutting hours so people stay under the limit where they have to provide it. I worry because it means she can't take care of herself in terms of getting check ups and dental work. I really hope things come down to where she can be covered.
Kim's Watermelon Gunkeenween on July 26th, 2013 12:26 am (UTC)
health insurance gleeeeeeeeeeeeeeee party!
ACcheekygal on July 26th, 2013 02:02 am (UTC)
So happy for you. And sorry your mom is ill. Keeping good thoughts going her way.

I changed careers because of health insurance. I chose between two job offers because of health insurance. And I can't wait until the rest of the country catches up to what your state has going on.
lavidaessueno on July 26th, 2013 02:43 am (UTC)
I have to get the fuck out of this state.

Some think tank released figures for the average annual minimum premium of a non-smoking man aged 30. In my state, that comes to a whopping $350.


And people are complaining about how expensive that is.

I would cry for joy if I paid that much per month, let alone for an entire year.
miera_c: penguin screammiera_c on July 26th, 2013 03:08 am (UTC)
Oh God, I'm crying for you. That's amazing, and of course exactly how it should be for everyone and I don't understand why anyone can possibly argue that it shouldn't, but here we are.
dave: aerynthedorkygirl on July 26th, 2013 04:13 am (UTC)
That is absolutely beautiful. After my grandfather retired but before my grandmother was eligible for social security benefits, she spent a long few years in gap coverage.

This is what America should look like!
drewandian: sunsetheartdrewandian on July 26th, 2013 04:49 am (UTC)
*hugs* Amazing!

Hey, PA, if MA can do it, why can't you!? (I'm a single mom who has medical assistance for the kiddos but no coverage for herself :/ )

Anyway....this is amazing. and makes me happy for you! With all the other stress you have, this is one less thing to worry about, which is so so good! *hugs you again*
nanda नान्दाnandamai on July 26th, 2013 12:23 pm (UTC)

I have been on MassHealth. There will be fuckups, and you will wait forever to get someone on the phone. But they pay for almost everything and it's FREE.
Jessi: a friend in needj_guda on July 26th, 2013 02:54 pm (UTC)
I would have started crying IN her office! That's so amazing. Sometimes, when you least expect it, things do go your way. Congratulations! *hugs*
Ravennoradannan on July 26th, 2013 02:54 pm (UTC)
Wow. That is amazing and wonderful, and we need that everywhere _right now_. I am so, so glad this isn't something you have to worry about. And, even, is an extra weight off. Yay, MA!
One Whose Honesty is Stronger Than Her Fear: Sarah grinningamilyn on July 26th, 2013 03:11 pm (UTC)
THIS is how things should work. I'm sorry it took the world so long to catch up with what your reality SHOULD have been. I'm SO happy for where you get to be today.

Welcome home, indeed.
Karen T: SG1 - thor is lovepoohmusings on July 26th, 2013 03:32 pm (UTC)
This post, and you, are beautiful.

She adds, "Welcome home."

That made me cry.

Clydesuzvoy on July 27th, 2013 08:46 am (UTC)
I have tears in my eyes!!
Samin_parentheses on August 2nd, 2013 01:07 pm (UTC)
Our home state is the fucking best. I'm so, so glad this is the experience you had (I got sniffly, too) and I can't wait for the rest of the country to get the hell with the program already.