We are looking at switching jobs too, and for us that means giving up our military insurance which, while run by morons who couldn’t administrate their way out of a wet paper bag, is AMAZING! It is the system that would be in place for all should we switch to a “socialized” model in this country. It is no less annoying, but it sure is cheaper.

I am so sorry this happened to you, so stressful and stupid. You embody the dirty little secret of all the anti-Obamacare people: the ones hurting most are not the much hated women, people of color and the poor, but those of us who have clawed our way into the middle class. If you really want to get your blood pressure up check out Deadly Spin by Wendell Potter. You are not the only person experiencing this and as long as Americans believe that insurance is a privilege for those deemed “worthy” and not a right for all human beings, you wont be the last.

This job will be worth it. This job will be worth it…

Hi, I thought I was the only one trying to get my mind wrapped around the US health care system.

As a Canadian who recently moved to the US to get married I find it really scary that you could get a bill in the mail if your insurer, for whatever reason decides to not pay the doctor and you could lose your house/savings or even both.

I didn’t move here for the health care that’s for sure, and in the meantime I’m extra careful with knives in the kitchen.

Yep – big hug and empathy from me.

Choosing for me to be a stay home mom makes me feel the same way. Ohhh, umm, I’ll skip getting new glasses and let me cancel my teeth cleaning and maybe that will save enough of the flex money to cover the unexpected expense of one of the kiddos needing stitches.

I stopped taking a medication (not life-saving) because it was too expensive. I find I am doing fine without it (which is scary in a different way); however, it seems rather ridiculous that anyone would stop a med due to cost.

I think some of the other comments don’t quite have the pre-existing condition thing down. It’s not that you could be denied coverage but they can put a waiting period for coverage to begin for pre-existing conditions. I know this because twice in our last two job changes I’ve had to fax in certification of prior coverage. Otherwise, it was going to be up to 12 months of NO COVERAGE for anything deemed pre-existing.

*head hits desk*

God bless Canada, and Tommy Douglas for starting our universal health care system.

My husband switched jobs in the past year and we had the 90 waiting period to deal with. I can’t even bring myself to think about the problems with our whole system right now, but I did get very annoyed by the 90 waiting period. It just seems ridiculous to me that this period exists in so many companies. Does it really save the companies so much money that it is worth the hassle that it causes employees?? And, I would imagine that it is a hinderance on recruting when families have to make decisions about it. Luckily we were able to buy a very inexpensive private policy for my husband and kids (I’m covered at work) because the price of his maintenence drugs weren’t expensive enough to make COBRA make sense. But, we spent hours going over the numbers and weighing the cost/benefits of our different options. I just don’t believe that the 3 months of savings that the employer has by having the waiting period is worth the hastle that is causes everyone face with the situation.

God, I am right there with you. I’ve had steady work with company benefits for 14 years. Three months ago my company went out of business and I was lucky to find another job quickly. A week later, I found out I was pregnant. We all went on my husband’s company benefits since mine didn’t kick in for three months.

Fast forward to a week before my company benefits kick in and my husband switches to a promising start up company with NO employee-offered benefits, a small salary with long-term incentives, and I fill out the paperwork at my new company to put our family of three (soon to be 4) on my benefits.

And then I was fired.

We are now looking at a $2000 cobra bill that’s coming sometime between now and June 1st and I have no job, am 7 months pregnant and will not be hired anywhere, am on unemployment and am looking at a discrimination case that costs $$ to pursue. Money that I can’t spend on an attorney because I have to spend it on frivalous things like healthcare and the mortgage.

We are so screwed.

Does Cobra even take credit cards?

I’m not reading the previous comments, so apologies if this is a repeat, but can you get a 3 month prescription for your medication before you lose insurance? Sometimes providers will work with you if they know you’re facing financial difficulties…

I 100% relate to this post. Only instead of going to work for a company with a less good insurance plan, my husband went to work for himself. No insurance plan. And it’s my chronic health problem that keeps us from getting good insurance. So it’s me that feels guilty because I can’t not have the condition.

We currently have the preexisting condition insurance for the whole family, because that’s all we can get. It’s expensive and it isn’t very good coverage. But it’s better than nothing. And that sucks.

Amen to all that.

And it IS a tragedy that all this squelches anyone’s dreams to pursue a non-traditional work situation.

I’d wanted to start a business forever, and I would have happily pulled together a few part time jobs until I could grow freelancing into a full-time thing, whatever it took. But no, no, thanks to healthcare costs I needed to stay at my shitty full-time going-nowhere office job and stew in my own misery until I could figure out a way to afford the healthcare I needed to go a non-traditional route with work. For me, it could only happen because I got married, which is fucked up. Now, I love what I’m doing, it contributes to the economy, and it never should’ve been delayed because I was cornered by healthcare into a certain type of job for year after year.

An overhaul to the system is beyond overdue. Good luck with everything.

Ok. but the point you’re missing is that it was YOU that didn’t make up your mind and get the check there in time, so NOW there is a lapse in your coverage. It’s not ALWAYS someone elses fault. Quit complaining about something that YOUR irresponsibility cost you. If you don’t pay in time, no one can save you from that….nor should they.
Yes,insurance costs are through the roof, but socialized medicine will work equally as well as all other government run programs. Right now here are very few Medical Centers that turn people away who can’t pay…once again the taxpayers, the 48% who pay ALL the tax, will pick that bill up and no one will be motivated to get a job and pay their own way.
THAT”s the real problem. Following your dreams should not = being irresponsible and expecting someone else to pay your bills.

My husband has Crohn’s disease and takes lifesaving meds that are close to $5000/month. He’d like to retire early from a job he hates. Think he’ll be able to? Think again. Not unless we fix this broken system of ours.

But I have faith that we will. We can’t be the only country that wants to live with this shit.

I wish you wouldn’t feel guilty about it – I think of it like this: my son has autism and we live in a state that has an autism mandate, where he can’t be denied insurance for a pre existing condition, and because we have it, our lives are changed for the better in ways I can’t even begin to articulate. My life and my husbands and our other three kids, too. But I don’t really want to live in this state, it’s not where I’m from, I prefer my home state, etc. But I never look at him and think, damn it, it’s your fault that I have to live here! Medical issues are medical issues, there’s no fault involved, or there shouldn’t be.

Also, I just had to have my six month old get tubes in her ears and I got the bill, 90 percent of which was covered by insurance, and it had a $250 charge for a Tylenol suppository. I made a joke about it on FB and a friend of mine’s husband, who is a doctor in an inner city hospital, said that it costs ONE dollar for the Tylenol, but that when you have insurance, they charge 250 times that so that you can cover 250 people who don’t have insurance. Can you imagine anything more effed up than that? It’s insanity. And that was a charge for something pretty straightforward, tubes in her ears. When we get coverage for my son, we have to see a billion doctors to get diagnosis. It’s crazy town.

Out of pocket my MS meds are $3500/month. There is no world that exists for me in which this is possible, so I’m thankful everyday for the coverage that we have. I understand the guilt, though, staying home with our son, generating no income, yet costing SO much. My job is important, of course, but there are no health benefits.

I hope you find some loopholes that can get you through the waiting period.

Methinks Jen is not taking *her* meds.

AMEN! I had hyperemesis in my last pregnancy, which as you may know, can be very serious and life-threatening to the fetus (and even the mother). In any event, I was prescribed Zofran which is crazy expensive, and because it’s primarily used as a treatment for nausea associated with chemo, my health insurance decided I was only allowed to have 10 days’ supply per 30 days. So the rest of the month was out of pocket – at which point I have to say thank GOD for Walmart, because they charged me $65 for a week’s supply which at CVS et al. was going for $250. (And I’ve always had really good health insurance – so while the underinsured and uninsured face HUGE obstacles, these problems also strike the perfectly insured, and let me assure @Jen a that I pay a sh*t-ton for my insurance, premiums + co-pays an have my entire adult life. We are all vulnerable to the system.)

I wish I could bottle your column and sell it on Capitol Hill. The debate about universal health care in our country took my BREATH away with its fervor and lunacy: more than at any other time, it made me feel alien and alone within my own country that so many of us are so virulently opposed to this basic concept. I’m so sorry you guys have this great worry to deal with; we have been there too, paying out of pocket for private coverage, and only people who have been trapped in that situation really now how isolating and terrifying it is. Good luck, and I also suggest Cobra for sure (don’t take any chances!).

In WA State, there is an exemption to filling out the health questionnaire; so long as you have had a continous 24 months of group coverage and you decline to take COBRA and are applying within 90 days of the qualifying event. It’s question #7 on the WSHIP Health Questionnaire. You’ll need to provide your COBRA notice from JB’s employer and the HIPAA certificate showing coverage start and end date.
https://www.wship.org/Docs/SHQ%20Insert%20Revised%2004%203%202012%20Final%20Post.pdf

Reading these comments has me seething. I know this is minor compared to many of the experiences above. But when I got my first job out of college and had to go to the gyno so I could get my birth control filled. The company refused to pay for the visit because evidently a uterus is a preexisting condition.

Sorry one more note to add: so long as the group coverage through JB was considered “creditable”, they should be able to credit the months of prior coverage towards the 9-month pre-ex that most individual policies have.

The way I understand it, your insurance company is REQUIRED to reimburse you for that medicine. It is a HELL of an outlay for you – that would freak me out. But, COBRA is a government act that allows you to continue your healthcare insurance for up to 18 months after separating from your employer.

COBRA requires insurance companies to provide you with the same insurance policy that you had while with the employer. There is a 60-day window in which you can opt in to the policy and coverage during that period is retroactive. (So, I’m sure it will be a headache, but that is why you were “denied coverage.” And COBRA is not the one reimbursing you, it is your same insurance company and everything you had before, you should have now.)

Honestly, I’m surprised you got the paperwork so quickly. Sorry that it sucks though and does make your life that much more stressful.

Ditto what Meaghan said above. And I’ve been in the “time period switching from company plan to COBRA and dealing with monthly medication” thing too. As soon as I gave notice to the company, my insurance started denying my prescriptions (even though it was still 6 weeks before my company benefits were to end). They wanted some guarantee that I was going to be extending the coverage through COBRA even though I had the aforementioned 60-day window. I ended up doing the same thing you did: I sent in the COBRA check before I had the coupons and before I had even left my company! And even when I saw that the check had cleared, it took another 2 weeks for my insurance company to give its blessing to continued coverage.

You are SO within your continued-coverage rights/requirements, if your insurance company even balks about reimbursing you, just get on the phone and raise hell. I’d think that the MS benefits people could help you push on them as well.

I was faced with a similar situation with my last job change. My university alumni association offered a variety of group policies with different options for each. I was able to tailor a plan that we could afford for those 90 days. Sure it did not cover everything but it covered the medications we also had to have and it prevented the lapse in coverage.

The situation is just awful. Both my parents are self-employed, so I was on my dad’s private insurance through college. I had to have an MRI done of my knee my junior year and even though I followed the referral/preauthorization/etc protocol to the letter, the insurance company denied the claim and refused to pay the bill for months. It pretty much ruined my life, repeatedly getting bills for a $2000 MRI and having to call the insurance company and argue with them about how they should pay for a covered procedure. And all the time when they were denying the claim (which was absolutely covered by our policy), my dad had to continue paying the $1000/month premium. Awful.

WOW Jen, you make me ashamed of my own name… remember you don’t have to read or like others opinions but to be so nasty… WOW.

I will not go in to my beliefs of the system, yups it’s pretty mucked up, and as a canadian – I know, and have experienced the benefits of socialized medicine.

But I do want to say this – Linda, not your fault. You are what you are, and we are given challenges in life to help us grow. Sometimes you wonder who invented that mucked up system too, but thats life. If JB was in this situation would you begrudge him? No. So don’t do that to yourself.

I didn’t read all the comments, so I don’t know if someone else mentioned this, but you should be able to pay PER PILL, not for the whole month. So maybe you could pay for 10 pills out of pocket or whatever while you wait for coverage.

Sorry to hear it, Linda! I have been without insurance andworking at a barely above minimum wage job. Its scary to face medical bills that you can’t affort. It does not make sense to have health insurance tied to employment.

Oops! Affort = afford

Dude. “Carry the Fuck…” So going to work that into a conversation at some point.

Shitty situation, for sure. I have no advice for you, other than to chime in that my mother-in-law has leukemia; *but!* there is a life-saving drug she can take daily to keep it in check. The prescription, patented through 2031, is $3800/ month. She’s 58 and would love to retire early, with her husband who is 10 years older than her. But she can’t because she can’t lose/ switch her health insurance due to the preexisting condition.

Another one: my grandmother is 82 and FEISTY. Lady smokes 2 packs a day, drinks whiskey in her coffee, walks 3 miles a day and has no health issues (apparently she’s the “smoking will kill you exception). She is, however, losing her hearing. She’s a wonderfully social person, and not being able to hear people speaking to her is so isolating. But Medicare doesn’t pay for hearing aids… They’re $5,000 a pop. Huh? I think we’re all chipping in and getting her hearing aids for her 83rd birthday next month.

Sorry Linda; that is an absolutely shittastick situation.

So messed up. A consultant I work with (and friend) just lost her husband–essentially because insurance didn’t approve a medication he needed for a rare form of liver cancer in time (a $1200 medication. We lost an amazing man over $1200.). Instead, the insurance company is now going to be paying a sh*t-ton more money for all the hospital bills, along with, I HOPE, a lawsuit from the family. It’s really heartbreaking, and I get so enraged when I hear all these horrible insurance stories. It’s just not right.

I’m an EB attorney that specializes in stuff like this. COBRA is generally retroactive to the date of the “qualifying event” (e.g., the reason JB and the rest of the family lost COBRA coverage due to his termination of employment). Although you have 60 days to elect it, the premiums you sent in should have been retroactive to that date. If you have any questions about your particular situation feel free to e-mail me. I can’t make the situation suck any less, but I can try to help you make sense of it.

Just to clarify – they will reimburse you (at the same rate they would’ve under the plan while JB was actively employed), provided you elected COBRA & provided the premiums within the initial 60-day window. Assuming that happened, there won’t be a gap in coverage at all. You’ll have COBRA coverage retroactive to the date the Microsoft coverage ended.

I have no advice, just choose to add to the many rants. I hate the healthcare situation in this country and I’m so disappointed because I believe deeply that we can do better. For reasons that totally elude me, we choose not to. Unacceptable America. Don’t make me pull this country over.

Coming back to mention the other thing: having to get on the phone with pharmacies/ doctors/ insurance companies/ HR/ COBRA/ everyone in the world to “raise hell,” often when you’re dealing with chronic illness or cancer or hyperemesis or some damn thing. (Or moving!) Like we have time for this. I think they make a lot of money off people who don’t have the time or energy or education or English to do it.

I would look at all the money you saved over the course of your husband working at Microsoft, and divide that by the $5,100 and I bet you feel better. I’m not saying we have a great system, but when you have the gift of no insurance expense for years, you should probably save that money for a rainy day such as this.

TOTALLY here you. I left Microsoft to work for a startup about 6 months ago and it was a huge decision given my type 1 diabetes. Luckily my husband works at Boeing and they have decent health benefits for non-union workers. And I definitely feel like a burden to my family with all my health care costs and other chronic illness crap. This is very common. Which doesn’t help, but you know. Youuuuu are not alooooone.

*hear (sheesh)

Every time I read about the health care system in the US I just don’t get it. I’m Canadian. And for all those people commenting about our “socialized” health care system we prefer to call it universal health care. Meaning we’re all covered regardless of income, etc. I can go to whatever doctor or hospital I want and don’t have to worry about how I’m going to pay for it. Is it perfect? No, but it seems a lot fairer to me. (And I guess I’ll stop complaining about the $50/month I pay for prescription & dental coverage through my job…)

I hear ya. I’m 27 and I haven’t so much as had my wisdom teeth out. I’ve worked my ass off my whole adult life and have never had health insurance. Every time I talk to my folks, I hear about their knee surgerys, their Prilosec prescriptions, their back pain pills, their sleep apnea tests… Neither of them will ever get out from under their medical debt, neither of them will ever retire. And they’re not slackers, stupid, or white trash, they’re just normal people in their 40s/60s, trying to get by. And that’s what I have to look forward to when my body stops being all indestructibly in-my-20s… It’s a sad state of affairs

I live in Massachusetts, with Obama/Romneycare and it is AWESOME. It makes things possible- like my husband being able to be self-employed.

No worries about being denied coverage, about being forced into crappy plans, or about lifetime caps.

You have to pay, yes, but still- AWESOME.

About that Australia idea that Cords had – yeah, as a US citizen, you can’t get coverage under Medicare (and the PBS) in Australia until you’re a permanent resident. As a temporary resident, I pay out of pocket and then seek reimbursement from my insurance. Some things are cheaper than in the US, some more expensive. My IUD cost $530 and I don’t know how much of that I’ll get back. It costs $33 for people under the MBS.

I’m confronting this nightmare of American Health Care as we speak, as I try to switch from my ex’s plan to private health insurance. It is, in a word, horrifying. Horrifying and financially insane. Here’s hoping we both get through the transition relatively unscathed(ish). xo

This is why it’s such a farce to have legislators who are guaranteed health coverage for free for life deciding this nation’s healthcare decisions.

I wholeheartedly agree that the health/medical/insurance system is broken as all getout, but as a person without insurance who can’t even afford to go to a doctor for regular checkups, I have zero sympathy for the idea that someone risks not having health insurance for a temporary time frame. *End Rant*

I completely agree. I’ve never understood why people are opposed to universal healthcare as being too socialist. As you said, if we covered health care for everyone, it would free people up to move jobs and start businesses. You can’t get any more capitalistic than that.

I haven’t read all the comments so I’m sorry if this is a repeat… but how rediculous is it that a pharmaceutical company or pharmacy has to charge $2000 per month for a prescription? Yes, I’m sure a lot of research went into developing and manufacturing the medicine. But that price seems way past the point of reasonable for a medication.

I have a couple of shitty health care system stories. The first being my issue with chronic UTIs (NOT sexually related, oh judgy ones, it stemmed from childhood). I had no insurance in college, and nearly went broke over it. It cost $300 for me to just go pee in the cup, which they make you do every damn time, even though you know what’s wrong with you. Then comes the super expensive powerful antibiotic, b/c you’ve been on too many antibiotics in the past. It was around $2000 a year, which may as well be $1 million to a college student.

My second example is from when I was 28. My husband worked at Yahoo! and had similarly awesome insurance (this was during their now-extinct glory days). I contracted salmonella and had a myriad of complications as a result. In the end, I paid about $3000 out of pocket between co-pays, which makes me really really wonder how much the grand total would have been had I not been insured. How awful it must be to get so ill, at no fault of your own, and have no way to get yourself the proper care.

Have you tried calling the pharmaceutical company that makes the meds? A lot of them have programs that help pay for prescriptions (especially if they are life-saving)and will give you free meds or greatly discounted meds. It’s worth giving them a call and at least explaining the situation. At least it’s temporary, I can’t see any reason why they wouldn’t help you (unless they are COMPLETE douche-bags, but lets hope they aren’t)

Don’t even get me started on how screwed up our system is. It became crystal clear to me when my Dad was in a hospital dying and my Mom had to tell the Dr. that we couldn’t try one last medicine that could prolong his life because SHE COULD NOT AFFORD IT. He died two days later. It’s sickening.