How the Health Insurance System is Screwing People (and by "us" I mean "Me and Kim")

[digitaldiscipline]

Not directly, but the health insurance system is not making me very fucking happy, in a very personal way.

K, as most of you know, has been temping since her tenure at LPZ ended. She's been on COBRA in the interim, which is, as probably fewer of you know, FUCKING EXPENSIVE.

Fortunately, I work for a company that's cool enough to offer Domestic Partner benefits. Open enrollment, unfortunately, happens in November, but if you have what is considered a "qualifying event" during the year, you can add your partner at any time during the year.

Not being able to afford COBRA isn't a qualifying event. So, in theory, K could get health insurance through my job, but in practice, she can't. Which means her options are: be uninsured, or go broke paying for insurance.

The invisible hand of the market, as evidenced by all those independent insurance commercials that have proliferated? They're the next thing to fucking useless, because they don't offer stuff like, you know, dental coverage, or they have a shitty prescription plan (if they have one at all).

Anyone who says we don't need to correct some serious goddamned shortcomings in the way medical coverage is provided in these here United States is cordially invited to KISS MY ASS.

Comments

[critus.livejournal.com]

Hrm. Perhaps there's another way around it? I know there's a set of criteria that have to be met in order for someone to qualify as a domestic partner...maybe if you did one of those she'd qualify? Put her name on a life insurance policy or in a will, perhaps?

[etcet.livejournal.com]

The list of things we can do is:
- Get married
- Wait until November

I suppose, obeying the letter of the policy but not the spirit, we could break up, then get back together, but that's fairly high on the "are you fucking kidding me?" bullshit meter, and is exactly the kind of system-gaming fuckery that makes me want to take a baseball bat to people for doing.

[critus.livejournal.com]

Have you actually run this past HR or are you just going from what the documentation says?

[etcet.livejournal.com]

This is from a conversation with HR, who called the benefit coordination office.

[critus.livejournal.com]

That's full of lame.

[aishlynn.livejournal.com]

YES IT IS!!!!!

oh and the real kicker here is that, if i were to go OFF the COBRA, the one (yes, this is just ONE) Rx med that i really, REALLY can't do without would cost me $422.99 PER FUCKING MONTH!!!!! And the generic (which -isn't- the same and i did take for a bit and it didn't work quite right... grrrr.) is a major savings at ohhhhh....$230.99.

No, seriously. and that's 1 of 3. and sadly, none of them but oral contraceptives is an option to drop. And HELLS NO am i dropping THAT one.

On the plus side, the temp agency i'm with (although my acct. rep is full of cluelessness for the most part) DOES have an insurance program and i'm looking into it. COBRA is currently $391 and change. Un-fucking-believable. and there's really no choice atm.

grumble, grumble, feh and meh.

(which, please note, is nothing like Double, double toil and trouble; Fire burn, and caldron bubble. although i -do- look rather witchy at the moment with my dye-gooey hair piled up on my head.)

[aishlynn.livejournal.com]

And yes, i know my leaving the zoo was voluntary. but to stay longer may have required another bevy of pills on the list AND... my being committed. to more than just my animals' health/well-being.

[ginnyland.livejournal.com]

Damn $391 a month for Cobra? That really sucks.

[ivy]

That's totally ridiculous. I'm so sorry.

All my chronic health crap became pre-existing conditions ten years ago, because I was between jobs and broke. (I got fired because I kept having diabetic comas. When I didn't know where my rent was coming from due to unemployment, hell no I did not have $450 a month for COBRA.)

Lots of sympathy.

[critus.livejournal.com]

The only reason I'm asking is that when Krystalle went on mine it was outside of open enrollment. Now, that was when they first implemented the program so perhaps they had exceptions in place at that point, but it seems to me as though if she is not, currently, documented as your "domestic partner" in our records putting the paperwork on file to do so would count as a "qualifying event."

[etcet.livejournal.com]

I think you got in during the "grand opening sale".

Simply filing the paperwork doesn't do anything but lay the groundwork for streamlining getting her on it come open enrollment time, unfortunately.

[critus.livejournal.com]

Shit. I just looked up the federal COBRA assistance deal and, like unemployment, it only qualifies if you were involuntarily terminated. :(

[etcet.livejournal.com]

Yep. One more way the entire edifice systematically ensures the nice people, who play by the rules, get the shit end of the stick at every turn.

No real surprise that I'm bitter about the entire process, really.

[cheez-ball.livejournal.com]

Amen!

When I went on a fellowship a couple years ago I lost my group health insurance. The other people who had been on this same fellowship said it really wasn't that big a deal to find insurance on the single payer market. I didn't notice they were all guys until much later. There's a series of rants on my LJ from this time.

So at first I went on COBRA. My health insurance went from around $200 a month with the group to $415 a month. After 2 months of paying this I said screw it and shopped around for single payer insurance. There was a lot of crap out there. The only program I could find with reasonable co-pays ($25), low deductibles (~$100) and no co-insurance was one called Scott & White (I think they're local to TX). That one was $330 a month. My spouse liked the service I got so he applied for it as well. Imagine my glee to find out they only charged him $150. We're the same age, both lifters (although he's not on the power routine like I am), with similar health issues (mostly allergies). The reason for the difference was simply my ovaries. I've been pissed off ever since. My fellowship is now over and I'm back on group insurance, at around $200 a month. The spouse is still on single payer insurance because it's cheaper than adding him to my plan.

Unfortunately the lovely governor of our fair state has declared that graduate students (state employees) are no longer full time employees and are now "half time employees." This means no one qualifies for FMLA anymore and all women lose their health insurance if they take any time off for pregnancy or delivery (same is true for men or women who take a leave of absence for any reason, including medical). COBRA, no insurance, or no time off are the only options, because you can't buy health insurance with any of the above. Well, other than marrying rich. So much for being "pro-life."

As for K, maybe one of the qualifying criteria would be losing the job at LPZ? When my spouse lost his a few years ago I was able to add him to my group insurance after about a month of HR paperwork lag-time.

[etcet.livejournal.com]

B/c the end of employment was voluntary, no, unfortunately.

Rick Perry needs to be fed to angry weasels an inch at a time, IMNSHO.

[cheez-ball.livejournal.com]

Suck! I hope you all can find something that works for you all.

Rick Perry needs to endure six rounds of chemotherapy and two rounds of radiation with no time off from work - as I saw one graduate student do the year he changed us over. Or perhaps he should have major abdominal surgery with only 2 weeks off. I saw another grad student return to work 2 weeks after her c-section. The second grad student was a foreign PhD student in statistics. The terms of her visa stated that she had to retain her student/employee status and health insurance the entire time she was in the country or face losing her visa.

[ginnyland.livejournal.com]

You would think that your domestic partner being unemployed would count as a "qualifying event." Something about that just seems very screwy. Regardless if she voluntarily left or not should not factor in because she was still jobless for a period of time.

So now it seems we face a choice: Stay at a job that is driving you batshit crazy and forces you to cost the insurance company MORE money with either medication or therapy. OR quit your job and either spend an arm and a leg on insurance, or go without insurance which would just cost taxpayers more money in the long run. OR, I guess we could just fuck it all up at work and get fired. None of which seem ideal imo.

/sigh. You talk about this on the same day Scott tells me to A)Start looking for a job in Florida and B)Start looking at insurance in Florida.

[etcet.livejournal.com]

Well, I have perfectly good insurance through my job. The problem is, I can't easily get K on it in a timely manner. We have a nine-month donut hole between now and the first of the year, when adding her in November's enrollment period would take effect.

[pixirae.livejournal.com]

One of the reasons why we're all on *my* insurance, even though Mike's company provides comparable insurance slightly cheaper, is all of this type of drama - it was much easier for some reason to add everyone to my plan than to try to get the right insurance at Mike's work when we got married. So we're all on mine. *sigh*

[y2kdragon.livejournal.com]

Yet more proof that the system "works just fine as it is", according to the legislators who voted against health care reform.

[sloot.livejournal.com]

What in the new rules would make your Rafe's current situation better?

---

(sorry - I was thinking you were K)

[etcet.livejournal.com]

Off the top of my head, I'd say that the subsidized premiums for purchasing private insurance would be. There may be minutae in the bill that would also come into play, but that's the obvious bit.

[sloot.livejournal.com]

How beneficial is that to most people when the rebate doesn't come until the spring?

(your post made me write a post I'd been considering for a while which is basically an inquisitive US healthcare post regarding the recent bills that have been passed)

[etcet.livejournal.com]

In our situation, where there's a bit of budget stretch as a two-income household, it's unpleasant but potentially possible.

[cheez-ball.livejournal.com]

And a ban on gender rating, would also probably help tremendously. Currently it's legal to charge women double, or more.

[kest]

In 2014 there will be insurance 'exchanges' that in theory will make buying your own insurance cheaper/easier.

[sloot.livejournal.com]

I'll be shocked if it's cheaper.

[cerisefemme.livejournal.com]

When I lost my job, it was considered a qualifying event. Maybe it's a California thing.

And 100% agree with you that healthcare needs help just not sure about the craziness that washington is pushing through.

[sor-eye-ah.livejournal.com]

Saw Sicko last night. Fuck Damn what a country *sympathy*

[faience.livejournal.com]

Don't forget how if you have any history of illness -- or worse yet, any kind of long-term or ongoing health problem -- it is difficult to impossible to get insurance from anyone no matter how much you're willing to pay.

Way to go, healthcare system.

[onezumi.livejournal.com]

Yeah COBRA is nuts!

So, I need orthotics. Lucky for me my insurance covers 90%. Near as I can tell they are almost $600. My god if I weren't employed I'd just have to do without.

Well, actually my problems with my feet? All because I had no insurance as a kid. My Dr just told me if I had gotten something done before age 9, I wouldn't be this bad off. Lovely....

[kest]

When I was unemployed, I actually found the cheapest Blue Cross plan to be cheaper than the COBRA. I know their prices have gone up since then, though (and might be different in your state) and it also all depends on what you need covered...dammit. I hope stuff works out for you guys. :(

[geeki.livejournal.com]

*hug*

That is probably my one beef about my work. We only offer SAME SEX domestic partners, so I couldnt carry Dom on my insurance.

Which...really fucking sucked. I dont think anyone should be forced into marriage.