Punished

Health insurance. Can we all agreed that it is, at best, a nearly impossible to understand, labyrinth-like system? And at worst it is a pit of greedy, faceless corporations that treat patients like profit sources?

In June of this year I lost my employer sponsored health insurance. They decided that it made better financial sense to pay the government penalties rather than provide us with health insurance. Now I have a BS in business. I can understand that. I can even agree with their choice. The business side of my brain totally sees the logic in their decision. The patient with a chronic illness though, she’s angry.

But getting angry wouldn’t do any good so I went through the whole healthcare marketplace mess, found an insurance that I could afford (barely) with a company I trusted. I thought I was good to go. I was paying more each month but I was back with BlueCrossBlueShield. They’d always been good to me and I thought the extra cost would be worth it to be back with a company I’d always had good luck with.

And here comes the plot twist. BCBS is not the company I once knew. I am not a person who needs their help. I am an account number. I am income. I am dollar signs.

One of my medications for my Rheumatoid Arthritis is Enbrel. Made by Amgen, it is a very expensive, once a week injectable med that has been a miracle for me. When I started taking it roughly 10 years ago I was on three other meds for my RA. Now I’m down to one other medication. It’s that good. It has never been cheap but it has always been covered.

Now, BCBS will still partly cover it. But only after I hit my deductible for the year. So that means until I hit that magic number I’m out over $3,000. A month. Amgen offers some great copay assistance programs. But they won’t help until I have a copay. Which I won’t have until I’ve met that deductible. It is a vicious cycle that is going to deplete my savings account and leave me searching for a second job or selling off everything I own one bit at at time.

As of right now I see no way out of this other than to stop taking my Enbrel. I’ve checked out several patient assistance programs. Four have already allocated all their funds for RA patients for the year. The fifth one I’m in the process of applying to – but it still won’t pay the bill currently staring at me.

The bottom line is that I feel like I’m being punished. Punished for being sick. I didn’t choose to get have a haywire immune system. I didn’t choose to respond best to an expensive medication. I didn’t choose to lose my insurance. I didn’t choose any of this. Yet I feel like my insurance is punishing me with this invoice.

How dare I be sick. How dare I need medication. How dare I.

No. You’re wrong, BlueCrossBlueShield. How dare you. How dare you expect people to pay thousands of dollars out of pocket for a necessary medication. How dare you force us to choose between our meds and being able to pay our other bills. How dare you, BlueCrossBlueShield. How dare all of you insurance companies out there.

You should all be ashamed of themselves.

And someone – no, everyone – should be working together to fix this broken system. This has to stop. This has to change.

~Elise

5 comments

  1. Michelle Phillips · August 21, 2015

    This kills me. My heart hurts. Healthcare is supposed to be there to heal people. I have no words.

    • writerelise · August 21, 2015

      It kills me too. There needs to be a major refocusing and restructuring in our healthcare. It is beyond broken.

  2. S.M. Lowry · August 21, 2015

    I agree with this! I was just saying similar things to my husband. We have providence. Double covered. I assumed that meant we had pretty good insurance. Nope. Most places won’t bill both. They bill one then expect us to pay and submit the rest for reimbursement. Much too time consuming and complicated for me. But the best part is that we have a huge deductible that we must meet first. I have no answers about how to fix this system, but I think we all need to start talking about it. It doesn’t work, and for people with major health problems it really fails (my husband had cancer and we’re still paying on those bills 6 years later). I’m very sorry to hear how much trouble you’re having. The fact that you might lose a med that actually works because you can’t afford it is awful.

    • writerelise · August 21, 2015

      I’m starting to think that there is no such thing as good insurance anymore. I’m so sorry you guys are still paying bills from 6 years ago. That is so wrong!

  3. kfdodge · September 1, 2015

    Oh Elise, I hear you. I agree with you. I just don’t know how to get the politicians and decision makers to not just listen, but understand how they’ve hurt us all. I’ve been selling group/individual health insurance for 6+ years and I hate HATE 99% of the changes forced down our throats by ACA. No one asked the brokers, who work with the companies and employees how to make changes for the better. Nope, they made decisions based on whispers and rumors and big data that is all soulless. It’s ridiculous. It’s hurting consumers. It’s destroying lives. I hope you find a way around your conundrum without going bankrupt. Keep hoping; keep writing.

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