This is the second in a short series I'm writing about going from having health coverage through an individual plan with Kaiser, to being uninsured for three years and counting. If you are interested, this is the first part of the series.
This blog was a little harder for me to write, for two reasons:
1. Admitting you are without health insurance is not easy. On some level, it feels like an embarrassing secret. Only my family and a few close friends even know that I am uninsured. Now here I am talking about it to a potentially large group of readers.
2. Discussing my own actual health issues is also difficult, because at nature, I am an extremely private person.
There shouldn't be a stigma attached to lack of health insurance. If it were affordable; if insurers couldn't reject you for every little pre-existing condition; most people would choose to have coverage. The more that people talk about what it's really like out there in today's economy, maybe that will bring increasing pressure onto our politicians to keep pressing forward with real change.
So, onward ...
By March 2008, I realized that I would have to drop my health coverage and be uninsured. It was a very difficult decision. Some family members offered to help finance my coverage, but I didn't feel able to accept their generosity. It wasn't like this was a short-term deal. My insurance rates (and everyone else's) would continue to jump ever higher year by year.
Instead, I began to investigate what sort of health care was available to me once I no longer had insurance coverage.
First of all, I turned to The Google (although now I use Bing for all my searches). I searched for "health clinics in Sonoma County" and it brought up a whole variety of information. For those in Sonoma County, here is a helpful link or two:
Public Health Clinics
Great info provided by the local community college
This search also led me to a website for a free clinic that offers not only medical care, but mental health care.
In other words, there were options out there for the uninsured and low income population. I chose one of the local clinics that offered a variety of health services and called their number. The receptionist explained that I would need to complete an application, submit it, and I would go on their waiting list. It might take up to three months to hear from them. She took my mailing address and promised to mail an application out.
A week or so later, the application arrived. It wasn't very lengthy. As I recall, it asked for the usual (name, address, date of birth). I had to provide my income information and list any current medical conditions, medications, etc. No medical exam was required to determine if they would accept me as a patient. No fee to submit the application. I mailed it back and calendared for two months down the road to follow up with them if I hadn't heard anything.
About a month later, I got a telephone call from the clinic. My application had been processed. I was assigned to a D.O. (osteopathic doctor) and given an initial appointment about 3 weeks in the future. I was advised to bring a recent paystub as proof of income, and my insurance card, if I had one.
The clinic was housed across from one of the local hospitals, in a row of older but nicely maintained single story buildings. When I registered with the desk clerk, she typed in my income level, asked how many dependents I had living with me, and advised me that with my income level, I was at the top of the sliding scale and would have to pay $45 for my visit. However, if I paid at the time of the visit, I would get a discount - I think 10%. So instead of my usual co-pay of $25 with Kaiser, I ended up paying around $40 and was happy to do it!
My doctor turned out to be a soft-spoken, laid back guy. He reviewed my health history form, advised me my blood pressure was a little high, and set me up to have some blood work done, as well as an eye exam. On my way out, a nurse scheduled a follow up appointment for me about a month down the road.
Over the course of the next several months, I had blood work done at the same clinic (I believe that cost me around $100); I had an eye exam - $40 fee; was prescribed BP medication; and discovered that Target has a great program for generic prescriptions for $4 for a one-month's supply. As time has gone by, I've had a mammogram (most of the fee was covered by a grant by a local winery), I had a small surface cyst carefully removed by an intern, and am scheduled for a dermatology visit to check for suspicious moles, etc. I've learned that medical care is (at least in my region) definitely out there, to a certain extent.
I really like my doctor. I like being able to schedule my appointments with him so that I am the first visit of the day. I have never had to wait longer than 5 minutes before being taken back to the examining room. I like being able to call the clinic and speak with one of the clerks directly, or if I get voicemail, receiving a return call later the same day. All in all, I've been very happy with the quality of general every-day care my clinic provides to me. If only I could be assured that I wouldn't develop any serious health problems, I'd love to stick with my current health care services.
(But of course, that's the real bugaboo about being without health insurance. Always in the back of your mind is the concern that your good luck will run out. What if a bus hits you when you're crossing the street; you break your leg somehow; you need hospitalization; or worst of all, you find out you have a serious disease of some kind that will require lots of expensive treatment? )
So anyway, that's how things went for about a year. I was healthy; my BP was under good control with affordable medication; I finally had a doctor I really liked. All that money I was going to save by not having health insurance? Well, that went toward trying to pay down my credit card debt. (Perhaps I'll do another diary or two sometime about how I eventually chose to deal with that, but that's another subject for another time.) I definitely had more financial breathing room. I was able to pay for extras like a week-long field trip for my son when he was in the 6th grade; school pictures; a yearbook; a new bike for him at Christmas. I didn't have to pinch so much on my grocery budget, and every Friday we had pizza and frozen yogurt as our weekly treat.
Then one Friday after work, I picked up my son, we grabbed a pizza and then some frozen yogurt and headed home. We were almost there. It was a warm summer afternoon and I slowed down and got into the left turn lane as we approached the turn off for our neighborhood. Out of nowhere a big truck turned right in front of us. He turned suddenly into my path. Even though I slammed on the brakes I hit the side of his truck, hard. All I remember thinking was "Please don't let [son] be hurt!"
My car ended up being totaled. I felt no immediate pain, and my son said he didn't either. By the next day, we were both hurting. And that's when I discovered that it can be a bit of a headache to be uninsured when you need care right away, especially on a week-end.
On the good side, I discovered how our local "urgent care" clinics operate. They are the place you go when you're sick or injured, but not to the level of an emergency room visit. They are open 24 hours; they cost much less than an ER visit; but you still have to wait to be seen, and sometimes that can take an hour or more. I ended up going to the urgent care clinics twice for the accident. Each visit cost about $500. (The good news: I didn't have to pay anything up front unless I wanted to. I was provided with information on how to apply for financial help with the bill, if my financial situation qualified me for such help. I was allowed to make payments until the charge was paid off.)
I had to wait to see my own doctor, but when I did, he gave me a referral for physical therapist and continued the pain prescription I got from the urgent care physician. Of course, the problem is that I suddenly had a number of unexpected expenses to add to my budget, and they began to add up. Still, I was lucky in the sense that my injuries were the result of an auto accident, and I carry medical payments coverage on my insurance policy. I was able to have my treatment bills submitted to my own insurance and they paid them up to the limit of my coverage - $5,000. After that, I was on my own.
So far, that's the most serious injury/illness I've had to face as an uninsured person. It reminded me that should I become truly ill or injured, I'll be facing bills that I probably won't be able to pay, even on the best of payment plans. Add in the fact that I'm not getting any younger, and so I've begun to try to find a way to get insured again.
In my next blog, I'll share the start I've made on applying for California's high risk insurance pool. I did look into the federal program, but it's only a bit less per month and it appears you must pay all your medical expenses up front and then submit them for reimbursement. I'd rather stick with California's high risk program and select Kaiser coverage instead.
If you stuck with this long diary, thank you. I hope it provided some insight (and maybe reassurance) for anyone facing the same situation. To be honest, it hasn't been so bad being without insurance.