Jessica Blacher – Santa Monica, CA

Published on

(Updated 2/4/13)

I am 55-plus. I’ve never wanted to be 65, but Medicare can’t come soon enough. My Blue Cross premium keeps spiraling upward yet I’m working fewer days and my income is down. I keep having to change policies–higher deductibles, more copays, less coverage–to afford it. Now it’s just backup in case of a catastrophe. And soon I won’t be able to afford any kind of health insurance.

My latest premium increase was 22.4%–$135 a month–making my premium $635 a month as of Feb. 1, 2013 for a basic policy with a $5000 deductible. That was on top of a previous increase last May. 

So I switched again to a policy that costs $597.00 per month with a $6000 deductible. My out of pocket limit went up from $9500 to $10,500.

I really can’t afford even the $597 a month and I will be in big trouble with the next increase because there is no higher deductible available.

Sadly, I just had a bad fall and my bills are now close to $5000.  Of course, my Blue Cross covered none of it! 

 As recently as 2010 I had a pretty good policy, with a $2500 deductible and $30% copays, for $600 a month. By January 2012 the premium went up to $715 and I had to switch to the $5000 deductible to stay insured. Now I’m back in the same awful bind–needing at my age to have some kind of insurance, but struggling to afford even the cheapest policy.

It makes no sense that the state insurance regulators have absolutely no authority over these crazy increases, no matter how much profit or surplus the company has. 

I tried to find a policy with another company and spent hours applying for one, but I was turned down after a grilling about my medical history, even though I’m generally quite healthy. 

So I’m stuck with Blue Cross. Less coverage and more fees. (I pay about $715 a month with copays and prescriptions.) Every trip to a doctor starts with a $50 upfront payment (except for my GP), that doesn’t count toward the deductible or the doctors’ fee. So if I got seriously ill the yearly cost to me would be about $18,000 even if every doctor was in network. On top of that my policy doesn’t cover acupuncture, which is important to me.

I don’t have a new car in the garage and I don’t take vacations. 

I’m paying a penalty for all the people who aren’t insured and I can’t afford to go to the doctor for anything short of an emergency. 

Recently I needed to refill an old cough medicine prescription, and my doctor’s office said they wouldn’t renew it without an office visit. I just couldn’t afford that for a bottle of cough medicine. 

Insurance companies are siphoning off the economic security of middle-class people like me. I’m gritting my teeth for the next increase on my crummy policy. What will I do then? I have no idea.

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