Seven years ago, at age 54, I was self-employed and of modest means, but completely debt-free. I had health insurance, but rarely made a claim. Today I am a 62-year old uninsured cancer survivor on the verge of bankruptcy from medical debt. I am too young for Medicare, too early for the Affordable Care Act and I have a pre-existing condition that denies me private insurance even if I could afford it.
I am sharing my story in the hope it will lead to affordable health insurance that will help millions of people like me when they need it the most.
In important ways I consider myself lucky. My cancer was caught early with excellent medical care, and it hasn’t metastasized. It’s my debt that has reached critical mass because of unaffordable and skimpy health insurance.
When I was diagnosed I was living within my means, building an IRA account and I had just inherited a modest amount of money. I had a catastrophic health insurance policy that I supposed would prevent medical bankruptcy.
Until I was 50, I always had good, comprehensive health insurance: through my parents, thenmy university, then a teaching job, then my husband’s company, and after my divorce, I paid for it myself. My rates rose and rose:
• In 1993, at age 43, Blue Shield only charged $75/month, but then escalated.
• In 1994, I switched to Blue Cross, and paid $88/month for a decent policy.
• In 1999 it jumped to $127.
• On my 50th birthday in 2000 it jumped sharply–too high for my budget, so I spent over a year without insurance, for the first time in my life.
Recognizing that age 50 brings new risks, I researched “catastrophic only” plans and bought a Blue Cross “Basic PPO” plan for $118/month. It seemed to offer the most for my tiny budget. I figured if, heaven forbid, I was in an accident or got cancer, at least Blue Cross would cover 80%. And once I paid the $1000 deductible and $2500 co-pay, Blue Cross would cover everything else. My rates gradually resumed climbing.
In July 2004, I was diagnosed with cancer. After the shock, I thought, “Thank God I have insurance. And with all the treatments I will need, I will quickly exceed my out of pocket requirement. Then Blue Cross will cover the rest of my care.” Unfortunately, I was wrong.
What Blue Cross’s marketing literature and confusing policy legalesedid not make clear was that none of my expensive specialist exams, ultrasounds, MRIs, prescriptions or lab tests were covered at all. Those costs would not apply toward the deductible or be covered in my out of pocket limit. The deductibles and copays for my biopsy, lumpectomy, and an emergency hospitalization exceeded my deductible, so Blue Cross paid 80% of my remaining hospital costs. But all those non-covered services and 20% co-payments added up to tens of thousands of dollars. I spent hours on the phone and computer researching, negotiating and pleading.
I financially survived through 2006 only because I qualified for the federally funded Breast and Cervical Cancer Program’s gap insurance, and in 2006, Blue Cross covered my $50,000 in hospital-based radiation treatments.
All that changed on New Years Day 2007. My government gap insurance benefits expired. Because of treatment side effects I had to cut back my work hours. I had already depleted my inheritance and savings. On that day my annual insurance deductible and co-pay were also reset, and now I faced five to ten years of post-cancer monitoring exams, lab tests, scans, and prescriptions, none of which my insurance covered.
I started paying medical bills and living expenses with credit cards, and that was another rude awakening. I learned the hard way how quickly a “Special 3% VISA Rate” jumped up to 26%, and how overdraft and late fees compounded.
On top of all my other costs, Blue Cross raised my rate every year, more than doubling the premium to $282 a month by 2010.
The final straw came when Blue Cross announced another rate increase in 2011. The alternative plans they offered me had a $5000 or $7000 deductible, along with the same spotty coverage. I was so steeped in debt, I had to drop my policy. As a single person who isn’t legally disabled, I’m not eligible for Medicaid in California.
I am now living from month to month. I’ve been uninsured since February and praying my health holds out.
My oncologist stopped charging me, but also stopped my tumor marker lab tests. Other non-urgent care, I just forgo. I have had to dip into my dwindling IRA account. At least I am now off some of the medications that had tough side effects, and am trying to increase my work hours.
For the past few years, I have supplemented my income by selling drugs —colorful leftover pills that I use as gemstones for my collection of Designer Drug Jewelry. It is my artistic way of expressing my conclusion that health care has become a luxury item.
Officer of Health Care for All, San Gabriel Valley. Makes “Designer Meds” jewelry (LA Times feature story). Has worked with Health Access in the past.