I’m not going to talk about promises made, or private insurance for entrepreneurs and small business owners, or anything like that.
I’m going to talk about our particular plan, from Forrest’s place of business, and how we’re utterly screwed next year because of it. He works at a decent company that’s been fairly awesome about health insurance, but is changing things up, presumably to force people out of the plan so that they don’t have to pay as much (because they do SOME price-matching – it’s what made the plan so awesome for us, this year).
Our deductible hasn’t changed. Our premium isn’t going up that much. Because of this, I guess we’re relatively lucky compared to some.
Where we’re being screwed is our co-pays for doctor visits and prescriptions.
The full price for both will go toward our deductible, and then will go back to the regular things we were paying before ($25/40 for docs/specialists, and $8/16/some-odd-% for prescriptions).
Our deductible isn’t AWFUL, but it’s not great when you look at both of us, and the issues we both have. I have my Lyme disease treatments and my regular treatments for the symptoms I’m having, very few of which can be handled by OTC medications. I will also have things to take care of post-hysterectomy, with hormone adjustments and follow-ups, which will go on for a while until I’m not only healed, but they figure out whether I need HRT or not (even with one ovary, it’s possible, but we’ll see). Tack onto that some emotional issues (mostly anxiety and panic attacks), and I’m kind of high-maintenance. I haven’t even started therapy, yet, so I don’t know how much that’s going to cost…but that’s another deductible-first thing.
Forrest has a CPAP, horrible reflux, and anxiety. He’s medicated for all of these, with regular visits to a sleep clinic and for blood tests for his cholesterol medication in there, as well.
You may argue that we’ll make our deductible quickly, and that may be true, but having to pay all of that up front is causing some serious issues in what our day-to-day life is going to be like next year.
For example, I just tallied up how much the prescriptions I had to refill today would cost with my co-pay as compared to if I had to just pay for them outright. Co-pays = $56. Outright = $831.49. Difference = $775.49 more PER MONTH for what aren’t even all of my monthly meds. My deductible will be met with just medications after something like 3 months. Yay? I think not. Where’s that money going to come from? I can’t work right now, I don’t know when I’ll be able to get a job, and I have other bills, as well.
Then there are my doctor visits, which I have to have at least every 90 days for some things, and monthly for other things. My co-pays for my GP are $25, while the specialists (which my surgeons, gyno, and sometimes my LLMD fall under) are $40. If I get sick in addition to my med visits, or if I have to visit the emergency room, just tack $40 or $150 onto whatever my monthly med total is…but I’m talking about basic monthly care, here. The last time I self-paid, they put me under some medicare thing to keep me from having to pay out the wazoo, but they’re not going to be able to do that, any more, what with the close scrutiny they’ll be under…thus, my regular GP visit will be around $200 a pop, and my gyno, for example, will be around $400 (because I’m no longer having preventative care – I have no uterus, for crying out loud, I’m just going in for maintenance of one ovary and for hormone levels, which aren’t considered mandatory care for women).
That adds at least another $1600/year onto my health expenses, bringing the total to around (using just the prescriptions I got today, which aren’t all of my monthly ones, but it’s close enough to round up to $900/month) $12,400 per year JUST for the basic care I need for my condition.
That’s not even taking Forrest’s care into consideration, and that’s basically the entire salary for a decent part-time job…but I can’t work right now, so where the hell is that money going to come from?
That’s just over $1000/month JUST FOR HEALTH CARE, and that’s not even guaranteed to be the lowest amount. I just…can’t.
Just for HIS medical stuff, Forrest is going to have to get a second, part-time job. He’s so stressed as it is that I’m not sure what on Earth he’s going to do. We’re not going to see each other unless I sleep all day and wait up for him at night, but even then we’ll say hi and he’ll go to bed to get ready for his main job.
And through all of this, yeah, I’m scared, but I’m mostly SO FREAKIN’ MAD.
I’m angry that Lyme is treated like a pariah’s disease, so that I have to work so hard to fix the mistakes made so many years ago, which takes a full 52x longer than the original treatment is purported to take by the CDC (2 weeks is what they say, 2 years is the actual estimate for long-term cases like mine, and I’m the norm, unfortunately).
I’m angry that I can’t work, that no one believes I can’t work because, again, there’s misinformation about Lyme and what it actually does to people.
I’m angry that I can’t help myself that much, and thus help Forrest, because of my illness. This also depresses me, which causes this awful cycle of feeling bad because I feel bad, which makes me feel bad about feeling bad, etc., ad nauseum.
I’m angry that I’m not being taken seriously by major players in the healthcare game, and that I have to fight just to get the basic care that’s provided to people with diseases that have been curable for decades…and which they get from unprotected sex (not talking about AIDS, obviously, but syphilis is on that list, YEP).
I’m angry that I’m made to feel like a second-class citizen because I’m up-front about my illness. I don’t tell people, “WAH, I have Lyme, FEEL SORRY FOR ME.” I say, “I have Lyme. Let me run down the physical symptoms and what I’m doing about them to make myself better so that I can stop being sick as soon as possible.” Doesn’t matter how positive you are when you present it, people still think you’re whining, and feel the need to point out that “at least [I] don’t have cancer,” or something like that. No, you’ve got it wrong – I almost wish I had cancer, if only because people would take me more seriously.
And what the hell are people with cancer going to do with this new insurance?!? I mean, holy crap, I have a choice whether or not I want to do chemo for Lyme (my treatment will just take a much longer time, but at least I will be getting treatment), but people with certain types of cancers have no choice – it’s either hook up that PICC line, or die in 3 months. What are they supposed to do when they’ve got such limited coverage?
I’m just…apoplectic. I JUST CAN’T RIGHT NOW.
And to top it all off, my rash is showing all signs of being an allergic reaction, now (it’s started itching, and it’s continued to spread even though I’m following all of my doctors’ suggestions), and that’s had me on edge. Yeah, it’s a little thing in the big scheme of things, but it’s just something I don’t need. Otherwise, I’m recovering fine, I suppose. My skin feels hot constantly (not just over my surgery site, before someone asks), and I have a rash spreading over my body. Those are my two main complaints. I just hope it’s not something that is a result of my medication schedule or something, because the last thing I need is my liver fucking up.
And speaking of my liver, I WANT A GLASS OF WINE SO BADLY. But nope – can’t have one, because meds. And this is where being a responsible patient becomes a pain in the ass. I don’t even want to get drunk – I just miss the taste of my wine. How utterly sad is that?
I will not have a drink. I will pout, instead. Then I will fume while watching Netflix. It’s the only recourse I have, right now.