I have health insurance now...Now What?

March 2, 2016

 

I am going to try not to get too emotional as I say this:  

 

I now have Health Insurance. 

 

Health Insurance.  

 

HEALTH INSURANCE PEOPLE!

 

At the age of 43, I never worked at a company that provided health insurance.    

While Obamacare was more affordable, it really did not help me much.  

 

I could not afford the monthly payment with a $5,000 deductible that basically covered nothing.  This was a significant expense as I worked in service-oriented jobs.  

 

This is a glimpse of how my life was without health insurance.

 

If I was sick, I tried to handle it myself.  And if you read my other blog, you would understand how that worked out.  If I sprained an ankle, I just hoped it healed with ice.  I never did any kind of preventative care because I could not afford it.

 

When I was in a car accident, I opted not to do additional physical therapy on my broken shoulder because I did not have insurance.  When my doctor told me that my shoulder was too “smashed” for surgery, I was secretly relieved. I would rather have the doctor tell me that surgery was not an option rather than for me to make this decision because of my lack of insurance.

 

I would cringe in embarrassment when people would hear me cough and say, "You need to call a doctor."  I felt that everyone had access to this basic necessity but me.  I kept making excuses why not to see a doctor because I did not want anyone to find out I did not have insurance.

 

Am I such a loser that I could not manage to get health insurance?   

 

I could not afford to be sick or afford to be healthy.

 

UNTIL NOW!

 

November 1, 2015 at midnight was when I began my coverage.  For once, I have a job that provides not only health insurance but good health insurance.

 

I posted on Facebook a picture of myself signing my health insurance acceptance form.  On October 31, I had wine ready to drink at midnight (when I begin coverage!) and a twinkie to celebrate (when I begin coverage!)

 

I had my 1,000 friends tried to guess what I was signing.  I turned this into a game!  

 

I bet you all cannot guess what I am signing Facebook friends!  

 

I was so READY for this!

 

Or so I thought.

 

When I posted (I HAVE HEALTH INSURANCE!), many messages of congratulations came flooding in.  

 

And so did the advice, questions and health insurance horror stories.

 

Do you have a good life insurance plan?

Did you select a primary doctor?

Read everything carefully as health insurance will try not to cover you.

Don't go to the wrong provider as it will cost you an arm and a leg.

What is your co-pay?

Does it cover prescription medication?

Health insurance companies will try not to cover what you need!

 

I began realizing that understanding health insurance requires advanced reading and critical thinking skills.  And probably persuasive writing if the insurance company refuses to pay some form of treatment.

 

Feeling slightly overwhelmed, I realized I needed to learn about my insurance and come up with a plan for my health. You never know when you will be sick.

 

Which was, unfortunately, on December 16, 2015.  Ironically, this was the five-year anniversary (to the day!) of when I was in a car accident where I broke my neck and shoulder.

 

I had a fever and felt very dizzy and could not stand up.  Reverting to what I always did without insurance, I figured I would be on the mend if I drink enough water and a McDonald’s Smoothie.

 

"Shouldn't you see a doctor?" I was asked.

 

How do I do that?  Do I just look in the yellow pages for one and ask if they accept my health insurance?  What kind of clinic?  What kind of doctor? By the time I would make an appointment, I may be fine so why bother?  I have not seen a doctor since my car accident, and I don’t remember the last time I saw one before that.  Who would I even see? Where would I go? And would a doctor even have time to answer my question?  Aren’t they with patients all day? I am fine.

 

But I really was not fine.  Three days later my leg swelled up, turned bright red, and I could not walk.

 

My plan was to elevate it, ice it and to wait and see.

 

"You have health insurance now.  You can get it checked out," a family member reminded me.

 

I mulled this over.  Yeah, I guess he is right.

 

We could not find the health insurance book that my twinkie was on during my November 1 midnight celebration to figure out where to go, and I began to feel worse.

 

I needed an ambulance.  

 

Yes!

  

"I am sooo excited!  I have my health insurance card and everything!" I exclaimed to the dispatcher.

 

Which I nearly forget as I was getting hauled out my door in a stretcher. “Wait, my card!” I yelped.

 

“Is it in your purse?” one of the guys asked.

 

Huh?  No.  It was actually in a sparkly blue three dimensional frame hung among pictures of my family.

 

He grabbed the frame, and we were off.  To the hospital, where I can show off my health insurance card to doctors, nurses, techs and receptionists.  And everyone else who may be there.

-------------------------------------------------------------

 

It is now Christmas, and I have been in the hospital for the past six days with “A Rapid development of cellulitis and a staph infection that left me with the inability to walk.”

 

Everyone who walked in my room, made comments such as, “It is so bad you are in the hospital for Christmas!”

 

It could be worse.  

 

Like five years ago, just for an example, when I was in the hospital on Christmas from a car accident that hospitalized me for 16 days with broken shoulder and neck.  I had nothing to do except worry.  

 

As I did not have insurance.

 

How much is an X-Ray?  How much is a CAT scan?  The doctor visits?  A hospital stay a night? Follow-up appointments?

 

In the wee hours of the night, I couldn’t help thinking, “What if I can’t afford rent because of my medical bills?  Will I be homeless? What will happen to my beloved cats?  Will I be able to get another car?  What if I can’t get a car, am homeless, and lose my job as a result?  Will have to live with my parents (who I love) forever?

 

“Do you think you will file for bankruptcy?” an insensitive friend asked.

 

Bankruptcy??

 

There goes my chances to buy a house (if I ever build up my credit and save enough for a down payment), buy a car and get a credit card (which I am not really supposed to have).  

 

If I go bankrupt, my life will be ruined.

 

Until someone said something that brought this all in perspective.

 

“Trump filed bankrupt,” he said.

 

Right. Donald Trump filed for bankruptcy in 2009, a year before my accident.  I nearly went bankrupt and Trump actually did.

 

Trump, more than five years later, is a billionaire and is potential front runner for the Republican nomination for President of the United States.

 

I, more than five years later, am sitting in a hospital bed in an ill forming hospital gown, eating endless free Sherbert and am glowing because I HAVE INSURANCE.  

 

I think Trump and I have both done well for ourselves.

 

The next day as I was preparing for my hospital departure, we talked more about my health insurance.  

 

Come to think of it, I think it was more of a talk about treatment to take once I leave the hospital.

 

As I inserted the term health insurance in this conversation, I felt similar feelings to someone who just got engaged.

 

He or she would get a happy, warm tingle when they say or hear the word fiancé.  Kind of like my conversation with the Health Care Professional (HCP):

 

HCP:  You will get a referral for lymphedema treatment.  

 

Me:  Will they take my health insurance?  (Warm, Happy Tingle!)

 

HCP:  Yes, and we checked as we have your health insurance information.

 

Me:  Oh!  (Warm, Happy Tingle!)

 

HCP:  We can give you information on choosing a primary doctor.

 

Me:  Will this be covered with my insurance? (Warm, Happy Tingle!)

 

HCP:  Yes, we have a list of referrals.

 

Honestly, I was not even listening to the answers as much as I loved just using the word health insurance in my sentences.   

 

And the last thing she said was, “Go to urgent care if you have a fever.”

 

Which reminded me that I still have not figured out where to go and how to do that.

 

I am realizing that having health insurance includes much more than doing Health Insurance dances, Facebook games, celebration events and gawking at my card. 

 

I mean, after my first day of coverage, I had a happy period where I did….Absolutely nothing about understanding how my health insurance works.

 

I want to be a successful Health Insurance Card Holder.  Very much so.

 

In order to do that, I need to figure some things out first:

 

A Primary Care Doctor

 

When I first was told I needed to get a primary care doctor, I just asked an awkwardly constructed question.

 

“What do I do with one?”

 

To me, a primary doctor seemed similar to having a college advisor.

 

I was required to have an advisor in college.  I never really knew what one did or how one can help me.  I never saw her, but if asked who mine was, I said her name.  

 

At the same time, I had friends and classmate who always talked about meeting their advisor, but I never knew why, what they talked about or what the advisors were used for.

 

I had a successful six years in college; I think did okay without one.

 

A Physical

 

When I played sports in high school, I was told I needed a physical.  I had a physical.  When I worked at a camp, I was required to get a physical.  I had a physical.

 

I have not had a physical since 1994.

 

I never thought I missed out.  When I signed my health insurance form, I was not thinking, “Yes, I can get a physical!”  I was thinking, I can get treatment if I am sick.  I won’t die.

 

I always thought people who got physicals were older or had a health condition.  I never thought people my age had one.  What is the point of having one?

 

I was now getting a bit embarrassed of my lack of knowledge of basic healthcare questions with people just gawking at me in disbelief that I don’t know a lot of basic information.

 

I mean one somewhat rude person said, “Oh MY God.  You don’t do annual physicals,” before she shrank away from me if I was contagious or something. 

 

So I immediately looked towards my closest frame of reference for answers.

 

My cat.  

 

Isn’t an annual vet checkup kind of the same thing?  Exactly.

 

I get a reminder note of scheduling a checkup for my cat each year.  At the appointment, the vet checks his ears, heartbeat, weight and with my prompting, tells me how handsome my cat really is despite his crying, howling and biting.  They give me literature on his care. 

 

And we are set for the next year until we get to do it all again.

 

------

 

It has been a month since this whole hospital fiasco is behind me.  It is kind of ironic, but now since I was in the hospital, I actually have a place to call for information.  As a valued Health Insurance Card Holder, I am now in their system, and I can get access to information!

 

It is very cool.  I received a list from the hospital of potential primary care doctors.  I could choose.  After a few hours, I had my top two selected!

 

One likes to play cards as a hobby and challenges her husband to games all year.  The other was a nurse who decided to go back to college to get her Masters later in life.  What ambition!

 

I was then told, “You need someone who specializes in your specific health needs.” Pause…

 

“What are your health needs?”

 

How do I know without seeing a primary doctor?  I haven’t had a urine sample, my blood sugar tested, my blood pressure or cholesterol tested.  I didn’t even get my liver enzymes tested!

 

Ha!  I bet you were not expecting me to say that.  I have done my research.  I especially loved adding the bit about liver enzymes even though I was secretly horrified about what that entails.  A sampling of my liver??  A liver prick? 

 

And why do I need to be checked for liver enzymes?  For what purpose?

 

I also did a self-guided tour of an urgent care facility.  It was interesting, actually.  Should I go there for a sore thought?  A mildly sprained ankle? A migraine? A rash? A cough? A cold?

 

I felt kind of bad for the person working at the front desk as he seemed dumbfounded with my questions.  He kept asking me what I was there for, and I kept assuring him that I am fine and really am not sick.

 

“I just want to see how this all works,” I told him.

 

At least I know where to go and when to go.  I am still kind of fuzzy at why I would go to an urgent care facility.   

 

I will just put this thought aside for now because, Guess what?  Tomorrow, I have an appointment.  With a doctor who accepts my health insurance ($30 co-pay!) for lymphedema treatment!

 

A doctor.  A doctor.  A DOCTOR!

 

My life really can’t get much better than this.

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