The Quest for Affordable Health Insurance

People with health insurance provided via their employer need to realize what a blessing they have.

We have paid for our own health insurance in one way or another for most of our married life.  For the last 4 years, we have had basically what amounts to a “safety net” policy.  For $350 a month, we get an entrance card to the doctor’s office (also known as an insurance card), a negotiated physician’s discount, and, well, that’s about it.  We have a $5000 per person yearly deductible and a maximum family out of pocket expense of $10,000.00.  Practically, this amounts to us paying for our own medical expenses and not going to the doctor unless we are desperate. 

To be honest, $350 a month is more than we can afford.  So, yes, we tried applying for Medicaid—at least for the kids.  We were denied because we make too much.  Also, to qualify we are supposed to let the kids go without coverage for 6 months first.

I was just putting up with the expense of insurance for what seems like nothing in return until Charis broke her arm.  It wasn’t a severe injury, but we now have over $2500 in medical expenses because of it.  This motivated me to investigate our insurance options again.I have a new option because of my new job.  I can get group coverage through my employer.  However, it is way beyond what we can afford.  For just me, it would be $639 per month.  To add Mark and the kids, it would be over $1300 per month.  So I called Anthem BC/BS to see if we could get coverage for just the kids, and Mark and I could keep the crummy coverage we have.  Well, because one of them has a pre-existing condition, they could only cover 3 of them.  To cover three of the children, the best policy is $311 per month.  The worst coverage is $188 per month.  Then we would still have to continue covering one of the kids under our crummy policy.  At this point, we must keep what we have and pray that God continues to keep us from any tragic illness or accident.

I am not in favor of government health care, but I certainly understand why many are.  I think, with the economy failing, many more people will have to pay for their own health coverage.   More people are getting laid off.  So there will be more people losing health insurance altogether.  If they do find new jobs, they will quickly see that companies who are scaling back on expenses don’t offer the same quality benefits that they used to.  As this happens, more people will find themselves faced with the situation we have dealt with for years.

Something has to change in the insurance industry and with medical providers if people are going to be able to manage just living from day to day. 

10 thoughts on “The Quest for Affordable Health Insurance”

  1. So true. That is where the Army has come in handy for us. That is definitely one of the perks. Maybe Mark could join the army! That is all you need…a deployed husband.

  2. Have you looked into the S-CHIP program for your state? I do the reporting for NC’s version, and for a family with four children, the income requirements really aren’t very high. Maybe that’s what you’re referring to. In case you haven’t seen it, here’s the website: http://www.dss.mo.gov/fsd/mchild.htm

    I don’t think NC requires that you go for any amount of time with no insurance, though I can see why it might be a requirement. I’ve considered signing our boys up, but I’m not convinced that they’d get as good care as they get now, and we’ve been paying the “family” rate for over 4 years now. My employer (being a health insurance company), makes it less than excruciating to pay for, though it’s still not cheap. Just one more chain binding me to gainful employment. =-7

    Not to say you aren’t right. We ARE blessed to be able to afford coverage for our whole family. Three C-sections don’t come cheap, and then there was the Jay-closed-his-hand-in-the-van-door incident when we broke in our new local urgent care facility, and the Daniel-might-have-cognenital-hip-dysplasia-and-we-won’t-know-unless-we-get-the-radiologist-from-Duke-in-to-charge-a-few-hundred-dollars incident. We paid quite a bit for that one, but we did want him to be able to walk! It was a false alarm, thankfully.

    I’ll pray for you all. Remember God is in charge, taking better care of your family than any human (and certainly any government program!) ever could.

  3. Brandy,

    We actually have discussed the Nat Guard chaplaincy, but Mark would have to sign up this year or he’ll be too old. I don’t think he will seriously do it, but it does have its benefits.

    Lenise,

    Thanks for your thoughts. Obviously, we are trusting God to take care of us. I think my post came off a little more personally than I wanted it to. Meaning that I provided personal examples to illustrate the overall problem with insurance and getting affordable health care in this country. Yes. I am frustrated by the fact that we are under-insured and that there’s is little to nothing that we can do about it. But my larger point was that I really do believe that something is going to have to change with the way health care is paid for in our culture or only the very rich are going to be able to afford it.

    I am pretty sure that what I applied for for the kids is the s-chip program. In MO it is called Medicaid for Children. But I will follow your link to be sure that it is the same thing.

    One thing I didn’t mention in my post that also aggravated me this week is that when I called the hospital to arrange payments for the care of Charis’s broken arm, they would only accept a certain level of payment, about 60 percent more than I was asking to pay. This would be fine if I didn’t have 2 other bills from the same incident making me have 3 additional expenses for the next several months until it the debts are paid.

    I do appreciate your prayers, too. It is only by God’s grace that any of us survive the convoluted way medical care is doled out, good insurance or not. And, I am grateful you had good coverage for the times your boys needed it. I do not begrudge others having good coverage; I just hope they understand what they have.

  4. Jennifer,
    Ugh! I feel your pain! Since moving here, we’ve been on our own, but not entirely. Phil’s brother was able to somehow get our little company into part of a larger group – a “paychex” type company that makes it somewhat easier, but still medical stuff is a huge strain on our budget.

    My Dad and I both watched a Frontline episode about different countries and how they run healthcare. There are some places, like Germany, that do it pretty well. I think there is potential to have a program that combines government and private insurance — but our silly gov’t would have to throw the current system out and start from scratch – instead of continuing to put band aids on it.

    Oh, well, for now – just know that we’re in the same boat!

  5. Jennifer,

    I do appreciate knowing that we’re not alone. With the health issues you face, I am sure this is a big deal. When we lived in Washington state, we were able to get group coverage through our business membership at Costco, but other states we have lived in since have not had that as an option. We looked into a group plan through a self-employment group here, and the cost was still prohibitive to us. Perhaps it won’t always be that way.

  6. jennifer, i remember when george lost his job in birmingham (a couple o’ times ago- you know how it is!), we looked at different options too. we had another family in our church who was in similar circumstances and they decided to use an organization called samaritan ministries. not sure if you’ve heard of it- basically, it’s a network of a whole bunch of believers who pay each others expenses each month, and no one family’s expenses are more than $285 a month. the idea is that you are actually bearing the burdens of other people in the Church and being blessed while being a blessing. i know they used it; we decided not to because of the amount of time you had to be part of it before pregnancy could be completely covered. i am guessing this is not an issue for you 🙂 if you would like, we can get you in touch with our friends. he is an elder in our church in birmingham. but the website is http://www.samaritanministries.org

  7. Yeah, Abby. We looked into Samaritan’s purse and another medishare program like it. What they don’t tell you until you get into the application process is that part of your monthly “share” goes to a premium for catastrophic health insurance. So they have underwriters, and therefore, they have pre-existing conditions that can preclude coverage–which we had. But thanks for thinking of us.

  8. I totally understand. . . In our family, I’m the only one with insurance (and it’s pretty good, to be honest.) It is prohibitively expensive to add Hubby and the kids. So, we pay out of pocket. Ack. Thankfully, we’ve been able to do that, no ‘extreme’ incidences. (Oh, and we DO have dental benefits for the whole family — and ortho at a very reasonable fee. . . so, we’re getting THAT cared for, even if they boys haven’t seen a pediatrician since shortly after we moved back to the States.)

    We did look into the Florida Kid Care program for the kids. Just in case. We’ve done the broken arms and pneumonia before. . . Our income was $100 over (annually!) the cut-off. *eyeball roll*

  9. When we were in MS they had that rule about the kids having to be off any insurance for 6 months before they could enroll in CHIP, but they do have done away with that rule now, I believe. At any rate, because of our income level, in MS our children qualified for Medicaid, even though we had BC/BS that was fully paid for by the church, so Medicaid ended up picking up the deductible and any copays. Great situation for them. My wife and I had to pay copays and had a $500 deductible each. All in all a good situation.

    Here, we have no insurance at all. The kids are on CHIP so they are covered, but we have not had any coverage since about 6 months after we moved here. We were paying through the nose for private health insurance with a ridiculous deductible just like you have, but it was either pay that premium or buy groceries each month.

    It scares me to death whenever my wife or I has an ache or pain or gets a cold or something. We are 39 and 41 respectively and can’t do this much longer.

  10. Even with our horrible coverage, we get a little scared about what would happen if something serious happened to us.

    It is nice to have sympathy/empathy. I am praying that folks like you and me will have better options soon.

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