I need insurance

Looking through health insurance plans and it’s all very confusing. I guess this is not news to anyone.

In the last couple of months, two acquaintances of mine have sustained serious injuries that required medical care, and that’s gotten me pretty scared. One was hit (and run) by an SUV while riding his bicycle, and he’ll probably walk unassisted again, but it will be months, and he’ll probably never have the mobility he did before the accident. The other had a motorcycle accident and lost a leg below the knee. So this stuff is hitting a little closer to home. I’m very lucky to have skated by as long as I have without any insurance.

In fact, two months after being assaulted outside my apartment, the bone next to my eye is still tender even though the shiner is gone. This scares me because I chose not to seek medical attention (against the advice of the SFPD) largely because it would have cost me a lot of money.

I need to remember: this is the United States of America. I’m not rich, so if I’m not insured, a stubbed toe could bankrupt me or even kill me. All the horror stories of people without insurance being shopped from emergency room to emergency room and driven around in the backs of ambulances until they died might be rarities or exceptions, but I’m in the target demographic. If it can happen to anyone, it can happen to me.

I am gainfully employed as a full-time salaried worker. My employer will pay a substantial portion of my health insurance premium. Unfortunately, it’s a small enough shop that we don’t have an insurance “group.” So I don’t get automatically approved.

Because insurance companies are in business to make money, and because their income is not dependent on the benefit they provide but in fact the reverse, there are rules that protect them from people that might actually cost them money by using health care. That means people that have used health care in the past are ineligible for individual coverage. Applying for individual health coverage in the past, I’ve been denied, and even on appeal refused access to individual health insurance policies. The reasons stated were simple:

Medical procedure in history.
Prescription medication in coverage history.

That’s right. One surgery and one prescription in my history were enough to exclude me, not just from inexpensive policies, but any policies. I was flat-out refused individual coverage.

So now I get to go back and apply for coverage again because I’m not riding the coattails of an employer’s insurance group, and I have to admit that my attitude about this is not great. But I’ve taken one action this week that gives me a little bit of hope. That is, I paid my psychiatrist. It was an old bill, and one that I disputed because I was supposed to be covered during that time (and also, I can’t figure out the itemization–there’s no possible combination of copays and full-payment that adds up to $440), but I just gave up fighting and paid the $440. Now that it’s paid I can call and ask about my record without having to deal with the outstanding bill issue. There may be some resentment, but the money is paid.

The question I want to ask is: did he ever diagnose me with anything? I would prefer not to have to answer “yes” to “have you ever been treated for…” questions. Some may call this a technicality, but unless a medical doctor makes a diagnosis, I don’t feel the need to answer “yes” on those forms. I’m not a medical doctor and even if I think I have suffered from a medical ailment, I am not competent to make such a diagnosis.

I’ve stopped taking all medication and it’s been a few years since the (very minor) surgery I had, so maybe I have a better shot of getting covered if I make an application now. I won’t lie on an application, but I will omit mention of any self-diagnosis in the absence of diagnosis from a medical professional. Hell, considering that I’m not an M.D. it would be lying for me to say “yes” based on my own appraisal, wouldn’t it?

So anyhow, yeah, I must get insured before I get hit by a truck or a jealous husband or something.