I Have Insurance. My Pills Still Cost $1,000 a Week.

Sarah Wildman’s story about her awful experience with the individual health care market [2] has hit a nerve. Wildman is testifying today [3] before the Joint Economic Committee on Health Care Reform and she has inspired several of you to send similar tales of health insurance nightmares. Some of you couldn’t find any affordable insurance, others have been nearly bankrupted by mental-health care or medications you need to survive. Here is a sampling of your stories. Some have been slightly edited for readability. Please send more to doublex.slate@gmail.com [4].

Couldn’t Even Get Crappy Individual Care

During the 2001 economic downturn I was laid off from my job at a Fortune 100 company. As a healthy 30-year-old I could not get health insurance. I had no medical issues, was within the healthy weight range and yet I couldn't purchase individual health insurance. I could not get approved for insurance because five years earlier before I had a test that came back negative. That's correct: Because the doctor ordered a test to be sure she didn't see anything—and she didn't—I couldn't get insurance.

Continuing health insurance through COBRA was not an option because the cost was significantly greater than my total monthly unemployment compensation, and would have quickly depleted our savings. As a result, my husband and I eventually settled for catastrophic insurance. My husband continued working toward his graduate degree; I was out of work for six months and relied on Planned Parenthood for my annual gynecological exam and access to birth control. When I finally found a position at a much smaller firm, my health care premiums were three times what I had been paying at the larger company.

— Cecily Welch, via e-mail

Bills for Depression Cause Even Greater Stress

Despite being relatively young (mid-20s), I have never considered skimping on health insurance. The fact that I have had a well-paying professional job with full benefits since the moment I graduated from college meant that it never seemed like an issue. Four months after switching to a job with a smaller company, and just a couple months before my wedding, I was hospitalized for depression. I had never had any mental health issues previously, so it never occurred to me that coverage for that would be any different.

It was such a nightmare. ... The insurance company ended up covering 80 percent of my $7,200 hospital stay and $400 emergency room trip, but only 60 percent of the $300 ambulance trip (they wouldn't let my husband drive between the ER and the hospital for "insurance reasons") and the $250/week follow-up psychiatrist visits. Of course, I say "ended up" because I got a letter informing me that my hospital stay was not covered at all a few days after I returned from my honeymoon. It took about six months to resolve everything, and I'm sure some people in my position would not have been able to deal with the weekly phone calls I had to make to get any coverage.

What I have learned since is that most insurance policies have completely separate rules for mental health coverage. Higher co-pays, lower caps, and generally less coverage. Most people don't know this until they need it, because no one ever thinks they will need it. More frightening still, it is nearly impossible to get coverage on the open market if you have any history of mental health problems. I'm incredibly fortunate: I had coverage then and I have better coverage now. (I switched to my husband's insurance through his employer, which is much larger.) I could afford the $3,000 plus I paid after insurance that year, and I was able to keep my job through all of this. For so many others, this is not true, and these are people least able to handle the stress.

—via reader e-mail

Pay $1,000 a Week or Have Fun With That Blood Clot!

Last week, I had a pain in my left leg and had to go to the doctor. Originally, they thought it was nothing, but I told them I have a history of blood clots—five-and-a-half years ago, I was sent to the hospital with five blood clots in my body, three of which were in my lung. The doctor sent me to have an ultrasound, and sure enough, I had another blood clot in my leg. Although I could continue working, I had to start taking warfarin and inject myself with a blood thinner called Lovenox twice a day.

Although I got warfarin very cheaply, Lovenox is very hard to find. After two other pharmacies, I found it on my third try. The doctor prescribed me seven days worth of the medication. The pharmacy said that they only had five days worth, and that it would cost $1,000! It turns out my insurance only covers generic medications, and Lovenox has no generic: It's either Lovenox or have fun with that blood clot.

This sent shockwaves over my husband, who has been unemployed since last

December—and we spent a lot of our savings during my unemploymentmere months before. We had been getting by on my salary as an editor—which isn't much—and his unemployment checks, but we did not expect to shell out this much.

Although my insurance company is not helping, a lot of people have reached out to help my husband and me—whether it has been a doctor giving us about $600 worth of Lovenox in samples (enough to cover three days) or family sending us information about reimbursement programs, although we're unsure if we will qualify because of his unemployment checks.

I'm still on the Lovenox, and am unsure when I will be able to get off of it. My stomach currently looks like a connect-the-dots page due to all the shots I have been giving myself. Although I developed a superhero for laughs in this ordeal—I am Anti-clot Girl—this is getting less and less funny as I see my future going down the drain. This is a long medical battle ahead, filled with doctor appointments and adjusting my medication.

—via reader e-mail

I Simply Gave Up On Health Coverage

I work in a small private law office and my employers can't afford to purchase a health care plan for their six full-time employees, though they have offered to help subsidize health insurance. And so when I first got my job, I went out to find myself some health insurance. All of the health insurance options I could afford outright sucked, but I applied for several anyway. That's when the rejection letters started rolling in.

I have two pre-existing conditions, you see. When I got rejected for keratosis pilaris coupled with dermatillomania I laughed so hard. A huge portion of the population has KP—it's those red waxy bumps you get under hair follicles. The only reason mine was diagnosed at all is because of the dermatillomania (skin picking disorder). I stopped laughing when I was rejected for vitamin D deficiency.

I live in Fairbanks, Alaska. I will always have vitamin D deficiency, even though I am really good about taking my vitamins to combat it. You can't help but have vitamin D deficiency in the winter when the sun is only up for four hours. So eventually I gave up, and I simply don't have health insurance. I am wishing for the public option. I'm not happy with not having health insurance. I would love to be able to see a psychiatrist for the dermatillomania or go to the doctor when I get sick or injured. But it's not like I have cancer or something. I am really worried about getting pregnant—I don't know what I would do if I got pregnant without health insurance. It's a scary, scary thought.

—commenter loquinmalie [5]

We Can’t Afford to Spend a Quarter of Our Income on Health Insurance

I am a massage therapist and work in a busy hotel spa. This year has been worse than most (for obvious reasons), but I've worked in this particular spa for several years and we have never been offered health insurance by the hotel. In fact, I don't know of any spa that offers any kind of health benefit, whether covered by the employer or not.

I applied for insurance through sites like ehealthinsurance.com, et. al., but while the prices initially looked good, once I disclosed that I have allergy-induced asthma (I haven't used my inhaler in months, but still), I was either rejected outright or I was informed that I would have to pay as much as $1,000 a month with a $5,000 deductible. My husband and I have a combined income of about $50,000, so $1,000 a month is a little out of our reach. We could get insurance through his work, but that would be about $1,000 a month to insure both of us—we can't afford to spend nearly a quarter of our income on health insurance (which will then have a $1,500 per patient deductible and then cover only 80 percent of approved costs).

—commenter igardner [6]

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