A History of My Healthcare Costs
Parents’ Plan, birth through age 23. Cost (to me): $0
Growing up I was lucky to have health care. My dad paid for it at first. I assumed all children had someone like my pediatrician, a kind man who always had Highlights magazines in his exam rooms and had children wait with their parents/guardians in their cars so we wouldn’t get extra germs. I thought all children got to go to the Treasure Chest and pick out a toy or a lollipop after a checkup.
At age ten, I said goodbye to my pediatrician. My mother had just signed up with Kaiser Permanente, the big HMO in Northern California. For thirteen years, I had Kaiser. When I started working, I paid my $15 copays. When I turned 21, Mom sat me down. “Does your work offer you health care?”
“Not to part-time employees.” I was working as a library shelver while going to community college.
“You’re only going to be on my plan for two more years. Hopefully, the health plan the Clintons have might help you.”
The Clinton health plan soon became dust in the wind, mostly because Republicans and some Democrats ground it up. The year I was 22, I had five fillings for cavities ($200 out of pocket) and OB-GYN work (everything normal). Then I took a breath, said goodbye to Kaiser, and walked into the unknown.
Planned Parenthood/Basic Care, ages 23–32. Cost: $25 per visit
I mention to a friend that I was dropped by Kaiser. She looks at me and says “What are you doing for insurance?”
“Praying I won’t get sick.”
“Screw that. Get Basic Care. Or Planned Parenthood.”
“Wait, what’s Basic Care?”
“County offers it to people working but can’t do insurance. You have to pray you don’t get really sick, but they can be good when you get the flu.”
“But Planned Parenthood, not sure about that.”
“They can help if you can’t get appointments with basic care. Also, they’re good with gyno exams and if you want to get birth control.”
I apply for Basic Care and am accepted. Planned Parenthood helps with gyno exams and birth control pills. I learn not to get appointments on the frst Friday of the month, because that is when the pro-life groups show up. One time when I had a horrible cold, Planned Parenthood was the only place that could see me in short notice. I was told to rest and given a prescription for cough syrup.
An escort walked me to my mother’s car. “I’m sorry, I’m just getting cough syrup. You should be helping women that need it,” I told her.
“Just let me walk you to the car, dear,” she replied. She was in her sixties, wearing a Guatemalan dress and Birkenstocks, so she had a grandmotherly way about her.
“I don’t understand, I’m not having an abortion. I was told they don’t perform abortions at this location. I’m just here…”
“It doesn’t matter. Don’t engage with them.”
“Them” were men outside holding up pro-life signs. I made the mistake of looking out the window. A priest looked at me, shook his head, then made the Sign of the Cross. It took everything I could not to cough on him and give him my flu.
Aetna Student Health Insurance, ages 32–34. Cost: $15 copay, $2,430 per year
In 2004, after working for several years, I finally transfer to a private women’s college. I see a nurse practitioner every other month and pay $10 for generic prescriptions. Thanks to scholarships, my insurance is paid for. One problem: they switch my anti-depressant from a brand name for a generic one because it’s less expensive. It takes two weeks to get used to the change. During this time I find myself crying in-between classes and gaining weight. Eventually, my body gets used to it. I also start taking Strattera since my learning disabilities are similar to ADHD.
Back to Kaiser Permanente, ages 34–42. Cost: $25 copay, $240 monthly, $2,440 yearly, plus $35/visit for therapy
The next eight years I have Kaiser again. I have to see three therapists to have them okay my Strattera. Since it’s a brand name, they are wary in prescribing it to me. Still, I get it, and at age forty I start to get mammograms. Thanks to a new rule through the Obama administration, I don’t have to pay the $25 copay, a small blessing.
The only problem is mental health. I went through a terrible time when I was verbally assaulted by a coworker, my sick cat disappeared, and a close family friend died. I call Kaiser’s Mental Health. “Well, are you suicidal?” the operator asks.
“It says on your record you’re taking antidepressants. You shouldn’t be depressed if you are taking them regularly.”
“But I am taking them regularly, and I am still depressed. Please, I need to talk to someone.”
“I’m sorry. You can’t just demand to see a therapist.”
Thankfully my work has an EAP program through which I find a therapist. As I send the initial email, the news is on the background. Gabrielle Giffords is in serious condition after she was shot in a Safeway parking lot in Arizona. The shooter is in custody. Politicians stress the importance of mental health, urging all of us to get help when we need it.
I see my therapist for four years, paying $35 a visit. I manage to recover from my depressive episode. However, hours are being cut back at work. After insurance is taken out, one paycheck is only $100 and it has to last me two weeks. Thanks to family, I manage to get by.
The same year, the Affordable Care Act (ACA) goes into effect. I decide to take a chance and apply. Though the federal site has glitches, I apply through Covered California. A month later, I find out I qualified. The plan? Medi-Cal, California’s version of Medicaid. At first, I wasn’t sure about this. Wasn’t that for people living in poverty? People on welfare? But I also knew I was at the point where I didn’t know what else to do. I was trying to maintain my credit. My luxuries were few: Netflix and Audible, totaling $20 a month. Then my rent was raised. This made the decision very easy. I tell my HR I am getting my insurance through another provider.
Covered California/Cal-Viva, ages 42–46. Cost: $0
Once I switch, I started saving $200 a month, which is huge. I also don’t have to pay for co-pays or prescriptions, saving me $100 every other month. After my hours are cut again, I quit and find another job at a local department store. For the first time, I have the freedom to choose where to work without worrying about whether my health care will be cut. I still see my therapist twice a month, for $70 out of pocket.
When I move to Central California in 2015, I switch to Cal-Viva, their version of Medi-Cal. I also learn that Cal-Viva will pay for therapy, thanks to the ACA. My therapist helps me get over my sadness about moving.
During the spring and summer of 2017, I am in a state of anxiety when Republicans try to get rid of the ACA. I start hoarding my medication and not taking the full dosage, which results in another depressive episode. It doesn’t help that Kaiser once again tries to take away Strattera again from me.
I end up calling person after person begging for help. I get one well-meaning woman who says “Well, how much longer are you going to be on Medi-Cal? You will eventually be working again, won’t you? This isn’t a program you can be on forever, you know.”
I debate asking for an itemized bill, so I can see how much the state has paid for my health care. That way I can write a check to the state for the full amount when I am working again, here’s your money, so long, I won’t let the door hit me on the way out. I don’t. Instead I say, very calmly, that I am in school, that the school doesn’t offer insurance, that this is only temporary, please, I need my Strattera. Since Strattera was just released in generic form, I don’t object paying $60 for a bottle. The next time it only costs $0, but I always bring $60 with me just in case.
I separate from Kaiser when they stop participating in the Cal-Viva Program. My new doctor is very good, making sure I get blood tests once a month, my medications are delivered, and am still seeing a therapist. Thanks to medications, monthly visits to my doctor, and seeing my therapist, I am doing okay. I’ve worked several jobs, mostly freelancing. Again, I know this is temporary, but I’d rather have something than nothing. Yet I am still nervous about finding a job, getting regular insurance again, wondering what will happen next. It shouldn’t be this anxious-making. It shouldn’t feel like you’re a child again, looking at the Treasure Chest, hoping you’ll get a good toy that doesn’t have red tape, that you won’t be shamed for taking it, and that it can give you what you need, no matter what it is.
Anonymous supports Medicare for All.
Photo credit: Sam Stockton, CC BY 2.0.
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