Insurance is Life or Death... Seriously
Updated: Oct 29, 2021
How many of us really know about medical insurance? About all of the benefits and coverage and out-of-pocket expenses that come along with it?
I can honestly say that I didn’t know anything about medical insurance before I met my wife, Candace. And I’m pretty sure I still don’t know anything, maybe just enough to get by. All I knew was that I paid my monthly premiums (which were taken out of my paycheck usually) and I had a certain amount of coverage with a certain copay for doctor’s visits and prescriptions. I usually didn’t have to go to see a doctor very much because I was in overall good health, which means I didn’t have a ton of out-of-pocket expenses. For me, it was simple.
I never needed traditional medical insurance when I was in the Navy. We were able to go see a doctor whenever we needed to and I didn’t have to pay for any prescriptions out of pocket. I also had vision and dental benefits at no cost on top of the medical I was already receiving. Sure, I had deductions taken out of my paychecks for a “premium payment,” but I never got billed for anything. It was mindless.
Currently, I get my medical care through Veteran’s Affairs (VA). I was able to enroll because of my veteran status and Honorable Discharge from the Navy. They base their plans on disability and/or current income if there aren’t any disabilities. For me, I don’t have a monthly premium, but I still have a copay for each visit that I make to see a doctor or participate in an activity within the VA. I get billed every month and depending on what I do or how often I visit, that’s what I get charged. Allegedly, I can go to any hospital that I need to (but I don’t want to test it because I know from personal experience the hassle and headache that comes from being seen outside of the VA system) and there are different coverage parameters for that depending on the outcome or how long I end up being an in-patient. I don’t have to worry about being employed with an employer that provides benefits, thankfully. I am covered whether I am working or not.
The only downside to the VA is they don’t provide vision and dental benefits unless it is absolutely necessary, as in, I show up and my eyes are in noticeably bad shape, or I have something going on in my mouth that justifies seeing a dentist. There are no annual checkups or cleanings provided that I know of. But overall, I am happy with the care I have received from the VA. I am still in overall good health, and as I get older, I have a good feeling I will still be well taken care of, thanks to my military service. But not everyone is that fortunate.
My wife’s medical coverage is a whole different story. She has gone through hoops and bounds to be able to get the coverage she has today. She has had to prove herself more than once, just to have to start all over again on several occasions. I have witnessed her battle with doctors and her insurance organization in order to receive the care she needs, as well as the medication she needs. There always has to be “proof” as in labs or people seeing her in the hospital and evaluating her or having an advocate on her side (like myself or other doctors that include things in their notes).
My wife has known people who have died or almost died in the middle of the approval process of their life-saving medications and treatments. She has known those who have died after being denied repeatedly as well.
At one point, my wife and I and her medical team were talking about a Stem Cell transplant for her. We were told she needed this transplant as a life-saving treatment because she had basically come to a dead end with the medications and other treatments she was already on and essentially had failed them. And then we found out my wife’s insurance policy wouldn’t cover any part of that, including finding a donor and the actual procedure. All because of insurance. It didn’t matter what any doctor said. There was no way around it.
And now we are back to square one. We don’t know where to go from here.
When it comes to my wife and her medical needs, the first question that is asked by either us or any doctor is, “Will insurance cover that?” It’s sad but true. It’s not even a for sure thing if she will be able to get what she needs, which is extremely scary. I have seen her reach out to doctors numerous times to try to get them to send something to her insurance, whether it was for medication or for treatments, just so that it can be approved. And we all know how “quickly” doctor’s offices move. They don’t. Unless they are a really awesome doctor and that doctor has a great staff. Which doesn’t happen too much, in my experience.
My wife and I are always faced with the fear that she could lose her medical benefits at any time. It’s not a great feeling, especially with all the treatments and the different life-saving medications that she takes.
I provide vision and dental benefits for both of us, through private policies. Her insurance policy doesn’t cover vision (completely) and she gets no dental coverage. Thankfully our policies offer decent coverage with some out-of-pocket expenses. That’s just how we have had to do things because of our current situation.
If my wife loses her medical benefits, that means that as her caregiver, I would not have an income. That is the only reason that I am able to stay home with her and go with her to all of her appointments. If she lost her benefits, I would have to find a job FAST, most likely at home, because I still couldn’t, and wouldn’t want to leave her home without me if I absolutely didn’t have to. If I couldn’t even find a job that I could do from home, I would have to find a night job or a swing-shift job so that I can still go to appointments with her and be able to be a mom at the same time. Oh, and maybe be able to get some sleep somewhere in between all of that.
I’ve been there, done that. I used to take care of my wife while I worked a full-time job. It was scary being away from her, and my job was an hour away from our house. If an emergency came up, I couldn’t be there as fast as I needed to or wanted to. I had to take time off of work to go to appointments with her, and I was always very stressed and tired. I don’t want to have to do that again. It’s nerve-wracking just thinking about it.
This fear and the different thoughts that run in the back of my mind is only a small part of the reason why I started my own business, and why I am hitting the ground running with it. Not only is it a passion of mine (rekindled again from my passion as a child and teenager), but it is something that I can do at home and still be around for when my wife needs me, and not have to worry about a set work schedule.
Not only that, but my wife and I are very hopeful that her body will heal itself and that we will be able to enjoy our lives more in the way that we have always wanted to, but haven’t been able to. We have plans. When that happens, I need to have something established for myself so that our income is not affected. We have lots of things to look forward to. We are relying heavily on our faith as we always have, especially at this point in our lives.
**By the way, check out my website www.kristinehutchinson.com for more information on what I do and what services I offer, and please share it with whoever you can!**
I never realized how important medical benefits were before I met my wife. There are a lot of uninsured people in this country because it is so expensive. In other countries, they make it a priority to make sure that there is a good healthcare system in place for its citizens. People in the U.S. get caught up in the political and financial part of health insurance, which is unfortunate.
I don’t feel like most people are properly being taken care of in this country, and it needs to change. It’s all about the bottom line and how much money these companies are making, which is a shame. So many claims get denied because it “costs too much” for the company or it’s not “necessary.” What is the point of paying monthly premiums if everything is just going to get denied and there are more and more out-of-pocket costs associated with medical care? It just doesn’t make any sense.