Have Not Health Insurance

Something has happened that I could never have imagined. Everyone in the U.S. that purchases health insurance have been divided into the “Haves” and “Have Not” categories.

I worked in corporate America for many years and I was always able to access a good doctor, pay my “co-pay”, get whatever care that was needed and move on to the next item on my “to do” list.

Now that I started my own business, I no longer have an “employer sponsored group plan” for my health insurance. I now have insurance that costs $600+ per month that I will apparently have great difficulty getting to use.

If you are fortunate enough to “have” an employer sponsored group plan, you will have better access to using your insurance. If you “have not” this type of plan and have an individual plan either because you own a small business or your employer no longer sponsors a group plan; my sympathies are with you.

I rarely get sick. (Knock on wood.) Last year, I went to my doctor who I have had for 12+ years with my “new” health insurance and was told by the receptionist that they accepted my insurance so I gave them a $25 check for my co-pay. I just needed to renew prescriptions. Upon leaving, I was notified that they did not accept my insurance and I would need to pay an additional $175.00 in addition to the $25 check I had already given them. They gave me the paperwork to get “reimbursed.” I sent it in to the insurer the same day. I was never reimbursed.

This year, I got a different company who had my doctor listed as a preferred provider on the insurer website. I have a PPO plan. I called my doctor to make an appointment and was told that she was no longer accepting insurance and would be moving to a “cash only” service in about a month. The receptionist said she would make an appointment for me if I had an employer sponsored group plan otherwise they were already only offering their service as cash only. I would have to submit paperwork for reimbursement. I asked how much it would cost for this “cash” appointment. She said she had no idea but finally said “perhaps” $80 after I pressed her for an answer. The same appointment cost $200 last year so I’m guessing the prices have not been reduced this year.

This is not an isolated occurrence. I have friends telling me the same story. I get it! The doctors are fed up with dealing with insurance carriers that pay pennies on the dollar for services rendered. They also might have to wait months to even get that money if the paperwork submitted was completed correctly.

The idea that I have health insurance and can see the doctor of my choice and pay a certain co-pay is a joke. The healthcare system is completely broken. I just hope I don’t get sick!