Insurance Linked to Employment. Company Folded in 2002. Scammed by "Limited Benefits" Company



(Interview August 2011. Oil in linen, 40 ins. x 30 ins.)


Update 2021

Insurance tethered to employment can cause so much stress. Barb was left uninsured when when her husband lost his health insurance plan. Barb was listed as a dependent on her husband's plan.


It was good to catch up with Barb. She wrote (my links), "I was covered by his (her husband's) Railroad Retirement insurance until he hit 65. Then, he automatically went to Medicare (which is great), but I was automatically bumped from any insurance because of - basically a technicality in the system you might say. So, the ACA would have solved that for me by giving me affordable insurance. Instead, I was offered $600+/month through COBRA. Other insurances were comparable and Aetna denied me coverage (because of my medical history!) outright.


"I feel lucky, lucky, lucky that I didn't have a medical bankruptcy while uninsured. I sneaked by. I had the means to get by even though I depleted my 401K.

"So, when the ACA went through, I was able to use it for about a year and a half at about $210/mo. until I turned 65 and went on Medicare.

Barb helped me and the sponsors launch 2012 Truth Tour: Medicare What's at Stake. Her portrait story was part of the advocacy effort.

"One major thing to note is that while I had no insurance, I injured my shoulder muscle. Instead of being afforded simple physical therapy for a few months, I had to let it go. Finally, when I got insurance through ACA, PT would no longer suffice and had to have shoulder replacement at - probably - $10K compared to a few hundred.

Medicare is fantastic!


"We are now on a Medicare Advantage plan and actually pay zero premiums. We had been paying about $300/mo and co-pays and prescriptions separately. We've been fairly healthy, so that is what I believe makes the difference. My husband had a bad year about 2 years ago with kidney issues. He was in the hospital three different times until they got his meds right for him. He's been good with watching BP every day, meds and a better diet.

I'm in good health....knock on wood. We are 79 and 74, so that's not bad.

 

A study. Oil on canvas 24 ins. x 20 ins.

Retired Secretary, Administrative Assistant & Archivist/Librarian for a Global Chemical Company, Age 63, Insured through Affordable Care Act (ACA) high-risk pool provision


Barb enjoyed several jobs throughout her working life in corporate America. Each successive position offered increased salary and medical benefits. As an archivist/librarian, Barb even received a 401K.


in 1990, while working as an administrative assistant, Barb had a seizure. She was insured through her job at the time and received medical attention with no insurance problems.


Barb was diagnosed and treated for venous angioma, which can be brought on by stress. Barb remembers being stressed that the family was $500 in the red a month before Christmas.


Barb's condition is treated with medication. She has not had a seizure for 12 years and counting.


Barb lost her her archivist/librarian job with the global chemical company in 2002 when the company closed their local campus.


Unemployed and uninsured, Barb found a way to get insurance through her husband's employer. She could be added as a dependent on her husband's policy.


Five years later in 2007, Barb's husband received a letter from his employer. Since he was turning 65, he would be eligible for Medicare, a federal insurance program. His private insurance policy would be terminated along with any dependents he had on the policy, namely Barb. Barb's husband's employer offered to continue insuring Barb through COBRA, a law that gives workers and their families the right to continue group coverage for a limited time. But Barb would have to pay the full $650/month premium for the COBRA coverage. The family could not afford it.


Soon after turning down COBRA, Barb discovered that she would have to pay $430/month out of her own pocket for her seizure medications. She withdrew money from her 401K to pay for the medicine.


From 2007 through 2010 Barb spent a total of $37,062.65 from her 401k for medical and dental expenses.


In 2008 and feeling desperate, Barb responded to an advertisement, “Medical insurance to cover doctor and hospital for $149/month." The company called itself a limited benefits administrator. Barb signed up paying 2 months in advance, then $149 every month until she realized she was scammed.


When Barb received her insurance card from this limited benefits company, she proceeded to get check-ups. The company denied her medical claims. The company's customer reps gave her the runaround on the phone. She knew then that she had been scammed. "I worked for 40 years and now I'm uninsured. This insurance hasn't paid anything. I thought they were going to help me."


One of the customer reps "with a conscience," as Barb put it, told her about getting medicine cheaper from Canada. She gave Barb the name of a website. Barb paid $232.22/ month for medicine from Canada that would have cost her $438/mo. in the US.


In 2009 and uninsured, Barb felt she needed a gynecological exam which, with lab work, cost $350. Her gynecologist let her pay off the bill at $25/month. Barb continued to buy medicine from Canada until October 1, 2010 when she qualified for her state's high risk pool.


The high risk pool was part of a temporary provision in the Affordable Care Act passed in 2010. Although the healthcare reform law passed in 2010, full implementation -- when individuals could actually buy policies on an online marketplace -- would not start until 2014.


Barb had a preexisting condition and was uninsured. In 2009 this meant insurers could review Barb's medical history and decide not to sell her an individual health insurance policy. Obamacare (the Affordable Care Act) outlawed this practice but ending preexisting condition discrimination would not start until 2014. So the new law made provisions for sick and uninsured people like Barb by offering insurance to this high-risk group until 2014.


Barb's insurance through the Affordable Care Act's high-risk pool provision cost $283.20/month. She hadn't had a mammogram since 2007. She also got a bone density test and lab work done. Barb's out-of-pocket expense for the $3,840 price tag for these tests was $566.33. She is on a $25/month plan to pay her out-of-pocket expense.


"I feel lucky, lucky, lucky that I didn't have a medical bankruptcy while uninsured. I sneaked by. I had the means to get by even though I depleted my 401K. There are people who don't have anything to fall back on and are on the street. I lost sleep, certainly, but I stayed active so that I'd be physically exhausted when I put my head on the pillow. I got involved in the fight for the ACA because I realized that so many people were too sick and dying, and I had to speak up. I speak up for those who can't speak for themselves. It could have been me."