Bills, Bills, Bills: A Cycle of Debt

Bills, Bills, Bills: A Cycle of Debt

Having RA is insanely expensive, even with health insurance. And now the bills are starting to roll in; I’m growing more and more afraid to go to my mailbox each day, afraid of what health invoice will be waiting for me. You owe $175! Please pay $240 by 2/16/15! $800! This is your final notice before this account is sent to collections! The list of medical charges (and threats) go on and on. Sigh. Yeah, I’ll get right on that. I do try to be responsible about keeping up with my medical bills, but it’s a daunting task and a juggling act. Other than the threats of my credit being ruined, I’m just not very motivated to pay these stupid bills, basically because of the unfairness of them and the unfairness of how outrageously expensive health care is in this country. I didn’t ask for this disease, but I have to accept it. What I can’t accept is being fleeced out of my hard-earned money and cheated from living the life I want to live because I suffer from a chronic illness.

In addition to the bills piling up now, another source of frustration for me lately has to do with my health insurance plan. I have my own co-insurance policy with a benefit plan that is…okay, I guess? I’m embarrassed to admit that I’m not very informed about health insurance options and I haven’t yet looked into finding something more affordable through Obamacare (I really need to check into this). I’ve had this policy and plan since I was on COBRA after I wasn’t covered anymore by my dad’s employer. After COBRA came this co-insurance plan and I was stuck with it, afraid to switch to something else from one of my own jobs, in case I didn’t stay at the job or the benefits wound up being worse.

Pre-Obamacare it was impossible for me to just buy my own affordable individual policy due to having a pre-existing condition. If I dropped my expensive co-insurance policy and for some reason I got stuck without anything, I would be in major trouble. Also during these years (after graduating from college), I didn’t qualify for government or state health care because I made too much money, which was a laugh ($11 an hour, I’m rich!). And the state option, Minnesota Care, required a person to be without insurance for several months before qualifying for the program. I talked to several different people about this strange rule and I never did understand it. With the unpredictability of my disease and the likelihood I could end up suddenly in the ER or need to go to the doctor, there was no way I could go without health insurance for months.

But let’s get back to why I’m frustrated about my insurance right now. The deductible for my policy is $500 with a $3,000 out-of-pocket maximum. Once the deductible is met, insurance pays 75% of the total cost of treatment. Luckily my monthly premium dropped by almost half thanks to Obamacare, and it’s now around $250 a month. I will happily celebrate that good news (and gloat to Republicans how Obamacare has improved my life)! Once the $3,000 out-of-pocket amount is reached, then everything is covered at 100%. For the past eight years, at least, I’ve been able to meet both amounts by around April each year, mostly thanks to the huge cost of my Remicade infusions and the other biologic drugs I had previously taken. I also had financial assistance for those medications which helped defer the huge costs of the drugs and helped me get my insurance to cover everything fairly early on in each new year. Well, those days are over.

Beginning Actemra infusions for the first time in late January of this year, I assumed that things would work similarly to how they did when I was on Remicade–financially speaking. Wrong! A month later when I received my first Explanation of Benefits for the Actemra infusion, I was disappointed to see that my share of the cost was only $300 and not the usual $1,000 I was charged for Remicade. Disappointed at having to pay less for a biologic? Crazy, I know. But what was I going to do? It would take me at least twice as long to meet my out-of-pocket maximum. The chance of me being able to stay healthy and out of the doctor’s office for months seemed very slim. I did sign up with a patient assistance program for Actemra, which is a relief, but it doesn’t help me pay for all of the other medical bills I keep amassing. Now I just keep stashing the bills in piles and try to pay them off, bit by bit, even though I feel like there’s no way I can keep up. I have more doctor appointments soon. And more prescriptions to get filled. It’s not fair and I don’t see how I can climb out of this hole in the near future.

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Comments

View Comments (4)
  • Anita
    4 years ago

    If you have your own business, you can get group insurance rates from some insurance companies as a small group of one. I work primarily on contract as a software engineer, using temp agencies/staffing firms as “middle men” because of the complex tax rules that prevent most employers from taking the risk of hiring freelancers — mostly thanks to unions, who don’t like freelancers since they can’t get a piece of that pie for themselves.

    At any rate, this means I change employers as much as 5 times a year, so even if the agencies offer health insurance, it varies so much and often has waiting periods, so it’s better for me to have own through my own business. I do occasionally get direct freelance work, but I also have a side business of online retailing on Amazon, Etsy, and the like, so I maintain a business entity for all that.

    Obamacare hasn’t been great for me, since I had a no-deductible plan with awesome benefits. It was expensive, but it actually saved me money. You can also deduct health insurance premiums as business expenses against your business income, with no floor of 10% like with normal medical expenses, so there were even more cost savings by having a higher premium with less out-of-pocket expenses that could only be deducted the usual way with the 10% floor.

    This year when I renewed, they no longer offered the plan I had and I had to get one with a $500 deductible. My premiums went down, but co-pays went up, so I’m actually spending more.

    Deductibles really make no sense for those of us who are “high maintenance” medically. We know our expenses will always be there, and deductibles can be difficult, especially since the beginning of the year often sees other annual bills popping up at the same time. I suppose it’s just a different sort of pain we have to deal with (like we don’t already have enough pain 🙂 )

  • Grannie55
    4 years ago

    I pay $750/month for a subsidized premium from my retired husband’s former employer for a $500 deductible (no deductible for pharmacy)/$3,000 out of pocket annually. It has such a good pharmacy plan that nothing can beat it, but the subsidy amount was frozen in 2008 with a 2 year warning and it goes up ~$100/month annually… I was working to cover my premiums and medical costs and just couldn’t keep doing it. The fatigue gets so bad now with age (59), but probably not as bad if I wasn’t on Humira. Now, we really struggle with the bills. Where do the subsidies for the medications come from? – I hope not my high premiums and insurance & my co-pays paying the $7500 every 84 days… I get irritated by the advertising because I feel it adds to my cost. (does anyone know?) Luckily I was a good saver before being diagnosed in my 40s and living off that now. I do feel like I am healthier not having a deadline to get up and keeping a consistent bed time. I do have to rest for a bit every 4 or 5 hours of normal activity around the house. Thank you for raising the bills/$$ subject in such a direct post.

  • gclc88
    4 years ago

    I know what you mean, but I have a friend with RA that is on SSDI and he doesn’t qualify for any help. He too gets the Actermra infusions, but it seems they help people who have private insurance but not the ones on Medicare. Well he gets $100 over the limit to get the extra help, but doesn’t make enough to pay his bills either. Some of the places are discounting him and he is paying $25.00..but the problem is that each and every time he goes to the doctor he has another $35.00 copay. He can’t even afford to go to the doctor. Worked all of his life and now has to be treated this way..so sad.

  • Maggy
    4 years ago

    Hi Angela! I know what you mean, but I found some Foundations that help with the deductible &/or copayments. Sometimes they help you go to the PharmaceuTical and they send you or your md the medicine for free. Hope you find some help. Actually I never used the meds you mention but I did find help for Rituxan and for Enbrel.

    Cotton hugs your way~~

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