New Year, New Bills

January 1st is usually a date that’s welcome and met with hope and enthusiasm, a chance for people to meet goals and better their lives in the new year. Not for me, however. I usually dread this date, as it cruelly resets my private health insurance policy back to “0” or “Start-Over.” This isn’t a good start-over, either. Instead it means that I’ll have to meet my expensive deductible and out-of-pocket maximum before my health care costs are covered at 100% (as they are right now, finally). The type of policy I have is co-insurance, which means that after my deductible is met, then all medical costs are covered at 75% with me owing the remaining 25% of all costs until my out-of-pocket maximum limit is met. This includes all doctor appointments, medical procedures, physical therapy, and prescriptions (I’m probably missing something). So for the month of December, like usual, I’ve been running around like a maniac trying to squeeze in doctor appointments, my iron infusions, and getting as many prescriptions refilled as possible before January. December is a hectic month anyway, without the added stress of being in “panic mode” trying to cram in as many medical appointments as possible before one’s health insurance goes back to being crappy and expensive. It’s a ridiculous and crazy way to have to live, yet right now I have no other choice.

The other sad and frustrating thing is that I’m still paying off medical debt from LAST year. Because I switched from Remicade to Actemra in January 2015, and the fact that Actemra is less expensive than Remicade, I didn’t reach my deductible and out-of-pocket limit until much later than I usually do. And I was sick a lot right away, which meant many doctor appointments early in the year. With Remicade, I had a nice little “system” going: I’d try hard to not go to doctor appointments until after my Remicade infusions helped me meet my deductible and out-of-pocket limit. The reason Remicade didn’t bankrupt me was because I luckily received financial assistance for it from the drug company’s co-pay/co-insurance program, Remistart. Well, switching to the cheaper Actemra put a pricey kink in that plan. And now that I’ve recently started Xeljanz, which is even less expensive per month than Actemra, I’m afraid that my medical bills for 2016 will be the worst they’ve ever been. It may sound crazy, but I’d be in better shape in 2016 if Xeljanz were more expensive. How do you stop this horrible, insurmountable cycle of medical debt, even when you have insurance?

I feel like a lot of people wrongly assume that just because a person has health insurance then everything is affordable and fine. Hardly. Like I said in the previous paragraph, I’m still trying to pay off medical debt from 2015. I’m currently in collections for it, which is embarrassing and demoralizing. Also embarrassing, my parents still help me somewhat with my health insurance, yet I’m still in debt. My father’s answer to this is the “miracle answer” –get a “real job” with BENEFITS! I don’t know what these magical benefits are that he’s talking about, because as far as I know, even if you receive benefits from your corporate job, there’s still a good chance you’re going to be hit with a high deductible and out-of-pocket limit. Friends whom I’ve talked with about this have confirmed that their benefits from their jobs are actually worse than my insurance plan. I’ve tried explaining to my father, “Dad, this isn’t the ’90s, or pre-2008.” Health care costs and health insurance costs are not as affordable as they once were. “Ok, so get a government job with benefits,” says Dad. Ok, sure, easy. I’ll get right on that.

One option is to look into MinnesotaCare, which is a health care program for Minnesota residents with low incomes. I’m not sure if I can even qualify for this, however, because my monthly/annual income might be too high (which is laughable). I’m also not sure if the fact that I currently have a health insurance policy makes me ineligible. I should probably try to speak with someone who works for the program about it though.

Finding a cheaper plan via “Obamacare” and the open health care exchange might be another possibility and it’s one that I also haven’t looked into yet (MNSure). However the thought of changing insurance companies, policies, and plans makes me very anxious. What if I switch to something else and the company raises the rates substantially? Or what if I switch to a different company and the company decides to pull out of the marketplace? I’m going to doctor appointments all the time and I reply on expensive medications and treatments. Being without insurance for even one day is way too big of a risk.

Here’s a disheartening and worrying article I just came across from October 2015 about the expected rise in 2016 insurance rates through MNSure:

“Ouch! Officials unveil big hikes in 2016 MNSure insurance rates”

Ouch is right. My own insurance policy has taken a hit as well, and the monthly premium has increased, not surprisingly. When The Affordable Care Act was first passed, the new legislation helped to cut my premium payments by nearly half each month, which was great. With the new increase for 2016, the premium is still less expensive compared to what it once was, pre-Obamacare. However, how soon will I be back right where I started?

For years I’ve joked about wanting to flee the U.S. for Europe, and a more affordable and patient-friendly approach to health care. A friend once told me that “joking is 50% truth,” and now, well, maybe that “fleeing to Europe” joke isn’t even 1% of a joke anymore. I don’t know what to do, but I know that I can’t continue living in this depressing and unfair cycle of medical debt. So tonight as I watch the ball drop in Times Square in anticipation of 2016, I’ll be feeling my stomach drop a bit too. Bring on the bills, I guess? Despite feeling worried, angry, cynical and depressed about a new year of expensive medical bills, I do hope that 2016 will be the year I can get my health care debt and expenses under control. Somehow.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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