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I finally have insurance, and it’s a blessing and a curse.

Like many fortunate people out there, for years I took for granted my health insurance.  I was covered continually from birth onward.  When I graduated college, my parents got coverage extended so that I could continue to be on their plan.  I remember working at Starbucks in college and meeting folks my age who were working there because of the “great benefits.” At the time, this meant virtually nothing to me. Because of my parents’ generosity and willingness to keep me on their insurance plan, I was extremely fortunate in that I didn’t have to worry about insurance coverage for the majority of my life thus far.

In between my year of AmeriCorps and my enrolling in graduate school, I had to get insurance for myself. My mom helped me navigate the waters and emphasized how important it was for me to have continuous coverage, no blips or even one day without coverage.  I didn’t understand the intricacies of this but followed her advice to a T.

When I started graduate school, I moved seamlessly to the University of Georgia’s student health plan.  I went to the doctor whenever I needed to, no hesitation, and I took good care of myself at a very low cost.  Again, I totally took this for granted. I just thought this was how the world worked—pay a negligible amount of money per month and your medical needs are covered.  At worst, you may have to pay minimal fees for out-of-pocket visits.

In summer 2006, I finished graduate school and wasn’t sure what my next move would be.  I was lucky enough to get a good insurance plan.

And then I was unlucky enough to lose it.

Due to a paperwork error on behalf of the not-to-be-named insurance company, I got dropped. The moment I realized their error, I made many phone calls, to no avail.  Because there had been a lapse in my coverage—even though the lapse was the insurance company’s fault—I was seen as a new applicant with a preexisting condition, migraine disease. And I was rejected.

I had no recourse.  After being rejected by numerous health plans, I just decided to give up the fight and go insurance-free.  And you know what? It wasn’t bad at all.  The main concern was that I might get in a serious accident or be diagnosed with a new disease that would require expensive care.  But, all in all, having no insurance was pretty affordable—most healthcare providers cut me a break when they found out I was paying out of pocket, and I used prescription assistance programs to afford my meds.

Despite how easy it was for me to live without insurance, I was counting down the days until I could get insurance again. I thought of what a relief it’d be to know I was covered.  How I’d finally undergo some pricey tests I couldn’t have afforded otherwise. How I’d turn into someone who went to the doctor regularly because my visits would be more affordable now that I only owed a modest co-pay.

I’m six months into having a pretty great insurance plan and haven’t been using it to my advantage.  After I pay the premium at the start of each month, I end up without much money to pay those copays.  And—get this—now that I have insurance, some of my medications (notably a biologic my rheumatologist prescribed to me for management of my psoriatic arthritis) are so expensive they are not an option for me—after my insurance discount and income assistance, they still cost almost as much as a month’s pay!  These are the same medications that were totally free when I had no insurance. I try to explain to the insurance company and the prescription assistance programs that I actually have less cash than I ever did since I pay so much for the insurance, that now is the time I am cash-poor and really need assistance, but they can’t help.

Turns out having good insurance is a blessing and a curse.  All in all, I remain grateful for it, but it’s definitely more of a pain than I bargained for. I thought it would serve as a passport to better health, but in many important ways it’s been a gatekeeper.

How many of you have seen the benefits and the drawbacks of changing insurance coverage? What does and doesn’t work well for you now that you’re insured?

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

Comments

  • Sandy
    5 years ago

    that is why i am always broke. meet my deductible every yr. i try to c my internist as much as possible and specialist least. specialists charge double what my internist charge. i get more bang for my bucks seeing internists.

  • Kat
    5 years ago

    I haven’t had insurance for five and a half years now. When we did have it, I was paying high deductibles on top of that, so I didn’t use it much. Now insurance is through the roof, and we have no extra for premiums, much less the deductible and co-pay. On top of that, I’m starting to suspect that food is the answer to many things we are given drugs for, which in turn give us side affects. I have a lot of research and healing to do before standing on that thought, but so far, it seems to be promising.

  • tucker
    5 years ago

    And don’t forget that many insurance plans have formularies – so your lucky *if* that drug is even covered at the very expensive copay…. Many times there are so many haggles with prior authorizations that doctors won’t even deal with them. My neuro will get a prior auth for meds if you pay a $25 fee. So I pay an extra $50 per year for 2 meds that cost me over $100/month in copays. But at least I can get them.

  • Staceymae
    5 years ago

    Thank you so much for writing this. Is exactly what I am struggling with. My Dr wants to run some expensive tests,
    MRI & EKG, and send me to neuroloogist, so now I have to get
    Insurance. In doing so, many of my Rx go up in price and I will lose my Relax program. My copay are 1/2 of what I pay in cash. I can get more tests, but the monthly Rx and new insurance payments are going to be exorbitant. So yes, blessing & curse, for sure.

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