Tuesday, April 14, 2009

Healthy Health Insurance

For obvious reasons (like, say, quadruple bypass heart surgery!) I am grateful that I have health insurance. Mine is through Kaiser. So far, the costs of the initial testing and subsequent surgery total $47,458.12.

My personal costs? $20 in co-pays for two office visits plus another $30 for additional medications.

I went back to work full-time yesterday, exactly four weeks and two days after the surgery.

Health insurance is on my mind because a colleague submitted her resignation in my absence, and I can't help but think she's making a terrible mistake. She's not happy with her supervisor, but the two of them have worked together for over 25 years. What would another couple of years matter?

More importantly, she's only 62. She can get social security, but she won't be eligible for Medicare for another three years. Unfortunately, even if she can afford COBRA (and I'm not sure she can) it will only cover the first 18 months after she leaves. That means she will be uninsured for another 18 months until Medicare kicks in.

Her response? "I'll just go to the emergency room. Besides, I'm healthy."

Umm--Hello? Didn't my experience teach you anything? I thought I was healthy, too. Instead, I've been a walking time bomb for years.

Who wants to risk a $47,000+ debt hanging over their retirement?

Not me, that's for sure. Now if I could just persuade my colleague.


Anonymous said...

Do you think you can write a post about your health? Did you feel sick before you got your operation? What is your cholesterol level? What foods you eat? How do you think this happened to you? Were there any warning signs?
I'm wondering if this could ever happen to me. Any advice on what to do to prevent this?

Grace. said...

Hmm--probably not a post because it really isn't about finance. But how about a really LONG comment?

My blood pressure and cholesterol levels are normal, thanks to years of meds. However, I've been a type II diabetic for ten years. And, thanks to parents and grandparents with histories of heart disease, I have seriously bad genetics. I'm pretty much of a couch potato and I don't really watch what I eat--at least up to now.

Warning signs? There was only one. While in Japan, I noticed that whenever I exerted myself, I became winded quickly and it took a minute or so to recover. I chalked it up to the Japanese habit of building temples at the top of hills on top of gigantic stone steps. But when I continued to get out of breath upon mild exertion after I returned home, I checked it out with my doctor. At first, she thought it was a respiratory issue, but all the tests were negative. Then she moved on to the heart. My EKG and blood tests were normal. My stress test? Not so much. That led to the angiogram which showed major blockage, which, of course, led to the surgery.

There is a lesson here. Women are more likely to die from heart attacks because they never know they even have coronary artery disease. Women often don't have pain or even chest pressure. It is shortness of breath, unexplained anxiety (particularly at night or early morning) and the sensation that swallowing is difficult even though one can still eat that are more common in women.

I feel very fortunate that my condition was discovered and corrected.

Imee said...

I hope you do persuade your colleague. I think she should realize that health doesn't just rely on how you feel but also through exams--it's possible that she has some diseases are camouflaging as we speak. Besides, in a recession like this, she's quite lucky to still have a job--there's countless out there who are amazing at what they do and still lost their job because the company they work for need to make cuts...

Sharon said...

Does your coworker know about having to only pay 35% of Cobra? It's a sweet deal at this point, as the gov't is kicking in the other 65%. She should NEVER be without insurance, maybe get a policy for catastrophe insurance, like for say, a quadruple bypass?

I'm so glad you are doing good, and are back to work!!

Grace. said...

Would someone who has voluntarily left employment be eligible for the government assistance with COBRA? I am aware of the subsidy but I thought it was only for lay-offs or involuntary dismissals?

Sharon said...

oops. You are right. I forgot that she left voluntarily.

Retired Syd said...

It is scary, this possibility of being without health insurance! If I were your friend, I would shop for a high deductible plan now while she is healthy. It's likely to be cheaper than Cobra.

Under HIPAA, if she does do COBRA, she is guaranteed coverage at the end of the COBRA period (although, not guaranteed at a price she can afford.) Each state has a different set of rules but HIPAA is Federal law, so available in all states in some form.

Living Almost Large said...

Glad that everything worked out!

Jerry said...

COBRA is fine, but it can be prohibitively expensive insurance. When my wife left her job and we needed the coverage, it would lead us to pay about $1000/month to cover our family of three. It was more than our mortgage!

Hattie said...

Hello, Grace. Just found your blog via Rhea.
I, too, have Kaiser, as did my late mother in law, who lived to be 97. She was well (enough) looked after, although I think they might have given her a little more attention and help. She was not as pro-active with physicians as I am.
My doctor stresses prevention, so in the last months I have had a colonoscopy, pap smear and "well woman" exam, and mammogram, consultation with a dietician, and a hearing test. I get my blood tested regulary as I have "borderline" blood suger. My medical costs in the past year: a about 25 dollars for office visit co-pays.
Kaiser also offers dental coverage most places, but not where I live.
I am over 65 and so have Medicare.

Anonymous said...

No one should be without health insurance. My partner and I got individual policies before we lost group coverage and they were cheaper than COBRA. Also allowed us to keep my partner's policy even after he was diagnosed with cancer (he's fine now). You simply can't find coverage after you've been diagnosed with a serious illness, even if you're deemed healthy again.

And, Hattie, I am unclear how you could have both Kaiser and Medicare coverage. Kaiser is one of many HMOs that can be chosen to take the place of traditional Medicare. With traditional Medicare, you can choose your physicians; with HMOs, you cannot. Traditional Medicare can be supplemented with various insurance policies to help cover costs, but those policies are expensive. I know; I now have one.

Health insurance costs must be reduced. We simply can't afford to pay gigantic premiums and have as our only alternative an HMO which requires us to use only certain physicians, certain hospitals, and certain drugs.