Now that a new healthcare bill has passed the House and moved on to the Senate, there is much discussion about the changes proposed. No one knows how the final bill will read, but it looks as if two groups in particular could be subject to significantly higher premiums: those approaching retirement age and those deemed to have preexisting conditions.
Remembering my own entry into the individual insurance market in 2003, I shudder to think how this scenario might play out in the lives of millions of Americans.
I came to Lexington from Pennsylvania after my husband died suddenly from pancreatic cancer. I closed the company we’d owned together, put my house on the market, and moved into a condo near our daughter. I was 58 years old.
I was pleased to learn that “average” individual health insurance premiums for someone my age were about $220 per month. Though higher than our company’s group plan, $220 was still reasonable.
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I completed the application, answering each question thoroughly and truthfully. Yes, I was currently covered by insurance. Yes, I had been a smoker but had quit 20 years before. No, I did not drink alcohol except for the rare glass of wine. No, I had no current medical problems and my blood pressure, cholesterol, glucose levels, etc., were normal. No, I did not take any medications on a regular basis. Yes, in the 1980s I’d been treated for hyperthyroidism, with no problems since. Yes, at one time I had seen a psychologist for clinical depression, again with no current issues. Yes, I was overweight. No, I had never had cancer or any other serious disease.
I considered myself pretty darn healthy, so when I received a quote from one insurer for $650 per month and a letter from another refusing to insure me, I was flabbergasted.
My agent next steered me to Kentucky’s high-risk pool. This “bargain” offered premiums around $450 a month, plus a very high deductible and co-pays. But by this time I was happy to get insurance at all.
I remained in the high-risk pool until March, 2005, when I got a job with benefits. When I later resigned to pursue a career as a freelance writer, I became eligible for COBRA, a federal program allowing workers to remain on their former employer’s health plan for a period, usually 18 months. Premiums vary by plan; mine were about $130 a month.
I was thrilled. I was also cautious, knowing I would eventually return to the individual market. Fortunately I never needed a doctor during that time, but to be safe I avoided any medical procedure, even routine gynecological care. Who knew what might trigger sky-high premiums down the road?
I remarried in 2007. My new husband was covered by Medicare and a Medicare supplement, but when my 18-month reprieve ended I was only 62 and once again at the mercy of the insurance industry. No insurer turned me down, but the best deal I could find had a $2,500 deductible, co-pays, and a monthly premium in the high $300s. By 2009 the premium had jumped to $550. It would have been $650 in 2010 had I not turned 65 and become eligible for Medicare.
Seven years later, my combined cost for Medicare Parts B and D plus a supplement is slightly over $300 a month. I can see any doctor in the U.S. who takes Medicare, and nearly 100 percent of my costs have been covered.
At 72, I still don’t take any medications on a regular basis and rarely see a doctor for anything but preventive care — except in 2013, when I had knee replacement surgery. Thank heavens my knee remained healthy until I was covered by Medicare. Can you imagine how insurers might rate this preexisting condition?
Susan Owens is a freelance writer in Lexington.