by Marilyn Kruse

In 2003, I walked out of a job at a large school district where I had worked for the last 14 years with few regrets.  The job never really suited me, or vice versa, but I had given it all I had.  Now it was time to move on, and help with some family issues that had been put on the back burner for too long. However, I was beginning to feel some trepidation about health insurance. 

I loved my HMO and dreaded losing it, but as I moved from a large group employee pool to individual, the prices of my premiums skyrocketed.  When I realized they could cost as much as $1000 a month in a few years, I had to let my beloved HMO go.

For the next four years, after a pay cut of thousands, I could only afford catastrophic insurance with large deductibles. I would cancel the policies after they became too expensive due to the 6-month premium increases, and find another. None of these insurance companies ever paid any of my health care expenses. Then one day, I landed in a hospital for an unexpected emergency for 4 days. My bill for four days was $20,000, and left me wondering how I could afford any insurance premiums at all. Of course, my insurance didn’t pay a dime of my bill, citing pre-existing condition as the reason.

At this point I was angry and frustrated.  Given my age, I had begun accumulating several more “pre-existing conditions.”  When I realized that insurance would cover none of them, I decided to gamble and cancel the insurance. After all, no insurance had helped me since I quit my job. So I was without insurance for 7 years.  I wouldn’t recommend this position for a person approaching their 60’s.  I spent much more time researching different problems on the Internet.  And when I was diagnosed at a questionable clinic as having carpal tunnel, I was panicked with visions of losing the use of my hands. Plus, every time I needed to renew a prescription, I had to pay $100 at another clinic. I was always worrying about one health problem or another. So many times I longed to just be able to call an advice nurse at the HMO.

Then I lost the gamble when I had an accident with a bad disc that impinged on the nerves in my foot and leg.  I was in pain and so frightened of what I should do. I couldn’t afford an MRI, so went to a chiropractor. That cost me about $5,000 altogether out of pocket, but of course it could have been much worse.  After accumulating the medical debt, I finally received the wonderful news that I had been accepted through the ACA for health insurance.

The entire process had taken about a month and a half, during the peak of all the controversy about failing computer systems, etc. First I had to apply for Medicaid, and only after I was refused, could I begin applying for a subsidy. I was scared off the computers temporarily, so applied directly to the marketplace at Connect for Health Colorado by phone. There were a few glitches and delays, but it turned out to be worth it. The premiums were only $55 a month, and the subsidy paid the remaining $611. The ACA allowed me to get the MRI, that normally costs thousands of dollars, and see a neurologist for only $10 total. 

Now it is July 2014, and I have returned to the HMO that I originally lost. I feel like a child bathed in a warm, soothing bath of safety and security.  Thank you, ACA! I definitely couldn’t have done it without you.

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