Many people in both my professions (writing and law) are self-employed and, as do I, face the on-going issue of how to pay for healthcare or obtain health insurance. With the changes occurring due to Obamacare or the Affordable Healthcare Act, whichever you like to call it, I thought it might be helpful to share my journey. I plan to check out Illinois' healthcare exchange on Tuesday, October 1, 2013 and will report on my progress.
I first purchased an individual health insurance policy a couple years out of college. I had a group plan at my office job (my degree was in Writing/English, thus the office job), but I'd discovered I could earn more temping through a downtown agency and give myself the freedom to take time off to write. I shared an apartment, lived on a very limited budget, and usually worked about 3 weeks, then took 1-2 weeks off to write, which I loved. My limited hours meant no health insurance through the temp agency. For less than $100/month I got a policy with a high deductible that I kept for about 4 years. Never met the deductible. I had no trouble qualifying, I don't even recall if the form was long or short or what questions there were, though I'm pretty sure someone came out and gave me a blood test. A few people told me I was young so I ought to just go without coverage, and I could always get treated at the county hospital. That sounded like a very bad idea. One of my friends, a year younger than me, out of the blue needed emergency surgery during a brief coverage gap. Her bill was tens of thousands of dollars, and she earned not much more than minimum wage. (She eventually finished paying about 15 years later.) Also, I felt that if I could afford health insurance, I should buy it, especially because I'd chosen to work less and earn less. Unlike many people who find themselves without insurance, I could have opted to stay at my job and keep my benefits.
Fast-forward a few years, and I developed carpal tunnel/tendinitis from all the typing for work and for my own writing (and my guitar playing). The treatment options weren't good back then, and the work comp doctor recommended working until it got really bad, then having surgery. I researched a little, learned that many people needed surgery again when they returned to work, and decided I ought to find something else to do for a living. It was a very rough time for me, but eventually I returned to school, earned a graduate paralegal certificate and got a paralegal job where I relied on my research and writing skills and had a secretary who did the majority of my typing. (Not everything was computerized at that time.) I also had health insurance with an exclusion for carpal tunnel/tendinitis, as I worked at a very small firm and the policies were more like individual than group policies. As I'd rejected the idea of surgery, the exclusion didn't affect me too much, but it didn't make me happy. I didn't know what I'd do if something aggravated my hands and I needed treatment.
Later I went to law school and became a lawyer at a large firm that had a group plan with Blue Cross. Hooray! No worries on exclusions, though I never needed treatment for the carpal tunnel while I was a lawyer, having discovered the Microsoft Natural keyboard (which I'm using right now). Even before I went to law school, I'd had in mind that eventually I'd open my own practice. Partly, again, so I could take time to write when I was able to afford it, and because I wanted to work for myself. It turned out I liked the large firm quite a bit, so I stayed 8 years. After year 6, though, I started talking to people who'd started their own firms to gather information. One thing I always asked, given my previous experience, was what they'd done about health insurance.
Those who were married generally got coverage through a spouse. Others practiced part-time and had a full time job where they got health insurance. Some tried to get insurance through an organization, like a bar association or writers' association. It turns out those types of plans are not group plans, but individual policies where the members get discounted rates. Which means, unlike a group plan, the insurer can turn you down. Which happened to a colleague when she opened her practice. I was shocked, as she'd never had any health issues and had only been hospitalized when she had her children. But she'd sought counseling during her divorce and was turned down even though she'd applied through the Chicago Bar Association (she was a member). The carrier — one of the major, name brand ones — said they don't cover people who have had any type of psychological counseling. She got insurance through another major carrier.
I decided to use COBRA for my first eighteen months on my own, which cost over $400 a month but kept my Blue Cross PPO. Everyone told me health insurers only look back 5 years, and I didn't see anything in the last five years that should be troubling, though I had gone to counseling for relationship issues myself before that time. I hadn't had any major health issues other than the carpal tunnel. My friends and colleagues thought I was crazy to be concerned. My only medications were for allergies, I don't smoke, I exercise and am within the recommended weight range for my height, and I'd only missed perhaps 3 or 4 days of work for illness in my eight years of practice. So I figured when my 18 months was up, I'd apply for an individual policy and I'd be set.
That didn't turn out to be the case. But more on that next post:
The Awakening for Kindle: http://bit.ly/15bViBm