Health Insurance Woes

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Being diabetic, I’ve had my fair share of dealings with health insurance companies.  However, three (almost four) years ago, I started working for my husband’s company and I got to deal with health insurance companies from the benefits administrator side.

Prior to working for my husband’s small business, I worked for a non-profit and we had amazing insurance, at the cost of a lower salary.  My deductible and out of pocket max were $500 and after that everything was free-queue the stockpiling of supplies!  I knew when I switched to my husband’s company things would be different.

When I started working for my husband’s company, I applied for a group health insurance plan for the two of us.  At the time, Obamacare wasn’t in action yet so when I applied for the two of us, we were charged an exorbitant rate because of my pre-existing condition.  They couldn’t deny me because it was a group plan but they could sure as heck could charge me and arm and a leg, and they did! Because we were a small group plan, my husband got charged at the same high rate that I did so our monthly insurance premiums were sky high.  On top of that, our plan wasn’t even that great.

Thankfully, Obamacare came out the following year and health insurance companies could no longer discriminate on my pre-existing condition and all they based the rates on were age and sex.  Because of this, our rates decreased dramatically so we were able to get a better plan for cheaper.  Our insurance broker told me that we were the only company he had seen where Obamacare actually caused prices to go down!  I guess most small businesses didn’t have a person with a pre-exisiting condition on their payroll so their price would have gone up.

How lucky was I! Or so I thought.  We had only one year of this nice plan and then it turned out that, again thanks for Obamacare, we were dropped from our Group plan!  I guess under the new Obamacare plan (in Virginia at least) a husband and wife team aren’t eligible for a group plan.  We would have to hire another employee to qualify or be dropped.  Because we didn’t have the means to hire another full time employee, we were dropped. The crazy thing is that we could be a father/daughter team or a brother/sister team and still quality but because we are a husband/wife team we don’t.

I was pretty upset when I first found out we were being dropped from our good group plan.  I started looking into the individual plans and none of them were as good as our group plan.  Oh well, it is what it is.  I selected a plan and that was it.  But nothing is ever easy!  I didn’t mention above but when we first applied to our group health insurance plan, it was for November.  So we were on a November to November plan.  This worked fine for the three years we were on a group plan. This year, when we found out we were dropped from our group plan, we again signed up in November for our insurance plan.

Everything was going just fine.  I had a $1500 deductible and a high out of pocket max, but I can usually get to that so I started ordering supplies and had a few doctors appointments.  I easily reached my $1500 deductible in the first month and was on my way to reaching my out of pocket max (I like to reach it sooner because then I get a few “free” supplies/appointments towards the end of the “year” plan.

At the end of November, I got a letter in the mail telling me how my plan was going to change at the beginning of the year.  I didn’t think much of it because I figured it meant when our plan year was up.  But then I got the invoice for January and it was higher than my December invoice.  This can’t be right!  I called my insurance broker and he told me that ALL individual plans start over January 1st, including mine!  I have always been on a November-November year so I had no idea it would re-start January 1st.  My insurance broker didn’t tell me that would happen either.  When I asked him about why he didn’t tell me he said he figured everyone knew individual plans were January to January.  If you have never been on an individual plan before in your life, how would you know that?!

So all the money that went to my deductible and out of pocket max goes to ZERO starting January 1st.  It’s like I essentially lost $2000 that otherwise would have gone to my OOP max.  I was so livid when I found this out on Monday.  Not only was I pissed that I lost that money but if I had known I was only going to have a plan for two months, I would have gotten the cheapest, crappiest plan.  I would have postponed my doctor appointments and waited until January 1st to order my supplies.

I’ve had a few days to calm down but hopefully this will be the end of the insurance woes for a while.  I am now on an individual plan that I know now is January-January.  I know I am not going to have the best insurance but at least I have insurance.  It’s been a pretty frustrating few years dealing with the insurance company but I hope things will be a little smoother going forward.  I still don’t know if Obamacare is a good thing or not.  On one hand, I love how they can’t charge you based on a pre-existing condition or deny you (I wouldn’t get an individual plan otherwise!) but it does suck that I can’t get a group plan anymore for my husband/wife company.  I just hope that I don’t have to deal with more health insurance woes when a new president gets elected next year…can I just have one or two years of peace with health insurance?!


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