Medical Expenses and Insurance

I have a friend (let’s call her Sally) who talked to me recently about how much her medical expenses have increased over the past year. Before she started seeing a psychiatrist for some of the issues she was having emotionally, she was on one medicine, and that was for a stomach issue that she’s had for several years.

About a year ago, Sally was diagnosed with several emotional disorders. This made her medical bills in a year six times more than what she’d originally had to pay in a year. Check out the difference:

Before the medication:

  • $48/year on stomach medication
  • $100/year for 1 doctor visit. Sometimes.

After the medication

  • $156/year on stomach medication (they switched her meds for this too)
  • $360/year on ADHD medication
  • $216/year on anti-depression/anti-anxiety medication
  • $200+ on doctor’s visits

Now, Sally still isn’t covered by health insurance. For it to be worth it, Sally would have to find insurance for $77/month or less… and then her visits and meds would have to be free for that to be worth it. We all know that’s not the case, so she’d have to pay less than $50 a month for it truly to be worth it. She doesn’t make a lot (about $12k a year), lives on her own, and doesn’t have any family around to help her out.

What’s she supposed to do? Luckily, she can afford all of her stuff out of pocket until the government requires her to get insurance. At that point, she hopes the government or some other entity will be able to help her get cheap insurance or that she’ll be able to get it through her job.

I bet you’re thinking, “What are her options?”  or “what are mine, if I’m in a similar situation?” Let’s explore that a little bit.

  • Go to a state or federal government site. Both have ways for you to figure if you are eligible for state or federal health insurance. Sadly, when Sally did this, she found out her premium was going to be more than what she pays in a year… and almost as much as she makes.
  • Go through a faith-based organization. There are several faith-based “insurances” that are basically assistance programs that, if you participate in them, will make you exempt from the mandate to have health insurance.
  • Just wait it out. Some specifics haven’t been outlined in the law as of yet. No one really knows how long it will be until it’s mandatory to have health insurance and how much the fines and fees will be if you don’t get it. Sad to say, in some cases it may still be cheaper to get fined. We won’t know that for awhile though, especially if ObamaCare gets repealed.
  • Just deal with it and get a plan. Sally doesn’t like this option at all. She simply can’t afford to get insurance. She has the only kind she can afford (accident insurance) and it doesn’t count!  Some people will just take it as it comes and buy a plan. Sally simply cannot.

It’s not a lot of options, but they work.  Hopefully, as time goes on, it will become clearer how it will be affordable for every American to have health insurance without breaking the bank. Until then, Sally’s going to just keep shopping around and paying her health bills as they come.

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