Why Is My Health Insurance Coverage Getting Worse Instead of Better?

Meagan Esler

| Oct 22, 2012

I’m not sure how everyone else is feeling about health insurance in the United States of America right now, but I know I’m worried. Ever since my type 1 diabetes diagnosis at 18 years old, I’ve been concerned about the possibility of losing my health insurance. But now, I’m even more worried by the fact that, despite my health insurance, my healthcare costs seem to be rising by the minute. It strikes me as colossally unfair that you can faithfully stick with your employer and still end up with health insurance that’s much worse than what you started with.  I feel overwhelmed by the new costs I’m seeing, and I’m sure I’m not the only one.

About a year ago, I had HMO insurance from Blue Cross/Blue Shield, and my prescription coverage was also through Blue Cross/Blue Shield. Although some of my prescriptions were expensive (because there is no generic for medications like insulin), they weren’t totally out of reach. Others, like test strips and glucagon, were even free.

Unfortunately, my employer, a hospital, stopped carrying the HMO option, began offering PPO insurance instead, and started using a different prescription provider, called Medco.  Since that time, my costs have been skyrocketing. Now, it’s scarier than ever to go to the doctor or pick up prescriptions, because I simply don’t know what kind of bill to expect.

For example, this year I required a laser procedure to close a hole in my retina (unrelated to diabetes). When I had this procedure before, it cost me only a $30 copay to seal multiple holes in both eyes.  Imagine my surprise when I received my bill this time: I had to pay nearly $900 for a single laser procedure, on one hole, in one eye, from the same doctor’s office I’d used for the previous procedure. Prescriptions have also increased quite a bit.  My insulin has gone up, and my test strips and glucagon are no longer anywhere close to free. I have to wonder, just how much scarier can things get?

While I’m extremely grateful to have health insurance, I do pay a lot of money every month to buy it, and so does my employer. So why can’t I comfortably and affordably visit the doctor?  I’m always afraid of another giant bill that will really hurt us financially. Now that I’m spending so much more on medical procedures and prescriptions, losing my insurance coverage sure isn’t my only worry. And I can’t help but wonder how everyone else out there is faring with diabetes and insurance.

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Categories: Diabetes, Diabetes Health, Diabetes Health magzine, Diabetic, Health Insurance, HMO, Type 1 Issues

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Posted by Anonymous on 6 December 2012

I also have Medco for prescriptions. As of September of this year, they pay for all of my insulin, test strips, anything to do with diabetes.

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