Two Stories of Consequences of Not Having Insurance through Work

On Tuesday, inspired by Labor Day, we looked at three mental health policy issues for employees. One of those was the declining number of people who have health insurance through their work.

What are the ramifications for people who do not have employer-sponsored health insurance?

Today, two members of the CFYM community describe their struggles to access mental health care services in the absence of employer-sponsored health insurance. After her health insurance through COBRA ran out, Janet faced the prospect of highly-restrictive coverage, then no coverage. Our other contributor’s story illustrates the unpredictability of insurance for people who are self-employed (and their family members).

It is our hope that implementation of the Affordable Care Act will alleviate access issues for people like these, so that their health care expenses become more manageable and their health improves.

Janet’s Story

I’m a 49-year-old woman with a master’s degree in clinical psych (ironically). After 20+ years of treatment for major depression, I was correctly diagnosed with Bipolar Disorder Type II seven years ago. Until recently, when I became too symptomatic to work, I had good-to-excellent health insurance that covered all of my treatments: medication, hospitalization, ECT, psychotherapy, and psychiatrist visits. My COBRA coverage of my health insurance ran out and I could only get very scant coverage that does not cover meds (I take 6 for BP, 4 for diabetes, and a few others), psychotherapy, or most hospitalization costs. I am limited to 5 physician visits a year, and the physicians who take this “insurance” are generally not ones I want to see. After investigating all of the group insurance plans I could think of, to no avail, I have applied for individual coverage but no one wants to cover a diabetic with a severe psychiatric illness and a history of hospitalization. So, my medical bills are almost $800 per month out-of-pocket and that doesn’t include blood work I need regularly, bimonthly visits to the psychiatrist, or the premium for my “insurance.” I don’t qualify for Medicaid or Medicare. I have gone without necessary treatment for my diabetes because I couldn’t afford it after prioritizing my mental health care as a more immediate need, which I will certainly pay for physically later. I’m hopeful I can get adequate coverage when the Affordable Care Act becomes fully implemented in 2014, but that’s still months away. In the meantime, my mental and physical health continue to deteriorate and it will cost a hell of a lot—financially, physically and mentally—to put me back together again.

A Mother’s Story

I am a mother in my late 40s. When my son began to suffer symptoms that would later be diagnosed as both obsessive-compulsive disorder and bipolar disorder it was difficult finding experienced, competent professionals that we could rely on. His condition led to two one-week hospitalizations. At the time we had great insurance, but since my husband was self-employed, we were dropped by that insurance and have since been on [another insurance plan] which does not cover either psychiatric services or psychologist visits. My daughter has also suffered from depression and anxiety so we have been hit pretty hard financially but are very fortunate to have a nice savings account that has helped us survive this health crisis financially. Other people are not so lucky!

0 comments