Disabled Woman Sells Home to Pay Health Premiums

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"I am really struggling. After food and housing and a few necessities my income basically goes to health insurance and health care."

My health insurance premium jumped up 15.6% over the first three months of this year, on top of a 346% increase from 2005 to 2012. At the same time my deductible has jumped from $1,000 in 2005 to $6,000 now. With a monthly premium of $764, a $6,000 deductible and another $12,000 I have to pay each year until 100% coverage kicks in, I am really struggling. After food and housing and a few necessities my income basically goes to health insurance and health care.

I’ve had an individual policy with Blue Shield since 1990. In 2005, I had to abandon my $191 per month $1,000 deductible plan for a $5,000 annual deductible plan. In 2012 the premium for the plan, which had a 30% copay and $7,000 out-of-pocket for allowable services, went up 346% to $661 per month.

With the implementation of Covered California this year, I had to switch to a plan with Blue Shield that started in February at $740 per month with a $6,000 deductible for medical and $200 for prescriptions. In March they increased it to $764 – a 15.6% increase over 3 months, on top of the 346% hike from 2005 to 2012.

Not only have my costs gone up, but my providers are suffering as well. For example, the plan only pays one of my providers $28 for a $75 treatment I regularly need for a chronic and debilitating condition. Most providers would drop me, but I am lucky this provider is willing to treat me at a loss.

My income from self-employment had been nearly flat with less and less of it expendable each year. Now I’m on disability income until I’m eligible for Social Security.  I’m really struggling to keep this unaffordable insurance but I have no options. My husband just retired at age 79 after working full time all his life; he’d been working mostly to support my health insurance costs and to keep us afloat. We just sold our home and will now rent to reduce our living costs to fit into his Social Security benefit.

This year my premium cost – barring any further increases – will be $9,041, plus the $6,000 deductible, plus $12,000 more out-of-pocket before Blue Shield covers 100% of charges they choose to allow. That’s $27,041 and doesn’t include my prescriptions or anything they deny.

I figured out that this last increase brings my premium cost alone to 34% of our taxable income. Add in the deductible and co-pays, and it’s actually far more. For the past 3 years, I’ve had to claim $30,000 in out-of-pocket medical costs on our income taxes – health insurance premiums plus all the costs Blue Shield won’t pay. Now that my husband is retired, what am I supposed to do about 2014’s expenses?

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