Before I can begin medical school, I have to prove that I am immune against and/or do not currently have: measles, mumps, rubella, chicken pox (AKA varicella), tetanus, diphtheria, pertussis, hepatitis B, tuberculosis, and polio. I think that’s it. Unfortunately this isn’t as simple as submitting a copy of my immunization records. I’m required to submit lab results showing that I have in my blood the antibodies against these various bugs and viruses. And since I can’t get a TB skin test, I will have to get a chest X-ray in addition to these various blood tests. (When I take a TB skin test, it will always come out positive whether or not I have tuberculosis. This is because I either had the TB vaccine as a kid or was exposed to TB. Or both. It’s a long story.) All of the above is not a big deal with health insurance. I would just make an appointment with my trusted general practitioner, hand over my form from school, give up a few vials of blood, endure a few seconds of radiation, and that would be that. Oh, and maybe fork over $25-50 for a co-payment.
Unfortunately it’s been a much more frustrating process. And to answer the question: technically yes, I do have health insurance.
I suppose I had this headache coming to me for quitting my conventional full-time-job-with-benefits much sooner than was practical. I have to confess that when my coverage from work ended, I thought about going without health insurance until I started school. It was probably an unnecessary expense, and a pricey one at that. I don’t remember the number exactly, but continuing my previous coverage from Kaiser Permanente (via COBRA) would have cost something like $600 a month. (COBRA is the law that allows people to stay on a group health plan, generally provided by a previous employer, when they become unemployed.) The alternative for staying insured was the individual insurance market, but after looking at a few plans, I was still on the fence. A friend from work and my robust sense of guilt convinced me to purchase a plan with a high deductible for catastrophic coverage. Just in case. It also helped that my boyfriend chose to buy individual coverage for himself after he had quit his job a few months prior. It would have been kind of hypocritical for me to become uninsured.
So this is what I have: a PPO plan with a $3500 deductible, meaning that all of my health care needs up to $3500 will be paid for by me and any amount exceeding that will be paid for by my insurer. It’s in my bank account’s best interest that I find the cheapest possible doctor and lab for my blood tests and X-rays. Thus, I stepped into the quagmire.
I tried to get my medical records from Kaiser, since I had some of the required bloodwork and booster shots within the past two years. Brick wall #1: it is too absurdly hard to get your medical records in this country. I had to pay to get a copy of my medical records (since it was for “personal use”). The patient records representative who took my release form said it would take 15 days. For the billing department to send me the bill, which I would have to pay before the records department would send me my records. Wow.
I was annoyed that I would have to pay for an office visit, since I technically didn’t need anything from a medical professional other than a referral to a diagnostic lab. Why can’t this be done over the phone? I called half a dozen offices to ask for the price of an office visit, and all the receptionists were completely baffled. “Don’t you have insurance?” they all asked me. Yes, I do, but I have a high deductible plan so I will have to pay for this myself. “Call your insurance company, they’ll tell you what the co-pay is.” No, I don’t have a co-pay. What I will pay is what you charge, so what do you charge for an office visit? “Huh?” At one place, I was put on hold several times and spoke with multiple confused people until finally, the doctor herself came on the line to talk to me. After I explained my situation (I have to verify my immunizations for medical school, I have a high deductible, blah blah blah), she told me “not to worry“ about my deductible because med school was going to be much more expensive. “You’re going to pay at least $65,000 a year for school, so don’t worry about it.” She went on to ask if my parents could give me the money for the visit (uh, no, they can’t) but finally answered my question: $100 for a routine visit. Thus I came to brick wall #2: no one knows what health care costs in this country. Sometimes (often?) not even the people who set the prices. Yikes.
Health care administration is the most nightmarish bureaucracy ever invented by man.
Mine are not by any means original complaints about the health care system: the inaccessibility of one’s own medical records and the lack of transparency in pricing are two of the most commonly cited problems. They would have been at the top of my list even without the frustrating experiences of the past few weeks (yes, weeks). I just wanted to complain.
