Miss Migraine: Shopping for health insurance

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on my blog of the same name on September 6, 2012. I’ve updated it with reflections and more experiences.

When I was 26, my partner was laid off and we lost our health insurance. It was 2012, and the ACA exchanges weren’t up and running yet. So, I had to shop for health insurance on my own, to ask questions like “What kind of formulary does this plan have?” and “What would the prescription co-pays be for venlafaxine, topiramate, verapamil, Maxalt, Migranal?”

Caduceus and headlight

“Caduceus and Headlight” by Flickr user takomabibelot. Used under Creative Commons license.

I had to check and double check for things like spinal manipulations and mental/behavioral health coverage. I had to weigh specialist co-pays against deductibles and monthly premiums, generic prescription co-pays against brand-name prescription co-pays and mail order pharmacy co-pays.

At the time, a colleague of mine, similar age, same career goals (writer), said this to me: “Yeah, I had health insurance in grad school. It was a decent plan. But I never used it.”

I use my insurance at least once every week. To refill prescriptions, to see my chiropractor, my therapist, my migraine specialist. To get another test done. So many tests. Yearly blood work, at least, but throw in a nearly annual visit to the ER and we’re talking CT scan or MRI on top of that, which always come out of the deductible.

The specialist visit co-pays mean more to me than the regular office visit co-pays. I hardly even looked at that column. I see my PCP once or twice a year. I see my migraine specialist every three months. But even more important, it’s the prescription co-pays I have to watch out for. Right now a generic version of my abortive drug, almotriptan, costs me $80 for 12 pills. A generic.

My friends, my colleagues, most of them don’t even know what their specialist co-pays are. I’m painfully aware of mine. I envy them, my friends who look at health insurance as a bonus, an unnecessary extra.

In 2012, a health care plan for two people with a $5,000 deductible cost us $500 per month. Honestly I don’t know how we afforded it, except that we couldn’t afford not to. I’ve been on several different insurance plans since then, some good, some bad.

On each one, though, I’ve had to fight for the coverage I need. Migraine isn’t a deadly disease in most cases, but it can be deadly in indirect ways. It can make you so miserable you just want to find relief in any way possible. It can make you desperate. And health insurers? They don’t care. They are only thinking about the bottom line. The ACA didn’t change that. Sabotaging the ACA didn’t change that.

But you know what will? Universal health care. I’m not going to debate the ins and outs of it or exactly what form it should take. Greed is literally killing people. Universal health care won’t solve all the problems of our health care system, but it could save lives. I hope one day I can talk to a teenager and tell them the crazy story of how you used to have to shop for health insurance.

For now, though, it’s open enrollment season with our current insurance provider, and I need to get back to the books to figure out which plan will be the least frustrating.

 

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