March 17, 2010 08:00:00 AM
By DENISE L. SCHMIDT
PANAMA CITY BEACH
Recently my ex-husband found out that he was being let go from his job of 13 years. Through this job he was able to provide health insurance for our son, whom I have custody of. Unless my ex-husband is able to afford to pay for COBRA coverage, on March 31 our son will loose his current coverage. Needless to say, my ex-husband is unable to pay for COBRA coverage, therefore our son will loose his health coverage. He is 13 years old.
I have spent the last few days consulting with the insurance representative through my employer. Unfortunately, as a single mother, I am unable to pay the $900 monthly premium in order to add him to my employer’s health plan. The insurance representative through my employer even looked into my buying an independent plan for him through a private insurer. The premium was one I could afford and I was relieved in thinking I would be able to get him coverage.
However to my surprise, the insurer has denied him coverage. My son is diagnosed with Attention Deficit with Hyperactivity — unfortunately a condition that is becoming more common. The medicine he is currently taking costs $173.95 a month. Even with a $300 brand-name deductible and a 40 percent co-insurance responsibility on my part, the insurer will not cover my child. They say that it would be too expensive for them. In other words, they wouldn’t make a profit. My child has never been without health care insurance.
There is an option for health care for my son provided through Healthease Healthy Kids. It is a Medicaid HMO program. In all of Bay County there is only one provider who accepts Healthease. Needless to say, with only one provider, there is a waiting list just in order to apply for the coverage.
I work as an account representative at a surgery center that handles all of the insurance billing. I know firsthand I am not alone in my struggle over health care. I also know that even though the quality of care is not supposed to be any different than that of private health care, I know it is. I have worked in this field for 13 years, the majority of those in pediatric care. I have seen how patients can be treated as second-class citizens simply because their health coverage was not private, whether they were made to wait three times as long to be seen by a physician or not seen at all simply because the physician “wasn’t accepting new Medicaid patients at this time.”
I don’t presume to know what the solution is. However, for those who say the system is fine the way it is, I say you are nothing more than an ostrich hiding your head in the sand. I also believe that commercial insurance should not be allowed to deny coverage to children NO MATTER WHAT. I am sure there are those who will disagree, but until they are unable to insure their children their opinion means nothing to me.
I have been employed since I was 14 years of age; I am now 44. I have paid taxes. I have never accepted a single penny in government assistance. My son is just a child. He has no say in the matter and is not capable of helping in the situation. To think that I live in the most prosperous country on the planet that provides so much opportunity, yet there are children who are denied health coverage by commercial insurance plans sickens me.
Shame on the insurers and shame on the politicians for letting them to continue to do so. I am challenging my representatives to hold commercial insurance accountable.
