Dirt in your skirt blog

Living On The Fray – Taking the Road Less Traveled

Posted on September 11, 2014 by Margaret Schlachter

A departure from the normal OCR related stuff, but somehow all of life seems to be OCR related. This post is personal and not meant to get into a heated debate or cause an uproar but to shed some light on a situation that I know I am not alone in facing here in the USA. To start we have to go back a little.


In July 2012, I quit my day job. The scariest thing about quitting a steady job and heading into a passion project and life was not the money part, not the worry of how to pay bills (which was already figured out) but it was simply health insurance. Yup that hot topic thing. Luckily, I lived in the great state of Vermont at the time. I say great state because only now do I know how well I really had it. When I quit my job, the next day I contacted the state and applied for their sliding scale system (single payer) and after one phone call had a great plan with a large national provider all to me at $25.00 a month based on my income level. This was a life saver when I went through a scare with an intestinal parasite which landed me in a hospital for an overnight visit. Otherwise, I paid the bill each month, didn’t really have any medical concerns and went about my life. Then I moved to Utah…


Upon moving to Utah my naive self thought I would do the exact same thing I had done in Vermont and quickly have a new healthcare plan and swap it. When I visited the state run site it stated they were not accepting any new people into state healthcare unless you were a single mother. Now I had and have no plans to have a baby just for healthcare so that wasn’t an option. As a stop gap I hung onto my Vermont residency for as long as possible to have that safety net incase of an emergency. But that’s wasn’t a solution and eventually I could not longer keep that as an option. Then I entered the scary world of the uninsured.


The world of the uninsured was new, scary and a place I had heard about from those growing up as more horror stories than true stories. I was/am too old to be on a parents plan, which I would feel bad about anyways. So I was wading in the sea of uncertainty knowing that the Affordable Care Act was on the horizon. During this time my boyfriend found a lump, well really two lumps in my breasts. This was while the enrollment was open so I held off getting any tests done until I was insured again under the ACA. I went to the marketplace, filled out the paperwork, and then waited to hear. After enrollment closed I got a letter in the mail saying I was denied because they needed more information. After a lengthy call with a very nice woman at the state she said they would give me a final notice in a couple weeks, and if they denied me again I would just file with the marketplace saying there was nothing for me and would have to look into other options.


The letter came a couple weeks later and I was crushed, a denial. A little more research led me to learn I fall into the fray, the people who by law the government is suppose to help and have an option for but at the same time the state doesn’t have a system in place. Writing doesn’t exactly pay the big bucks. So here was I again, in the fray, open enrollment closed, private company plans costing 30% of my monthly income in some cases all with extremely high deductibles. This is where I stayed and where I am. I had ignored the lumps for a couple month until they started to change shape.


Fearing the worst like many women and with much encouragement from my boyfriend I made the first appointment. Prior to that appointment, I cried, I worried, and I stressed at not the worse case scenario but the bills that would accompany such. I spoke with friends who had gone through the big C before and all told me to worry about health first then the costs afterwards. My first appointment was with a NP at a local Planned Parenthood, a godsend for women who are in the fray. She thought they were nothing but referred me to a specialist and gave me the specialist in the area who work on a sliding scale. Another appointment was made.


The thing that most don’t realize until you are in the situation is the stigma that goes along with being uninsured. You are asked at each appointment and you have to talk about it over and over. Most are nice, but sometimes an air of judgement is there and it’s not comfortable. I know I chose my lifestyle and make no apologies for it, but looks can still hurt.


The second appointment, a specialist, deemed again probably nothing but now I needed an ultrasound to confirm any lingering doubts. So the referral was sent to the next step. However, the fray dweller I am before scheduling the appointment I had to talk with the hospital financial services before an appointment could be made. The appointment was made and when I showed up for the final testing, the hospital had a different referral than the one they handed me with an additional test. Thus came the awkward moment where you need to tell them you are not getting both tests and you are not paying for both tests. But everyone was nice and an extra half hour later, I got the one test.


The good news is everything is in the clear. There is nothing to worry about and I am all set to resume normal troubles and stresses in my life. The grand total of these three visits being a cash payer has come to just over $500.00 not a small sum, but better than worse case scenario. This is still a large chuck of my monthly income.


I was told growing up not to talk about money, not to talk about money troubles, not to talk about health issues, and definitely not to air laundry like this. It’s the old new englander and puritan values that run deep in my family. And this post is just something you don’t talk about. But I know I am not the only one in this situation and this is only one person’s experience. My little medical bump is a mere blip in the radar and many face much much harder issues than I do.


But this whole experience has been scary. It’s scary as someone who plays by the rules, doesn’t try to cheat the system, works hard, and overall tries to be a productive person in society ends up in the fray. Currently, this is my place in the whole system. I choose the state I live in and I live with those consequences. If I lived in one of the 30 states which extended government aid in health care this would be a very different story. But I don’t and I am just one story. When the marketplace opens again in the fall I will apply again and hope the next outcome will be more successful.