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Losing Insurance - A Personal Reflection and Journey

by Alexandra Collins



















Here in the United States, the healthcare system is pitted against us all. According to the Department of Health and Human Services (2024), in the first quarter of 2024, 8.2% of Americans aged 18 to 65 were uninsured. That is 27.1 million people without health insurance. Collins & Gupta (2024) found that many people in the United States with healthcare insurance still struggle; many are experiencing medical debt, errors in medical billing, and denials of coverage.


I have experienced issues with health insurance before and watched my mom suffer due to inadequate healthcare coverage or not having insurance at all. I saw the toll it took on her, deteriorating her health and making her choose between getting treatment or putting food on the table. She passed on June 24, 2024.

  

My most recent healthcare challenge began on November 24th, when I received a notice from Medi-Cal that my Medi-Cal coverage would be terminated at the end of November. I was upset and stressed because I only had a few days to get this taken care of, with the Medi-Cal office closed on Thanksgiving and the day after.

 

On November 25th, I called Covered CA and Medi-Cal. Covered CA could not help me, and the Medi-Cal office, including my caseworker, who could not bother to call me back, could not help. The first Medi-Cal representative I spoke to told me I could not apply for Covered CA until December 1st. I was skeptical about this claim because why would they want me to be without insurance, given that Covered CA does not kick in until the following month after enrolling in a plan. I spoke to someone from Covered CA, and they told me that I could apply.

  

On November 26th, I called Covered CA to apply and enroll in a plan for December. At first, it was complicated because when they looked me up, it showed there were three cases linked to my name. The representative helped me consolidate all the cases to ensure I could apply without issues. He walked me through the application. Unfortunately, we ran into a problem. My application could not go through because it would be automatically rejected. On the Covered CA website, the reasoning behind this is: “Medi-Cal: Awaiting Review.” The representative explained to me that Medi-Cal had not released me. I was confused. If my insurance is being terminated at the end of the month, why have they not released me? I called Medi-Cal and waited over an hour to connect with someone. As it was, I was running 20 minutes late for work because of this; eventually, I had to hang up because I needed to keep my job.

 

Fast forward to December 1st, as Medi-Cal was closed from November 27th to November 30th, I called the Medi-Cal office. I spoke to a representative. I asked the representative to release me, and he said he would. I called Covered CA, and they told me it was still saying I was not released.

  

On December 2nd, I called Medi-Cal again and finally got a solution to fix this issue. The Medi-Cal representative told me that, for them to release me, I need to provide proof of my

November income, write a sworn statement that I no longer receive unemployment, and that I no longer work for my previous employers. Afterwards, he told me to call my caseworker or the Medi-Cal number to let them know, so they can begin the process of releasing me. I felt ecstatic, but curious why they could not have told me this from the beginning. I uploaded all the necessary documentation.

 

On December 3rd, I called Medi-Cal. The woman I spoke to reviewed the documents I uploaded and said she would begin the process to release me, but she needed to run to a meeting and would call me back after she finished. She called me back late afternoon while I was at work. She told me I was actually approved for December before this; however, my portal showed my Medi-Cal was discontinued. She corrected the mistake Medi-Cal made. I was grateful to have my insurance reactivated.

  

On December 4th, I called my doctor’s office to schedule an appointment and asked CVS to fill my prescriptions. Fortunately, my doctor had an appointment open that morning. I was happy. Ten minutes later, the doctor’s office called me to say my Medi-Cal was showing as inactive. I rescheduled the appointment. CVS left a voicemail stating that my prescription could not be filled because my insurance was inactive. I was upset, and I cried. I had thought this was the end of having to call Medi-Cal continuously. I called Medi-Cal and found out it can take one to three business days for it to appear at the end of the process for doctors' offices, pharmacies, and other medical facilities. I felt relief, but was annoyed. I wish they had told me beforehand how long it might take for the provider to reflect.

 

I wondered if my experience was unique. Truthfully, I doubt it was. The healthcare system in the United States is broken. It is constantly adding stress to people’s lives and making it difficult to obtain and keep health insurance.

  

I make $20 an hour and work roughly 37-40 hours a week. To receive care with lower copays, I will have to pay $227. I am in a difficult place. I take several medications and have several medical issues, including mental health issues. Even though I will still pay copays, it would be less expensive in the long run than choosing a cheaper plan with a higher deductible and higher copays. As is, I am already doing what I can to earn extra money by selling my old clothes on platforms like Depop and Poshmark, in addition to taking surveys and participating in focus groups.

  

Right now, people in the United States are in fear, as the Affordable Care Act tax credits are set to expire on December 31st. While Democrats are mainly trying to get a three-year extension of ACA tax credits, there is no guarantee of a vote before the deadline. Without the ACA tax credits extended, we will see insurance premiums skyrocket.

 

 


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