We’re beginning another occassional series of stories from Massachusetts residents who were recently, or still are, uninsured. If you want to post your story, you can comment below or send me an e-mail(marthab@bu.edu).
Thanks for reading, Martha Bebinger
John Kulig lives in Central Massachusetts. He works 2 part-time jobs as a chiropractor and as a physiology instructor. Neither job offers health insurance. John purchased insurance in time to avoid the penalty on his 2007 tax return. Here is his description of that process and his concerns looking ahead.
In October 2007 I had the opportunity to attend a weekend informational meeting sponsored by the Health Connector at the YWCA in Worcester. The most comprehensive plan, in my opinion, was the plan offered by Blue Cross and Blue Shield. But at $400.00 per month it was quite expensive and beyond my means. I also spoke with a representative from Fallon Clinic. I was surprised when she stated that my working two part-time jobs was a “life style” decision. (It isn’t – I have not been able to find full time employment.) Fallon’s plan was approximately $300.00 month and allowed me to see my current physician but there was a $2000.00 per year deductible. The representative then gave me a phone number to call. After several days of leaving messages, I was directed to a web site. I was emailed an application but was not able to personally contact a representative at Fallon on line. I found Fallon very difficult to deal with. Most of the other plans offered by the Health Connector also had $2000.00 per year deductibles.
While at the October meeting I had the opportunity to speak with a Health Connector Official in the hall. I asked him why the health care reform law was based upon income only and NOT income vs. expenses. He just smiled and stated a person could file for an exemption. When I asked what the guidelines would be for an exemption, he said he didn’t know-they hadn’t been developed yet. His smirk made me feel as if I was being patronized.
From a fiscal point of view, it made more sense for me to pay the fines rather than purchase health insurance. However, I also realized than having health coverage is important. With the December dead line approaching, I finally purchased a health plan, independent of the Health Connector, but one that met the guidelines of the Massachusetts Health Care mandate. But the plan I purchased is less than desirable. While the monthly premium is $275.00, it has a $2000.00 deductible per episode not per year. If I get a kidney stone, I pay the first $2000. If I break a leg that same year, I have to pay another $2000.00 deductible. It does, however, cover annual eye exams, routine laboratory testing and medical treatments if I’m diagnosed with cancer.
At this point in time I have three important tasks ahead of me:
1. Search for affordable health insurance with better coverage
2. Find a third part-time job to help pay for it or…
3. Continue to search for fulltime employment with benefits.
John Kulig
Mr. Kulig – thank you for sharing your experiences. A major concern many of us health reform advocates have is that those who have the ultimate power and responsibility to set health policy in the state – our legislators and our Governor – do not appreciate the realities of day-to-day life for the average person in the Commonwealth.
We can, and must, do much better than the current health insurance law.
Visit http://www.MassCare.org/about to learn more about this work.
Mr. Kulig,
I would almost guarantee that I know exactly what you purchased for health insurance. You actually purchased a basic hospital plan with riders that can be added on with an additional charge to make the plan look more comprehensive. I would advise you to read your policy in great detail. You will find that there are things in there that will limit your coverage.
For an extra $25 per month, you are probably better off with Fallon. If you want additional info, I can provide an email address. Just for the record, I’m an insurance broker.
(1) “I also spoke with a representative from Fallon Clinic. I was surprised when she stated that my working two part-time jobs was a “life style” decision. (It isn’t – I have not been able to find full time employment.)”
Fallon is primarily a MassHealth (Medicaid) provider. Her behavior was typical of the nasty, dismissive, arrogant behavior of those who work with the poor. They are judgemental and apparently presume that anyone who comes in their door is stupid, lazy and the cause of their own financial situation by choice. The cow should be fired for her rude and demeaning conduct.
I do a fair amount of charity work and have seen people like this woman in action. I will say that the local Welfare office has learned that they had bloody well better mind their manners if I am accompanying someone who has come to apply for a program – or they will be hearing from the agency director within 36 hours. (Helps to be inovlved in policy stuff at upper levels of state government – they pay attention to you.)
(2)”While at the October [2007]meeting I had the opportunity to speak with a Health Connector Official in the hall. I asked him why the health care reform law was based upon income only and NOT income vs. expenses. He just smiled and stated a person could file for an exemption. When I asked what the guidelines would be for an exemption, he said he didn’t know-they hadn’t been developed yet. His smirk made me feel as if I was being patronized.
You WERE being patronized. Once again the typical social services sort who assume that anyone (1) needing their services is thick as 2 bricks and/or (2) isn’t real worthy of their time.
You were also LIED TO. (Want to give us a name? They should be ousted from office for that.)
The affordability schedule had been out since June 2007.
Here is the affordability schedule for 2007 (tax returns 2008)
http://www.mahealthconnector.org/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/About%2520Us/Publications%2520and%2520Reports/Current/Connector%2520board%2520meeting%2520February%252014%252C%25202008/3A%2520-%2520Affordability%2520Schedule%2520Proposal%25202008%2520-%252002%252007%252008.doc
Here is the proposed affordability schedule for 2008 (tax returns 2009.)
http://www.mahealthconnector.org/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/About%2520Us/Publications%2520and%2520Reports/Current/Connector%2520board%2520meeting%2520February%252014%252C%25202008/3A%2520-%2520Affordability%2520Schedule%2520Proposal%25202008%2520-%252002%252007%252008.doc
Mr. Kulig, thanks for your story. I assume that you probably are in your thirties by the premium rates you were quoting. Still I think those rates are high. I am over fifty and for me and my husband to purchase a decent insurance plan would cost us around $1200 a month or more. That person who told you that having two part-time jobs is a “lifestyle choice”, is very rude and out of touch. What does she think, that you choose to work numerous part-time jobs because you like variety?…Well hope things get better for all of us. Have a great Holiday!