We’re inviting people to share their stories of the health-care marketplace. Here’s one, as told to Elizabeth Celms. While these stories talk a lot about insurance, this site is generally about price transparency — and of course, insurance and price transparency have a lot of overlap. The number of uninsured people is around 50 million in the United States today.
Today’s story is about being stuck “in between insurance,” and where that can land you. Because the subject of the story asked for anonymity, citing the possible effects to her privacy and future insurance coverage, we are using a pseudonym.
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Camden, 27, between insurance
In the summer of 2009, Camden took a temporary leave of absence from working as a flight attendant for a major airline. This meant that she was still an employee but did not get health benefits. While on leave, the 27-year-old picked up a waitressing job in downtown Los Angeles. Because her salary was less than $2,000 a month, Camden, a Los Angeles resident, could not afford the cost of COBRA as short-term coverage.
“I was supposed to go back to flying in three months, so I thought I’d try to make it without,” she said.
Then the boating accident happened. Camden’s left leg was split open at the knee (a gash that required more than 20 stitches), her rib cage was broken in two places and her thumb was shattered. She was rushed by ambulance to the emergency room, where tests were conducted, medication injected, stitches sewn and bone casting administered.
“I was sobbing and sobbing – not really because of the pain, but because I knew how much this was all going to cost me,” Camden said.
The first bill was $500 for the ambulance. Then came the hospital bills.
“That’s when I started to seriously panic,” she said. “The total bill was around $10,000. I was trying to figure out how to borrow this money. My aunt said she’d loan me the money with a payment plan.”
Because Camden needed follow-up X-rays for her shattered thumb, as well as appointments to have her stitches checked (she got an infection) and removed, the bills kept climbing: $200, $350, $400.
“In one day I had lost all of my savings,” she said. “And I couldn’t work during this whole mess, because of my broken thumb and rib cage. It was a nightmare.”
It got worse. Two weeks after the accident, a doctor told her she would need surgery to correct the shattered bone and cartilage in her thumb.
“I asked this doctor for an estimate on the surgery. He said anywhere from $9,000 to $11,00. At that point I started crying.”
At a complete loss, she turned to a friend for advice. The answer surprised her.
“I called my friend bawling, and she told me that all I had to do was go to Harbor-U.C.L.A. Hospital. I’d be
waiting in line with all the homeless people, she said, but I’d get to see a doctor. I didn’t realize that making $1,400 a month put me within the poverty level and that the state would cover me.”
The first thing Camden had to do was apply for ORSA, a Los Angeles County low or no-cost medical care program. Under the ORSA plan (which stands for Outpatient Reduced-Cost Simplified Application) qualifying patients can get health coverage, including prescription medicine, within county hospitals and clinics for “low cost or no cost.”
Camden qualified for “no-cost coverage,” which meant that all of her medical bills at Harbor-U.C.L.A. Hospital, including the $9,000 surgery, would be covered.
“I made low enough to be completely covered for all of my medical bills, because I was considered ‘under poverty,’” Camden said. “If only I had known this at the beginning of my accident, it would have saved me more than $12,000.”
Although she was more than relieved to have her surgery and accompanying doctors appointments covered, being on the ORSA program meant waiting in line for hours, days and even weeks to see a Harbor-U.C.L.A. Hospital doctor.
“I was given a date, three months after my ORSA application, to come back for surgery,” Camden said. “‘But you’re going to have to wait in line,’ they told me. ‘And get there early.’ I asked how early and they told me 3 a.m. or 4 a.m. So I did. By 6 a.m. the line was wrapped around the block. For a good week and a half, every day was spent in some line at the hospital until my surgery and follow-up was complete. I was there most days from 8 a.m. to 3 in the afternoon.”
Not long after that, she was back at work and covered by insurance. But she drew some conclusions. Now, whenever she hears someone say they are in between insurance and going to “wait it out,” she tells them her story.
“Young people are naïve. We don’t realize that going without insurance can land you in such an unbelievable situation,” Camden said. “That accident emptied my entire savings in one swoop.”
Got a story? Let us know: info at clearhealthcosts dot com.