An Open Letter to Health Insurers (Hi, It’s The Redhead…)

Image courtesy of Flikr: Takomabibelot via Creative COmmonsDear [insert name of Health Insurance Company here]:

Allow me to introduce myself – Erika Napoletano. Writer. Self-employed. Small business owner. I carry my own health insurance. Your company’s health policy, as a matter of fact. For the price of $152.31, I have the privilege of paying $30 every time I need to go to the doctor, $50 to see a specialist, and I have a $1500 annual deductible with a $6,000 max out-of-pocket expense per annum. I can get prescriptions for $5 at your pharmacy (that is, if they’re on your Preferred List) and I only have to pay 20% of all expenses beyond my deductible.

Pretty awesome for a gal like me who runs her own company, right? Especially since I have no employer picking up even part of the tab on my insurance bill. Awwyeah – I am SET when it comes to health care!

I’m sending you this letter today to thank you. Yeah, I know you don’t really get a lot of thanks as of late, what with all the hubub with health care reform being the national topic du jour, but I am going to thank you. I have a ton to be thankful for, and if it weren’t for you, I would have a whole lot less. Since you have to get through this letter and on to the pile of letters complaining about your service, I’ll get my praise rolling. (Out of respect for your time, I’ve bullet-pointed my gratitude – I’m awesome like that.)

  • Gratitude Point #1: Thanks for helping me save money. In July of this year, I broke my left ankle. Boy, oh boy – did I break it, and to the tune of eight screws and one plate. So, I sat down and reviewed my health coverage and decided to apply for a more comprehensive policy than the one I currently had. After all, what was $30 more a month to save me a couple thousand if I got hit by the proverbial truck again? No less than two weeks later, you sent me a letter, declining my request. The reason? Because I’d recently been on serious medication (Percocet for the pain following my ankle surgery) and had major surgery in the past 12 months (repairing my tibia & fibula – remember the plate and screws?). You’re right – what was I thinking? Slipping and falling down 2 stairs (the cause of my injury) has the potential to happen again. Considering I was on the pain pills for one whole week and still have half a bottle sitting in my kitchen drawer, the potential for addiction also exists. You have saved me $360 per year by declining my request for a better health plan. Thank you.
  • Gratitude Point #2: Thanks for being willing to continue insuring me. I got my renewal notice in the mail yesterday. Considering I’m such a klutz and had to actually use my health insurance this year, I think it’s great that you’re willing to renew my health coverage for $168.30/month (that’s the policy for which I currently pay $152.31/month). You’ll let me spend $191.88 more a year on the same coverage I currently have but you still won’t let me spend $360 more per year on a better plan. You have still saved me $168.12 per year. Thank you.
  • Gratitude Point #3: Thanks for letting everyone in your work place have the chance to excel. I am ALL about giving people the opportunity to expand their skill sets and your commitment to the practice – well, I have experienced it first-hand! When I was 11 days post-op, I went in to have my splint removed and a cast put on my ankle. I was escorted back to have my vitals taken, and the same man taking my vitals (with the designation MA – Medical Assistant – on his name badge) informed me he’d be the one removing my splint, surgical tape over my incisions and be redressing my wounds. Well, OK! After he caused me a pain that was possibly more excruciating than my original injury by almost ripping out my 11-day-old sutures, I finally succeeded in removing the surgical tape myself. He was awesome with the hydrogen peroxide wash and I have the scars on my left ankle where he ripped off my skin to remind me of his commitment to doing the job he was tasked with. You strengthen the patient-provider bond, especially between those with less than 62 hours of health science coursework (all of which can be taken ONLINE!). Thank you.
  • Gratitude Point #4: You’ve made me something great – a valued customer. Since I went a got all clumsy and actually had to (gasp) use my health insurance, I’m now considered “high risk.” Since I’ve had this serious medication prescribed and undergone major surgery, I can’t apply to switch to another insurance carrier for at least twelve months. That means…I’m staying your customer! Isn’t that awesome? We get to be together for another twelve months of coverage. You’ve raised my premiums and I have no other choice than to remain your customer, but you ARE still saving me a net of $168.12 per year by not letting my enhance my policy and are keeping me moderately insured in the process. Thank you.

In closing, Kaiser Permanente (whoops-did I just say that?), I’d just like to say this: I originally applied for your insurance because your HMO center was close to my then-office. Easy access and decent premiums. Flippin’ sweet! But now that I’ve been your customer for less than a year, I have to say that access and cost should have been the least of my criteria for choosing a health provider. I don’t know if my experience at any other provider would have been different. Sad, but true.

While I don’t know what the solution is, we’ve got another 12 months to figure it out, don’t we? But hey – I know you’re busy being one of the largest health providers in Colorado and don’t have much time to spend helping me figure out a solution. Being a small business owner, heck – I’ve got all the time in the world! I’m working in a tough economy, building my brand and you know what? I’m doing it all myself. I have no Big Guy to help me save for retirement or give me a 401(k) match or pick up part of the tab on my benefits. No-sir-ree! I’m going to put on my big girl britches and sit over here and be thankful, by golly. Thankful I qualified for health insurance before I became such a “risk,” that I can pay your (soon-to-be-rising) premiums every month, and maybe I can score another injury by year’s end so I only have to pay for 20% of the cost for repair instead of $1,500 + 20% next year. (Wanna know a secret? I’m going to try to blow-out a shoulder or something. I hear those can be SPENDY!)

Sincerely,

Erika Napoletano
Head Redhead
ErikaNapoletano.com

 

14 comments
The Redhead
The Redhead

I think part of the US problem, especially given those currently opposed to a national health care system, is the COST. Everyone looks at government-run systems abroad and thinks - wow, those premiums are cheap and care is free in many cases. But there's annual overhead for those governments, too. Personally, I don't mind paying more in taxes to put into place a national health care plan. People are so bent out of shape on taxes in our country that it jades their outlook on many topics. Thanks for stopping by!

jonakajon
jonakajon

I live in Australia. I pay 1% of my gross salary to the Government each year ie that is AUD$560 per year and ALL my medical expenses are covered for me, my kids under 16 and my wife (if she was not working).ALL MEDICAL EXPENSES...no deductibles.Oh sorry...I pay AUD$5.30 for each presciption for medication up to a maximum payment of AUD$530 per year. After that all medication is free.

Kevin
Kevin

Once again, I renew my dedication to my Canadian-ness. I just spent 16 days traveling in the US, partaking in risky behaviors (hiking and canyoneering). Had an injury occurred, I'd have asked them to patch me up just enough to send me home. I had many people ask me what I thought of the Canadian health care system; while it's not perfect, I'm incredibly happy with it, and would never - never - give it up.

Katie
Katie

I've had the distinct pleasure of fruitful phone calls and working with helpful insurance company reps when it came to my own ankle surgery a couple years back. Which means...I should be well-prepared when I get knocked off my family's insurance next month. Happy Birthday to me! I'm thinking of listing my hobbies at the start of every conversation with potential insurers...just for kicks. If I'm gonna be "high-risk", I might as well own it, right?

Mayor Milobar
Mayor Milobar

If you were here in Canada you would pay approximately $50 to *gasp* the government for medicare. No physical, no age restrictions, no worries about previous conditions or accidents. Hell, even if you don't pay your premiums they still cover you and pay for your multiple thousand dollar surgery, they'll just eventually send you to a collection agency. Not for the cost of the surgery mind you, just for the unpaid premiums. Prescriptions are on your own dime, but you can always invest in separate private insurance to cover that sort of thing. I can see why people in your country think socialism is such a bad idea.

Harlan
Harlan

Someday I'll have to tell you about the stuff I saw after my stroke in 2002. My insurance company was quick to cover everything... but it was pretty clear to me that there was a lot of unneeded repetition probably as CYA stuff, and very poor communication that led to even more repetition.

Tori
Tori

Love the sarcasm, the companies are probably too idiotic to catch it though. I've had more then my fair share of insurance problems. I have a chronic illness and am on many medications. When I had to look for my own insurance I was turned down left right and center, the only reason someone was willing to cover me at all was to not cover the illness and charge $300 a month. And the coverage sucks big time. The whole is ridiculous and infuriatingly unfair.

Stone Fox
Stone Fox

WOW! i pay $137.00/month for our family of FIVE. no deductibles, 80% prescription coverage. all you have to do is move to canada and you, too, could save save save! on healthcare.

DTP
DTP

webmd.com. The only health care provider anyone needs.

JR
JR

$152.31 per month! WOW! Where do I sign up? I'm self employed and the lowest cost plan I can find is over $5000.00 per month! (50 year old male, no prior conditions, $500.00 deductable $50,000 lifetime max, no prescription coverage)

Rebecca
Rebecca

Man, I love your stuff. Great writing. On topic. Fab.

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