As an entrepreneur and small business owner for most of my life. I understand the challenges involved with being self-employed. The new ACA (Obamacare) has called a whole new challenge for small business owners. That challenge is is called “out-of-pocket expenses” this is great story by Amanda Glassman. Give us call if you like to learn how to prevent some of these “out-of-pocket” expenses.
Just last month I turned 26. It’s a momentous occasion for any adult: you receive that five-year reunion email from your alma mater, realize you’ve been an adult longer than you were an adolescent. Your life is now, undeniably, in your own hands. You lose your parents’ health insurance.
As a writer who has opted out of a traditional career path, it is even more terrifying. As a young woman prone to full-body, tonic-clonic seizures, it is unbearable. Because creative types, aspiring young entrepreneurs, people taking the path less traveled aren’t covered by employee benefits. They’re on their own. Enter Obamacare. The solution to the problem of underinsured Americans… right? For $95 dollars a month, you can have access to hospitals, doctors, important prescription medications. You’re safe. For $200 a month? Why, you’re practically golden.
Screech to a halt in front of the Rite Aid pharmacy counter. Labor Day. 10 a.m. The $510 bill for Lamictal boring a hole through my skull. Those dull, echoing words: “your insurance doesn’t cover this medication.” Lamictal, the generic drug used not only to treat epilepsy, but bipolar disorder, PTSD. It’s the drug that my doctor, the Head of Neurology at NYU medical center, prescribed as the best anti-epileptic medication on the market. It’s a generic, all-pervasive pharmaceutical drug. Everybody uses it.
If Anthem Blue Cross had a headquarters, you can bet your top dollar I would have been camped out in front of there that Monday morning. Maybe with a picket sign. Maybe just with the very long, very depressing receipt. Instead, I waited impatiently until the next day. And even more impatiently on the phone for an hour that next morning. And again, those soul-draining words: “Your medication is not covered.”
See, the sneaky thing is, lamotrigine is written in black and white, right there on the approved prescription drugs page on my provider’s website. I know. I checked. I checked before I wrote the check for $200 a month for their Gold Plan, and again after. Just to be sure. Just because I was terrified of what would happen if I had chosen the wrong plan. Because I couldn’t afford not to have it covered. Yet from outside the medical field, I wasn’t informed enough to know that, golly gee, the covered medication was for something called tabs, not the Extended Release formula that I need. To keep me seizure-free. To allow me to drive my car. To allow me to leave my house. To allow me the peace of mind to swim in the ocean with my friends on a California weekend.
So here I am, 26 and paying out-of-pocket nearly more than I make in a week because a leading insurance provider, on an expensive Gold-Level plan, cannot give me the medication I need. In a country priding itself on innovation, we’re doing a hell of a job making sure our young adults can take the risks necessary to push our country forward. So we can have those non-profit organizations, the iPhone apps, the car-sharing websites that make our lives easier and more streamlined. The innovation that we say sets America apart. So, the health care problem is not over. And at 26? It’s just getting started.