Medicare Explained by One Who Knows

You may not realize this but fashion models are considered contract labor. We have agents to promote us and manage our bookings for a hefty 15% of our earnings. But all the rest is up to us. And in order to get the best possible tax help a model needs a tax accountant who specializes in Entertainment Industry tax rules. Then we have to provide for our own insurance.

While I was healthy and working I bought my medical insurance from United Healthcare, the only large insurance company providing coverage for individuals in Utah at the time. In the beginning my monthly premium was $325 a month. I thought that was pretty high, but it was the only option. Then I started getting hefty premium raises every six months or so. It was not that I was sick, it was just "a little adjustment for the rate of inflation" according to the billings person at United Health Care.

I ran into a rough patch. In a six months check-up with my internist, where urinalysis and blood work were done, I seemed to be having a "sugar spill" in my urine. This required further tests and a visit with an endocrinologist. More tests were done. And in the end, it turned out to be one of the many strange permutations of stress and depression. Then I got a notice that my insurance had gone up to $500 a month. But the drugs for depression were very expensive, so I kept the insurance. But I also kept getting more and more depressed. I was referred to a good psychiatrist who diagnosed me with bipolar disorder and put me on a good mood stabilizer (another very expensive drug) which made it possible for me to keep working so I could afford my insurance. I was chasing my tail.

Within a month of getting that Bipolar diagnosis Untied Health Care doubled my monthly premium. At $1,000 a month for just me, I had to drop private coverage. Then I couldn't afford to pay for my therapist, get my drugs filled, or pay for follow-up care. No psychiatrist will prescribe without follow-up care.

As I grew more stressed by the depression and the rising bills, I was able to work less and less. Finally I was bankrupt. Fortunately I filed before the rules were changed for individuals filing for bankruptcy. So medical bills and the cost of private health insurance ruined me economically. Not having insurance made it impossible for me to pay for my drugs and this led to a lengthy hospitalization for psychosis. Which was the result of untreated bipolar disorder.

I was advised to apply for disability. I applied with all the documentation they required and they turned me down after a three month wait while they decided my fate. A friend of mine who's a social worker told me that all first-time applications for disability are turned down, no matter what. Proforma. I reapplied and was turned down again. After further conversation with my friend I discovered that there were attorneys whose specialty was disability law. So I got a disability attorney. They assess your case and if they're pretty sure they can prevail they take your case for a percentage of the lump sum award. If you finally get on disability they reimburse you for the time from your first rejection to a successful outcome. This whole process took over two years, so even though my monthly disability stipend is the minimum possible, three years worth is a tidy sum. The payout is based on your earnings at the time of your award and for the three previous years. These are the lowest earning years for most people who end up on disability. So I got roughly $700 a month to live on and Medicare. It is Medicare that saved my life. And that is not hyperbole. Once I was on Social Security Disability and Medicare parts A, B, and D (the only good thing G W Bush did in his entire presidency) have saved my life. Once on Medicare I was eligible for the fabulous care by Valley Mental Health and the Master's Program for bipolar patients over 50. They saved my life, and that is not hyperbole.

Medicare is far better coverage than my $1,000 a month private insurance. Every referral from my internist had to be okayed by some bean counter at United Health Care. Under Medicare I have never had to wait while a bureaucrat has weighed whether or not my well being was worth the cost. And if I needed help finding the part D private piece of the pie that Bush gave the private sector, a "bureaucrat" at Medicare patiently helped me find the one that would cover all my drugs at the lowest cost. In my case that's Etna. Since my income is so low, I get extra help with drug costs, so there is no "doughnut hole" for me. If the public sector were picking up the cost of the part D coverage it would be simpler and therefore less expensive for taxpayers. It was giving part D to the private sector including the drug companies, that has made part D a problem for so many. It is the drug companies and the private insurance companies who lobbied so hard for their hand out from the Bush Administration that has driven up the cost of that program and made it a bureaucratic nightmare for so many senior citizens and their families to negotiate.

I have the experience of both options--private and public. I'll take the simplicity of the public option over the bean counters in the private sector any day.