Suppose you have a health insurance plan such as Mail Handlers and your employer, the Veterans Administration, required you to opt-out of Medicare if you took it. You pay your premiums, your co-pays and your prescription costs. You visit your doctor regularly and you have lab work. Then maybe you have an X-Ray and visit the emergency room. You may even have surgery which requires a hospital stay and your plan pays 80/20 after you meet a certain deductible. Things are basically going O.K. and you have managed to keep up with the costs and pay your bills.
You may go on like this for years and your premiums keep going up. You are retired, stay active, and don’t think too much about your insurance. After all, it has been there for you when you needed it.
Then BAM! You have a stroke or another illness that requires a hospital stay and extensive aftercare and physical therapy. It may even require time in a nursing home. THEN you discover that you have to fight with your insurance company for therapy your doctor orders because your claims are denied by the health insurance company’s doctors. THEN you discover that you do not have any nursing home or long-term coverage at all! And all of these years you thought you had decent insurance and thought it would be there for you when you needed it most. You didn’t even think about having to buy a SEPARATE policy to cover long-term care. It never crossed your mind because you thought your health insurance was SUPPOSED to cover you when you got sick, no matter where you had to go. You thought your insurance company would always be there for you, then BAM! It isn’t.
WOW, your former employer made you opt-out of Medicare when you retired back in the early 80’s and now you find out that Medicare takes much better care of patients than your insurance does. And there is nothing you can do about it now that you are 85 years old. You can be angry. You can cry in your Ensure. Or you can tell your story and inspire others. You can fight back and push for cradle-to-grave single payer health coverage for all Americans.
What if you have no recourse but to pay out-of-pocket for your long-term care expenses with the risk of losing your house and all of your assets? What would YOU do?