The Point: The Incredible, Uncoverable Leg
In this installment of The Point, Hub blogger Kate Petersen’s mother tells about her attempts to get both legs covered by a single health plan. Easy, you say…
I am a speech and language pathologist in a public school system in Arizona. My husband is a retired Public Health Service officer with excellent federal health insurance, and additionally he works full-time as an epidemiologist at a nonprofit organization. In addition to his federal health benefits, he has also subscribed to the insurance program offered by his employer so as to cover our daughters as dependents, and to provide primary insurance for me.Do you care about changing the health care system? Send your support of health care reform to Congress by signing the petition now (the link works today!) then sending it on to your family, friends and coworkers.
My story begins in May 2005 when I was going to an awards dinner. Late on the afternoon of the dinner, after my two-mile exercise walk, I decided that I certainly needed a new frock for the dinner and slipped on sandals to take a brief walk-through of our local outdoor mall. I succeeded in finding a new dress, but was running very late in getting ready, so I was running across a street in the mall area to get to my car, when the side of my sandal hit a pot hole in the street between brick pavers and I fell. I continued on my way and went to the dinner, but I had trouble walking and so afterward my husband took me to the emergency room.
I had a non-dislocated fracture of my right ankle. With a standard course of treatment of casting and non-weight-bearing for six weeks, followed by a walking boot, I gradually returned to full function. There are no residuals from the fracture.
In 2007, my husband’s business changed insurance companies, and the monthly premium substantially increased. We considered buying our own policy in order to maintain my coverage and that of my remaining dependent daughter, who was still in college. My husband got several quotes through an insurance broker who came to the house to ask the ‘few questions’ before collecting the fee and signing us up.
After a lengthy discussion, he told me I would be covered with the exception of my right leg…Not ankle—leg! I told the agent that there was no follow-up care to my simple fracture, my right leg was uninvolved, and that I was back to hiking and exercising and had been for two years. But he was unswayed in his pronouncement that my right LEG would never be covered.
Needless to say, my husband and I signed up for his company’s group insurance with a higher premium after all, to avoid my leg exclusion. If the broker agent had only asked the right questions, he would have found out that I had also had a minor surgical procedure on my right index finger earlier that year to remove a cyst – again, without any further treatment. Perhaps then he could have offered me insurance with an entire right SIDE exclusion!
With health care reform, companies would be barred for denying people with pre-existing conditions coverage – pre-existing conditions that I found out can be specious and exaggerated at the expense of consumers.
Our current system of health insurance coverage is sad and unfair, and I am so grateful to the President, Congress, and all the advocates who are devoting their time and energy to seeking change and justice in the health insurance system so that people get health care benefits they so badly need.