Lack of Medical Coverage with Multiple Sclerrosis

Mandy Crest Health Guide
  • Often we don't delve more deeply than the headlines on issues which don't directly effect our own lives. We don't take the time to understand things which we have not experienced personally. The “health care crisis” is such a headline.

    There are more than 45 million Americans without health insurance. Among those are stories in which life and death decisions are being made. My story is not quite so dramatic. My life is not at stake, nor am I without a roof over my head, but the stress levels are high and the fear is very real. It has gotten personal.

    Imagine, if you will, a year in which you experience divorce, job loss and a diagnosis of multiple sclerosis. Imagine then that your multiple sclerosis is active enough to prevent you from working full-time, which in turn disqualifies you for employer-based group coverage. You are not fully disabled and therefore ineligible for Social Security Disability. After the 36 months of COBRA coverage allowed by law you join the ranks of those seeking individual health insurance with the diagnosis of a chronic condition.
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    The search for coverage is a time-consuming, confusing and discouraging process. As it turns out, multiple sclerosis will put you in a category of the least desirable and most expensive, called “Premium Level 4”. If you meet all the requirements under HIPPA laws you are guaranteed coverage, but there is no limit on the premium an insurance company may charge.

    Depending on the state in which you live you can expect premiums hovering at $1,000 per month on a policy with a deductible of $5,000. That's with no dental or vision coverage. In addition, the only available medications for treatment of multiple sclerosis, not yet available in generic form, average $1,000 - $2,000 per month and are not covered on an individual plan.

    My husband and I have fully accepted the reality of the disease and the limitations it places on us. Our only real hope for warding off the worst of MS lies in those daily injections. Do the math and the problem becomes apparent. Like a snowball rolling downhill it grows month by month.

    It is difficult not to take this personally. Are only the super wealthy and those fortunate enough to have employer-based group insurance worthy of the medical care necessary to maintain a good quality of life? Shouldn't all Americans have access to the same health care coverage as congress and federal employees? Why are so many left to teeter on the high wire without a safety net?

    As the political process moves forward and election day draws near keep in mind that you, too, could find yourself in the position of making gut-wrenching decisions about your health, or that of your spouse and children, without that safety net. Meanwhile, members of congress sleep peacefully at night, knowing that they and their families are spared this crisis.

    Listen carefully to the candidates' positions on health care. Separate sound bites from solid plans. Put the pressure on our next president and our next congress to take action so that basic, affordable health care is available to all citizens.
Published On: December 28, 2007