Living in NYC and not being a billionaire is, well, a challenge! I’ve been out of college for 6.5 years now and my savings account is…let’s say minimal. Part of that is the high cost of rent, student loan payments, the mark-up we have on basically everything….but another SIGNIFICANT portion of my budget? Healthcare-related expenses.

Now, I’ll start by saying that I do have a few underlying health conditions. I receive treatment for mental health conditions and Hashimoto’s disease. But otherwise I consider myself a VERY healthy person.

I could also honestly save money by buying crap-for-you frozen dinners instead of vegetables, and cancel my gym membership…but I’m not going to do either of those things because they’re not healthy for me. And after I was horribly unhealthy for a few years during my time in grad school I’m just not going to compromise my health again. (Sidebar: to all those people who say you can exercise at home instead of going to the gym…yes that’s technically true…but I lift heavy, and honestly buying all the equipment I use would be FAR more expensive than paying for the gym!)

Like a good girl, I am attempting to review my expenses from the year and make a budget for the next one (slightly depressing, but necessary because I live in NYC). And the amount I’ve spent on health care is frankly SHOCKING. Over $2,000 after tax on healthcare…and that’s NOT including my monthly premiums (about $100) nor prescriptions (~$40-50 per month). So that 2K is solely on copays and office fees not covered by insurance.

Before I go further, let me say I am a big supporter of the Universal Healthcare Act (Obamacare). I believe every American citizen has the right to health coverage. But I don’t think it went nearly far enough. (Semi-sidebar: I do think as a result of a Obamacare a whole lot of right-leaning insurance execs wanted to say f*** you and made coverage a whole lot worse for a lot of us….it’s unfortunate, but in this country healthcare is a business….and to be honest they always could have done that long before Obamacare).

So, as a runner I do get injured from time to time. And a LOT of my healthcare expenses this past year went towards my calf injury. Why? Because the calf injury, while an overuse injury, was caused by an ankle sprain from my teen years that never healed properly. And that meant physical therapy/ hell to get it better.

(If ANYONE reading this has the ability to NOT choose Cigna for health coverage, please do it. I used to have UnitedHealthcare, and they were far superior both in cost, accessibility, and quality of providers. Your employer might offer a better plan than mine but I found it almost impossible to get anything covered under Cigna’s laborious “review” process. )

When you’re injured, often a first step is radiology (including x-rays, MRIs, etc.) but that’s only covered by coinsurance under my plan… So if you want to role out a broken bone, you need to shell out $75 minimum unless you’ve already met the 1K deductible…and then you only need to pay like $50 because coinsurance sucks.

I had to role out a blood clot with my injury…which was about as fun as it sounds. Yay ultrasound…I actually went to the ER for that on purpose. Because the $250 ER copay was far less than actually getting a radiology referral and paying out of pocket…

That brings me to the physical therapy coverage which is just terrible. I had previous PT for a labral tear (UnitedHealthcare) and it was a breeze compared to my calf injury (which was actually less serious). $15 a visit and I was able to go as many times as the PT recommended (ended up being like 20 times, twice a week for 10 weeks).

In contrast, with Cigna I was only allowed 6 visits (at first) at $50 a pop…had to go a PT far away…and had to sometimes wait weeks until I could go back because I needed to get approval. I had to CONTINUOUSLY petition for more visits and would get bogus excuses for them being rejected like “my PT did not evaluate me properly” (they did) or “you’re not getting better fast enough” (what…?) or the real kicker “your provider is using an experimental treatment” (wait…is PHYSICAL THERAPY the experimental treatment???).

AND…with Cigna there were FEWER than 10 in-network PT offices in ALL OF NYC. You read that right.

And absolutely NONE of them had running knowledge. That meant my PT, while helpful and well-intentioned, had to basically guess on when I could run, how much, the intensity, etc. It ended up taking a few months because I was really better because of all the guess work.

I have actually considered looking for a new job because my insurance is so bad….but I honestly ask….would that help? Can you really find the granular details of a company-provided health plan pre-interview, or even during the offer? I don’t even know many friends or family members with decent insurance any more.

That brings me to  now…I am injured again but I really don’t want to go through all that insurance hell. It’s minor enough that I can (hopefully) take a week or two off and be better. I am paying 100% out of pocket to see an ART. But at least I was able to get a Black Friday discount on a package. (America…)

So yeah, I know I’ve rambled a lot. Not quite sure on the point of this post except for the true irony that is Cigna “sponsoring” the Miami Marathon when they make it basically impossible to receive the physical therapy necessary to keep runners/ athletes healthy.

F*** insurance. All the worst is my knowledge that I am coming about this from a point of privilege as a white middle class woman. I can’t imagine having even worse insurance or no disposable funds to spend on healthcare at all.

——–

P.S. I didn’t even discuss the coverage for my other issues. Like my Hashimoto’s. I have to FIGHT with my insurance to get them to cover routine blood work to monitor my thyroid levels. Apparently the doc needs to use a very specific billing code, use only a specific lab, etc. One minor detail goes wrong there and I’m stuck with a huge bill.

There are few endocrinologists in NYC to begin with, and I recently got a letter that mine will no longer be covered by my insurance. So I’m overdue for an appointment and need to find a new one. Womp womp.

P.P.S. Maternity coverage apparently doesn’t exist on my current insurance, or technically it does but it’s so bad it might as well not… Ha. If I got pregnant I would be screwed. Estimated cost of a delivery under this plan: $1500 standard/ $3000 c-section. FOR JUST DELIVERING A CHILD. God, they should pay YOU for that. Prenatal/ postnatal care are also extremely limited. Just getting to birth would make me broke, let alone raising a child.

(Sidebar: My generation gets too much flack about being bad with money….I called my mother to confirm, and under my father’s blue collar job’s health insurance…my parents did not pay a cent for prenatal care nor delivery in the 1980s…and VERY minimal fees while I was hospitalized shortly after birth. Same with my siblings. I, as a middle class woman with a white collar job in 2018, would be severely burdened by the expenses associated with childbirth…and any complications would probably darn near bankrupt me. That’s the reality of the world we live in. And let’s remember this is with the supposedly coveted middle class employer-provided healthcare…I can only assume marketplace plans are worse.)