"Being uninsured is expensive"
A continuous struggle I’ve had since aging out of foster care is accessing and navigating healthcare services without health insurance. I know I am not alone in this; according to the Northwest Foster Care Alumni Study, more than half of young adults who have aged out of the system do not have health insurance and 61% do not have dental insurance. Though I am hopeful the new extension of the Affordable Care Act that allows former foster youth to receive health care benefits until age 26 will improve these figures, I still find them unacceptable. What makes this statistic so alarming is: “Youth in foster care face medical and mental health challenges at significantly higher rates than other children, often as a consequence of the circumstances that led to their removal from their home and sometimes exacerbated by their experiences in foster care” (Health Care of Youth Aging Out of Foster Care, American Academy of Pediatrics, 2012).
Being uninsured is expensive. I've paid close to $7,000 in emergency medical bills since coming to college and aging out of the system. My largest individual bill was over $4,000 and took me a year to pay off through monthly payment installments. This figure also does not include the recent $2,300+ bill I have sitting on my desk from an ER visit in March that I have yet to pay. Being uninsured costs me in other areas as well, such as my car insurance premium. My monthly payment is significantly higher due to my lack of health insurance.
I feel ashamed to admit that I am uninsured. Treating physical ailments and having access to health services feels as though it is one of the most basic human rights and needs. I have remedied my fear of disclosing my former foster care status by realizing nearly everyone encounters some form of family drama or life struggle. I cannot, however, remedy my feelings of shame, embarrassment, and frustration surrounding my lack of health insurance. It is an awful thing to rank and evaluate your self worth in the midst of great pain in the middle of the night. Far too many times have I said to myself, “How much money am I willing to pay for this pain to go away? What will be the risk if I do not seek professional help? Am I worth the trouble, or can I withstand the pain?” All of those healthcare taboos you’re warned about, such as not relying on the internet or WebMD to diagnose a problem, do not apply to the uninsured. WebMD was often my only option.
I whole-heartedly believe that my limited access to health care has caused further health concerns to develop. Consider my ankle, for example. I injured it in November of 2013. I decided to go to urgent care based on my friend’s recommendation, who is a nurse. I couldn’t put any weight on it and could hardly move it. After paying $200 cash just to be seen by the doctor, I had two sets of X-rays preformed (at an additional price) because they couldn't see through the swelling. I was told that that the doctor thought I had a hairline fracture but that I had to come back in a week after the swelling went down for another X-ray. I was given a prescription for pain medication that was too expensive for me to fill. I decided not to go back in for an additional X-ray due to fear of another large bill and borrowed a walking cast from an acquaintance instead. I thought my ankle was healed after a few months, despite the occasional shooting pain in my right foot, specifically near my toes. Lately, it's been getting a lot worse and I experience pain almost daily. I have thought about seeing a doctor but am waiting until I have health insurance in fear I will be referred to a specialist that will undoubtedly be expensive without insurance.
My ankle is only one thing on my list of health concerns I am eager to have addressed. Next on the list is having oral surgery to remove my wisdom teeth, which desperately need to be taken out. I am excited to report that – hopefully – I will officially have health insurance (including dental!) in 2 weeks from today. Learning this news felt almost as good as receiving my acceptance letter from grad school. After a 7-month application and re-application process through Medicaid, I have finally selected an approved plan and have already begun researching doctors in my area. To illustrate my difficult, lengthy application process, I’ve created this timeline:
What was most difficult for me throughout this process was the division of services. When I finally did speak to someone at Michigan Enrolls and explained my situation to them, they kept advising me to “ask my worker.” I explained that, as an alumni of foster care, I did not have a DHS worker any longer. She then referred me to “my DHS caseworker” in charge of Medicaid, which again I did not have due to my unsuccessful enrollment. I was repeatedly told that the department I was speaking with couldn’t help me, and to try another division of services that I had already tried to contact. Whenever I would reference my time spent in foster care, the few people I spoke to had little to no knowledge of what this meant for me in terms of insurance options. On several occasions, I felt as though I was educating the Medicaid professionals on my insurance options, when it should be the other way around.
If you are a professional working with youth in or from foster care, I have a few recommendations to help students access healthcare:
The Guide to Accessing Healthcare can be found here: http://fosteringsuccessmichigan.com/library/how-to-get-health-care
If you have any questions, or receive any messages that say that you have been denied coverage, There is help available! Please contact:
Leslie Adams, Foster Care Health Analyst
Child Welfare Medical Unit
Office of Child Welfare Policy and Programs
Michigan Department of Human Services,
235 S. Grand Avenue, Suite 514,
P.O. Box 30037, Lansing, MI 48909
Fostering Success Michigan is a program of Educate Tomorrow that aims to increase access and success in higher education and post-college careers for youth with experience in foster care. Learn how you can contribute to building a holistic network that insulates (i.e., strengthens protective factors and reduces risks) the education to career "pipeline."Make a Donation