If I could go back in time to high school, I would trade in chemistry and calculus for a class that demystifies taxes, credit, and health insurance. Let’s call it Adulting 101. Since I have yet to get a practical handle on time travel, I now find myself in the second half of my twenties attempting to find an affordable health insurance plan for the umpteenth time. I have had better luck finding long term relationships on dating apps than consistent health coverage that suits my needs.
Why is American health insurance so complicated?
The short answer to the above question is that American healthcare is a for-profit industry. Capitalism doesn’t quit when you get sick! Hopefully, I’ll live to see the day when the United States government deems affordable access to healthcare a human right, but I’m not going to end up hospitalized holding my breath. I can’t afford to. So how does one begin to navigate a world wherein copays and premiums are prerequisites to staying healthy?
Being Young and Uninsured
For many adolescents and young adults under 25, health insurance is their parent’s problem. Through the scope of American right of passage, age 18 signifies gaining the right to vote, 21 means getting to buy booze, and the ripe age of 26 means getting booted from your parents’ health plan. If you were not fortunate enough to graduate into the tradition of 9-5 employment and gain access to health coverage during your early twenties, you know what I mean. Some of us will never earn access here, no matter what age we are. Since moving out of state at age 18, I was left to manage my own health insurance long before my frontal lobe fully developed. That teenage sense of invincibility doesn’t pair well with prioritizing health insurance.
Even for those who can milk parental plans through their 25th year, it may not be all cartoon bandaids and lollipops from the doctor’s office. Receiving health care under a parent’s plan can elicit privacy concerns, especially for minors. What if your parents aren’t open and supportive when it comes to your sexual health? What if your state requires parental consent to receive STI screenings and treatment? Maybe you don’t want your parent’s critical eye pouring over your itemized hospital bill. There are countless reasons why relying on parental health coverage might leave you feeling vulnerable or exposed.
America Is Moving The Wrong Direction On Health Care
However, if insurance coverage is missing from your life, for whatever reason, there are alternative ways of accessing low-cost reproductive healthcare. Being lucky enough to live in a city offering robust social services, I frequent our subsidized and “sliding scale” women’s clinics, which are open to patients regardless of their insurance status. Women’s clinics are a good option for those who are underinsured or uninsured altogether. However, funding for such clinics’ is the target of the current administration’s Title X “gag order. Additionally, visiting a free or low-cost women’s health clinic may not be an accessible option for those who live in areas of the country that do not prioritize access.
It is also worth noting the unfortunate existence of fake clinics that masquerade as women’s health outposts, but exist only to shame and misinform women about their reproductive health and the choices that are available to them—notably on the subject of abortion. Be sure to do your research and seek reputable, medical facilities when possible. If this sounds overwhelming, it can be! There is no shame in wanting privacy and comfort in addressing your reproductive health needs.
One bright and cherry footnote to this gloomy situation is the emergence of nationwide online healthcare coverage. These days you can get advice and treatment online whether you are experiencing some funky symptoms or just need a prescription for birth control. Finally, an option that is both affordable and accessible regardless of where you live or whether you are insured! Services like Wisp are also discreet, which can be helpful if you still live with, er, roommates (parents).
Don't American Students Get Health Insurance?
Another lifeline in the world of health coverage is offered to full-time students at America’s universities. Sadly, this brief coverage expires at graduation and is not offered to part-time students or anyone who cannot afford to go to college. When I left college, losing regular access to my university health center was all the more noteworthy during the series of unpaid internships that followed. The rationale for college-grads like me is that with a little hard (free) labor, I would be offered a full-time position. Doesn’t always work out that way, I’m afraid.
On top of the pro-bono work I performed, I supplemented my income with part-time work in bars and restaurants, which almost never provide health insurance (unless forced to). In my head, ‘benefits’ is a mythical concept originating from the mouth of the far-reaching corporate machine. I have yet to experience firsthand the magic of “paid time off” or an “optometry visit!”
If employer-based health insurance isn’t an option, a good place to start is researching whether your state offers government-subsidized health insurance policies based on your income. Believe it or not, there are folks whose entire job is to assist with the process.
Still Searching For Health Insurance...
Between changes in employment status, zip code, and general health needs, I’ve switched insurance providers a handful of times. It is always a headache. Policies are never straightforward. There is an entire catalog of confusing terms, like deductibles, network providers, coinsurance, copays, out-of-pocket limits, preauthorizations, premiums, etc. And dental is a separate issue altogether!
Yet another drawback of shifting coverage is chasing down medical records. Every time I find a new healthcare provider, I re-litigate my medical history, cobble together immunization records, track down dosage information and outdated doctor authorizations for prescriptions, and generally do a lot of guesswork while filling out paperwork. The most aggravating experience I’ve had as a result of swapping providers is trying to convince an office administrator over the phone that I had a UTI and could not wait 72 hours for an appointment to get a lab test. Having a long history of chronic UTIs, I knew that waiting days for an appointment could result in a kidney infection, exponentially increasing both my pain and the cost of treatment. The repetitive cycle of making appointments to introduce my medical history and sometimes convince a new doctor of my own bodily knowledge can be exhausting and embarrassing.
To complicate matters further, potential revisions or outright repeal of the ACA may deregulate insurance coverage for birth control and other preventative health measures, even for potentially life-saving exams, like mammograms and STI screenings, or (if you’re lucky) it leaves the decision in the hands of your employer. I certainly don’t need my boss to have the final say in my sexual health.
If there is any silver lining from living through COVID-19, it is that we no longer need to book specialized doctor’s office appointments and fork over a copay to treat a UTI! Medical care is available by phone and online. We’ve switched over to a subscription-based model for all our entertainment—why pay for a million useless channels (remember home shopping?) when you can subscribe only to the platforms with the content you actually watch. The same goes for healthcare!
Using telehealth fits comfortably into my monthly budget while affording me the freedom to receive prescriptions discreetly at my door. It no longer matters where I live, who I live with, or whether I am insured; online reproductive health coverage is here, for everyone. And there’s no worrying over meeting deductibles and out-of-network expenses. I may not have everything figured out with this whole adult thing, but at least my sexual health is on the right track!