Just a few weeks ago, I aged out of my parents’ insurance plan and scrambled to find my own coverage that would tide me over until I transitioned to residency in June. This scrambling began way back in November, when I first submitted my application for Medi-Cal. The process appeared simple at first: Soon after I filled out my online application, I received an identification card in the mail, followed by information on different plan choices. I was feeling pretty good about my proactivity. But then complications arose.
The first issue was that I was out of town for six weeks, starting the first week of December, for residency interviews. During this time, Medi-Cal sent me first one letter, then a second letter, asking for additional information, with the warning that if I didn’t respond by the end of December, my coverage would be terminated at the end of January. Fair enough. But of course, I missed this deadline, since I only returned to the Bay Area in January. When I called Medi-Cal, they told me my case had been closed and I’d have to reapply.
Which brings up the next complication. My new application took into account my 2017 wages, which included my predicted residency salary (never mind that I wouldn’t need Medi-Cal coverage after residency started) and no longer qualified me for Medi-Cal. I opted to pursue a separate plan through Covered California, and a very helpful Covered California representative helped me choose one that would best fit me with a low premium and a special coverage start date of February 1, just a few days after my birthday. I was good to go!
Or not. This special start date was not conveyed to my insurance provider and when I called them, they said that I would have to work with Covered California to fix this error since on their end, they wouldn’t be covering me till March 1. So I called Covered California and – you see where this is going – they told me to call my provider back because everything looked good on their screen.
So back and forth I went – each time waiting up to 45 minutes to get a representative on the line. As I write this entry, I still don't have confirmation from my provider that I'm currently covered and was told by service representatives to check back in a few weeks.
Trying to get coverage has been a tedious and difficult process – and this is for someone who is English-speaking, educated and familiar with the health-care space, with a permanent address and access to both a phone and a computer. I can’t help but wonder what it must be like for patients who don’t have any of these advantages. Even just thinking of the first factor I listed: How do patients with limited English proficiency (LEP) fare?
According to the U.S. Census Bureau 2013 American Community Survey, the number of LEP individuals in the United States is over 25 million, with the highest concentrations being in immigrant-heavy states such as California and Texas. Studies have shown that LEP individuals have are much more likely to be uninsured, have fewer physician visits and receive less preventive care.
Thus far in my training, I’ve taken it for granted that patients somehow find their way into doctors’ offices, and indeed, it often feels like there are too many patients squeezed into a clinic day rather than too few. With the various health care policy changes occurring in the political arena, I sincerely hope that it becomes easier rather than harder for individuals to acquire medical insurance because let me tell you from personal experience, it’s already hard enough.
Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category.
Hamsika Chandrasekar is a fourth-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.
Photo by qimono