The Kind of Insurance You Have, As Well As Where You Live, Will Determine Your Medical Treatment
by Kama Linden
I am a SAG-AFTRA performer who had very good insurance through our Union. Every doctor was willing to take Anthem (Blue Cross). I could be seen the same day for everything from bronchitis to a hand injury. However, the Board of Trustees has decided to kick thousands of members to the curb because, according to the Board, “seven members had bills of over 1 million dollars”, including a premature baby who needed “many procedures”. Therefore, they have put all the seniors who had guaranteed health care for life, as well as many actors, background actors, and people who were too rich for Medicaid and too poor for monthly premiums, to the curb, hence, the “marketplace”.
Although I made the required 50 days to be able to have reduced priced COBRA at $184 a month (I had 60 days in under 9 months, and WOULD have made the required 84 days had Covid19 not shut down all film production on March 13th), I was told, “since you made it last year on dollars, and not days, we are not going to honor this”, even though the pamphlet I was mailed stated the information from the first sentence. Technically, I made it BOTH on days, as well as dollars, but no one answered my appeal. I went into the NYS marketplace and was told that I could qualify for Medicaid, as I was on Unemployment.
Although the paperwork was tedious, having to enter each and every one of my employers and the dollars and cents, having FREE insurance seemed GREAT! I was also told that if I had bills from the previous month (all of September), I should have those sent into Medicaid. GREAT! I had a head injury and had to go for a CAT scan. I called White Plains Hospital and told them to change the billing provider to the Medicaid. Radiology still did whatever they wanted, and charged my SAG insurance anyway, leaving me with a bill of $94.77. I called to have them correct this MULTIPLE times. “Jennifer,” said, “I put this on your SUPPLEMENTAL PLAN just as you instructed” (I did not yet CHOOSE a supplemental plan. Had she followed my instructions, she would see that the ID number was not that of a Medicaid plan, and the insurance was based out of California, and not NY). She just wanted to do whatever got the doctor paid fastest, not caring if the bill goes onto my credit report or not.
Cut to October, I was running in the park, and I rolled my ankle over one of those spiky balls that fall from the trees. It did not CRUSH, it was HARD, and really torqued my ankle, but I finished my run. I never should have wrapped it, and attempted to train my client, as that made it swell more, and by evening, it was severely swollen. The ICE made my ankle LOCK vs. bringing down the swelling. I was set to work the next day on a show, and calling out was not an option, as we were already COVID tested. Going down the Subway steps the next morning did not help, nor did standing on line for over 2 hours waiting for our test results so that we could be admitted into set. No chairs were provided, even though SAG would have had a field day with this pre-COVID. About 45 minutes in, I sat down on the ground with an ice pack I had brought from home. We were allowed to get breakfast about 90 minutes in, and I asked for a chair. First I was given a FLOPPY chair that almost injured me more, then a regular folding chair. After 20 minutes, a COVID supervisor took the chair away “because he needed to do paperwork”.
After I was admitted into set, the PA power walked me to holding. I explained that I had a sprain, and could not keep his furious pace. Later, another PA power walked us 6 blocks to “get lunch”, and another 4 blocks to go to where we were supposed to eat lunch. I iced as much as I could, and thankfully, ended up not being used.
During my wait time, I tried to start calling orthopedists. The one in the Bronx said, “we can see you next Thursday” (1 week). The BEST one was Mount Sinai: the first doctor said, “we don’t take Medicaid”. The second doctor said, “for new patients, our first appointment will be in January 2021”. I screamed, “are you F****** kidding me!!!!!!” so loud that everyone on set heard me. I called White Plains Hospital, who said, “you can come here, but in order to get physical therapy, you will still have to see an Orthopedist, so try this one”…I found one associated with White Plains Hospital, and was seen the next day.
This doctor gave me his “15 minutes”, literally. I have never been rushed along so fast in my life. But his assistants were pretty good, and one gave me a very good brace. I came in with the wrap and a past air cast, and the one that they gave me is very flexible and supportive. Paid for by Medicaid. I was told that “I could probably run in it”. Although I will say, it does limit your ankle flexibility, even though it gives me lateral stability, which is a sure way to keep pulling the bottom of the posterior ankle ligament.
I was then furiously trying to call Physical Therapy offices. Some were closed by 3 pm as it was a Friday (Shabbat). Most would NOT take Medicaid, or at least not STRAIGHT UP Medicaid. Going back to Metrosports was out. Others had a 2-month waiting list. By then, I would be BETTER, or my foot would fall off.
Thankfully, both as a trainer/instructor, and someone who has had one too many sprains, I knew the drill. Use the theraband. I was able to do a bit of step with a lower step. Some Yoga. I borrowed a STEM machine and Ultrasound machine from a Physical Therapist friend. But what if I didn’t know what to do for myself? Two months to get help is insane. All because I was on Medicaid, as opposed to insurance where I have Copays. Even workman’s comp was easier to get great physical therapy. But Medicaid? Fugghedaboudit!
I hope to work enough this year to get back on the SAG insurance. Or pick up another kind of job that will give me benefits. But for now, free is free. It’s just that the hospital may be my doctor from now on for every little thing. Which I cannot imagine would be cost-effective to the program. In November, my supplemental plan will kick in, which will allow me more freedom of choice of doctors. But the scary thing is, what kind of insurance, especially in the time of COVID, can determine what kind of care you get, as well as your outcome.
Kama Linden is a singer-songwriter with 4 studio albums, the newest being, “Everything In Good Time”, releasing in Summer 2020. She is also an actress, fitness instructor, freelance photographer, and has a fitness book: “Healthy Things You Can Do In Front Of The TV”.
Apple Music
https://music.apple.com/…/everything-in-good-time/1517559501
Bandcamp:
https://kamalinden.bandcamp.com/alb…/everything-in-good-time
Spotify:
