Welcome to tokoni

Having worked my entire adult life, I have always had health insurance coverage through my employer. When I got married, my family was covered through my employer plan. Because I worked for large companies who offered generous and comprehensive health care plans. The biggest decisions were around PPO, HMO, and provider plans. I took for granted that healthcare costs were largely covered and never hesitated to seek medical (or dental) care.

Then I left the corporate world to be a stay-at-home mom. Focus on my family and work on a personal legacy versus a professional one. It meant, though, finding health care coverage for me and my family. I hooked up with a “producer” (agent)-completed out applications online and was promptly declined by one provider, and underwritten and classified as the highest risk level of the other. Thankfully, my son and husband were immediately approved-and while they were in the lowest risk level-the premiums double that of my monthly contribution through my employer’s plan.

The rejection was devastating-because I take rejection personally, but also because I “thought” I was in good health. Weight-check. Non-smoker-check. Alcohol-hardly ever-check. I do have seasonal allergies (who doesn’t in California?) of which I have a nasal spray prescription and I do have a borderline condition in which I have to take the minimal dosage of meds (less than 12% of the normal dosage). As I found out-the allergies and the “expensive” nasal spray and a doctor’s visit where I complained of a sore wrist (carpal tunnel red flag for the insurance companies), and to a lesser extent, the borderline condition led to the denial of coverage. I was also informed by my “producer”, that under those circumstances, that no health care provider would cover me at any cost. Now I was mad.

As it turns out, I can get coverage through Guaranteed Issue through HIPAA, which stands for the American Health Insurance Portability and Accountability Act of 1996. The rate is almost twice of my son and husbands plan costs combined. I have coverage-but not without experience the inexplicable standards of the health care industry. I wonder how people who really need health care-get health care if they are of the many who do not have coverage? I understand why and how so many people are not covered by health insurance and that it seems almost impossible to qualify on an individual basis. Accessibility, affordability are huge obstacles. How can we promote health when we don’t give people the opportunity to access and afford health care?