Graduated, Unemployed & Un (Der) Insured (Preview)

Why You Need to Stop What You’re Doing Right Now to Purchase Health Insurance
AND How to Pick the Provider & Plan Best for You
Copyright © 2010 by Heather R. Huhman

Published by Come Recommended
7707 White Cliff Terrace
Derwood, MD 20855
E‐mail: pr@comerecommended.com

All rights reserved. No part of this book may be reproduced in any form or by any
means without written permission from the author or publisher.

Special thanks to the entire Come Recommended team, especially Beth Farrar for
the design work and Kristina Allen, Mollie Crist, Lindsay Elias, Tyrone Gayle, Sarah
Morgan and Sarah Tiambeng for the time they spent helping me research this e‐
book.
by HEATHER R. HUHMAN 2
TABLE OF CONTENTS

Introduction 520
The Risks of Going Without Health Insurance 2127
Can’t I Still Receive Medical Care without Insurance? 23‐24
Can I Afford Health Insurance? 25‐26
Don’t Put Yourself at Risk 27
Know Your Rights 2833
The Grad School Option 3436
The Fine Print 34‐35
Student Healthcare Clinic 36
Short Term Health Insurance 3743
I Graduated & Don’t Have a Job Yet. Now What? 37‐38
Quick Tips 39
Shop Around 39‐41
Benefits of Short Term Health Insurance 41‐43
Cons of Short Term Health Insurance 43‐44
Long Term Health Insurance 4548
I Got a Job Offer, But Health Insurance is Not Included. Now What? 45‐46
Long Term Insurance 47‐48
Employer Sponsored Healthcare 4951
HMO vs. PPO 49‐51
HMO 50
PPO 50‐51
Consolidated Omnibus Budget Reconciliation Act (COBRA) 5255
I Had Benefits, But Lost My Job. Now What? 52‐53
What Constitutes a Qualifying Event? 53‐54
OK, I think COBRA is Right for Me. What’s My Next Move? 54‐55
Shopping Around for Health Insurance 5658
Healthcare Reform and You 5963
What’s Up with the House Bill? 60
OK, Now What Exactly Does This Mean for Me? 60‐61
Through the House, Into the Senate 61
Senate Healthcare Bill? Why Should I Care? 62‐63
About the Author 64
Discount on the Next EBook 65

INTRODUCTION
“It won’t happen to me.” We’re all guilty of thinking that—myself included.

My health issues started fairly early in life, the more personal of which I won’t go
into here. I’m going to focus on one particular ailment that began when I was a 15‐
year‐old freshman in high school—and will be with me now until the day I die.

I was a star softball player. At that point, I had been playing for nearly 10 years,
most of which was in a competitive fast‐pitch league. My team had even won the
Illinois State Championship and placed 14th in the World Series one year for our age
group. It was my dream to one day qualify for the Olympic team—and things were
looking good that year.

It was the day before our first game of the high school season. (Once you hit high
school, you can’t play on a competitive traveling team during the high school
season.) I was all set to be our starting third baseman—and the fourth hitter (clean‐
up) in the lineup.

We were playing a scrimmage (half of our own team playing the other half), and I
was first up to bat. Adrenaline pumped through my system like mad as I stepped up
to the plate. It was the first time we were playing on our new field—we even played
on it before the varsity girls. I remember telling our coach we shouldn’t play on the
field so soon after laying the sand because it would be too soft, but she dismissed my
concern and I quickly forgot I even mentioned it.

The field was so new we didn’t even have the homerun fence up yet. Perhaps if that
had been up, what I’m about to tell you would never had happened. I pelted the first
pitch so far it almost landed on the soccer field where a team was practicing. But
since it couldn’t be labeled an official homerun, I took off.

I was easily the fastest runner on our team. (I know this because I always won our
“suicides.”) I rounded second before the girl even reached the ball. But I didn’t slow
down.

As I rounded third, I heard my coach—who was standing by third base—yell,
“Heather, stop!” The sound of my name had an immediate effect. I stopped. Hard.

My left foot dug deep into the soft sand. I turned to return to third base because the
ball was finally coming back into the infield, but I fell over. My coach threw her
hands up to stop the game. I felt no pain, but my left foot was literally dangling from
my leg.

“Why did you stop me?” I asked. “Because you were going to score too quickly,” she
replied. To this day, I don’t know what she meant by that.

A groundskeeper had to come out with a truck to bring me to the medical room in
the athletics department. My mom had been called, and I felt pain for the first time
as they put ice on my ankle. When she arrived, we rushed to the emergency room.

“I don’t see anything wrong,” the doctor told us. “Just to be safe, let’s get you in a
cast, and I’ll see you in two weeks.” Whew, I thought. My softball career wasn’t over.

Because you can’t remain on the team if you miss more than two games, I had to suit
up over the cast for the next two weeks. It was painful to watch my backup playing
third, only because she was so rude about it—but that’s a story for another time.

I returned to the doctor two weeks later, happy to get that stupid cast off my leg. If
you’ve never been in a cast before, not only do crutches suck big time, but
showering is nearly impossible!

“Let’s see you walk,” the doctor said. As soon as I put weight on my left leg, I fell
over.

This is probably a good time to tell you that I had an HMO (health maintenance
organization) insurance plan, and our doctor’s office was a “teaching hospital.”
Throughout everything during high school, I will see the same doctor no more than
twice and repeat my story countless times.

“Hmm…your x‐rays are clean,” the doctor continued. “Let’s try another two weeks in
a cast.”

I was injured at the end of February, and this dance would continue until May.
Meanwhile, since our softball season didn’t end until June, there I was—suited up
and attending every game.

As I mentioned, they finally decided to go in surgically in mid‐May to figure out what
was going on. The problem? My leg had gone clean through my ankle, destroying the
cartilage and a good chunk of bone. The doctor removed the floating pieces, put me
back in a cast, and I missed only one game.

Unfortunately, it was not meant to be. What I didn’t know was, at the time, there
wasn’t a surgery to actually fix the problem. All they did was remove, not replace.
There was now a hole in my ankle. But, I dutifully went to physical therapy three
days a week in hopes of at least playing on my competitive travel team in the fall.

I’m not sure if this is a requirement in every state, but our high school required
everyone to pass the presidential fitness test, which included running a timed mile.
“But I can’t run yet,” I told my gym teacher in early September. “I have a note from
my doctor.”

She didn’t care. And let me tell you, that’s the fastest mile I’ve ever run. I might be a
great sprinter, but a long‐distance runner I am not. I knew I was injured badly about
half‐way through, but I kept going. I wasn’t about to fail out of gym of all classes! As I
crossed the finish line, I collapsed, crying. This time, I was in a lot of pain.

I would have another surgery the following May (yes, it took them that long to
decide I needed it), but wouldn’t walk again until I graduated high school. And even
then, doctors referred to my walking as a “miracle,” seeing as I had lost so much
bone and cartilage from my ankle. I was even “studied” by the University of Chicago
Hospital because they planned to write a book about my medical wonder.

I might have had a crappy HMO, but thank goodness I had some sort of health
insurance. The situation could have been a lot worse. Sure, there was no continuity
in my medical care, but at least I was getting it—and some of it was being paid for by
someone other than my parents.

However, the story doesn’t end here. I continued to have problems with the ankle,
as you might imagine. I would be walking, and suddenly it’s like it wasn’t there—I
fell a lot, particularly on stairs. I’m sure the emergency room staff thought someone
was beating me, but I assure you that’s not the case!

When I graduated from college, my first job paid 100% of my health insurance—a
PPO (preferred provider organization) nonetheless. After my experience with
HMOs, I vowed to get a PPO plan after I was no longer covered under my parents’
insurance, no matter the cost. I wasn’t going to take any chances.

I left that job after four months because 50 percent of the employees quit in a two‐
week period, including my boss, and I didn’t know the future of my role there. So, I
went under my husband’s (Brett) PPO plan because my next job didn’t offer health
insurance.

Fast forward to November 7, 2008. I’ll never forget the date as long as I live. We
were leaving for a week‐long vacation in the North Carolina mountains. It was 5 a.m.
and still dark outside. Brett was honking at me from the car because I was online
still, chatting with my Web developer about the Come Recommended site.

Brett finally came inside, closed my laptop and walked out the front door with it. I
followed him and headed down our front steps. Then, he shut off our porch light.

I don’t blame him for what happened next. I’ve always complained our
neighborhood is too dark. I thought I was on the last step, but alas, I was not. I
stepped forward and fell what felt like through the ground itself. I gave a blood‐
curdling scream that caused our neighbors’ lights to turn on. After all, it was 5 a.m.

Those who know me know I don’t have much luck with vacations. Something always
goes horribly wrong. So I sat on the ground for a minute, thinking about what to do.
Should we go to the emergency room, or just head on our way?

After a little while, I hobbled to the car. I’m fine, I thought. There’s no reason to ruin
another vacation. “Are you sure you don’t want to go to the emergency room?” Brett
asked me. We headed out, and changed course toward the hospital after a few
minutes on the road. My gut was telling me not to be stubborn.

Five hours in the emergency room (so much for getting to our destination before
dark) resulted in—you guessed it—clean x‐rays. By this time, my ankle was the size
of a softball. “We’re going to cast you, just to be safe.” No, please, don’t, I thought. Not
again.

The vacation went poorly, to say the least. It was a resort for active people. So much
for our racquetball set in the trunk. Poor Brett did most things on his own, although
I didn’t let him leave me alone in our condo for more than a few hours at a time.

Two days before we were supposed to head back, I received a call from my
orthopedic surgeon’s office. “Can you come in a day earlier? He’s no longer available
for your scheduled appointment.” We packed up and headed out.

“I want a MRI,” I told him. I wasn’t about to accept the x‐ray’s results. Even though it
had only been one week instead of two, my ankle was huge, and I still couldn’t put
weight on it.

I just know he thought I was a hypochondriac, but he wrote the script. We met again
a week later to discuss the results. I was missing approximately a centimeter of bone
and cartilage in my ankle. For such a tiny joint, that’s a lot. (Oh, and my ligaments in
the area were torn, causing the severe swelling.)

Remember how they couldn’t repair my ankle in high school? Well, the surgery was
now available. It involved taking parts of my knee, putting them in my ankle and
inserting pins to keep everything in place. My situation was particularly tricky,
however, because of the exact area I injured. The surgeon would actually have to
break my ankle in order to get to the affected area.

Because the surgery involved both my knee and ankle, it would take two surgeons to
do the job. (Apparently no one doctor works on both knees and ankles.) I called our
insurance company to make sure the surgery would be covered, as did the surgeon’s
office. In both cases, we were told I’d only owe a $275 co‐pay.

Unfortunately, both doctors weren’t available at the same time until December 3,
2008. And I didn’t meet the knee surgeon until going into the operating room.
“You’ll never know pieces of your knee are missing,” he told me. “This is a routine
surgery. We take from parts of the knee you don’t actually use.” Ok, I thought. Let’s
do this.

The first words out of my mouth when I woke up were, “You put a tube down my
throat, didn’t you?” Yes, indeed they had, although I wasn’t told why. My throat hurt
so bad. My entire body hurt like I’d been in a car wreck.

A machine above my head kept beeping. “Keep breathing,” the nurse would tell me.
What was happening? What time was it? Where was Brett?

The surgery was supposed to take 45 minutes. I went in at 1 p.m. and was out at
3:30 p.m.—twice as long. I woke up around 4:30 p.m., and Brett was notified I’d be
out soon. However, I couldn’t move and can’t even describe the pain I was in.

Beep, beep, beep. “Keep breathing.” One nurse shift was over, and another began.
Then another. “Can you please get my husband?” I asked.

Brett came back and told me how long he’d been waiting since they told him I was
just about ready to go home. “I know,” I said, “but I don’t think I’m ready.” They kept
giving me more pain medication, which was making me nauseous.

Looking back, I can’t believe they let me leave that evening. It was around 11 p.m.,
and I was still having breathing problems. I was so scared I’d stop breathing in my
sleep that I made Brett stay up all night with me. Two days later, I returned to the
knee surgeon (because he was available of the two doctors). My pain was incredible,
and the drugs they originally gave me were not doing the job.

At that point, he told me one of my lungs partially collapsed during the surgery—
hence the problems breathing. When were they going to tell me? Probably never, had
I not come in complaining.

He took a look at the pain pump installed in my leg—another little surprise I didn’t
know about until I woke up from the surgery. It was dispensing correctly, so he gave
me some stronger drugs.

I would be back to their offices approximately twice a week over the next month and
a half with all sorts of problems. The receptionists knew me by first name. And, call
me crazy, but I had a feeling the doctors thought I was exaggerating my condition.

I originally was told I’d be able to go back to work on January 2, 2009. Since
November 7, I hadn’t been in the office because I was a liability. (I worked on the
11th floor, and what if there was a fire?) Luckily, working for a healthcare
organization, my employer understood and allowed me to work from home.

Throughout December, Brett and my dad would take turns caring for me. I couldn’t
get up and move on my own. It’s hard to imagine too many things worse than a
grown woman asking her father to help her go to the bathroom.

I wasn’t allowed to shower until the stitches came out, so sponge bathing in the
kitchen (since I couldn’t make it past our first level) it was until December 27, 2008.
My sisters‐in‐law thoughtfully bought me a beautifully‐smelling Bath & Body Works
set for Christmas. Best present I ever received.

Although I still couldn’t walk, I finally returned to the office on January 26, 2009. By
that time, I was at least in an air cast and crutches and able to put some weight on
my leg. And with encouragement from co‐workers, I ditched the crutches within a
week.

However, I had complained numerous times to my doctors that I wasn’t receiving
appropriate physical therapy care. Since I’d been through it several times before, I
knew what to expect. And because the physical therapy office was actually owned
and operated by the group of surgeons, I thought they’d take my complaints
seriously. At that point, they were probably sick of me and just looking to offload
me.

Things still weren’t right by March. I started with my new physical therapist on
March 3, 2009. She did more during my evaluation appointment than the other
group had done for the past several months. That’s why I called her the next day
when I couldn’t reach either of my surgeons.

I stepped out of the elevator exiting the Metro train, and my leg “locked up.” (I was
later told this was not the proper terminology, but what else do you say when you
can’t bend your leg at the knee?) Not only that, but the pain was worse than when I
got out of surgery.

My office is about 150 feet from that elevator, but I couldn’t make it. In typical, D.C.‐
area fashion, people walked right by me as I lay on the ground. I actually
contemplated calling 911—just to get someone to drive me over to my office so I
could get out of the cold.

I finally crawled up to the doors and got inside. My physical therapist offered words
of comfort, but not much else. She couldn’t explain what was happening to me.

The following day, I reached my knee surgeon. He was just as baffled.

After another MRI, he decided to go back in the knee to plug up the hole. “It
shouldn’t be causing this problem,” he said, “but we’ll see if that helps.”

I didn’t know it at the time, but the pieces they took from my knee were supposed to
regenerate on their own. Hindsight is a beautiful thing. Perhaps I should have
known that, since my ankle never “grew back,” my knee wouldn’t either. Or at least
the doctors should have.

“But first, I want to rule out nerve damage,” he continued. He sent me to see a pain
specialist. After all I’d been through over the years, this is actually when the worst
began.

The pain specialist took one look at me and said, “There’s no way you have nerve
damage, but I’m going to perform a few tests just to make sure.” He proceeded to
poke and prod me, asking me all sorts of weird questions like, “Do your toenails
always grow at different rates?” This time, I thought he was crazy!

“I’ll be damned,” he said 30 minutes later. “You have reflex sympathetic dystrophy. I
want to see you as soon as possible to begin treatments.” He handed me two
brochures that were supposedly going to answer all my questions about the
disorder and the “treatments.” Unfortunately, they did neither.

So, I turned to my good friend Google—and immediately became scared out of my
mind. Reflect sympathetic dystrophy, or RSD, is an incurable, chronic pain
condition—a key symptom of which includes “continuous, intense pain out of
proportion to the severity of the injury, which gets worse rather than better over
time.” As it turns out, the pain starts in the injured area, but can spread throughout
your entire body, paralyzing you if a doctor does not get the disorder under control
“soon enough.” What does “soon enough” mean? I wondered.

Again, I checked with my insurance company before beginning the treatments and
was assured I’d only owe a $20 co‐pay each time.

For the first treatment, which involves sticking a tube in your spine and injecting
medicine into it, I didn’t have most of the typical RSD symptoms. By the third (and
final of its type allowed in a year’s time), my entire left leg felt like it was on fire. I
was having trouble wearing pants, skirts, you name it. (I dare you to try explaining
that to even the most understanding of bosses!) I wasn’t sleeping at all because the
sheets hurt me whether I was on top of or underneath them.

“There’s nothing more I can do for you,” the pain specialist told me. What? No!

I desperately called every pain specialist in my insurance company’s directory,
trying to find someone who knew how to treat the extremely rare RSD. Finally, the
very last doctor on my list seemed to know what it was—he’d written several
papers about the disorder, according to his bio—and agreed to see me very quickly.

It was now the end of May, and I could barely walk. The condition had spread to my
right leg, and I was using a cane. The doctor entered the room, took one look at me,
and screamed down the hall for one of his colleagues.

“Who’s been treating you?” he asked. I gave him the original pain specialist’s name.
Apparently, he used to work in their practice, and left on not‐so‐great terms.

“Wow, Stewart messed this one up big time,” he said in front of me and my husband
to the other doctor. “What are your thoughts?”

They devised a treatment plan, and sent me to another one of their offices in
Virginia for the actual procedures. Turns out, the original treatment I received was
the wrong one for this condition.

Again, I made a call to the insurance company—the same $20 co‐pay would apply.
Within three days of seeing the second pain specialist, I was on the table receiving
the most complicated epidural nerve block ever performed because of the extent of
my condition. Three tubes would be inserted simultaneously in my spine, followed
by medicine flowing down them and removal of the tubes. The pain was
tremendous, and I passed out—twice—after the first procedure.

This would continue every other Friday until September, but I noticed immediate
improvement after the first procedure. I even attended a conference in mid‐June,
and was able to walk around without the cane, as long as I took frequent sitting
breaks.

But, while I was finally in remission for the time being, the news wasn’t all good. I
walked into what would be the final procedure to date only to be handed a bill that
needed to be paid right then and there or I wouldn’t be treated—for $1,000 for
every epidural nerve block. Apparently, even though I had the best health insurance
in the U.S., it wasn’t good enough. We obviously paid.

In November 2009, we received a $5,000 bill from the surgeon’s office. In December,
a $4,000 bill from the hospital. Even though we’ve nearly gone bankrupt (not to
mention I will need these treatments for the rest of my life, as their effects only last
about a year), the situation would have been much worse had I not had insurance.

I realize this is an incredibly long (but hopefully captivating) story about the risks
you take when you don’t have health insurance. But, as a new, unemployed graduate
without health insurance (or perhaps even employed but underinsured), you need
to understand the importance of getting coverage—immediately.

Throughout the pages of this e‐book, you’ll learn your health insurance rights, what
COBRA is, why you might want to consider graduate school, different plans offered
by employers, short‐ and long‐term insurance options, how to shop around for a
policy and the potential impact of healthcare reform. It’s all here.
ABOUT THE AUTHOR

Heather R. Huhman, founder & president of Come Recommended,
is passionate about helping students and recent college graduates
pursue their dream careers. As the oldest child in her family –
even among her extended family – she did not have anyone to
guide her through the trials and tribulations of developing her
career. Now, as an experienced hiring manager and someone who
has been in nearly every employment‐related situation
imaginable, she is serving as that much‐needed guide for others.

Heather knows and understands the needs of today’s employers
and internship and entry‐level job seekers. Her expertise in this
area led to her selection as Examiner.com’s entry‐level careers
columnist in mid‐2008. The daily, national column educates high
school students through recent college graduates about how to
find, land and succeed at internships and entry‐level jobs.

Additionally, Heather is a career expert for the CAREEREALISM Twitter Advice Project, the job
search expert for Campus Calm, a contributor to One Day, One Job, One Day, One Internship, Intern
Advocate and Personal Branding Blog and author of #ENTRYLEVELtweet: Taking Your Career from
Classroom to Cubicle (2010) and the e‐books Relocating for an EntryLevel Job: Why You Probably
Have to & How to Do It (2010) and Gen Y Meets the Workforce: Launching Your Career During
Economic Uncertainty (2008).

Heather resides in the Washington, DC area with her husband, dog and two cats. She is available
to answer your questions or speak at your next event.

CLICK HERE TO
BUY THE E-BOOK NOW

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Why You Need to Stop What You’re Doing Right Now to Purchase Health Insurance

Copyright © 2010 by Heather R. Huhman

ABOUT THE AUTHOR

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