Aging out of parental health insurance has always been an issue for young Americans with chronic health conditions. But ever since the 2010 Affordable Care Act allowed young adults to remain on their parents insurance until the age of 26, there has been a universal deadline.
Louis Philipson, director of the University of Chicago Kovler Diabetes Center, told BuzzFeed News that he sees many young adult patients with Type 1 diabetes living in fear of this deadline.
Theyre on their parents insurance now, but some are in the gig economy, moving from one job to the next as they start their lives, they may not have a job with insurance that covers their insulin, or their job may have zero insurance, or its a job thats under-insured with high deductibles, he said.
The rising cost of deductibles the annual amount that a patient must pay out of pocket before their insurance plan begins to pay is an issue for all Americans. A comprehensive nationwide analysis published in May showed that deductibles in job-sponsored insurance plans have quadrupled in the past 12 years and average more than $1,300. High-deductible plans are also common for those who choose to be insured through the state exchanges established under the ACA, and these deductibles can be even higher than those with job-sponsored plans. In 2018, the average deductible for the most popular type of plan on the exchange was nearly $4,000. The cost of the deductible is in addition to the cost of the monthly premium payment.
Since being kicked off your parents insurance is considered a qualifying life event, young adults are given a 60-day special enrollment period after their birthday to sign up for new insurance. But some young adults with Type 1 diabetes find it difficult to afford their medicine even with government-sponsored insurance.
I looked into it, Laverty said about going on government insurance. But it was going to be so stupid expensive that it wasnt worth it.
He said that the plans he was able to find on the exchange had such high deductibles that he felt he would likely find a full-time job with benefits before he met his deductible. In the interim, he would be paying list price for insulin during that in-between period with or without government insurance.
The first month [of medication] alone could be $1,000 or even more, Philipson said. It breaks budgets, it forces people into untenable situations: You have to choose between rent and insulin.
Turning 26 theres a looming fear that youll be spending $500 a month, $5,000 to $6,000 a year to stay alive, Philipson said. This isnt an option. Type 1 diabetes is a fatal disease if you dont have insulin.
The deadline is approaching for Allie Marotta, a 25-year-old living in Brooklyn.
Im a freelance theater person, theres no insurance there, Marotta told BuzzFeed News.
Marotta is planning to either get a job with good health insurance or buy insurance from the government. However, she is preparing to be uninsured for a period of time, since both of those things take time. So, with the help of her endocrinologist, she has begun stockpiling insulin.
Marottas doctor has been giving her her insulin samples from the supply that endocrinology offices keep on hand for emergencies and to teach newly diagnosed patients how to dose themselves. Marotta said that her endocrinologist is also prescribing her extra insulin.
Shes like, Lets get you as well-stocked as you can for now, so you can bide that time a little bit better, Marotta said.