Cancer and the Fear of Losing Health Insurance

Please, God, don't let my husband leave me. Not that he's planning to—as far as I know. After all, he's stuck with me through so very much, including the discovery of a cancerous tumor the size of a softball in my lung. And through my monthlong hospital stay, while he took care of our kids, oversaw housewide construction, and handled the insurance bills. And through months of chemotherapy and, later, weeks of radiation treatments where the other women in the waiting room and I confessed that we feared that our husbands would leave us … without health insurance.

My therapist told me that it's normal to fear abandonment when you're at your most vulnerable, and I'm grateful that my husband has stayed with me in sickness and in health. Yet I'm grateful not just to have a good man, but to have a good man with good health insurance.

An employee at a midsize IT firm, my husband has access to a Preferred Provider Organization (PPO), a flexible health-insurance plan with many choices of doctors and medical facilities, from a large insurer in New Jersey. It covers most of our medical bills and pharmaceutical costs, and even provides a modest vision plan for my husband, our two kids, and me.

During my treatments for non-Hodgkin's lymphoma two years ago, our insurance carrier paid for almost all of my medical bills, which totaled upwards of a quarter of a million dollars—and counting.

Naturally, we've paid into this insurance plan from my husband's paycheck. And we've paid our $3,000 annual family deductibles, my $1,000 individual deductibles, copayments and out-of-pocket costs all along.

But even my oncologist was surprised at how good our coverage was—until he dropped our plan last year, citing a low reimbursement rate. Still, our insurance company not only covered the costs for most of my cancer treatments at a topnotch New York City hospital with some of the best doctors in the world, but also my posttreatment scans and tests, including last month's $12,000 biopsy, which assured that my cancer is still in remission.

The truth is that we are one layoff and one positive PET scan away from health-care-related economic troubles. I can't help but worry. My husband's work—developing the online presence for banks, credit unions, and credit-card companies—is not exactly a stable business these days. So we are socking away money just in case. We use coupons and shop at discount stores. We're hanging on to our cars as long as we can—my 2002 minivan has 112,000 miles on it; my husband's 1999 Pontiac is approaching 90,000 miles. Vacation this summer will mean traveling to our community lake.

It feels all wrong to rely on my husband's employment and our marital status to be able to continue the kind of quality cancer treatments and tests that saved my life. As a self-employed author and blogger, it would be difficult for me to get affordable health insurance with the kind of coverage that my husband's corporate job allows us now. If I became a single mother, it would be even harder. And now that my oncologist is out of network, our out-of-pocket costs are higher. Plus, our investment portfolio has, of course, taken a hit, and most houses for sale in our area have been sitting for more than a year.

Luckily, we live in New Jersey, a guaranteed issue state where we can't be denied coverage for preexisting health conditions—even cancer—and we won't face exclusion periods imposed on our health-insurance policy as long as we follow certain rules. For example, if my husband lost his job, as long as we kept up our COBRA payments, roughly $1,500 for a family of four, for up to 18 months, we can't be denied coverage down the road. And now the government is chipping in up to 65 percent of such payments for many people laid off this year.

And yet, I still worry. I've heard plenty of health-insurance horror stories from other patients and survivors that give me pause: there was the woman I met at radiation therapy who was denied insurance because she was diagnosed when she was between jobs and, therefore, between insurance plans. Unemployed and single, she couldn't afford her COBRA payments. Then there was my mentor from the Leukemia & Lymphoma Society, a mother of three with no health insurance, who was told that the only way to get government assistance for her medical bills was to divorce her husband.

And then there was the Canadian on an Internet cancer forum who praised her country's socialized medicine: "We just got a third PET scan machine in Ottawa!" she sang. Three PET scan machines for the entire Candadian capital? There are more PET scan machines than that in the Manhattan radiology center where I get my scans. And PET scans are now considered the gold standard for identifying the kind of cancer that I had.

I listened to their stories and realized how very lucky I am to have such good insurance. And yet I know that just one layoff or one cancer recurrence are all that could be between me and a health-care crisis like so many Americans are facing today.

In March, my husband's company issued 5 percent pay reductions to stave off layoffs. As long as he still has his job, that's fine with me. It's his health insurance that's so invaluable for us. Perhaps my life depends on it.