by Golda Philip, Health Fellow,
National Women's Law Center
Medicare, Medicaid. Being 61, my mom has 4 years to go until she qualifies for Medicare. Medicaid, the joint federal-state program that provides health insurance coverage to certain categories of low-income individuals, also isn’t an option. To qualify for California’s version of Medicaid (called Medi-Cal), you need to meet both income eligibility standards AND what’s called “categorical eligibility.” This means to qualify for the program, my mom would have to fit into one of the following categories: 65 or older, blind, disabled, under 21, pregnant, a recipient of various forms of state assistance, living in a skilled nursing home, a refugee, or a parent of a qualifying child under 21. My mom doesn’t fit into any of these categories.
Individual health insurance market. We here at the National Women’s Law Center have talked a lot about the individual health insurance market. My mom tried her luck with this option as well, and after searching and searching, she found an insurance company that would cover her. For almost half a year, she paid almost $400 a month for her premium. She soon got a letter in the mail from her insurer, informing her that her coverage was being rescinded because she had a pre-existing condition. My mom has diabetes, but with regular exercise and diet, she has for years been able to control the condition with only minimal medication. The insurers didn’t seem concerned, however, when my mom’s doctor wrote them telling them as much. As long as she had diabetes, they wouldn’t cover her.