Stride Stories: Work the system, don't let the system work you

[Situation: Laura Morris lives in Denton, Texas. She did not carry any medical insurance between 2007-2013. “It was too expensive and the coverage just wasn’t that good,” she said. In 2014, with the advent of the Affordable Care Act (Obamacare), she bought insurance but wasn’t pleased with it, learning after-purchase it didn’t cover her favorite primary care physician. In 2015, she secured a great-paying startup job and bought an expensive policy that covered her physician. That’s where Laura's story starts.]

When I enrolled in 2015, I was paying over $400/month with United Healthcare. Twice within five months they called me telling me that my premiums had not been paid, when it in fact they had been (and I had proof). That May, the startup could no longer pay me the $5000/month because their funding didn’t come through.

I was angry at United Health for the payment issues and wanted a way out. I learned on you can make mid-year healthcare changes if you have an income change – I was going to make $15K, as opposed to the $60K I was expecting.

At this point, normally I would’ve qualified for Medicaid, but because I live in Texas the politicians voted Medicaid down. It’s one reason why getting medical insurance in Texas is a special kind of hell. Because of this Medicaid gap, said I didn’t have to carry insurance, so I walked away from United Health and went uninsured.

The primary care doctor I was seeing set up medical memberships - a monthly fee I paid which made office visits $10. I used that coverage for the remainder of 2015. If something catastrophic had happened, and I needed to go to the emergency room, I would’ve been in trouble.

[Interviewer’s note: Laura’s become extremely distrustful of the whole health system and developed a “leave me alone” feeling towards mandatory health insurance. I could hear her frustration in every word she spoke to me over the phone.]

I started driving for Uber after the startup failed because a bored Laura is not a good thing [laughs]. This past November, when I was going to start looking for health care again, I got an email from Uber about Stride. I went on your website, and entered my expected income of $24,000. I found an Aetna plan for $58/month, which fit my budget but didn’t cover the doctor I wanted.

At this point, I called Stride and got Megan on the phone. I explained my situation to her, and during that first phone call, she found a Scott and White plan that covered my doctor. Unfortunately, it was going to cost me about $144/month.

Going into 2016, my max budget for a plan was less than $100/month, so I told Megan $144 was too much. The $58 Aetna plan didn’t seem like a good option if I couldn’t see the doctor I wanted. At that point, I was prepared to not have insurance and just pay the tax penalty in 2017.

But Megan called me back about two hours later with a different solution – get the $58 Aetna coverage, so at least the catastrophic stuff would be covered, and keep the membership with my doctor. Megan said, “I realized when divided monthly, the cost of your doctor’s yearly membership + the Aetna premium + the $10 doctor’s visits would actually be less than the annual cost of the Scott and White Plan.” With Megan’s idea I’d be covered from both ends, and I wouldn’t have to pay the penalty of $695. I liked this solution, and when Megan re-verified my information, the Aetna plan came up as $41/month with my subsidies.

Great, $41/month to forestall tax penalties and have a catastrophic plan. Getting coverage will cost me $492 this year, versus being uncovered and paying a guaranteed $695 tax penalty (plus being exposed to medical bankruptcy).

If I had not had Stride to turn to I wouldn’t have found this solution; I certainly wouldn’t have carried medical insurance this year. So did Stride help? Absolutely. It gave me somebody to talk to where I could say, “I’m having problems, what are my options?”

Megan was amazing. She impressed me with her calm during our initial conversation, because I was pretty angry. What REALLY impressed me was when she called me back and said, “Hey I’ve been thinking about this and I have an idea that could help you.” That was completely and utterly unexpected and immensely helpful.

I’m curious to see what free care comes with my Aetna plan. Right now I’m a little gun shy to use my insurance, which is a sad state. Here’s where my mind is: I’m going to use my medical membership with my $10 copays. I’m going to keep Aetna at arm’s length in case something really bad happens. I really don’t ever plan to look into what they have to offer because I don’t trust them. And if I feel that way, how many other people are out there that feel that way?