Into The Abyss: A Freelancer (Fretfully) Prepares To Pay For Health Insurance

The form lay on my desk for weeks, untouched. I knew exactly why I didn’t want to fill it out: doing so would start the ball rolling toward a significant change in my health insurance – and how much I pay for it. However, these changes were coming whether I liked it or not, and ignoring the form meant my coverage would disappear altogether. With time running out, I gritted my teeth and grabbed a pen.

The focus of my procrastination: the eight-page MassHealth Eligibility Review Form. A short back-story: I moved to Massachusetts in 2008 after losing a job, and qualified for the state’s version of Medicaid after my unemployment insurance ended. In practical terms, being on MassHealth has meant I haven’t had to pay a monthly insurance premium or co-pays when I go to the doctor. Due to a chronic condition (that's for another story), I take at least four medications a day, which currently cost $3.00 each per month.

But I’ve only been able to get this coverage because I haven’t had an income – something that changed over the last year when, at 35 years old, I started working as a freelance writer in the WBUR newsroom.

Because I’m now earning something, I’m almost guaranteed to be cut from MassHealth and be required to pay a portion of my health care costs. Budget cuts on Beacon Hill mean that some MassHealth members will be dropped this year – the cover letter that came with the form warned of that. I’m completely okay with being one of them. The scary part is the uncertainty of how much I’ll be paying, and I had a hard time trying to get an estimate.

After 2006, when Massachusetts began requiring almost all residents to have health insurance, it established the “Health Connector” to oversee the new law and help people find the coverage they need. The Health Connector’s website is relatively easy to use and informative, whether you are new to Massachusetts or a change in circumstances means you’re looking at new insurance options.

That’s not exactly the case for MassHealth. Although there’s one eligibility form whether you’re applying for MassHealth (the fully-subsidized, no-cost program) or Commonwealth Care (a low-cost insurance with a sliding scale based on income), finding information online is tricky if you go to mass.gov/masshealth. Through that route, you reach the Office of Health and Human Services, which oversees MassHealth. Trying to find out how much I might have to pay each month, I went to the site… and became completely lost. I spent a lot of time clicking from one list to another, without finding any solid information. That has to be frustrating to other people who just want a simple answer (as I did) and discover a complicated, confusing maze of menus instead of a user-friendly and helpful tool.

Which leads me back to the form. After the unsuccessful search, and feeling even more in limbo (if possible), I started filling in the information. My situation is pretty straightforward – single, no kids – so it didn’t take as long as I’d feared. However, for someone whose income picture is, shall we say, “flexible,” it’s a bit daunting.

As a freelancer, some weeks I work every day, some weeks not at all. That’s been tough to handle the last few years, and is about to get more complicated. Adding fixed monthly expense like health insurance (plus co-pays and prescriptions, which are mandatory for me) without a fixed monthly income means I may have to make some unwanted lifestyle changes. For example, I spend a lot every month on gas, since my boyfriend lives in Providence and I’m in Boston. Will this mean we don’t get to see each other as often?

For now, all I can do is wait. It all comes down to how the state calculates my income – and that’s out of my control. But all in all, I’d rather pay and keep my insurance than have no coverage at all. Having no health insurance is what truly scares me… which is a reality for far too many people.