Coverage Choices
Navigating The System
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District resident Doreen Hodges, 43, has learned a thing or two about navigating the insurance system for her family, which includes an 8-year-old boy with Down syndrome and autism and a toddler born prematurely. She's so adept at it that she helped launch the local branch of the nonprofit group Family Voices of DC so other parents with special-needs kids don't have to go it alone.
A year ago, Hodges's husband was on disability, receiving half his ordinary income and paying $427 a month for a workplace PPO that had a $2,000-per-person deductible and covered about two-thirds of their $5,000-a-month medical bills. To help them with expenses not covered by the PPO, the family also received assistance from DC Healthy Families, a combination Medicaid and children's insurance program for low-income families.
The family lost the workplace PPO in March, which meant DC Healthy Families had to become their primary coverage. But a bureaucratic hitch left them without any coverage from April to July. The result: They racked up $9,000 in bills, largely for physical therapy for the kids.
Hodges, who says she earns $15,000 a year at a part-time job, is trying to get Healthy Families to cover that extra debt. "It's been hard trying to keep food on the table and gas in the tank," she says, and she has fallen behind on her rent.
The proportion of Americans with medical-bill problems increased across all income levels between 2003 and 2007, according to a new study by the Center for Studying Health System Change. Nearly one-third of lower-income families (a family of four earning less than $41,300, for example) had problems paying medical bills last year.
