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Maryland Couple Has Insurance, but It Hasn't Covered All Their Expenses


(By Katherine Frey -- The Washington Post)
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Sandra G. Boodman
Kaiser Health News
Tuesday, January 13, 2009

For years Jackie and Jim Eyler enjoyed the trappings of financial security: ample savings, a nice house, relatively little debt and what they thought was good health insurance.

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Everything changed in 2005, when Jackie Eyler, now 57, was given a diagnosis of advanced breast cancer and the medical bills started pouring in.

Since then, the Westminster, Md., couple estimates they have shelled out nearly $50,000 for expenses such as drug co-pays and durable medical equipment not covered by the health plan offered through the company where Jim has worked for 35 years.

The Eylers' predicament is common among people being treated for cancer or another serious illness that involves frequent doctors' visits, multiple medications and medical equipment.

The Eylers' new plan, which took effect this month, has higher premiums and skimpier benefits.

"Partial coverage is like having half an airbag in a car," observed Karen L. Pollitz, director of the Health Policy Institute at Georgetown University.

Jackie, who developed congestive heart failure and suffered a stroke during aggressive cancer treatment, isn't sure how long they can continue to afford co-pays of as much as $80 for the 15 drugs she takes or those Jim has been prescribed for type 2 diabetes, heart and thyroid problems, and bad knees. Last summer he underwent surgery for early bladder cancer.

She said she feels "very upset and nervous" about a possible recurrence of her cancer and about the relentless torrent of medical bills.

Jim Eyler, also 57, said he has been working as much overtime as possible. He worries about the declining value of their house, the security of his job and the six-figure loss his 401(k) account suffered last year. The credit card he used to pay off every month now carries a $10,000 balance.

Does he see any solution?

"I could croak," Eyler said, adding, "No. We can't get our health back."


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