We’ve Fallen Through the Cracks: Johnny’s Story

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Johnny and his wife worked all their lives, paid taxes, and paid for health insurance expecting it to cover them in times of need. But when those times of need came, the insurance company pulled the rug out from under them and left them struggling to pay for both their medical bills and for the insurance that left them high and dry. Now retired and living on a fixed income, Johnny is trying to get his life back after an injury and navigating a system that let him and his wife fall through the cracks.

MEET JOHNNY

“It was pretty simple, painless. I like simple. I think that’s what stops a lot of people from going – the not knowing. The not knowing the cost or what’s involved.”

– Johnny R., Tennessee, on working with MDsave

Johnny is a retired railroad worker living on a fixed income with his wife.

I hurt my back on the railroad years ago and had to leave the service because I just couldn’t do it anymore. I didn’t have enough time [on the job] for a full pension, just a partial pension and disability. The railroad had the best insurance plan in the world. The problem is, the year after I retired I moved to Tennessee from Southern Louisiana. The company I used to work for moved to Canada and I kind of had the rug pulled out from under me.

Then my wife was booted off of her insurance. I don’t know how you can be eligible for insurance then all of a sudden not, but after she lost her insurance, she was diagnosed with breast cancer. So we’re dealing with all the bills from the anesthesiologist to the surgeon to the hospital…there were ten different entities that we were paying out to.

Our life changed when I hurt my back. We worked all our lives, paid taxes. The healthcare system in this country is in deep trouble. In our age bracket, I feel like we’ve just fallen through the cracks. I have a twin brother the same age as I am, but the reason he’s hesitating [about retirement] is because he’s afraid to lose his insurance.

Why didn’t insurance cover your wife’s breast cancer?

When my wife was kicked off of her insurance, I went to some insurance company to get her coverage, and we paid for health insurance. I was still insured. One of the things they covered was mammograms. She didn’t want to go, but I said, “You don’t have a good reason not to go.”

When she came back, I could see it on her face. I said, “They found something, didn’t they?” That’s when this whole insurance thing started. We submitted a claim to insurance, only to have them say, “it’s a pre-existing condition.” But how did they know? We didn’t even know. So I ended up paying both the hospital and the insurance.

How did you hear about MDsave?

Recently, I kicked my back out again. I was weeding the yard. I probably shouldn’t have, but you’ve got to do what you’ve got to do. The chiropractor sent me to get an x-ray a couple of weeks ago. He recommended you guys, and I was just amazed that I could afford it.

I’d never even heard of MDsave before. The receptionist gave me the paper with the phone number, and I made the call. They gave me the paper with the confirmation on it and said, “You’re good to go.” I like simple. I think that’s what stops a lot of people from going – the not knowing. Not knowing the cost or what’s involved.

The receptionist at the chiropractor’s office said that even their insured patients go this route because it’s actually cheaper than what they would pay with a deductible. What I’m paying out of pocket wouldn’t even meet a deductible every year. If I walk in there without insurance, it costs me less than if I walked in with insurance.

What was it like working with MDsave?

I couldn’t be more pleased, because every time they [the doctors] tell me I needed an x-ray, I would panic. All the world of medicine and insurance and all the red tape, I’ve basically found someone who I can talk to. It was a good experience, that’s what I can say.

It was pretty simple and painless.

How are you feeling now?

I’m hoping I can get this thing straightened out. I’m just trying to get where I can stand up and walk straight again. I just want to get my life back, and get up to where I can do things again.

You take for granted when you can do, and when you can’t do, you sit up and take notice.

I’m getting worse by the day, have been for years, and if I ever do get myself in the body shop, they’re going to have to do a total restoration. That’s because of putting off the treatment for an inability to afford it. When you reach a point when you can’t go anymore, then it’s just – I guess that’s our human nature, we don’t do anything until we have to. I’ve talked to so many people who are in really bad shape, and would really benefit from medical care.

I’ve been active all my life. I’m a mover. I know there are a lot of people in my age bracket who can still be productive in society, but the way our healthcare system is set up there’s no place on the board for us.

It’s easy to see how someone in our position can get pretty discouraged about healthcare. We’re not in this thing by ourselves – a lot of people are in the same boat.