Posts Tagged ‘restrictive network’

Krissy Williams, Pratt Institute

I am a junior at Pratt Institute with a major in Creative Writing and a minor in Psychology. After college, I hope to pursue a job in creative writing.   

My family and I qualify for Medicaid although we’ve had to switch to metro-plus because Medicaid wasn’t as accessible for our needs. Due to the limitations under Medicaid, I really struggled with being able to access certain doctors and therapy because a lot of therapists didn’t take my insurance. It took me months to find the care I needed. In one instance this caused me to go into debt, because I went into a therapy office thinking that they covered me. However, days after the session they informed me that it was not fully covered by my insurance and gave me a bill that I couldn’t pay off for months. I’ve also noticed the more advanced therapy treatments I need like EMDR are inaccessible to me because it is only for people who have the funds to pay out of pocket. My family and I also struggled with getting our prescriptions filled under Medicaid as many pharmacies, for example Walgreens didn’t accept our insurance.

I think we shouldn’t have to be upper class or rich to have good care. Lower-income individuals are always at the short end of the stick when it comes to these things. Therapists don’t take insurance because the health care system doesn’t pay them enough. In return this causes therapists to overcharge and only cater to upper-class people which leaves us with nothing. This is not fair to those who have chronic illnesses who cant afford to pay for treatment. It’s ridiculous we have to pay to get the help we need to live.

Valerie Guerrero, SUNY Cortland 

I am a SUNY Cortland student in my fourth year. I am a dual major in Spanish and Sociology with a concentration in Criminology. I was born in the Dominican Republic where I lived until I was 12 when my mother decided it would be better for us in the United States. I currently live in the Bronx when I am not away at school. I have been at SUNY Cortland for my entire college career. I chose to go here because my high school volleyball coach attended SUNY Cortland and they promoted this college all throughout high school. Along with that, I wanted to go away to school, and Cortland provided the best EOP program for myself and my family.

In my family, insurance is through my mother through the government. There have been many times when a member of my family needed a prescription, but insurance wouldn’t cover it, so we simply just went without it. When I was in high school, there was a point when I didn’t have insurance, and we weren’t able to get our annual physicals; the school almost kicked us out. At this time, I didn’t have insurance because my mother was switching to a different insurance company due to my sister going upstate for school at it being too far for the insurance to cover. 

Recently, I went through a tough situation with medication from my insurance company. An uncommonly known fact of birth control prescriptions within the United States is that to refill a prescription of birth control pills a patient needs to attend an annual appointment with their OBGYN. When it was time for me to attend my appointment, I was in the Dominican Republic, and instead, I made an appointment with a doctor there. I was not aware that the United States doctor would not accept this visit and still wouldn’t prescribe my pills. If I were to go off these pills, since they’re hormonal, it would affect my body in multiple ways even if it were only for a few days. So, prior to running out of pills, I decided to go to the closest planned parenthood to me. Because of the type of insurance that I had, I was worried that I would have to pay completely out of pocket. Before insurance, the visit, tests, and my prescription would cost over $100 on top of the $105 I had already spent on transportation to and from the facility but luckily it was covered. If my doctor and insurance could have made an exception one time, I would have been able to avoid all of this. 

I feel that we need to make a universal, single-payer form of health care for so many reasons. With a universal form of healthcare, my mom wouldn’t have had to change my insurance because my sister went away to school, my family could have always gotten the prescriptions they needed at a decent cost, and I would have never had to go to planned parenthood which some insurance companies do not cover. If I am working and paying taxes in this country, I believe insurance shouldn’t be something I need to be concerned with.

Nicole Masaki, Canisius College

I attended college out of state (primary residence was California, but went to college in New York), thanks largely to the scholarships I received from a private college. While in college, I was on my mother’s health insurance plan she had through her job. Despite her working for a municipal government and in a unionized role, we still could not afford more than the lowest cost plan. And while I was in high school, it was great for local care especially because I do not have major health concerns. 

But when I went to New York for college, I quickly learned that the health insurance plan I thought worked for me, only worked because of where I was located. While in college, I did not have access to a primary care doctor or preventative healthcare. During the fall semester of my junior year, I woke up one morning and my shoulder was stiff and sore: it even hurt to put on my jacket or backpack. Several days went by and one night I suddenly got very dizzy and my whole arm went numb. With both sides of my family having heart conditions, I knew this wasn’t the time to worry about coverage: I needed to go to the emergency room. We called our campus’ Public Safety and they drove us to the emergency room that was only a few blocks away from campus. 

When I checked in, they of course asked for insurance. So I handed them my one and only insurance card. In California this was all I had ever needed. But the staff working asked where my second card was, she was only familiar with New York health insurances. 

Shortly after I was seen, I explained to the ER nurse what I had been experiencing the last few days and the reason I came in today–family history. I was hooked up to a heart monitor, a nurse pricked my finger to check my blood sugar levels and I was taken in for an x-ray. Thankfully I was not seriously ill: only a pinched nerve. I was asked if I wanted a prescription for a higher dosage of ibuprofen than what I could get over the counter. I declined, I was back to worrying about the cost. I went home and did my best to rest, well the best that a full time college student could rest. 

Two weeks later my mother called me. She asked why I hadn’t given the hospital my insurance– She had just received a bill for the full cost of my hospital visit. After calling our insurance company, they informed us it was not “medically necessary” for me to go to the emergency room. Of course they didn’t take into account that at midnight the only health care open was the emergency rooms, and I would not have known it wasn’t medically necessary unless I went to the emergency room. After months of fighting both our insurance provider and the local hospital, we managed to get our bill down to the $500 maximum for emergency visits. 

My first job after college was environmental justice based community organizing in the San Francisco Bay Area. My first question was not how much I would make, room for growth, or company policy–It was healthcare coverage. The cheapest plan available to me was $300 a month. I was expected to spend ¼ of my monthly income on health insurance “just in case”. With rent, high cost of living, and my six month grace period on my student loans coming up, I knew I wouldn’t be able to afford health insurance through my employer. And the Department of Education would not take “sorry I need health insurance” as a valid reason to not pay back my loans. I have never in my life felt so fortunate to be a healthy adult with no chronic health conditions. 

I have personally seen how flawed both the healthcare provided is and the health insurance industry. We need a healthcare system that is easy to understand and works for all people. When individuals are seeking healthcare whether that be preventative, treatment for long or short term conditions, or emergency care they should be able to focus on their health and wellbeing not just what they are able to afford before going broke.

Kisbel Estevez, SUNY New Paltz

My name is Kisbel Estevez. I am studying Sociology with a concentration in Criminology, and a double minor in Deaf Studies and Communication. I am a senior at SUNY New Paltz. I plan on attending Graduate school in Manhattan. There have been many occasions where myself and/or my family members have needed medical assistance but we’re told our insurance wasn’t accepted so we were turned away. We were forced to deal with it ourselves most of the time. I am covered through my mother’s job, I have Health First Medicaid. I am very much concerned about losing my health benefits; health benefits are not something that comes easy to minorities in America, sad to say. I am struggling with costs of medical bills. Hospital visits can be overwhelming. It can be a back and forth dispute between hospital expenses and my insurance covering it. It is very unreasonable how we are not able to have accessible healthcare for all when many other places around the world are able to achieve this. Universal healthcare is a good idea, because a universal system doesn’t rely solely on government funding. It can provide better coverage for every person. We need to put more efforts into providing a more accessible healthcare system which provides TO ALL.

Aryssa Hernandez, SUNY New Paltz

My name is Aryssa Hernandez. I am studying Psychology with a concentration in Biology. I am a Junior at SUNY New Paltz. I plan on obtaining a master In Psychological Counseling after college. There was a time my grandma needed healthcare and wasn’t able to get it. My grandma was unable to get healthcare due to her residence status. She had to pay out of pocket for her bills which was a hardship on the family. I have health insurance through my parents’ jobs.

I am also concerned about losing my health benefits due to aging out of my parents plan, because my parents will no longer be able to keep me on their plan once I turn 26. 26 seems far but it is around the corner. My parents have never lost a job that provided us insurance, but I see them put up with a job they hate in order to keep their health insurance. My family has not experienced COVID medical bills or long term symptoms, but as someone who used to work in the emergency, this was very common. Health isn’t a privilege, it is a right. Many are stuck in a toxic work place just to make sure that their families have health insurance and this takes a mental toll. Additionally, it causes the pile up of medical bills which can cause detrimental effects on a family. Universal healthcare is a good idea because it would act an equity as health is a right and access to healthcare is also a right.

Sukyung Kim, Pratt Institute

I am a Communications Design student with an emphasis in Graphic Design at Pratt Institute in Brooklyn. My family struggles a lot with healthcare because a lot of hospitals and medical services near us don’t use our insurance, so even though we’ve never been denied medical services, we still struggle a lot to find in-network services. My parents’ jobs don’t provide insurance, so we all have to apply by ourselves, and it’s expensive. Currently, I am using the school’s student insurance; I switched because of complications with my parents’ insurance, but going through the school is harder than using other insurance companies because I didn’t receive any guidance – I have to find the information out on my own. 

I used my school insurance last semester, but the bill (which included the last bill from the past year until now) wasn’t charged until a week ago in a bulk amount of over $1000 rather than in the smaller, but more frequent, amounts that it was supposed to be charged in. I have to settle the bill in a week, otherwise I’m going to be charged an extra $200 fine; I’m also unable to register for my classes next semester because of this fee that I have to pay, so I’m stuck because I can’t get this amount of money on such short notice.

A more equitable healthcare system would be less burdensome for families that have issues to worry about besides healthcare. So many different things in life require insurance, and that costs a lot of money on top of expenses like rent. With universal healthcare, we wouldn’t have to worry as much about hospital bills; we could just focus on recovery instead of stressing over how much debt we may have after recovery. Under a single-payer system, no one would have to worry about whether or not they will be treated, no matter how significant the illness is. It’s better to focus on life and death without the variable of money and feelings of stress due to the potential of leaving debt for family members.

Jade McKinney, Pratt Institute

I’m a first year student studying film at Pratt Institute. After school, I’m going to become a director and open my own production company. I have needed healthcare and haven’t been able to get it. Very recently, the plan I was on changed from covering my prescriptions and pharmaceuticals to a different setup. The new plan covers me and my parents, but not my prescriptions, and I need my prescriptions to be able to function. Going into the pharmacy, standing in line, and getting told that I couldn’t get my prescription- not even getting a call from my insurance plan to tell me what’s happening with my plan, not even a heads up- was a lot. I was told that it changed because my dad had retired, but I don’t stay in touch with my dad, so I wouldn’t have known.


I have government insurance, and it used to allow me to go anywhere in the country and get covered when my dad was on active duty. Now, because he’s retired, I can only go to certain military bases or hospitals to get covered. I’m very concerned about losing benefits due to aging out of my parent’s plan. With my current insurance, I have it as long as I’m in school until I’m 25, but if one day my dad decides to take me off his plan, he could. So every time I go into the pharmacy, I have to wonder “Am I going to have healthcare today?” Or I have to call my main practitioner and ask, “Am I still enrolled with you?” It’s really intense.


I believe that it’s important to have a more equitable healthcare system in New York because healthcare is a right. People deserve to have access to hospitals and to other things that they need, and they shouldn’t have to be struggling to pay bills or worrying about if they can eat or get their medication. That’s not fair. People deserve to be treated, even if they’re just scared they might be sick and want to go in for a checkup. There’s no price you can put on somebody’s health. That’s why universal healthcare is important- because at the end of the day, when it’s profit versus health, there shouldn’t even be a competition. It should be health every time, a public good every time.

Jennifer Chuqui, Queens College

My name is Jennifer Chuqui and I am a freshman at Queens College, CUNY. I am majoring in Psychology and I’m interested in going into either forensic or clinical psychology after college. I was originally drawn to psychology because I see a therapist and I know how impactful it is to have support and guidance from a professional in the field. Mental health is an important part of healthcare that is often overlooked. Many people avoid going to life saving treatments, such as therapy, due to the hefty copays and lack of in-network providers.


Personally, I can relate to the financial stressors brought on by seeking essential health services. A few years ago, I went to a routine dental cleaning. At the check up, my doctor discovered that I had an infection and needed a root canal. My dentist couldn’t provide this service himself, so he recommended another in-network doctor. Upon contacting the other dentist, his office said that the procedure would cost an additional $600, even though it was covered by health insurance. They were wrongfully trying to take money from my parents. At this point, I was worried about the financial burden that this would place on my family. My parents are separated, so they both planned on paying half, but it would still be a huge expense for us. Luckily, in the end I was able to receive the procedure with no additional cost. Doctors should not have to spend their time parsing through complicated insurance plans. There should also be less convoluted language in insurance plans so that it is harder for doctors to overcharge their patients. Instead, doctor’s offices need a simple, universal plan so that they have stricter guidelines and have more time to focus on administering life saving and highly important treatments.


Outside of my root canal experience, I have concerns about paying for health insurance in the future. I currently have medicaid. While it is covering my health treatments for the time being, I worry about aging out of the system. If I do not meet the income requirements, I could lose my health insurance, while still not being able to afford treatments.


The New York Health Act would create a more equitable healthcare system. Currently, one’s financial resources determine access to care. Even if one is able to access care, there can still be financial stressors related to healthcare, such as with my root canal. With the New York Health Act, everyone would be able to have the right to healthcare, while paying much less for treatment.