This is a weird situation. I’m pretty scared right now because I have schizoaffective disorder and PTSD that will rapidly get worse without meds and therapy. The only reason I’m functioning now is because of those things. I am 22 years old. I’ve been on my mom’s plan for the past couple of years. However, this year I qualified for social security disability. Based on this I would also qualify for medi-cal/medi-caid (I do live in California), and then in 2 years for medi-care.
Last week my mom told me she was taking me off the plan out of spite. She has been abusive my whole life and is very unsupportive. Then today, when I went over to visit my sisters I was panicking, so I tried to bribe her to put me on her plan. Well that doesn’t really matter to her, it’s not about money but more about her feeling she has control over me and weaponizing health insurance/sabotaging my recovery. I also have multiple siblings so there is no financial incentive for her to take me off anyway. Anyway, then I saw the handbook for her new upcoming plan for this year (which is different from ones in the past) and I looked at it, and the plan is an employer plan that is not very popular. The deductible is $5,000 and NOTHING is covered before the deductible is hit beside an annual physical exam and such. On the old plan, I could go to office visits just fine and I never had to meet the deductible first because office visits were covered before meeting the deductible (I pay all of my medical expenses and am independent of her). This plan is not like that. I will have to pay $5,000 before anything is covered, and then only 70% of the price of services is covered, 30% would be my coinsurance. Also, it is an HMO and the network of providers is very small. None of my current providers are covered and hardly any in my area.
So I took back my offer to bribe her for to be on the insurance plan because I could not afford care under that plan anyway. I mention, ok that is fine, take me off, this plan is not viable for me anyway, due to the deductible and coinsurance. I know I qualify for medi-cal now so I will just apply for that. She then immediately switches, and says “well I’m not gonna have you control me and tell me what I’m going to do” and “you won’t let me be a mom” and finally: “well then I’m not taking you off my insurance in that case.” WTF. I fucking lose it. I tell her I cannot afford treatment under her plan and that it is my right to seek my own health insurance that is affordable for me and that she is a horrible person for trying to control me in a sick way and sabotage my recovery so that she can still feel like I’m under her thumb. She refuses to take me off.
I cannot have both insurances because medi-cal will be the secondary insurance and her employer insurance would be the primary insurance. This is problematic because I’d have to pay the employer insurance deductible first, which I cannot afford, and especially because it is going to be very problematic to coordinate care and payment to providers between these two, especially given the employer plan is a limited HMO plan. I have already applied for medi-cal stating my current employer insurance that I’m a dependent on will expire January 1.
It is open enrollment for her for this plan still, until December 15. From what I understand, dependents can be removed for any reason during this time period. I have tried calling her employer’s human resources department and they said that they’d have to talk to her and get her to request remove me, but she will not do that.
I’m scared. I absolutely need to continue treatment. I have been in the hospital multiple times this year and am trying really hard to get stability. Any advice is much appreciated.
submitted by /u/Due-Abalone-6943
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This is a weird situation. I’m pretty scared right now because I have schizoaffective disorder and PTSD that will rapidly get worse without meds and therapy. The only reason I’m functioning now is because of those things. I am 22 years old. I’ve been on my mom’s plan for the past couple of years. However, this year I qualified for social security disability. Based on this I would also qualify for medi-cal/medi-caid (I do live in California), and then in 2 years for medi-care. Last week my mom told me she was taking me off the plan out of spite. She has been abusive my whole life and is very unsupportive. Then today, when I went over to visit my sisters I was panicking, so I tried to bribe her to put me on her plan. Well that doesn’t really matter to her, it’s not about money but more about her feeling she has control over me and weaponizing health insurance/sabotaging my recovery. I also have multiple siblings so there is no financial incentive for her to take me off anyway. Anyway, then I saw the handbook for her new upcoming plan for this year (which is different from ones in the past) and I looked at it, and the plan is an employer plan that is not very popular. The deductible is $5,000 and NOTHING is covered before the deductible is hit beside an annual physical exam and such. On the old plan, I could go to office visits just fine and I never had to meet the deductible first because office visits were covered before meeting the deductible (I pay all of my medical expenses and am independent of her). This plan is not like that. I will have to pay $5,000 before anything is covered, and then only 70% of the price of services is covered, 30% would be my coinsurance. Also, it is an HMO and the network of providers is very small. None of my current providers are covered and hardly any in my area. So I took back my offer to bribe her for to be on the insurance plan because I could not afford care under that plan anyway. I mention, ok that is fine, take me off, this plan is not viable for me anyway, due to the deductible and coinsurance. I know I qualify for medi-cal now so I will just apply for that. She then immediately switches, and says “well I’m not gonna have you control me and tell me what I’m going to do” and “you won’t let me be a mom” and finally: “well then I’m not taking you off my insurance in that case.” WTF. I fucking lose it. I tell her I cannot afford treatment under her plan and that it is my right to seek my own health insurance that is affordable for me and that she is a horrible person for trying to control me in a sick way and sabotage my recovery so that she can still feel like I’m under her thumb. She refuses to take me off. I cannot have both insurances because medi-cal will be the secondary insurance and her employer insurance would be the primary insurance. This is problematic because I’d have to pay the employer insurance deductible first, which I cannot afford, and especially because it is going to be very problematic to coordinate care and payment to providers between these two, especially given the employer plan is a limited HMO plan. I have already applied for medi-cal stating my current employer insurance that I’m a dependent on will expire January 1. It is open enrollment for her for this plan still, until December 15. From what I understand, dependents can be removed for any reason during this time period. I have tried calling her employer’s human resources department and they said that they’d have to talk to her and get her to request remove me, but she will not do that. I’m scared. I absolutely need to continue treatment. I have been in the hospital multiple times this year and am trying really hard to get stability. Any advice is much appreciated.
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