A Big Headache

The insurance assurance

When the Covid-19 pandemic struck, I felt a wave of relief. “Finally!” I said to anyone willing or close enough to listen, “This is going to expose the massive failures in our healthcare system, and we’ll come out of this better than before.”

It really looked that way. The government was throwing money and assistance around like candy at a July 4th parade. I would have bet my tiny kingdom that the American health insurance industry would have changed for the better. Better access, better plans, better costs. Man, I was so sure.

And I was so wrong.

Since losing my employer-based health insurance in March 2024, I’ve had four different plans (and I’m writing this not even a year later). Navigating the health insurance marketplace is like braving the treacherous waters of the South China Sea without a compass, charts, or sails for your mast. Even if you find a plan that works for you, the effort will leave you with a headache you should probably get checked out now that you’re covered. That’s why I turned to a health insurance broker.

Carmen Valentino is one such brave soul who helps people find the best plans for their budget and healthcare needs. Or at least come as close as possible to meeting those needs. She works with a health insurance general agency called Healthcare Solutions Team. She could go out on her own, but, she says, “I’d have to work with each insurance company individually, and that would be a headache.” See? Headaches.

“The healthcare industry has gotten very complicated,” Valentino says. “There are always changes in the industry.”

One big change is when hospitals buy out other hospitals, which, once the ink is dry on the deal, can render some health plans useless because of the way insurance companies contract with providers. For example, Valentino says, “Loyola used to be in-network with Aetna. But Ascension came in, and suddenly, Loyola won’t accept Aetna, leaving Aetna members unable to see their preferred providers.”

Most consumers don’t have that kind of industry information. Agencies like Valentino’s, however, have the resources and knowledge to stay ahead of any changes so they’re better able to guide their clients’ choices.

As of January 1, 2025, the federal government — champions of making healthcare insurance more available to all through the Affordable Care Act — restricted short-term medical plans to just four months. The problem is that the feds, and many states, see short-term plans as temporary, for those in between jobs where their next employer would offer coverage. But if the job search lasts longer than four months, you’re back to square one. Or, you head over to the marketplace, which is what millions who don’t have employer-provided health insurance do. That’s when things can get even more expensive and just as confusing.

More and more, it feels like we’re getting less and less from our health insurance. “Why,” I ask anyone willing or close enough to listen, “is it so difficult to keep my family safe and healthy at an affordable price? Why does it feel like health systems and insurance providers and our government hate us?” Will we have to wait for another pandemic for real change?