Yesterday I got a letter in the mail. Joseph was declined enrollment for individual insurance coverage because of an ear infection. An ear infection. He’s otherwise absurdly healthy. But they won’t insure him. No higher rate, no rider, no pre-existing condition waiting period, just a letter declining enrollment. The irony is that I had applied for a high-deductible policy. So even though we would be liable for the first $3,000 of his healthcare costs (and up to $10,000 out of pocket), Anthem (Blue Cross & Blue Shield) of Colorado claimed that the risks were too high for them to cover our son because he had a bleepin’ ear infection. We can apply again once his “condition” is in the clear for at least 60 days, but he needs coverage before that.

I received two of these letters recently too. Anthem declined me automatically, no negotiation, because I had been through fertility testing in the past five years. Testing, not treatment. It didn’t matter what the diagnosis was. It didn’t matter that, in Colorado, no individual insurance covers pregnancy expenses (except high-risk coverage), so there is no way to “upgrade” policies to include maternity coverage after acceptance. I was also declined by Kaiser, simply because I had been to the doctor more than twice in the past 12 months (I broke my foot last year and had three or four follow-up visits).

You see, I’m losing my benefits as of May 1st, so I had applied for individual coverage for both Joe and myself. But with this turn of events, Joe and I are now left with three lousy options. Cobra coverage (~$1000/month, low deductible), Dan’s group policy (~$800/month, high deductible), or CoverColorado (~$500/month, high deductible), a “high risk” plan for people with pre-existing conditions. I don’t know about you, but these are incredibly high rates for the average family, especially considering the high deductibles and the fact that these rates are only for two of us. (Thankfully Dan’s health coverage is included in his benefits package).

Our story isn’t unique. I’ve heard about similar experiences from friends and family. And I’ve met several people without health insurance as well as other families and small business owners who opt only for major medical coverage. I’ll never forget the struggle, guilt, and anguish a friend of ours had after her toddler got a deepish cut on his forehead. She knew that he was ok (the fall wasn’t hard) but that the cut would heal better with stitches. Yet she hesitated taking him to the emergency room (of course it happened on a weekend evening) because the expense would be completely out-of-pocket. They were struggling to start a family business and had already borrowed again their credit cards. So they opted not to take him to the doctor. In the end, he was fine and the cut healed, but it did leave a scar, both on his face and with his parents. It was a huge wake-up call for the family, who now realized that every sniffle, sneeze, and boo boo — which under “normal” (group health coverage) circumstances might generate a trip to the family doctor — could now bring about the same financial dilemma.

Don’t fool yourself and think that it couldn’t happen to you. Especially in this economic downturn, people from all walks of life are losing their jobs, and with that, group health coverage. Some folks’ employers are passing along the increasing costs and others, like myself, are simply losing benefits and must turn to individual coverage. At the same time, insurance companies seem to seek out the tiniest excuse to decline enrollment, limit coverage, or increase premiums. This isn’t just an issue for seniors on fixed incomes or the sick or poor. This is a crisis that can affect anyone and, I suspect, will hit the middle class pretty hard in the next few years, especially if the economy doesn’t turn around quickly. It might not be an issue you have to face now, but you never know. That’s something to think about when November rolls around.