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Patients' Medical Histories Shouldn't Determine Whether They're Insurable

By Esteban Zapiain, advocate and blood cancer survivor | May 25, 2024
Advocates walk in front of the California capitol in Sacramento

All patients deserve access to quality, affordable health plans. Fortunately, most insurance cannot use patients' pre-existing conditions against them. But these protections don't exist for Medicare Supplement Insurance, known as Medigap. In fact, Medigap is one of the only types of health coverage that can charge patients more, or deny them coverage, due to their age or health status. 

LLS is advocating for policies that would allow patients to enroll in Medigap—without paying higher rates—regardless of their health or age.

A version of the following op-ed was originally published in Spanish by La Opinión. It was written by Esteban Zapiain, a retired music teacher and a member of the Livermore Amador Symphony who lives in Union City, California. Esteban is a chronic myeloid leukemia patient and a volunteer advocate with The Leukemia & Lymphoma Society.

I could only hear white noise coming from the doctor after he told me my diagnosis of chronic myeloid leukemia. I could see and hear him, but nothing coherent entered my ears. That was 13 years ago, and April marks what I call my “cancerversary.”

Since those terrifying early days of my diagnosis, I’ve learned a lot more about my cancer—and how I can manage it. These days, it’s the potential cost that frightens me almost as much as the disease itself.

I am 73 years old and on Medicare, like millions of other Californians. Traditional Medicare doesn’t pay for everything and has no out-of-pocket maximum. To help cover the costs of my ongoing medical care, I depend on supplementary insurance through my spouse’s employer. 

The author, Esteban Zapiain

Supplemental insurance is critical for many seniors – especially for people living with serious, chronic medical conditions like me. That extra coverage means we won’t risk losing everything if we need a lot of expensive healthcare. But I worry about what would happen if she—and I—lost our coverage. 

In 2018, that almost happened. We had a real scare when my wife had to have heart surgery. Until then, it never occurred to me that if I were on my own, I might have to get my own insurance. Little did I know that if I did, I’d be charged more for the Medicare Supplement Insurance because of my cancer diagnosis. 

The best-kept secret in healthcare is that Medicare Supplement Insurance plans, also known as Medigap, can deny coverage or charge more for people (like me) who have a pre-existing condition (like cancer). This is unfair since nobody chooses to have cancer. And it’s impractical since nearly one in two Americans has a pre-existing condition. Unfortunately, protections for folks with pre-existing conditions don’t extend to Medigap.

To be fair, there are other options for Medicare enrollees seeking to save money on their health costs. Many enroll in Medicare Advantage plans. However, these plans are often impractical for people with serious medical conditions since patients are forced to navigate various restrictions and narrow networks. That usually prevents them from seeing the oncologist they have seen for years or keeps them from seeing specialists who may be out-of-network.

California Senate Bill 1236, authored by State Senator Catherine Blakespear, will change this. It will stop insurers from using patients’ health history to charge us more or deny us coverage. And that means Californians like me, who live with a chronic illness, could finally get affordable and high-quality health insurance after age 65.

Our medical history should not decide whether we are insurable. I urge the legislature to pass this meaningful legislation now to benefit all Californians as they age.