Critical Illness Insurance in Action: How Burpees Turned Into a $7,500 Near-Death Debacle

Critical Illness Insurance in Action: How Burpees Turned Into a $7,500 Near-Death Debacle

1000 667 Bana Jobe

Chronic diseases affect more young people than you might think: About 1 in 2 millennials say they have some type of chronic illness. That includes many illnesses, from multiple sclerosis to cancers of the skin and colon — all of which are affecting millennials at increasing rates.

All those health issues can snowball into high health costs. Even with health insurance, you might be hard-pressed to cover high deductibles and coinsurance while having enough left over to make rent and buy groceries. And what if a health issue rendered you unable to work?

That’s where critical illness insurance comes in. Just ask Sofia, a 28-year-old legal assistant by day and kickboxing instructor by night. She didn’t realize she had a genetic heart issue until after she collapsed in the gym one night — and she couldn’t have guessed until after the fact that she’d end up owing thousands in medical debt three months later.

What Happened

To call Sofia healthy would be an understatement. She followed a vegetarian diet, had a standing appointment with the treadmill every day and never touched a cigarette. On the outside, she looked like the embodiment of health, one with the stamina to teach two kickboxing classes a week on top of everything else.

One night, she decided to get in some extra cross-training and cardio work after her class. All of a sudden, in the middle of a burpee, she collapsed. Her friends called 911, and the ambulance took her to the ER.

Her diagnosis stung: Sofia, not even 30, had had a heart attack because of a genetic issue called PLA2, which caused blood clots to form in her heart. Those burpees put extra pressure on her heart and caused the attack. It’s an issue she never knew she had — yet three months later, barely rehabilitated, she owed $7,500 in medical bills.

Why It Happened

Sofia had good benefits through her law firm, which paid for her monthly premiums outright. But even though she didn’t pay a premium, she still had a pretty high deductible.

Within weeks, the medical bills started coming in, and Sofia quickly blew through her savings to pay for them all. Once she met her $5,000 deductible, coinsurance kicked in, requiring her to pay 20 percent of the costs of care until she met her plan’s $7,500 out-of-pocket maximum.

During the health scare — from the first night in the ER to all her follow-ups and tests weeks later — she had to take unpaid time off from her job. After that, the health bills joined a growing pile of other unpaid bills (think utilities and credit cards) that she simply couldn’t afford. Eventually, Sofia had to move out of her apartment and in with her parents.

Of course, she felt lucky to have survived, but it was still a hard pill to swallow.

What Could Have Happened

If, before all this happened, Sofia had bought a critical illness plan to supplement her regular health insurance, she might be in much better financial shape.

Let’s say she did, and that her critical illness policy came with a $20,000 payout for a heart attack. Within a week of her ER visit, she could have filed a claim and had cash in hand before the hospital bills even arrived in her mailbox.

The lump sum payment would have covered her medical expenses, medications and even household bills like rent, groceries and utilities while she got back on her feet. And after it all, she could have kept her apartment, protected her savings and avoided having her parents as roommates.

Planning for the Unexpected

Though Sofia had a rare genetic issue, her story isn’t uncommon: Nearly 4 in 10 young people have a high-deductible plan, many with an even higher out-of-pocket maximum than Sofia’s.

When the unexpected happens, supplemental insurance can protect you from going bankrupt (or moving in with your parents), all for about $10 a month, depending on your situation.

Sure, you may think you’re healthy as can be — but so did Sofia. What if it all changed tomorrow? Life doesn’t become risky the moment you decide to jump out of a plane or take a bet on barely expired gas station sushi. There are always risks. And that might sound scary, but it doesn’t have to be if you have the right protection.

For more on how to know if a critical illness plan is right for you, read 6 Questions to Ask Before Buying Critical Illness Insurance.

Bana Jobe

Bana Jobe is an award-winning medical writer with over 10 years of experience

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