A question about healthcare in the US, please

[jsayer88]

Hello,

Hopefully this is the best place on the forum to post this. I have a question that I hope those of you living in the US can help me with.

I'm British, my wife is American and we have been living here in the UK. We've been considering our options for the future regarding where to live but a big potential stumbling block is the current situation with healthcare in the US. I have Crohn's disease and we need some firsthand advice/information about life over there, please.

I was diagnosed almost 20 years ago and for the most part it behaves itself rather well. I went through a bad patch in 2007 and had a small part of my lower intestine removed but my health following that has never been better. I now see my specialist at the hospital once every other year just to check in and we never have anything to say to each other.

I am taking a few medications every day to keep things running smoothly and that perhaps is where the majority of my questions/concerns lie. I'm on Mesalazine (known as Mesalamine over there?) primarily, but also some supplements daily - Ferrous Fumarate (didn't get on well with Sulphate) and AdCal, which is a tablet form of Calcium and Vitamin D3. We've found my Vitamin B12 levels drops over time so four times a year I also go into the doctors for a shot of that.

It seems the medication that I'm used to (and get on well with) is all available in the US, which is obviously a good start. My first real question is how likely is it that I'll be able to request that I be given particular medication rather than whatever the current favourite medication is by a healthcare professional? Perhaps more accurately, am I going to be able to get the medication I'm used to through an insurance policy or is it more likely the case that only one particular option will be covered/available and anything else won't be?

Prior to moving here my wife was fortunate enough not to have required much experience with health insurance and with how things have been changing over there of late we thought it best to seek some real world thoughts, experiences and opinions.

I'm aware this is perhaps a rather vague question so far (and doubtless one that perhaps shows my ignorance of how some parts of the system over there work). I apologise if I haven't quite used the correct terminology but I'm hoping you understand what I'm basically trying to discover .

Anything you can contribute to this will be greatly appreciated.

 

[Clash]

I would think it would be easy enough to get meslamine here and having your medical records to back up your regimen would go a long way. As to the insurance side of things it can vary so widely but others here may be able to give better info on that.

 

[my little penguin]

Insurance plans vary
Most get insurance through the employer .
If you have employment already set up contacting the human resources department where you plan to work would be a good start. They can give you the benefits policy numbers to call. There are actually two plans -medical covers doctors visits tests and hospital stays etc at a certain percentage . The second type is prescription coverage which covers drugs at a certain percentage until you reach your out of pocket maximum ( dollar amount ) then all drugs for the year are free.
What brands are covered are known as formulary vs brands covered at a lower percentage non formulary. Again this can change based on the plan you have through your employer.
If you both work then call both employers to determine one of they cover spouses and two which plan covers more of what you want.

If for some reason you don't have insurance through work -tgen there is the insurance market place through each state that will sell you different plans .
These tend to offer less benefits for more money than employer plans unless your income is very low.

In nutshell you can ask for your specific med - depending on your specific company plan how much of it it covered could vary greatly.

One med Ds was on asacol HD( 5-ASA) just stopped being covered through my plan . It was covered in my DH's plan though which is why we have the kids on both.

Good luck