High insurance premium

[Crohn's sux]

high insurance premium

Ok, so I'm a 35 year old male (turning 36 next month) living in California and I have had Crohn's disease for years now. Luckily as long as I don't eat crazy things and stay on my meds I have minimal issues. I just received a notice from my health insurance company (Anthem Blue Cross) that my premium will be increased to over $550 a month. I'm a struggling small business owner and this is becoming quite the financial burden to say the least. My insurance agent states this is the lowest rate available until of course when new legislation takes place in 2014.

Should I feel lucky I have Insurance at all, or is there any other options that would offer a lower monthly obligation? Any help would be appreciated...I'm no insurance guru and I don't have the slightest idea how to shop around for health insurance.

This is my first post here so thank you!

 

[maria]

THat's a lot! To me it is. Curious to see what others have to say on this.

 

[LOSTnut]

Not quite sure but before I became employed again I had to search around for insurance and switching over from Cobra, i.e. staying with the insurance I had would have cost me around $800 per month plus a $5k deductible per year. No other insurance would take me because of Crohn's.
And, at the time the state health insurance just had changed the rules and would no longer accept singles.

 

[Crohn's sux]

Thank you for the replies. Before I was self employed my insurance premium was of course MUCH lower because I was part of a group health plan with my employer. Then, after that when I was enrolled in COBRA it went up, but not as high as it is now. At least it isn't $800...yet, lol.

When shopping around for health insurance is it best to just call individual health insurance companies or apply online? Is there any assistance programs for somebody in my situation? I've heard of the California PCIP program, but don't know much about it. Like I said I don't have much experience in this. Thanks again.

 

[chrisnsteph1022]

Be careful switching insurances-you may have a pre-existing clause or waiting period.

 

[LOSTnut]

I called my insurance because they send me a letter a couple of months before Cobra expired. Turned out it was a broker who checked several insurance companies ... hence the rejection of most of the others due to Crohn's.
You cannot even get Aflac as supplemental insurance with Crohn's for short and long term disability, which I thought sucked majorly. I cannot even tell you how glad I am that I now have group health again.
And, as far as I know as long as you had insurance they cannot imply a waiting period anymore .. only if you didn't have insurance, but I could be wrong there.

 

[bozzylozzy]

wowzers that is a massive burden! what do you do if you cant get insured??? (as im in the UK, i dont know how it all works) the illness is stress enough without having that to deal with too..

 

[Kelly2]

http://www.mrmib.ca.gov/

California Major Risk Health Insurance Program. Check it out. I think there are currently about 28 different states that offer high risk insurance programs to their residents and California is one of them. It is meant for people with certain conditions which would make it more difficult to obtain insurance - and crohns/IBD is on the list.

 

[LOSTnut]

There are PCIP (?? - I think that is the acronym) plans but you HAVE to be without insurance for 6 months and provide letters of rejection from an insurance company. Who wants to be without insurance for 6 months when you can avoid it?? What can happen with Crohn's in 6 months??
All my stuff happened within 2 months with a 5 months recovery and several follow up hospital visit, lasting between 2 and 4 days.
Talking about reaching the deductible at a horrendous pace ....

 

[Crohn's sux]

Thanks for the replies everybody. I did a little research on MRMIP and PCIP and I don't think either will work. As LOSTnut mentioned PCIP requires a 6 month lapse in coverage and proof of denial of insurance coverage. The monthly premium for MRMIP would be $717 for Anthem or $449 for Kaiser (if I'm reading it correctly). Kaiser would be a slight improvement but I've heard they can be a little shady.

Thanks again. I guess I'll continue researching options.

 

[simon47]

what is wrong with the system ??

Wow , i cant believe you guys have to pay so much for your coverage. I'm almost embarassed to say that through Blue Cross and Alberta Health here in Canada, I pay $67 per month, and get covered up to $35,000 a year. I do a co-pay, but on my Humira which is $1800 per month , I pay $25. Pre existing conditions were not a problem, and any resident of the province is eligable. When will other governments get their (probably firm) poop together and start helping Crohn's sufferers. Hang in there , things have to change....don't they !!?

 

[NikiB]

Agreed! I can't believe how many posts I read about people having to wait in pain until their insurance kicks in. I guess we have it pretty good in Canada. On the flip side of that our hospitals in B.C. are so overcrowded. When I was in the hospital last year for my surgery I was put in the hallway because there weren't any rooms available!

 

[lowone]

The group policy benefit line item last year for my combined (medical dental vision) health insurance was 1300/month(employer paid100%). This year it's 980/month(employer pays 95, I pay 5%). And for that change my coverage sure has gone down in coverage. My out-of-pocket max has doubled and lots of stuff that was covered isn't now. I have not seen any bills this year though so can't say too much about the changes.

Lialda costs are the one diffrence I have seen a change in, December my co-pay was 15 January it was 80. (though I did join the discount card thingy so it ended up 10). Though with what my pharmacy is claiming it is billing insurance for their part of the cost... This will be the first year the insurance company will make a loss on me, instead of a huge profit.

 

[LOSTnut]

Yeah, that's why only the healty ones here in the states complain about universal health coverage ... or they have never been without insurance and sick at the same time.

 

[scoutfinch]

$550 a month for private insurance Single coverage is pretty average to slightly above average.

Unfortunately, unless you have a very low income, you'll find it difficult to find less expensive private insurance (although you can "comparison shop" by visiting the websites of various other insurers, such as United Healthcare, Cigna, Aetna, etc, to see if they have a cheaper and/or better value plan).

 

[Crohn's sux]

Wow , i cant believe you guys have to pay so much for your coverage. I'm almost embarassed to say that through Blue Cross and Alberta Health here in Canada, I pay $67 per month, and get covered up to $35,000 a year. I do a co-pay, but on my Humira which is $1800 per month , I pay $25. Pre existing conditions were not a problem, and any resident of the province is eligable. When will other governments get their (probably firm) poop together and start helping Crohn's sufferers. Hang in there , things have to change....don't they !!?

$67 a month? I could have done without knowing that, LOL!

I think my best options at this point are signing up for a group health plan with my business partner (which most likely won't happen) or checking to see if there are plans with lower premiums within my current health insurance provider. I may check around with other insurance companies as well to see if there are better options, though I'm doubtful.

Thanks for the replies everybody.

 

[Miss Underestimated]

Is there any kind of association for people in your line of work? Often associations offer group coverage.

 

[Crohn's sux]

Is there any kind of association for people in your line of work? Often associations offer group coverage.

I honestly don't believe so in my profession, but I guess it can't hurt to check. I'll try anything at this point.

 

[Miss Underestimated]

I have an agent friend out there but all he sells for health is BC/BS. Maybe a higher deductible would lower your premiums? I did that for several years - had a $3,500 deductible with a $10k stop loss. Had it the year I had emergency surgery. Put it all on credit cards!!

 

[System-X]

@ Simon47: You say you: "get covered up to $35,000 a year"? What happens when you go over that amount? That is basically the cost of 1-2 infusions of Remicade.

 

[David]

I'm self employed and have a $265 monthly premium and $7,000 deductible.

I haven't been to the doctor in almost a year (not sure the exact duration, I lose track). I can't afford it. I fear something going wrong. I can't afford $7000.

 

[System-X]

I hear ya! My employer doesn't offer major medical insurance. The only place that would accept me is the High-Risk health insurance, thus I'm paying $300/month plus a $5,500 annual deductible ($9,100/year out of pocket). I get hit with my full deductible on my first treatment of Remicade. (My insurance gets billed $21,000 per infusion).

 

[tots]

When we lived in Calif my mom joined the California Farm Bureau. It was cheap 40 bucks a year and she was able to join their grp ins policy. My sister has/had anorexia and this was the cheapest and best kept secret in Calif. If that dosent work look for quirky things like that. Get your realitors lis. etc.. Other states have a Farm Bureau too.

 

[simon47]

@ System-X , your meds seem way pricier down there...I did the three loading sessions of Remicade and the billed amnt to insurance was about $12,ooo. It was to be about $4,000 . every 8 weeks after that. I had a reaction and switched to the Humira, which is about $1,800. per month( needle every 2 wks). So its close , but with that and the azathioprine, I'm covered. Also the origininal covered amt. was $24,000, but I called them when I needed more and they increased it with no increase in premium.

 

[System-X]

Simon47, if you had maxed out your $35,000 (say you had 4 week session of Remicade over a course of a year), would everything above and beyond the $35k limit be out of pocket?

 

[System-X]

tots - that's an interesting thought process. I'm going to research. Thanks.

 

[simon47]

System-X, when i talked to the insurance co. when i needed it raised, they asked what meds i needed and when i told them they said ...yup they're at the top of our list and just upped the limit ,so i dont think it would be a problem. Gov't health stuff is pretty good here. Of course at the other end of things, dental sucks . Each dental office can charge whatever the heck they want, so you really have to shop around.

 

[System-X]

Simon47 - so basically they start you off at a $35K limit. If you need more coverage, you need to prove the reason to have your limit bumped up?

 

[simon47]

Starts at $24,000. I needed more so they bumped it up to $35,000. The program is a joint project between blue cross and the provincial health and wellness. Yeah they're pretty cool.