Loosing my Insurance, what are my options?

[POTTYTIME!]

Hi all,

I have recently been told im going to loose my insurance. Although it was expensive (by my standards), it paid alot and the deductible was reasonable. Now im loosing my insurance, im at a loss on what my options are? I have severe Crohn's Disease, abnormal liver function, about to have spinal fusion, on thousands of dollars in meds a month.

#1. Is there any other option than "nobozo care"? Sorry if I offended anyone but that's what I think of it! Anyways, the monthly costs are outrageous and the deductible is unobtainable. On the other hand, im classified as pre-existing conditions. (Or am I)?

#2. Under a humana insurance, is crohn's disease a pre-existing condition?

#3. Does a humana or nobozo plan even cover humira?

Any information would be appreciated. Thanks.

 

[Clash]

ACA or obamacare did away with preexisting condition clauses. So ins can't turn you down for a pre existing condition.

 

[POTTYTIME!]

ACA or obamacare did away with preexisting condition clauses. So ins can't turn you down for a pre existing condition.

Ok, so humana or blue cross cant turn me down? But can charge me an arm and a leg to insure me? Thanks. Do you know if they cover Humira? Im on blue cross through my company. But is it different coverage when you get it yourself? I know blue cross Anthem does not cover humira.

 

[Clash]

You might can call the reps of each of the companies and find out I would think. Or it might be that you have to contact who the prescription coverage will be with since humira is covered on the prescription side.

So for us, through my husbands job, we have BCBS for medical and px is through caremark. So, on Remicade it's covered by the medical side and humira is covered on the px side. Remicade, since it involved iv infusion, nurses etc fell under medical and humira since a self injection is covered by px side.

 

[Robrich]

You can go directly to the private surface companies that offer coverage in your state.
An nsurance broker might be helpful for you. He gets compensated by the Ins.. Co.
They have to take you during the open enrollment period which I think just started.
Cost is age based. Coverage is better than through ACA. Go for the lowest deductible plan they offer due to your high bills.
Humira should be covered but check how much. 70%,80%?
Abbvie will cover up to like $700/ mo of the uncovered amount.
ACA is for those who qualify for subsidy due to low income.
Good luck. You are in better shape than before ACA.

 

[POTTYTIME!]

You can go directly to the private surface companies that offer coverage in your state.
An nsurance broker might be helpful for you. He gets compensated by the Ins.. Co.
They have to take you during the open enrollment period which I think just started.
Cost is age based. Coverage is better than through ACA. Go for the lowest deductible plan they offer due to your high bills.
Humira should be covered but check how much. 70%,80%?
Abbvie will cover up to like $700/ mo of the uncovered amount.
ACA is for those who qualify for subsidy due to low income.
Good luck. You are in better shape than before ACA.

thanks for the info. Now, even after open enrollment, dont I have a time frame to enroll if loosing your insurance is classified as a life changing event? Because I still have insurance but just until the end of the month.

 

[tots]

I was without ins for about 6 months when my husband was laid off and didn't have any trouble with our new ins when he got his new job.


Lauren

 

[Robrich]

Potty time yes. Believe so but you would have to confirm. The new insurer would require a letter from your current employer or whoever provided the insurance.
I believe you have 60 days for the life changing event to get new insurance.
Open enrollment I believe lasts through February.

 

[northwesterner]

I second the advice to use a broker.

They can access plans that are "on the exchange" as well as ones approved in your state that are "off the exchange." Not knowing your financial situation, you may or may not qualify for a subsidy.

In 2014, our benefits were cut back heavily at work and given my age it was more cost effective for me to buy insurance directly rather than through work. I bought "off the exchange" because I was not subsidy eligible and the additionally selection off the exchange I found a plan that would work for me.

If you are not comfortable with estimating your annual co-insurance, deductible, figuring out if your prescription costs count against the total out of pocket limit or a separate Rx out of pocket limit (I believe has to be a single, combined out of pocket limit for all plans now but cannot remember the effective date of that rule off the top of my head) then you really need to see a broker who can sit down with you and figure all this out.

I've purchased individual insurance for something like 7 of the last 10 years, so I'm pretty savvy on these terms and figuring out my best choice. If you don't have that experience, it is critical you find someone who does to help with this decision, as your coverage choice as someone with IBD is extremely important.

 

[katertot]

Sorry to hear you are going to lose your insurance. I would also suggest working with a Certified Application Counselor (CAC). CAC's are different than brokers because they do not work for a specific insurance company. If you are going to be purchasing off of a state or the federal exchange (through healthcare.gov) a CAC can help because they have been trained to assist people in using the site and helping people navigate the system. I would check with your local hospital or health department to see what kind of options they have as far as assistance for applying goes. It can be complicated to understand what certain plan offers and having a chronic illness you want to make sure you are covered for what you need.


Also, to answer your question, you can change insurance outside of open enrollment if you have a life changing event (marriage, divorce, birth of a child, losing your job/insurance). However, open enrollment goes until 1/31/16 so you should have time to get a new plan to start once your old plan ends.

Good luck!