How's Your Health Insurance?

AyeOhKay · **How's Your Health Insurance?**

With everything that I've been going through lately, I am reminded how important health insurance is! I'm getting ready to start a chemotherapy that is administered as a pill. The first thirty days will cost us out of pocket $1,300! That's in addition to the other 5 medications I'm on. But, I found out that the retail price of this drug is over $6,000! Thank heavens, we had good insurance. I won't even begin to tell you about the total cost. But, here is some food for thought: My lifeflight flight (which was 50 miles away) was over $9,000! And, the bills that have come through our insurance for my first surgery (I've had another similar surgery since) are in excess of $100,000! These are full cost, before our insurance paid anything. I can only imagine what the total will be when all is said and done.

Remember, I was a "perfectly healthy" woman before this all began. Noone would have expected me to have a malignant brain tumor and require such medical intervention. I have all my annual check-ups every year! And, the doctors always bragged on how healthy I was and what good care I took of myself.

So, how's your health insurance? Is it sufficient for the unexpected?

desertmom · 02-17-2008, 05:53 PM

Ours isn't, and it gets worse every year. I was perfectly healthy until after I had my first child. I rarely used my insurance except for annuals and to cover my birth control pills, unless I got a really bad cold, infection, etc.

This year, I'm forced to see a number of specialists. My copay for that is $50! And these are repeat/followup visits to see how therapies and meds are working. And the tests are woefully underfunded. I was astounded at how much out of pocket I had to pay for my mammogram and biopsy. Separate ultrasounds and MRIs are costing me an arm and a leg, too.

What is interesting is that when I did get catastrophically ill, the Urgent Care, Ambulance, ER and hospital bill were covered in full. However, insurance did mess up (?) and tried to have me billed for the Urgent Care and ER copays. Thank God I had done the research by the time the bill came and knew it was an error. I honestly think insurance companies "mess up" on purpose. I have too many examples to think otherwise.

I'm thankful I have insurance, but I wish it was better. (DH works for a large corporation, and the insurance is Cigna.) The copays and then co-insurance make it so I'm afraid to go for annual mammograms and other things that should be done, due to the cost. And, considering that early detection is key for saving health, life and dollars, it's so wrong that the tests aren't covered more. I don't know how the average person can do it.

Samantharae · 02-17-2008, 06:22 PM

As of right now I have Tricare (from my father). But that will only last two more years. I will be 23 and healthy. What kind of insurance should I look into?

beautifulbabies · 02-17-2008, 07:10 PM

My insurance rocks. It's through Cigna but even through the same company they vary so much. We have no copays for well visits like checkups, immunizations, annual exams, etc. Then for everything else, the company covers the first $2000 of the deductable, we cover the next $3000, then it's fully covered after that. Whatever portion of the $2000 company money that we don't use gets carried over to the next year. So since we rarely have sick kids, we probably will NEVER have out of pocket costs. I think we used about $300 of our company money last year so we started this year with almost $4000, which we shouldn't use much of either. I love it! Prescription costs are affordable anyway (I believe usually $10) but we always put a few hundred dollars in a flexible health care spending account for the tax benefits. The company issues us a debit card with that money so I can just use that at the pharmacy.

AyeOhKay · 02-17-2008, 07:14 PM

I didn't mention that our "normal" prescription copay is only $10, but my chemotherapy drug is considered a specialty drug and billed differently.

melsb · 02-17-2008, 08:12 PM

Angie thanks for the reminder. I know just a little over a year ago my brother, not even in his 50's had a heart attack and no insurance. He also had a lifeflight that went about 75 miles.

Thankfully he survived and is still able to work but this set them back a bit.

taylyn · 02-17-2008, 09:07 PM

Quote:

But that will only last two more years. I will be 23 and healthy

Unfortunately this is something noone knows for sure.

Thanks for the reminder again, Angie.

Ours is good.
We have two plans , all have a low deductible and whatever we do pay out of pocket the second plan reimburses us 75 %

But seeing people go through Lengthy illnesses , I know there is so many things that come up that insurance doesn't cover.
I know A man with great insurance too , that didn't cover a procedure he needed .
And not to mention all the gas money and the travel expenses.

maggie · 02-19-2008, 04:12 PM

For the last 11 years we had excellent insurance. Dh changed jobs last summer and our insurance now is not nearly as good. We have Aetna now and we are paying way more for way less. We now get billed for all things besides copays (any tests run, breathing treatments, any lab work, etc.). Like desertmom, we never used to need it. Well, the past few months we have had 2 ER visits and a surgery for my 2 year old and it has cost us thousands of dollars out of pocket. Our insurance covers 80% after the deductible, but we had to meet the $2500 deductible and 20% of an $8000 surgery is still a lot of money.

I feel like every week we get a bill for something else that the insurance company didn't cover. It wears you down. Our only other choice for insurance with this company was Kaiser Permanente, and it didn't appeal to me at all since you can't use any of your own doctors. It seemed very subpar to me.

liamsmom · 02-19-2008, 04:34 PM

Quote:

Originally Posted by maggie

Our only other choice for insurance with this company was Kaiser Permanente, and it didn't appeal to me at all since you can't use any of your own doctors. It seemed very subpar to me.

You might want to look into the Kaiser plan your dh's job offers. When an employer offers a Kaiser plan, it is typically a group plan that comes with great benefits.
Yes, you will have to change to one of their doctors, but you can choose which one, they do not assign you. I have had Kaiser for 20 years and have always received excellent care.
During my teenage years, I had a pediatrician who specialized in teen medicine and I love my ob. I have broken bones and owed nothing after seeing specialists. I was induced early with ds because of possible preeclamsia and had to be sent to UCSF (very top of the line) because the Kaiser l&d's were full. For two months I received almost 30k in bills from UCSF and Kaiser paid for every cent, including the circ and all pain med. I paid $250 to have my ds.
My mom has had many medical problems and she has had top care, multiple surgeries, costing about $150 each. All lab work was covered, pescriptions $10, unless a special one costing $20 or $30 (for 100) and $15 copay. No dedctible! These are often the kind of benefits that come with group plans.
Dh has one of these group plans through his job right now, but it costs $650/month to put me and ds on. So, we have to purchase a separate Kaiser plan, unfortunately with a deductible. I hate having a deductible, but for the same prices with another company we would actually be offered less coverage. Around here it's still the best deal.

stxmom · 02-19-2008, 04:39 PM

We had Humana for the last 5 years until Feb. 1, DH's company changed to Blue Cross Blue Shield. Humana was awful and every year our deductible went up. So far with Blue Cross Blue Shield our meds should be cheaper. On Humana DS's ADD meds cost us $55 on Blue Cross Blue Shield its only $15.