I am only an adjunct faculty member, while my husband works FT, so our insurance is from him. After reviewing our coverage, I see that I'll be fine if I have to take MTX, but not if I have to take an injectable--basically, I just can't go that line of thinking right now, as I'm so overwhelmed.
My question is this: what if he wants to switch jobs? I know that in the U.S., as along as you don't have a lapse of insurance, certain laws require insurance companies to cover you. But they can refuse to cover my RA costs, can't they? What are your experiences with this?
This realization has pulled the rug right out from under me. I thought I was past the crying stage, but I just realized how far from true that is. I know that this disease could affect my family, but it's just now occurring to me that my husband's dreams of pursing another line of work could now be ruined because of me.
Good morning,
I'm sorrying you're feeling this way this morning. Is your husband considering changing jobs soon?
I had this question when I was new at a job once. I was concerned the employer health plan could turn me down for my pre-existing condition, RA. A friend told me that employer sponsored health plans can't do that. It seems to ring of being true because I've never had an issue with any company I ever worked at. If you went through an insurance plan that was not through your husband's new company then there may be an issue. However, I'm sure that, although it may take some research, you would be able to find one. Here in Massachusetts where I live there is a state funded health program that covers people who are without insurance. It bases its premiums on the amount of money that you have.
I don't think that your RA is going to stop your husband's dreams of pursuing another line of work. What is he thinking about doing?
If there is no laspe in coverage no preexisting condition clause can apply. That means if your husband changes jobs and insurance doesn't start immediatly you guys MUST pay for CORA coverage. its expensive in the short term but much cheaper in the long run.
The infusion medications are generally covered under chemotherapy in most policies. You won't see them listed seperatly. And many times the injectables are covered but under a "special" pharmacy coverage. These meds are often not listed on your formulary list. Call your insurance company and ask for sure.
Good point made by Buckeye,
There is Cobra coverage from your husband's previous employer.
Thanks so much, everyone. I feel some relief now--thank you so much for your calm and informative responses. Researching all of this will make me a much more informed voter in the upcoming election, to be honest. I'm embarrassed to admit that I took the whole topic of healthcare for granted up until now.
I am going to call my provider today. Humira is listed as one of the covered drugs, but it has lots of little asterisks next to it to show that there are major limits on it. Still, I'll cross that bridge when I come to it.
Again, thank you all so much. I'm in the midst of creating my syllabus and exams for the upcoming semester, but I was just about hysterical over this. I feel as if I can concentrate now.
As long as you dont have your ins lapse they cannot deny you coverage. Im not sure what the legalaties (sp?) are if you go from a group ins plan to individual plan but I know with Group plan they cannot deny you coverage. With regards to the injectables, the manufactures have a lot of different kinds of assistance programs to help you if you either have no insurance or if your insurance does not cover the drug so you could also look into that too. Hello,The only thing I would add to the wonderful advice you have received, is when your husband is applying for a new job, on his first interview he should ask for a copy of all of the benefits information. The benefits package is extremely important in making a decision about accepting a position, and is usually non-negotiable. If you educate yourself about what they are offering for available plans and options, you can make an informed decision, rather than make a committment based strictly on salary.
The other thing you should be aware of is for those of us with health conditions like we have, individual coverage isn't really a very promising option. Without the group rates available through employment packages, premiums can become outrageously expensive when you are trying to purchase insurance as an individual. That makes some career paths which involve being self-employed impossible for many.
Good luck to you. I hope he can find a postion in the field he is dreaming about which has a good group plan which will work for your needs.
Karen
Nothing to add you are full of good advice already. I hope things work out for you and your husband.