Need Insurance Advice - Keep or Switch | Arthritis Information

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I don't have a job and I buy my own insurance.

 
Currently I have a 00 deductible insurance that I pay ,076 annually.  My office visits to the doctor cost me out of pocket.  If I meet the deductible, insurance will pay for everything above 00.  Here's the tricky part.  My medication seems to be working at controlling my RA and I don't think my bills will come anywhere near the 00 deductible.  So, right now, everything I am paying, including prescriptions, is all out of my pocket.
 
I am thinking of switching to blue cross.  It will cost ,349 annually.  It will also have a 00 deductible.  My office visits would cost .  Right now, I always hesitate to go to the doctor because I feel that an office visit is expensive.  It would be nice to just pay to see the doctor with blue cross.  I am tempted by how much I can save.  Should I do it?
 
Thanks.
Cindy,
 
Shopping for and comparing health insurance plans is very difficult these days, especially for an individual plan, whose premiums tend to be higher, and coverage less than a group plan.
 
There are several things to consider besides your monthly premium amount, doctor copay and deductible.  For example, there's drug coverage.  Right now you pay the full cost for prescription drugs?  Does the new plan you're considering have a prescription plan?  Are your meds on its drug formulary list?  Does it have a copay?  What prescriptions meds are you currently on?  If you had to go on something like an expensive drug like a biologic would either of these plans cover it?
 
Have you been diagnosed with RA?  Are you sure the new plan you are considering would accept you even though you have a preexisting condition?
 
How do these 2 plans compare as far as coverage for labwork, xrays, tests, gyn exams, mammograms, hospital coverage?
 
You aren't working now, but in the future will you get a job, and would that job provide health insurance?
 
Sometimes a lesser premium may mean less coverage.  I would check and see if there is health insurance counseling in your area.  In California, there is a state government office that provides health insurance counseling for seniors.   Perhaps there's a nonprofit organization that does something simlar, perhaps check with your local Arthritis Foundation chapter.
 
You need to study the information Blue Cross provides, and ask a lot of questions.  I don't think anyone here could recommend which plan to choose without having more info on each plan and about you personally.
 
Finding affordable health insurance and decent coverage is difficult these days for many.  Do your  research, and repost if you have more questions.  Good luck in making the best decision for you and take care.  Sorry I wasn't much help.
 
 
 
 
 
 
 
 
 
I don't know who the other carrier is, but BCBS is pretty easy.  wil you purhase a ppo or wil it be a homo?  the main info to find out, which docor will you be seeig  if its a hmo, will our pcp give you an insurance  referal to see you
 
I'd suggest really breaking down the enefits.  Some carriers offer PHyscal therapy by giving 25 visits per lifetime per condition.  So to break it down, you break your leg, need 24 visits, and then down the line something happens weith your leg and you need PT...sorry, you're out of benefits or life on that RX.  It can be confusing,  The propblem with this desase, you can have pt on your shoulder and it helps, but will have to hve it done again down the line.  be sure your benefits meet your needs.  Also, BCBS is taken at most places. Other carriers are not.  In example, Harvard Pilgrim blitzes the tv saying you can go anywhwere, there aer lots of doctors offices that refuse to take harvrd Pilgrim. You relly have to break it down and do your homework of whjat your needs are.
sorry forthe sittyh typing, ambienhas kicked in.
I have BCBS and I've been real happy with it. I have a ,000 deductable and rarely does it even come into play. I've only had to meet it when I've had to have MRI's and in those cases I had to meet my deductable for the year before it would pay. Luckily I've only had 3 and 2 of those were in the same deductable year.
 
I have prescription coverage and that's worth it's weight in gold let me tell ya. I don't know what meds you take Cindy; but if you are ever in a position where you need a biologic you can almost forget it unless you have coverage. You're talking about no less than 00 a month and as much as 00 a month for an injectable. That's not including the other 0 or 0 worth of medication you'll likely be on at that point. (If you aren't there already)
 
I've gotten my monies worth with Humira alone. I don't know what would have happened to me if I hadn't had my prescription coverage.
Cindy,
 
Be sure you are comparing apples to apples.  Blue Cross may have several different plans.
 
My cousin had Kaiser insurance and lived in southern California.  She moved up to northern California and found the Kaiser insurance plan up here would have a higher premium, so she went with a cheaper plan w/a different insurer.  When she became aware that the coverage wasn't as good as Kaiser's, she tried to go back to Kaiser.  Because she had discontinued her plan, she was no longer eligible for it, but would have had to purchase another Kaiser plan with high copays.  So she went with another insurance company.
 
My cousin, a senior, was shopping for supplemental insurance to Medicare.  At open enrollment time, she is often besieged by insurance sales people, trying to get her to switch to the latest plan available that year.  Often they have misrepresented information trying to make a sale. 
 
When shopping for an individual health insurance, you must read the plan very carefully and understand all aspects of it.
  
 
I'm surprised at the number BCBS gave you.  When my husband was looking into it he was told it would VERY expensive to switch to them because of my pre-existing condition.  Make very sure you've been given accurate information.  Get it in writing.  Please be very careful.  This is an important decision.I want to switch because I would love to save money on the insurance premium and doctor office visits.  I am only taking cheaper drugs like prednisone , plaquenil , and methotextrate right now, so presently prescription costs don't really hurt me.  But my brother thinks I shouldn't switch insurance because my RA would now be considered a pre-existing condition and insurance companies could decide not to pay for my treatment or doctor visits if my RA gets worse and I start needing expensive stuff like injections, infusions, remicade, enbrel, or humira.  Is that true?  Am I less  insurable now that I have RA?

the switch would be from Golden rule insurance's plan 100 policy    to    Blue cross of illinois' blue choice select policy.

edit:  hi jesse88.  just saw your post.  so I should be worried about the pre-existing condition now?
Cindy742008-06-03 15:39:14Just because you aren't on expensive meds right now....doesn't mean you won't be one day. It took me 9 year to get to where my meds were a buden; but I'm here. The times flies....trust me. The weaker meds rarely hold things off for long. It takes more and more and then stronger and stronger as the years go by. I'm one of the lucky ones.
 
Some are much worse off and few ever see it coming.
 
Plan for the future hoping for the best but being prepared for the worst. Your brother is right.
be very careful about the pre-existing conditions clause..
 
some insurance companies can exclude your pre-existing condition up to as long as 18 months..
 
they aren't denying coverage.. but won't insure that condition for a period of time..
 
when you're transferring with a job.. it's usually 30 days.. but otherwise it can be quite lengthy!!
 
good luck..

Better to go through a lenthy waiting period now than later if you're doing well.

i was thinking ... if I were to apply for blue cross, would it be bad if I didn't tell them I have RA ? ... how would they even know? ... since many people have a sudden onset of RA, including me, I could just wait until July or August and then tell blue cross RA hit me out of the blue, it's not pre-existing, it just happened today ... am I being stupid?

do the insurance companies consider RA to be a serious ailment like epilepsy or diabetes? my friend has epilepsy and she can't find any insurance companies that will insure her. Cindy, I understand your predicament and your frustration with finding affordable health insurance, but you must be very careful these days when it comes to health insurance.
 
What you are suggesting is fraud, if Blue Cross found out that you withheld this information that would be basis for them to drop you, then you'd be in a pickle, cuz then you might face an even harder time  finding insurance.  Here in California, I've read about folks that were dropped from individual plans when they became sick and started putting in claims, the insurance companies would scrutinize their applications and find reasons to drop them, and one reason would be omission of prior conditions.
 
You live in Illinois right?  Look up the state high risk insurance program.  Talk to someone there and see what advice or help they can give you.  You might be eligible for this program, I don't know, though sometimes these programs no longer accept new people if they don't have adequate funding -- its worth a try though.  Keep us updated, good luck.
 
 
Yes; Insurance companies consider RA a serious illness. It can be very costly and anything long term and costly is considered serious.
 
RA is serious....although if manged properly many of us handle it very well for many many years.
 
There are varying severities of the illness; but they consider it all to be the same because there is no way to predict who will handle it well and who will be crippled completely. Also; you can go years and suffer a mild form of the illness and then take a dramatic turn for the worse practically over night.
Yes Cindy, be worried about the pre-existing condition now.  And don't even consider trying to dupe the insurance company.  They have ways of learning things and then you'll really be in deep ka-ka.  No kidding, tread very carefully with this insurance switch.  I'm not saying don't do it, but ask for a copy of the policy you would be getting and read every little bit of fine print.  Anything you don't understand, have it explained to you....I would go so far as to say don't even completely trust the agent for an explanation.  He's in the business to sell insurance.  Get an explanation from someone else who is knowledgable about insurance.  Your brother sounds pretty savvy.  Maybe he can guide you.  And good for you for asking about this first.  You've saved yourself a possible insurance nightmare. 
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