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Crohn's Disease Forum » General IBD Discussion » Insurance and the Election


 
11-09-2016, 01:09 PM   #1
aypues
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Insurance and the Election

Now that we know what we are getting in the White House, I am worried. I always had insurance even before Obamacare, and just continued buying it because with Crohn's there really is no choice, no matter how expensive it is. My concern is that Trump has said Obamacare will be repealed and replaced. With what?!? This is anxiety producing. Do I need to get a desk job with employer paid health care? I like my work/life balance now and I don't feel too stressed out, which as anyone with Crohn's knows is optimal. As a self employed person I don't have to go into work everyday like most other people. Sure I pay a lot in insurance, but I just grin and bear it as the true cost of my treatments is outrageous and completely unaffordable. I hope Trump can get us some sort of universal health care (as he previously supported) that everyone can get behind, even Republicans. If we go back to the days of pre-existing conditions, and this and that, it may be disastrous for us.
11-09-2016, 01:24 PM   #2
Scipio
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The key thing is as you note is Obamacare replace it "with what?" If the replacement a comprehensive program that addresses real needs things might work out okay. If it's just go back to letting the insurance companies call all the shots then we might be in for a pretty rough ride. Let your congressman and senators know your concerns
11-09-2016, 01:27 PM   #3
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I hope he can do something good for all of us
11-09-2016, 01:35 PM   #4
Cat-a-Tonic
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I'm terrified of this too. If they bring back the previous things like lifetime caps on coverage and not covering pre-existing conditions, I think a whole lot of people are going to be absolutely screwed.
11-09-2016, 07:14 PM   #5
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I'm in the UK and I was talking to my consultant last week about how lucky we are here. We wait longer for appointments and perhaps have more hoops to jump through but emergencies are dealt with immediately and it's all free at the point of use.

My thoughts and love are with you all, I can't imagine what this must be like. You guys with your population desperately need an NHS.


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11-09-2016, 11:40 PM   #6
Justanothercp
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Yes, anxiety inducing. We won't know until they decide something.
I agree with Scipio, write to you local reps and even to the new president. I think handwritten notes expressing concern are the only input we can give....
11-10-2016, 08:06 AM   #7
Beach
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I didn't watch the election coverage that much over the last year. From what I took there was the typical politician talk of more health care services, more "life saving" drugs to be approved, then calls to repeal Obamacare. In some respects I thought the mentions contradicted themselves.

Already about 18% of our nations GDP goes toward health care costs. Other western countries pay half, around 7 to 8% of GDP, and typically experience better health outcomes.

With 2017, the ACA was no longer to cover insurance and hospital losses for treatments. As a result I saw some hospitals were saying they would no longer take patients that had ACA exchange insurance. Instead those patients, if he/she wished to make an appointment would need to buy insurance outside the exchanges and pay the government penalty.

The typical medical mess overall I though.

This past weekend, after being told earlier my insurance company was dropping me again, and I would need to find new insurance with much higher costs, I opted to go the Christian Health Sharing route.

It isn't insurance. It works similar. Having it does exempt me from the government penalty. I can see and go to what ever hospital I wish. I could not be turned down due to pre-existing conditions. The main requirement was that I needed to live a Christian life, including avoiding recreational drug, avoid tobacco, limited alcohol intake, etc. Costs are reasonable too. On the negative, it can be more work for me.

I've read good reviews with the Christian sharing plans. I'll be finding out if they are true going forward.
11-10-2016, 08:49 AM   #8
DEmberton
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Already about 18% of our nations GDP goes toward health care costs. Other western countries pay half, around 7 to 8% of GDP, and typically experience better health outcomes.
I found out that Humira costs the NHS (UK) 352 per dose; that's about $850 per month. I've seen here and can find elsewhere that it costs more like $4000 in the US. It shows how much profiteering and middle men are involved in healthcare.
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11-10-2016, 08:57 AM   #9
Sophabulous
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I found out that Humira costs the NHS (UK) 352 per dose; that's about $850 per month. I've seen here and can find elsewhere that it costs more like $4000 in the US. It shows how much profiteering and middle men are involved in healthcare.


Wow that's ridiculous! We are very lucky here, although Virgin are picking up NHS contracts now and privatisation is starting to happen.

Me and my type 1 diabetic friend are incredibly fearful of having a system like the USA :-/


11-10-2016, 10:06 AM   #10
Beach
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I found out that Humira costs the NHS (UK) 352 per dose; that's about $850 per month. I've seen here and can find elsewhere that it costs more like $4000 in the US. It shows how much profiteering and middle men are involved in healthcare.
Interesting. I'm not surprised.

Not long ago we had a disturbing or humorous, it depends on how one looks at it, situation with buying prescription drugs out of Canada. If you lived near the Canadian border, for awhile many Americans would cross the border to buy their prescriptions out of Canada. Prices were significantly cheaper there. Americans would even go on drug buying holidays into Canada. There were bus tours put together for making medical visits to our neighbor to the north.

When this was learned, the government and drug companies worked to put a stop to the practice of Americans buying prescription drugs in Canada. The excuse given was that the Canadian drugs are unsafe.

The bizarre part is that often the prescription drugs were made in America. Shipping the made in America drugs over the border into Canada and then return the drugs to Americans buyers was causing the medication to become unsafe. That is/was the official stance of our government.

We have a great many problems with our medical system in America. I'm not a fan of what we have. The problem is that most Americans are proud of our medical system. It is viewed as having perceived value.

One positive way to look at our health care system in America is that it creates many good paying jobs. In many ways it could be thought of as a make work program. I'm sure that is how some politicians view it to some degree.

It would not be difficult to reform our American medical system to be less expensive, and to have good health outcomes compared to other western countries. We could cut costs in half I imagine without to much effort. To do so though will cause a reforming of our economy. Not to mention howls from the political opposition of job losses and people not being cared for medically. Rationing is the word often mentioned

I see the stock market is rallying again today. It is said to be an election rally. I believe the main stocks going up in value are in the health care sector.
11-10-2016, 11:30 AM   #11
DEmberton
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BTW it costs me 8.20 every 4 weeks for Azathioprine which it turns out is a little more than it costs, so they actually make a profit.

By all accounts the US healthcare is very good for the people that it does treat, whereas we offer equally bad treatment to everyone. I have family in France and theirs is far superior, but then they have a system where you pay a small fee but crucially serious or chronic conditions are covered so you don't end up being bankrupted by being ill.

OTOH UK healthcare is so hung up on the principle of being free it ends up not working well for anyone, but the NHS is such a political hot-potato nothing ever happens to improve anything. I think both the UK and US should have a good long look at what happens in France and Germany because they do seem to have struck a much better balance.
11-10-2016, 11:37 AM   #12
Sophabulous
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BTW it costs me 8.20 every 4 weeks for Azathioprine which it turns out is a little more than it costs, so they actually make a profit.



By all accounts the US healthcare is very good for the people that it does treat, whereas we offer equally bad treatment to everyone. I have family in France and theirs is far superior, but then they have a system where you pay a small fee but crucially serious or chronic conditions are covered so you don't end up being bankrupted by being ill.



OTOH UK healthcare is so hung up on the principle of being free it ends up not working well for anyone, but the NHS is such a political hot-potato nothing ever happens to improve anything. I think both the UK and US should have a good long look at what happens in France and Germany because they do seem to have struck a much better balance.


I think the problem is that so many people in the UK, often the ones who are chronically ill are living on the breadline. Another benefit cap has just come in, bedroom tax etc. Even just a tenner to see a GP could be too much.

There was a time in my life when I was a student and I couldn't afford all my prescriptions so I was trying to stretch my inhalers as far as I could and I just ended up with chest infections. If it hits those on a lowest income the hardest (which it will), their condition would potentially end up going unchecked, becoming serious and requiring more serious measures such as hospitalisation to control. That's just a lot more expense.

I don't know enough about France/Germany's health or benefit system to comment further but I do fear losing the NHS would make life incredibly difficult for a lot of people here, myself included.


11-10-2016, 11:39 AM   #13
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These days I have a pre-payment certificate at 10.40 per month for as many prescriptions as required so that makes a huge difference. It's just a shame I didn't know about it then!


11-10-2016, 12:25 PM   #14
Cat-a-Tonic
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Humira is insanely expensive here, but there's a savings program through the manufacturer. I believe it ends up being $5 per injection if you qualify for the savings program. So that's obviously much better than $4000!

It's like that for a lot of meds. I'm on Lialda, which would be about $500 per month before insurance. After insurance it's $75 per month, and I also have a savings card through the manufacturer, so in the end I pay $10 per month. There's no way I could afford it at $500 per month. So yes, it sounds scary at first but once you get discounts and savings then it's not bad.
11-10-2016, 02:02 PM   #15
DougUte
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My health insurance here in the U.S. is actually quite good. The insurance pays all but a small co-pay (after my deductible) and like CAT said, Humira ends up costing me $5.00/month, with the co-pay assistance program. All the expensive meds like Humira have their own co-pay assistance programs. With this, the prescription expenses are not bad at all.
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11-10-2016, 02:06 PM   #16
Sophabulous
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So how does it work there guys? My understanding is that some jobs provide health insurance but if not you have to take it out yourself, is that right? If it's through your job do they still cover pre-existing conditions and does the employer actually pay or is some of this taken from your wage?

Are the prescription costs on top of insurance premiums or included? Does it depend on the insurance? Just trying to get a feel for how this all works


11-10-2016, 02:09 PM   #17
Sophabulous
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For example here in the UK obviously we have the NHS, but you can still buy private health insurance. However the doctors you see privately are most of the time working for the NHS too so they're not 'better' if you see what I mean.

You wait a lot less time for appointments, but some companies offer something as little as 1000 outpatient cover which is pretty much one consultation and a full set of blood work. As you all know that's nowhere near enough to diagnose IBD. Furthermore if I bought private health insurance now it wouldn't cover anything pre-existing.


11-10-2016, 02:16 PM   #18
Cat-a-Tonic
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Many employers do offer insurance, especially larger companies. Small companies, I think if they have less than 25 (?) employees, then they aren't required to provide insurance. I do get insurance through my workplace as I work at a large company, but my husband is a chef in a restaurant so he is not offered insurance (he gets coverage through my plan through my workplace, I'm allowed to add dependents to my plan such as my spouse). My workplace pays a big chunk of my health insurance premium and I pay a smaller amount, I end up paying something like $200 per paycheck which is automatically deducted.

For prescription costs, there is usually a co-pay associated. With my insurance, typically generic meds are $10 per month out of pocket for me and name-brand meds are more, so I always go with generics whenever possible. My Lialda is only available in name-brand, so that's why I have to get the savings card to bring the cost down on that. But other things, like pred, ranitidine, etc are all $10 per month with my insurance and birth control is free under the Affordable Care Act. Oh, and yes, it does vary from insurance to insurance and maybe even from pharmacy to pharmacy. It's a super confusing mess sometimes!

The ACA removed the pre-existing conditions clause, and I have no idea how that's going to work now that old what's his face (I refuse to say his name) says he's going to repeal the ACA. That's the part that scares me the most. We'll just have to wait and see how that plays out. For the time being pre-existing conditions still legally have to be covered by all insurers.
11-10-2016, 02:24 PM   #19
Sophabulous
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Many employers do offer insurance, especially larger companies. Small companies, I think if they have less than 25 (?) employees, then they aren't required to provide insurance. I do get insurance through my workplace as I work at a large company, but my husband is a chef in a restaurant so he is not offered insurance (he gets coverage through my plan through my workplace, I'm allowed to add dependents to my plan such as my spouse). My workplace pays a big chunk of my health insurance premium and I pay a smaller amount, I end up paying something like $200 per paycheck which is automatically deducted.



For prescription costs, there is usually a co-pay associated. With my insurance, typically generic meds are $10 per month out of pocket for me and name-brand meds are more, so I always go with generics whenever possible. My Lialda is only available in name-brand, so that's why I have to get the savings card to bring the cost down on that. But other things, like pred, ranitidine, etc are all $10 per month with my insurance and birth control is free under the Affordable Care Act. Oh, and yes, it does vary from insurance to insurance and maybe even from pharmacy to pharmacy. It's a super confusing mess sometimes!



The ACA removed the pre-existing conditions clause, and I have no idea how that's going to work now that old what's his face (I refuse to say his name) says he's going to repeal the ACA. That's the part that scares me the most. We'll just have to wait and see how that plays out. For the time being pre-existing conditions still legally have to be covered by all insurers.


Thank you so much that's really interesting! Although $200 a month still sounds really high to me sitting here in the uk! I was until a week ago I was working 2 jobs but I had to give the second one up because I was constantly flaring and they were basically going to get rid of me anyway for absences.

Even before that this would have made life very tough for me. It sounds like a scary time for you all, hopefully your leaders will take these concerns seriously. It doesn't pay to have so many people unable to work through sickness but not able to afford the meds to manage their conditions. I've heard that Obama is moving to protect planned parenthood which hopefully he can do. I've seen a lot on the internet about women rushing to get IUD's while they still can, which on day one doesn't create much confidence in 'he who must not be named.'




11-10-2016, 03:50 PM   #20
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I work for the State of Utah, which in itself is a large employer. My insurance premiums are paid entirely by the State of Utah, which is a nice deal, but we do accept get lower pay because of that. My wife is also covered by my health plan and, because she is disabled, Medicare covers her co-pays and deductibles.

The ACA requires that pre-existing conditions be covered, and The ACA requires that preventative screenings, like colonoscopies, be covered at 100% - no cost to the paitent.

If you have insurance through your employer, which the majority of Americans do, then things are pretty good. Where the problem still comes (even after ACA) is with the cost of having to pick up insurance on your own. ACA requires Americans to get insured or pay a penalty. Some people (who must have good health!) think it is less expensive to pay the penalty than to be insured.

I think the thing to do is to amend the ACA and fix the things in it that are not good. Insurance premiums are rising through the roof. I thought the ACA was suppose to be Affordable!
11-10-2016, 04:09 PM   #21
Cat-a-Tonic
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Sophabulous, that's actually $200 a paycheck, not $200 per month - I get 2 paychecks per month so that's $400 per month. To be specific, I just pulled up one of my paychecks to be sure of the numbers - if you add up medical, vision, and dental, I'm paying $235 out of each paycheck myself for those benefits. My employer is paying $467 each paycheck for those benefits. So I'm paying about 1/3rd and my employer pays about 2/3rds of what my benefits cost every 2 weeks. So, yeah, it's pricey, but it'd be a lot more pricey if I had to pay for that all myself!
11-10-2016, 04:21 PM   #22
Beach
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For me, I've been buying health insurance through the ACA exchanges. Insurance costs have kept rising.

Before the ACA I was paying around $100 a month. This past year I was paying over $500 a month with a high deductible of $6000 I believe. With my insurance company leaving the ACA exchanges at the end of the year, new insurance through the exchanges was going to run me about $600 a month.

As mentioned earlier too some hospitals have indicated that starting in 2017 they will no longer see patients that purchased insurance through Obamacare.

You can still buy private insurance. it is relatively inexpensive. I believe it would cost me around $100 a month still for private insurance. On top of private insurance costs, I would pay a penalty from the government.

I don't take any medications. It's not from a lack of trying. None of the medications given me in the past were helpful. Thankfully for my colitis diet changes have improved my situation.

I recently signed up for a Christian Health Sharing plan. It costs me ruffly $45 a month. No government penalty is incurred. The plan is somewhat similar to the $600 plan I can purchase through the exchanges.
11-10-2016, 04:35 PM   #23
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Wow


11-10-2016, 04:57 PM   #24
Cat-a-Tonic
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Wow, Beach, a $6000 deductible is crazy! I believe my deductible is $500 person/$1000 family.
11-10-2016, 05:08 PM   #25
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The deductible and out of pocket max plus monthly premium are how we chose which package at work to take
Monthly premium is directly out of your paycheck and most include benefits package as part of the job offer so you know going in /consider it part of your salary
Ds has been on humira for 5 years
The copay assurance program through humira is not income based
They pay for almost all of it at the beginning the year we pay very little then Ds hits max out of pocket for prescription and all his prescriptions including humira are free for the rest of the year - so we actually pay very little at all a year
We just assume Ds will hit max out of pocket and switch over to 100% coverage and no copays . We add that to the premiums to figure out our yearly health costs for ds

Pre existing conditions or lifetime caps on insurance or coverage of kids to age 26 are my big concerns since the insurance we have covers everything we need
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11-10-2016, 05:38 PM   #26
Cat-a-Tonic
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MLP, this is actually the first year (out of the 7 years that I've been ill) that I've met my out of pocket max! And that's only because I was hospitalized this year. For Sophabulous, if you're wondering how much it costs to be hospitalized in the US, the bill before insurance was over $27,000 for 5 days (after insurance, it was "only" $800!).

On a related note, I've been reading some scary things online saying that women should strongly consider getting an IUD before old what's his face takes office. They're not sure what old what's his face (or his even scarier VP) is going to do in terms of birth control, women's health, etc. I'm 37 and don't plan to ever have children so I just emailed my primary care doc to ask about getting an IUD. Hey, if I met my out of pocket max already anyway, it shouldn't cost me anything, so hopefully I'm just being prudent and not panicky. (Okay, I'm probably being both.)
11-10-2016, 05:38 PM   #27
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Our insurance is a High Deductible Health Plan also. The deductible is $2,000 / person $4,000 / family. Our plan's fiscal year starts July 1st, and we usually have the deductible met by October. I had an option of staying on the traditional plan, but believe it or not moving to the high deductible plan is saving us about $6,000 - $8,000 a year over the traditional plan's co-pays, etc..
11-10-2016, 06:29 PM   #28
my little penguin
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I would check with your gi as well about the iud
I know some have had minor gi things depending on material /hormones etc..

Ds has had imaging and scopes every year so not hard to max out
11-11-2016, 02:35 AM   #29
aypues
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For me, I've been buying health insurance through the ACA exchanges. Insurance costs have kept rising.

Before the ACA I was paying around $100 a month. This past year I was paying over $500 a month with a high deductible of $6000 I believe. With my insurance company leaving the ACA exchanges at the end of the year, new insurance through the exchanges was going to run me about $600 a month.

As mentioned earlier too some hospitals have indicated that starting in 2017 they will no longer see patients that purchased insurance through Obamacare.

You can still buy private insurance. it is relatively inexpensive. I believe it would cost me around $100 a month still for private insurance. On top of private insurance costs, I would pay a penalty from the government.

I don't take any medications. It's not from a lack of trying. None of the medications given me in the past were helpful. Thankfully for my colitis diet changes have improved my situation.

I recently signed up for a Christian Health Sharing plan. It costs me ruffly $45 a month. No government penalty is incurred. The plan is somewhat similar to the $600 plan I can purchase through the exchanges.

I am intrigued by the churchy health plan. I went to the website but it isnt laid out clearly, or i'm not on the right site. I asked for additional information. I too will be having to buy a $628/mo ACA plan next year unless I can find something else. It is a really good plan though - blue shield platinum, no deductible, 4k out of pocket max, etc. Curious what the religious plan will exclude besides sex reassignments and abortions, it isnt clear on their website. Will they exclude LGBT people too?
11-11-2016, 04:46 AM   #30
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I had to quit working in 2014 & go on short term disability because I was so sick from Crohn 's.

I stayed on COBRA as long as I could afford to, which wasn't long at $700/month.

I had no insurance at all for a few months after my employer fired me, and I also had no income.

I would've been homeless if not for my sister letting me live with her.

When I was finally approved for Social Security disability, I got insurance through Affordable Care Act. I qualified for a subsidy & paid $94/month; $10-$15 or less for prescriptions.

In September 2016 it had been 24 months since I had to stop working, & I was automatically signed up for Medicare. The premium for it is $122 & premium for prescription plan is $66.
I went without my Entocort for over 2 weeks because I couldn't afford the $130 co-pay.
I just ordered 100 pills for $66 from an online Canadian Pharmacy; but the medication comes from India.

I did call the insurance company & ask them if I could just keep the "Obamacare" & they said no, the government won't allow it. So I'm paying 3 times what I was just for premiums, & all my medication is more for the co-pays.

I worry about price increases, which I've already been notified the prescription plan is going up, but my Social Security payment isn't being increased...

I just thought I was struggling before, now it's much worse.

And when I tried to use a discount card from the manufacturer for one medication, the pharmacy told me I couldn't since I'm on Medicare; they said all the savings plans are like that; invalid if one is on Medicare or Medicaid...

It really makes me feel hopeless, because I'm hopefully about to go on a biologic, & now I'm afraid I won't be able to pay the co-pay...

Dana B.
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