Tuesday, July 18, 2017

Keeping up with medical needs, forging a plan

My exit packet arrived from my now former employer, with documents to return to them. Included is a breakdown of how much COBRA medical insurance through them would cost:  it's more than my mortgage payment, so really not an option. It's supposedly only good for 18 months, and then I'd find myself in this same situation. I have 6 weeks to address my next insurance plan as well as to ensure that the kids are covered somehow.  I've asked DX to look into putting the kids under his plan, he told me that open enrollment starts Aug 1, there will be someone at HR with info. I advised him, that due to losing coverage, effective 9/1, the kids would be able to do the paperwork now, effective for Sept. One DS plans on getting ins thru his employer. Another plans on getting it thru his school. This leaves DD who really is only eligible for one more year. With ongoing, preexisting issues, she must maintain coverage. Last DS, if placed under DX's plan, I would be able to get payment to DX to cover his share. I await more info.

Meanwhile, I am able to join  a health plan thru a side gig, allowing me to not have to resort to ACA insurance,which would me 3 times as expensive, with a higher deductible and lousy coverage. I've reached out to 2 reps from the company and need to follow up with one more and get the paperwork sent to me for completion. Based upon my phone conversations, it looks like this is a go. There are 3 versions of their plan, I intend to go with the middle cost one. It has a "reasonable" deductible of $2500, with an OOP cap at $6600. From meeting the deductible, one has to pay a 30% copay until the cap is met. Then, the ins company would pay all costs. Regardless of my status, this company would cover at 100% well woman care, annual mammograms and annual GP physicals. It's BC/BS. e Only caveat is that if I go out of plan, they will not pay, unless it is a serious accident/life threatening scenario. Kicker is that the insurance plan year is Jan-Dec, so joining in at Sept, means having this $2500/$6600 scenario (probably won't meet) thru the end of this year, only to have it reset come Jan. I am used to a school year plan, so this is an adjustment. No worries, especially as previous, before high dedeuctibles were in vogue, I had a calendar year based plan.

Meanwhile, I am addressing any medical needs now, while I am still on my current plan. Annual mammogram and gyno appointment, physical for DS, eye appointment for DS, dental cleaning, etc.

I am also on top of RX refills, as my deductible is met so these are "freebies."

 I'v stockpiled a bit, and hopefully will not have to refill many RX's with the exception of my next PSA RX.

My RX's keep getting played with, due to reactions. I have now officially failed the 4 drugs that the soon to be over insurance company insisted that I be on before they will "allow" me to be on the drug of choice, by 2 different MD's. Burns me to no end that insurance companies can control a patient's plan of care. I also took advantage of a B1G1 1/2 off or 25 % off both sale of the brand vitamins that I take. I wanted more, and they were out, so a raincheck was offered. I was told that their delivery comes in on Tuesdays. I was able to pay for these with some residual funds in my HSA thru this job/insurance company. I intend to use the rest towards a replacement lens for my glasses that got scratched.It's a new "year" for the vision rider of my plan so I can take advantage of a small rebate offered thru this rider.

Insurance is a necessary evil, luckily, as my finances currently are, I am able to absorb the cost of medical insurance premiums for myself. Meanwhile, I will be looking into setting up a HSA, if I am allowed to. Otherwise, I will establish a separate savings account and amass $6600, as that would be my maximum OOP obligation.


NAN said...

Maybe because you are in Connecticut but I am thinking with subsidies ACA would be more affordable? My brother has a plan at age 61- no income (401 K $$) - and pays about $60 a month. He has only one prescription though and good health but he did use it for cataract surgery. I think he paid for half.

Busy Bee said...

Insurance is one of those necessary evils kind of thing in today's world. When the ACA "stuff" was coming into effect, we actually came out financially ahead for my husband to take a job that covered insurance. Our self employed health insurance was already high, but after ACA it was beyond ridiculous.

CTMOM said...

Busy, it's cheaper for me to get Bc/BS insurance thru my side gig, than to go thru ACA. That said, I will not get the additional eye/dental rider @ $75/month or $900/year. I get 2 dental cleanings, call that $250. I gt one vision eye appointment every 2 years, so assume I go once a year, that would be about $200. I'd rather pay OOP cash $450 (estimate) than pay $900 only to get $150 back on dental cleanings (there is a $50 deductible each cleaning).

CTMOM said...

Nan, I am drawing a pension (which is taxable) as well as a taxable side gig, so I have a healthy income, by many folk's standards, just not in CT. I am not eligible for any subsidies thru ACA, and comparing apples to apples for BC/BS, I will pay less for the privatized version thru a side gig. I've worked out the maths. Ideally, will get thru Sept-Dec without many medical expenses as they will all (except for my Oct annual physical)go towards the deductible for 2017, which I don't expect to meet. Deductible resets come Jan 1. Then I move to what will become my new normal. Meanwhile, I am seeking additional, PT employment to cover these added costs, to build up a savings account to cover the max OOP. I remain concerned about the costs of my RX, luckily, I have found drug company rebate/cost reduction programs. They won't work if one is on ACA-another consideration.

Julie Vidani said...

I need a side job that offers insurance! I buy mine through ACA at this point. My husband is 12 years older and on medicare and my part time job does not offer insurance to part-timers.

NAN said...

I know you have researched it. Brother opted to not have a pension so maybe that helps him. Problem is around here few places offer health insurance to part-timers. I am fortunate- excellent health and when my husband died, his company let me stay on their plan for the group rate. I still use the supplement with my Medicare. It also has dental/eye and costs me $101 a month. ACA is great for bro and the service providers I work with who make maybe $10-12 an hour.

Busy Bee said...

We use BCBS, too. It is usually the best option in my area.

It is great that your side job offers insurance. I'm sure it is in part because we are in an economically represssed area, but some of the full time jobs still don't offer it here.

My husband will qualify for medical through the VA starting in a few years so we will reevaluate then.

We do the same thing on dental and vision. It is cheaper for us to pay out of pocket. Also, don't know if yours will or not, but our dentist gives a 10% discount for not having to file insurance. It isn't a lot, but every dollar helps.