Friday, July 21, 2017
Talking drugs, and planning for change
Part of my severance package with my former employer, was being able to stay on their group medical insurance for a full 12 months. I planned ahead, and "prepaid" the premiums while I was receiving additional salary for 6 months, which were the terms. This allowed me to not have to be concerned with paying premiums while no longer receiving salary. This also allotted me ample time to do my homework, explore my options, plan ahead. This plan also allowed for me to have significant savings to play around with on a monthly basis, while I remodel.
One area of concern is the medications we take. Whenever possible, we got a 1 month RX filled at a local pharmacy, while simultaneously sending a 3 month RX in to mail order, netting 4 month's worth of maintenance medications. Surplus has built up over time.
I will be able to have BC/BS insurance just for myself, at a cost that is higher than I am accustomed to, but still reasonable, relatively speaking, compared to ACA coverage costs, not to mention the lack of coverage that ACA provides. This is especially important for us with preexisting conditions, and I have an expensive one.
I currently am living on 61% (bills are still moderating somewhat) of my take home income, allotting me an additional 39% as savings or extra. This can easily absorb the aforementioned insurance premiums. I have inventoried all of my RX's on hand, reviewed the next refill dates, and have determined that with the exception of one medication (cheap at $10.69 for a 3 month supply), I have enough meds to get me thru to January, when my new "year" as far as deductibles and co-pays are concerned. Meanwhile, I will join an existing plan effective Sept 1, with 4 months to go, and another deductible that I will have to meet over those 4 months.
I have also reviewed my known medical appointments for those 4 months:
-annual physical will be covered in full, no deductible to worry about
So no anticipated costs incurred.
I have been proactive in addressing my medical needs during this insurance transition period, especially as we met our existing deductible back in March. Outside of the aforementioned premiums, which will be paid through salary deductions at the pretax rate, and the one known maintenance RX to renew in Sept, I don't anticipate any other expenses at this time, beyond a dental cleaning (I will not have dental or vision screening on my new insurance. For the $900 it would cost to add it, I may as well pay OOP. Since I have MEDICAL eye issues, all of the appointments with my opthalmologist will be covered under my medical insurance . I am aware that this may change (meaning needing additional appointments and/or RX) and should I need to seek medical care, I will, and take from savings as needed to meet those costs after the claim clears insurance from Sept thru Dec.
Come January, it will be easier, the new plan year having started with the new deductible, I can plan out what I need, medically, and will have to wait and see how long it takes me to meet the deductible, which will be $2500 for just me (my current insurance, if I had just me on it, would have been $3000 but my former employer covers 1/2 of that, so actually $1500 OOP) I also know that once the $2500 is met, I have a co-pay system to get through and once that maxes at $6600, all costs are covered by BC/BS. These are hard numbers for me to work with. I plan on setting aside $500/month of my savings to cover the max OOP, and stashing that in a separate savings account just for medical expenses. I am not permitted to have a FLEX or a HSA thru the company. Another factor is my expensive RX's. Assuming that BC works like my current insurance plan, I can order the meds, use a drug company sponsored assistance program and while the whole costs goes against my deductible, the drug companies tend to pick up some to a major part of the cost. My about to start new arthritis RX is $9707.55 for 3 month supply thru my current company. All I'd need to do is order a 3 month supply come Jan 1, and I've met the initial deductible ($2500) and then it's supposed to go towards the max OOP of $6600, in as a copay with me responsible for 30% (enter drug company discount programs). All of my maintenance drugs come due for Jan, so I anticipate that I will quickly chip away at that $6600. Additionally, I know that I have appointments already scheduled for 2018, including at least one in Jan, and that appointment requires that I get labs done ahead of time.
DX has agreed to add the kids (2 at least, although all 4 can go onto it, it won't impact the cost)to his plan. DD and one DS will split the increased cost in premiums and refund him that. He has a good plan, sending over the paperwork for me to copy for my records as I am responsible to report in all financials as regards the one DS to be on his plan, to some overseeing entities. *(UPDATE: 3 kids are definately going on DX's plan, and will split the additional cost in premiums to add "plus child(ren)" into 1/3 each so now at $147*(approx) each) 4th kiddo was to compare costs with costs thru his work)
While change can be difficult, the medical insurance questions seem to be resolved.