Is anyone here enrolled in one of the health coverages currently to choose from on the healthcare.gov site? Husband WAS planning on retiring from GM until he was told health coverage would cost $1100 a month plus $5000 deductible.I'm T1 and am on an Omnipod and Dexcom.
Does anyone know which of those plans, if any, would cover a.a pump (preferably omnipod) b. 10+test strips per day c.dexcom with sensors and d.insulin
Don't know where to begin?
Thanks everyone
I wish I could offer some advice, but the Affordable Care Act is anything but.
Here at my small company we are thankfully gradfathered one more year, so my current plan, $1,000/mo premium (covering me + family), $1,250/individual $2,500/family deductible, with a 6% premium increase this year will be replaced by ACA-compliant plans next fall, with a 40% premium increase, $3,000/ind $5,000/fam deductibles.
I won't be able to afford it. I'm not sure what I'm going to do.
Dave, that’s depressing. I’m one of those people that think access to health care is a right, not a privilege. I’ll stop at that before I wander into a political mine-field. I hope that between now and your next decision time for health care coverage for you and your family, you’ll discover some options that you can afford.
Diabetes is hard enough when just managing day to day blood glucose levels. Negotiating and securing affordable access makes management harder, not easier. Good luck with this; the worry must make things difficult.
Have you looked at healthcare.gov yet to view the plans available? It seems easy to use, and I'll need to look into this once my husband retires in a few years. It looks like the deductibles and OOP limits vary a lot, but there seem to be a lot of different plans to choose from. Blue Cross typically covers pumps, and I think United Healthcare has some decent coverage as well. You can also talk to a representative to check on the specifics.
Start hoarding supplies and insulin as much as you can now!
If my husband retires at 65 when medicare kicks in I'll still have two years that will need coverage. GM has been slowly increasing in cost over several years like everything else. Problem is he hired in after 1996 so that wonderful $180/month doesn't apply, surprise!
I'm going to assume that since I prices are the same for everyone, whatever the costs/percentages are applies. I'm basically curious as to do they cover Omnipod pumps and/or cgm's
Thanks for the kind works, y'all. I'm hoping something legally changes over the next year so BCBS can continue to offer the current plan I'm on (Elements Preferred Plus).
If not, I'm probably looking at a "Bronze" plan, which will pretty much result in my health care costs increasing by about $10,000/year. Not something we can afford. Might have to pull my son from the private school he attends (he has a learning issue), and put him back in public school where he was basically being baby-sat.
The irony is, through premiums and copays, we come out just about even every year -- that is, we could go without insurance at all, save for the catastrophic risk. Under the new regime, we'll be coming out thousands behind, and I'm one of the "expensive" people out there from a healthcare standpoint!
I don't qualify for subsidies. I've been successful in my career, with enough income to support a family of 4 comfortably, so far.
That may change, next fall.
You will find comfort in the fact though that your increased premiums and family bankruptcy will fund quality free healthcare for an entire family of illegals though. lol sorry couldn’t resist.
LOL yea but in reality, if you're undocumented and here illegally you can't get health coverage through the exchange. I suppose anyone can get an illegal soc number and drivers license but not sure that's enough.
I do
:)I have no advice on it. All I can do is pray something drastic changes with the whole thing. Right now my husband and I have great insurance and I feel blessed to have it. I'm afraid that all the law has done is give some people coverage that isn't all that good and certainly not affordable unless you're on medicaid. I personally think lots more people are going to be harmed from it than are being helped.
Nobody can really answer specifically because the plans vary by state and county. You need to check out the plans on the Marketplace, where they have pretty specific information on each plan. Contact the individual company with any questions you have. If you are getting a subsidy, the Silver plans are usually the best bet because the cost-sharing benefit lowers your deductible and out of pocket max.
I get frustrated with the amount of misinformation about the ACA. It's true that some people have big premium increases due to the law, but in many cases, it gets scapegoated by insurance companies and employers. Many of the previous plans were also "junk" plans, with caps on what they'd pay or other restrictions. Of course, there are also people who have far lower costs.
In my case, I purchase my own insurance. I was stuck in a $630 a month plan with a $2900 deductible. In the 14 years I had the plan, the premium increased 1300% (starting at $45 per month) and they never paid out a penny, as I never hit the deductible. I couldn't switch to a different plan because of my "pre-existing condition" (this crazy thing called "diabetes") I was in an insurance death spiral, with no options other than keeping the terrible insurance or going without insurance completely.
Thanks to the ACA, there are no pre-existing conditions. Diabetics can purchase the same plans everyone else does for the same cost. I was able to get a better plan with a lower deductible and out of pocket max for under $200 a month. It also includes free preventive care and co-pays, which my other one didn't. I will save over $8000 this year thanks to the new law.
Note that I do get a subsidy and cost sharing, helped by the deductions allowed a self-employed person, particularly the self-employed 401(k) (non self-employed people can also lower their MAGI through retirement plans). However, even without the subsidy, the monthly premium would have been $220 per month cheaper than my old plan, with better coverage.
Of course, plans will vary greatly from state to state.
You're welcome.
Although I missed the part where you thanked me for paying for your HC.
I'm far from rich, by any measure. I'm successful enough that I don't qualify for any subsidies, help, etc. Rather, I'm seen by far too many in our society as a teat to be sucked upon.
The ACA is great for people that qualify for free stuff. For the rest of us, it's turned out to be a major stinkbug.
By that reasoning, I paid for other people's HC for the previous 14 years.
It's weird how people complain about things like healthcare subsidies when they're taking lots of deductions like mortgage interest, which lower income people don't get. I'm doing quite fine, btw, but it would be nonsensical not to take a subsidy available. I need it a lot more than Donald Trump needs his million dollar tax breaks.
Ok-So putting all our political opinions aside. (there are pros and cons to EVERYTHING people!) I just want to find out, IF I need to get insurance and IF it's still around in two years) how do I find an insurer from this new healthcare pool who will cover my Omnipod! I did call Omni directly and they gave me their "code' and suggested that when I find something, call and ask directly and I'd have my answer. Sounds like A LOT of phone calling and honestly, I don't have a lot of hope, especially considering that Medicare doesn't cover it, but I guess that's the only way.
And (just my 2 cents) while we have been fortunate enough to have always had decent coverage through employment, I feel for those who have not been so lucky and this change of policy of no denial or jacked up prices for those of us with pre-existing conditions is a God send.
For the most part, the individual plans cover more than does Medicare. I think you'll have a decent chance of finding a plan that covers the Omnipod.
Of course, before the ACA, it's likely you would have been denied from any regular insurance due to being diabetic and would have had to join a much pricier risk pool, if it was even available in your state.
In May, 2014 we found out I would no longer be eligible for Medicaid in the state of SD. OUr governor had decided not to participate in the plan the the US gov recommends for persons my age, I was 62 in June. We spent the months of June and July looking for insurance through the Health Care program. As Badlands suggested, each state has their own companies that support their insurance programs, so go to HealthCare.gove and scroll to you state. Then call the number they provide and ask for print outs of their programs. All programs are NOT the same. There are levels of deductibles and copays as with any insurance. There are services some will pay and another won't. In the final hour we found a program through my clinic that paid a low deductible because of my diabetes and also supplies free of charge most diabetic related services. No pumps yet, but those will surely come. It has been a tedious process to learn to deal with insurance companies and the letter of "their" law, but I'm working it. My monthly premium, is about $250 with a $1000 deductible...which with diabetes doesn't take much to mount up.....I"m currently looking for a better prescription program as this one is making me pay for some pretty pricey drugs....but I get my insulin and diabetic meds free from the drug companies. Check with your clinic or hospital to see if they have a patient advocate that can help with your pump from the manufacturer. It's sometimes depending on your income, but all companies are different. Affordable care isn't perfect yet, needs some tweeking, but it beats the $1400/month I would have had to pay without it. Good luck!