Hi everyone! Forgive me if this has already been hit on as a topic. Because of the new laws with insurance, my folks have informed me that the both of them were informed that their current insurance provider was dropping them for various reasons due to extenuating circumstances... I don't really know what they are might be some other situation, point is they have to find a new insurance plan. It got me to thinking... I know not a lot about if insurance has changed for diabetics right now. As of now I have a job with a hospital where I get good insurance but am being forced to find a new job because they've cut my hours so much I can't afford to stay at said job and I also will be moving to a new area come January or February. It also doesn't help that for some reason the costs of all my meds and supplies have almost doubled. So I suppose my questions are:
Is it still ridiculously expensive for diabetics to purchase their own plan? Are pre-existing clauses still a thing? Do we have to deal with that?
Can anyone give me some advice on where to start about looking for insurance if I have to buy my own plan/is it even possible?
For YEARS all I've been told is "It's best to just get on a group plan through your work" but that closes a LOT of options for me. An unbelievable amount. I'm curious to know if anything has changed.
For me, the Affordable Care Act (aka "Obamacare") was a godsend.
I'm self-employed, so I pay for my own insurance. In 1999, I was a healthy 33 year old and purchased insurance for $45 per month ($2350 deductible). Two years later, I was diagnosed with diabetes. In the following years. my premiums skyrocketed while the deductibles increased, but I was unable to switch insurance companies because of my "pre-existing condition." I was in an insurance death spiral, with no options other than keeping the terrible insurance or going without insurance completely.
By last year, my premium had increased from the original $45 in 1999 to $630 a month, while the deductible had increased $600. In the 14 years I had the policy, I never hit the deductible, so they never paid out a single penny.
Thanks to Obamacare, a pre-existing condition is a thing of the past. 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 for under $200 a month. It also includes free preventive care and co-pays, which my other one didn't. I will save over $6000 this year thanks to the new law.
For me, I couldn't get insurance due to my type 1. I was 30 when Dx'd with rapid onset type 1, my insurance plan tried to drop me form the plan (after about 10 years of paying premiums with no claims). Fortunately my employer's HR dept went to bat for me. When looking for new insurance after moving to another job, I was hung up on, denied. Even when I said, what if I were to pay out of pocket for the D things, can I get coverage in case I'm hit by a bus? Moe. So ACA is great in my opinion. Yeah, there are some kinks to work out 0- like any major change. And from what I can tell, those plans that disappeared weren't all that great - very high deductibles and a low % for which the healthplan was responsible in case something happened.
Thank you guys! Doing a lot of my own research today and this has been helpful! Looks like I'll be able to purchase my own plan and not be reliant on a job. This is going to open up a lot of options for me! This weekend I'm going to shop around. My move date is around January and it looks like the cut-off for enrollment for the new year is Dec 7th, so I'll have to get moving
I pay about $340 a month for the Platinum Coverage. I pay 10% for all durable medical equipment. I also only paid 10% to start on the Dexcom and Tandem Insulin Pump (so about $50 for the Dexcom Receiver and $400 for the pump). I pay about $15 for all my prescriptions. So yeah, I think that the ACA is pretty dang awesome.
As a silly sidenote, please dont call it Obamacare. It is not designed to take care of Obama. Nor does he come to your house to take care of you. Its health insurance.
It has made my life miserable. Private school for my handicapped son which would have been covered by his insurance and disability before, would now cost me almost 100,000 a year out of pocket, which of course there is no way on esrth i could afford. The only way it appears I could avoid this is to quit my job… Which apparently pays me too much, lower my families income level to poverty levels, and then go on various forms of welfare. Obamanomics have not been good to my family. I haven’t noticed and improvements regarding health coverage either. Maybe it’s been good for people with no income, I don’t know.
He’s covered by three different insurance policies— two private insurances primarily and then a subset of Medicare called Tefra which is for children with major disabilities, but unlike conventional Medicaid its benefits are only for the child and eligibility is not determined by parents incomes-- apparently since the reform it also watered down the benefits to not cover what he needs, which is unimaginably expensive… Furthermore the ACA did away with many of the protections that individual states had passed which protected individuals with disabilities and laid out rules about how insurers had to pay for their needs. I’m sure some people may have benefited from this mess but I was certainly not one of them.
I don't know what state you live in, but if your son is school age and has a disability (and an IEP- individualized education program) then the public school system may have to pay the tuition. I'm in special education and we've covered a few private school tuitions depending on the disability.
Thanks, that’s how it works here too, but the school district would only foot the bill if its determined (usually by a judge) that they are unable to accommodate his needs-- which around here generally would mean that he’s a danger to himself or others in the public school setting-- which isn’t really the case
I see you are from Alaska and since that's part of the US your son's rights fall under IDEA. You could file a due process complaint and the burden of proof falls on your district to show they can meet his needs. I used to be the Director of Special Ed for my district, but now act as a consultant. You can message me and I can answer questions or offer advice if I am able.
