That fun little problem called health insurance


#1

Hey there everybody.

I belonged to Tudiabetes many years ago and enjoyed being part of a community of diabetics who just–got it. But, I didn’t stay for very long. The reason? No idea.

Anyway, I am working an emotionally and physically draining job that pays very little. I want to quit. I have viable options including, working two part time jobs from 4pm to 10pm and eventually going back to school. Even better, one of the jobs is working from home. But here’s the catch–neither provide health insurance (because why would they?) but my current full time job does.

I’ve heard terrible things about private health insurance. I’ve heard people not have a single issue and highly recommend it. I fear that calling a private health care provider, I will be met with “We can’t give you prices of those meds without an order” or “WE HAVE TOP NOTCH CARE FOR DIABETICS!” only to find out that I’m screwed by high costs and lack of care.

I’m looking for real advice. Not from typical people who never have to see a doctor, let alone a specialist every three months. The only place I could think of reaching out was here, where people go through the same thing I go through every second of every day.

So, without further adieu, I desperately need help figuring out if private insurance is actually an option for me. If anyone has info, I would appreciate the help. I’m looking for costs every month and for medications (humalog pen, levemir, ultra test strips). Also, what has your experience been like with private insurance? Pleasantly surprised? Roughest time of your life?

Any and all experiences are welcomed. I have a serious system going now where I can afford the high costs of my meds and have really cheap insurance from my job. Despite how bad my job has gotten in the 4 years I’ve been there, I would stay just for the security that diabetics need.


#2

I’ve been using the health exchange for a few years, though recently had to move to Medicaid for awhile. My husband got an extra job where he was offered health insurance and he had to turn down the benefits so we could stay in the exchange. Reason being the deductible for diabetics (only one plan offered had coverage) was $5000. So it would have taken me a year to get to an individual deductible for $5000. My plan in the exchange was pretty good. $500 deductible for each of us, affordable strips but $585 insulin. I have to use Novolog and they would not move it to formulary. We received a subsidy, so we could afford the plan but full price was going to be $1500 a month without it. It’s not hopeless, but you have to make calls and research any plan you qualify for.


#3

Last year I priced out very thoroughly on healthcare.gov with what I was projecting our household income would be in a state we were considering moving to to see what different levels of private insurance would cost us in that particular state. I’d recommend that as a decent place to start. You have to put a fair bit of time and input into it in order to get much of anything meaningful in return… but might be worthwhile in your case…


#4

Some states don’t offer lower healthcare premiums so you should check that before quitting your job.


#5

Some states have their own exchange, such as New York and colorado. But starting at healthcare.gov will direct you to those that do. I know some folks in NY with reasonable plans.

List of states with own website.

https://www.healthcare.gov/marketplace-in-your-state/


#6

Ugh without a job I might as well be begging on the street. I have private insurance through my job. My copay is I believe $25. I pay $20 for every prescription related to my diabetes. And I file all the prescriptions I fill at the end of the year on my taxes. Without the private insurance though I would have to apply for state insurance, meaning Medicaid. I have at times had to buy insulin at cost. Private insurance I don’t have a problem with, it is actually very useful. However, not every single doctor out there takes every single insurance. Once when the company changed insurance carriers I had to change my doctor who I had seen for years and was very comfortable with. So you would have to find a doctor that accepts the insurance you have. Insurance companies usually have lists that you can look at. With private insurance I feel it is easier to see a doctor, but you should spend time at finding a doctor that is good for you. I don’t have any dental though, that is the one thing my job will not provide. I have not seen a dentist in over 10 years. Last time I saw one was because I never had my wisdom teeth taken out, and was experiencing pain in my jaw. Let’s just say it was difficult, but I managed to go around the insurance problem with the dentist, and I got all four wisdom teeth taken out at once. Never seen a dentist since.