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I was hoping someone can help me with my current dilemma concerning health insurance. I am currently a substitute teacher and my husband was laid off in November and accepted a job at a temp agency in March. Between November and the end of February we were paying for COBRA coverage for just husband as we couldn't afford it for both of us and we wanted to keep him from having a lapse in coverage since he has bipolar disorder. I was uninsured during this time. My husband takes daily medications that total about $500 a month without insurance. He also sees a therapist bi-monthly and a psychiatrist once every 3 months. Our insurance through the temp agency only allows you to fill 12 prescriptions a year and will pay $20 towards each prescription. The pharmacist found us some kind of discount code that she could use that allowed us to not use the insurance at all and knocked the price down to about $50 a month, but I don't know how long it will last. His psych has worked out a payment plan where he will pay the copay on his old insurance and the rest will be covered with county health funds, and his therapist has worked out a cash payment plan with him. I am thankful we are able to afford to meet all of his healthcare needs even without good insurance, but I am uncomfortable having him go without being insured. I have no chronic health problems. I only use my health insurance for a yearly physical, flu shot, and my birth control prescription. I accepted a full time teaching job in March for next year so we decided to switch to the insurance offered by the temp agency so we could afford to insure both of us and then we would get us both on my employer's policy when school started in the fall. When I opened my packet to choose my plan and saw the prices my heart sank, and I knew our plan was not going to work. My employer only offers Employee or Family plans, not Employee+Spouse. There are 3 plans with choices of family deductible. The cheapest family plan with a $3000 deductible is $1367 a month. My employer pays $600 a month towards our benefits so it would be almost $800 a month just to insure my spouse for medical! If we went with one of the plans with a lower deductible it would be over $1000 a month. That seems ridiculously expensive and is double the price of the COBRA we were paying for him. My employer's contribution would cover all of either of the plans for just me. I feel like we now have three options 1) Cover me on my employer and keep him on the crappy temp insurance until he secures full time employment and have him get coverage from his own employer and use the other means we have secured to keep his medications and care affordable as long as we can. Pros: Cost, no worries about pre-existing condition issues for him. Keeps him with proof of continuous coverage Cons: This insurance doesn't really meet any of his health care needs and will pay out a lifetime maximun of $5000 so we would be screwed in a real emergency. It only keeps him from being uninsured and having a lapse in coverage. 2) See if we can get him private health insurance for less than $800 a month now and have him switch to his own employer's plan when he gets full time employment. Pros: He would hopefully have better coverage and we could hopefully use his insurance to pay for his meds. It would have a high enough maximum that we would be covered in a real emergency. Cons: I don't know how much it would cost or if he would be denied coverage for a pre-existing condition. 3) Keep the crappy temp insurance until the new pre-existing condition regulations pass (October?) and get him private health insurance then. I looked into one website and they had plans with quotes between $35 and $250 dollars for a regular 25yr old male in Iowa but I am assuming it would be more once he filled out personalized information. Any insurance goons have an idea how much more? Are we being unreasonable to think he will qualify for something with a $3000 deductible for less than $800 a month? Will he even qualify for private health insurance with a mental health condition? It looks like most have exclusions for therapy and in-patient and out-patient mental health care but include up to 4 specialist visits a year. I know his therapist would not be covered and we would keep having pay her in cash, but would his psych count as out-patient mental health care or a specialist? Could any insurance goons weigh in with what option is best or how to best navigate private health insurance? Anything we are missing or need to make sure to consider? There seem to be so many similar plans and I don't know how to decide what plan will best balance cost and meeting his needs. Sorry for the wall of text but I feel really lost and don't know where to start.
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May 5, 2013 23:22
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| # ¿ Apr 28, 2024 11:52 |
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