Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group To cancel private insurance or not to?

Hello all, hope all is well, I'm back and my insurance has changed, it jumped to $250 for a 3 month supply of Enbrel which works out to $54 after flex spending which is still better than a lot of people have it. I'm definitely counting my blessings. I still have my private insurance as well as my work insurance. The question I have is that I am filling out the paperwork for a new rheumy and it asks about secondary insurance, do I have to put the personal insurance on there? If so, does that mean that I could potentially pay more out of pocket? Does anyone have any experience with multiple insurance cases? What happens if I don't include both? Is it possible that they will search my previous records and see that my previous claims were made with the doctors with one and now I'm using another?

Wow! there are a bunch of us who would love to have your insurance plan!! Good for you. I am very happy for you.
I would never give up any insurance we have because of the possibility of being un-insurable. I know I am because of the Lupus diagnosis did that immediately and then add all this other stuff. I have been on Medicare for disability since 1987 very young. I didn't have any choice. Once you qualify for Medicare with our company, it becomes your primary. My hubby is retired but we won't give up our insurnce. It is pretty good but nothing like yours. It does pay very well for our Scripts and just cost us $102 a month with $20 for co-pay for most of our scripts for 3 months getting it maill-order unless it is not an approved one and then it can go up around $100 which still isn't bad for 3 months. I had met my out-of-pocket by the middle of the year and they picked up 100 per cent after that. We just aren't even going to take a chance on ending up with no insurance or very expensive insurance unless the company decides to drop their retirees which is happening all over the country.

I would say you are very blessed and in a good place to be financially. I am very happy for you.

Even More Blessings.
Possi

Eric is insured by two different insurance companies. His Dads and mine.

As far as the billing, the way it works for him is you have a primary insurance that pays the brunt of the bills, and then the secondary insurance which pays anything left over after the co-pay.

Erics dads (Paul) birthday is in February and mine is in September. So...that automatically makes Pauls insurance the primary as his birthday falls earlier in the year than mine does.

So, Pauls insurance gets the bills. they pay what their plan calls for. then the doctor or hospital bills my insurance for the rest.

When Eric goes for his Remicade, we do not pay anything out of pocket. Actually, we dont pay anything out of pocket at all, but....if Eric had an appointment for the regular doctor and my insurance had to pay part of it, I would be billed for my co-pay and that is it. Everything else is covered.

I hope that makes sense...if not, let me know, and I will try again.

If both of your insurances are under your name, I am not sure how they would decide which is the primary and which is the secondary.

Find out if your company is self insured. If not...ask your HR person. They may be able to help you. If your company is self insured, dont ask. They will be looking out for themselfs first, not you.

You could call the insurance commissioner in your state. I am sure that they could answer any questions that you have.

I dont think I would dare to give up the private insurance. If something happened with your job, you may need it. Yes, there is cobra, but it is short term, and very expensive.

Good luck!

Lori

I can't tell you what to do regarding the employer vs. private insurance. However, I do know that once covered by an employer plan, if you leave or are terminated, they must offer your COBRA for 18 months, perhaps longer in some cases. Then, it is my UNDERSTANDING that as long as there are no lapses in coverage between COBRA and private insurance (should you need it), pre-existing conditions may not be denied. I UNDERSTAND an uninsured 63-day post group coverage expiration (including COBRA) grace period is also allowed and does not count as a lapse for pre-existing conditions.

You may want to investigate at U.S. Department of Labor

Should you find yourself able to drop the private insurance, maybe you take the former premium and put it into some kind of savings vehicle to hedge against any insurance uncertainties in the future. Just a thought. Good luck.

thanks for the insights, this is good information

Your insurance sounds good.. i wish i had yours.. my employer just changed plans and Enbrel is sooo expensive on the new plan GRRRRRR