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#505304 07/22/14 05:34 AM
Joined: Jan 2009
Posts: 4,501
Likes: 1
rumble Offline OP
Supreme_AS_Kicker
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Supreme_AS_Kicker
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Well, my insurance year...so to speak.

With half the year still to come, Hubby and I (both with PsA) have reached our out-of-pocket max for the year already (a total of $6000 out-of-pocket). eek2 Therefore, we will only be required to pay copays for the rest of 2014. And all our meds are free for the rest of the year. This year brought a lot of changes on the pharmacy benefit. Tier 3 was $60 last year and this year was $60 or 50% whichever was higher. Most were higher. frown But that got us to the max faster than last year. smile

Glad I have a good plan. Wish all of you could have this insurance. But I'd probably rather us all be healthy instead.


DX: Psoriatic Arthritis, Osteoporosis, Psoriasis
Meds: MTX since Oct 2009, 15mg/week. Cimzia-restarted after 2 yrs away.
Epidural Steroid Injections x8; Lumbar Radiofreq Ablation x2
SIJ Steroid Injection x3; Bilateral Radiofreq Ablation SIJ x9
rumble #505309 07/22/14 02:47 PM
Joined: Sep 2011
Posts: 526
Veteran_AS_Kicker
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Veteran_AS_Kicker
Joined: Sep 2011
Posts: 526
I wish I had all the money in my pocket that I have put out on doctors, medication, lost work. Can I sue for pain and emotional distress?

rumble #505310 07/22/14 02:49 PM
Joined: Jul 2001
Posts: 3,334
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Joined: Jul 2001
Posts: 3,334
Glad you've reached that limit.
Here in Canada we have to pay for some of our drugs until we reach a deductible. I do pay about $63/month and that covers everything including dental. Surgeries, hospital visits, doctor visits, specialist visits, x-rays, CT scans, blood tests etc...
Check this out and see what it would cost you:

Find Your Plan


Timo
rumble #505312 07/22/14 03:20 PM
Joined: Sep 2001
Posts: 6,162
Likes: 13
AS Czar
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AS Czar
Joined: Sep 2001
Posts: 6,162
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Hey, rumble:

I appreciate Your sentiment, but my own insurance costs are much lower and not just because I don't really need physicians anymore (knock wood). But I wish YOUR costs were as low as my own!

HEALTH,
John

Timo #505313 07/22/14 03:21 PM
Joined: May 2002
Posts: 2,370
Colonel_AS_Kicker
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I'm in Canada and I don't have a deductible Timo....or do you mean just the cost of the plan ?

Sherri

Last edited by sherri; 07/22/14 03:21 PM.

sherri #505320 07/22/14 06:27 PM
Joined: Jul 2001
Posts: 3,334
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Joined: Jul 2001
Posts: 3,334
Hi Sherri. I was meaning the cost of drugs, sorry I wasn't very clear. Once I reach a certain amount I get reductions in my costs. Not sure what that total is though...


Timo
rumble #505327 07/23/14 03:39 AM
Joined: Jan 2008
Posts: 21,346
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Very_Addicted_to_AS_Kickin
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Very_Addicted_to_AS_Kickin
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Originally Posted By: rumble


Glad I have a good plan. Wish all of you could have this insurance. But I'd probably rather us all be healthy instead.


couldn't have said it better. smile

right now, i'm trying to get blood glucose strips…right now, they are costly me more than my Humira…Ironic.



sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)
Timo #505334 07/23/14 12:39 PM
Joined: Nov 2001
Posts: 18,186
Likes: 7
Very_Addicted_to_AS_Kickin
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Very_Addicted_to_AS_Kickin
Joined: Nov 2001
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Hi, I don't think we have that in Ontario. I know there's Trillium for people on benefits, self-employed or seniors, but I don't know about a deductible.

Love and Warm Hugs,


Kat

A life lived in fear is a life half lived.
"Strictly Ballroom"

rumble #505363 07/24/14 06:46 AM
Joined: Apr 2002
Posts: 3,607
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Posts: 3,607
That sounds like a great med plan, Rumble. Thank goodness for that kind of help. smile

Just wanted to confirm for others that might be searching - that here in Canada drug and health plans vary from province to province, and also often depending on your income. From my experience, Alberta was much more straightforward and paid for much more than the BC system. It's kind of confusing that AB Blue Cross is the standard public provincial drug coverage program in Alberta, which is sort of equivalent to the Fair Pharmacare plan in BC. Pacific Blue Cross in BC is an optional program, and I don't believe it is a government program like AB Blue Cross - it's something you can add on top of Fair Pharmacare. Am I right Timo?

Biologics are pretty much always on special authority and getting coverage for those is a whole other ball game! I don't seem to be having any luck in getting on a biologic in BC, but didn't have any issue in Alberta.

Megan #505381 07/24/14 04:03 PM
Joined: May 2002
Posts: 2,370
Colonel_AS_Kicker
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Colonel_AS_Kicker
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Posts: 2,370
Alberta is wonderful......I have 2 Blue Cross plans....one through work and one on my own to cover Simponi. Work plan is fabulous...my employer pays $40 a month and I pay $13 a month. I pay $63.50 a month for my own plan. So I pay $76.50 a month to get 100% coverage on $$$thousands of dollars worth of prescriptions a month. I am very fortunate and thankful smile We also do not pay at all for any tests or surgeries and that healthcare is covered by the government smile

Sherri



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