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Author Topic: Scream And Pay Another Deductable  (Read 890 times)
PrimeTimer
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« on: September 18, 2016, 06:48:55 PM »

Another rant. Steam has been coming out of my ears on this one but nothing we can do. Husband's employer was bought by another company and....we are having to start over with another insurance company and having to meet their annual deductable/out of pocket expenses again. And it's already September. Come January, we start over again. We chose a plan with the highest premium but lowest deductable. Not all of our meds are covered 100%. We pay and we pay and we pay.... :rant;
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
Michael Murphy
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« Reply #1 on: September 19, 2016, 09:34:36 AM »

Check and see if the old deductible is counted to the fixed amount that they pay for. In other words my old insurance had a limit of 3000 dollars once that was reached the plan paid 100 percent of the amount over.  It may not be as bad as you think, check with your state insurance commission they make rules about this.
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PrimeTimer
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« Reply #2 on: September 21, 2016, 08:06:11 PM »

Check and see if the old deductible is counted to the fixed amount that they pay for. In other words my old insurance had a limit of 3000 dollars once that was reached the plan paid 100 percent of the amount over.  It may not be as bad as you think, check with your state insurance commission they make rules about this.
Unfortunately, my husband is being treated as a "new hire" by his new employer and they use a different insurance plan from the one we had. So between now and the end of December we have to meet a deductable and OOP expense again and then in January, start yet again with meeting an annual deductable and OOP expense.
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
Michael Murphy
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« Reply #3 on: September 22, 2016, 04:26:47 AM »

For giggles I would contact your state insurance commission and check to see if the state has rules that protect you. Also contact your social worker you may be eligible for assistance because of the additional expenses.
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solid98
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« Reply #4 on: September 22, 2016, 09:02:06 AM »

Is he eligible to continue with COBRA on the old insurance then switch in Jan? Would AKF be able to help with the COBRA premium?
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PrimeTimer
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« Reply #5 on: September 22, 2016, 12:36:45 PM »

Is he eligible to continue with COBRA on the old insurance then switch in Jan? Would AKF be able to help with the COBRA premium?
No, COBRA is out of the question. COBRA is very very expensive (okay, unaffordable) and I believe it would only apply in a case where the employee has been laid off (which has happened to the both of twice before). Since his new employer bought his old employer's company, in other words it was not a merger, he is considered now to be a "new hire". He has to start all over again. He's just lucky to still have a job. Even his former manager had to requalify. We realize how fortunate we are to have insurance, it's just maddening how much the cost of it has increased while coverage has decreased.
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
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