I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: cattlekid on September 17, 2011, 11:18:06 AM
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So apparently, workers for the city of Chicago for 2012 will be provided a 'wellness incentive' for their health insurance. If they get a health screening and consent to follow up calls, they get a $50 monthly 'discount' on their health insurance. No benchmarks will currently be required to be met to get the 'discount'.
This got me to thinking. I see this trend more in the private sector as well. Before I was diagnosed with ESRD, I never thought much about it. Now. because I still have two years on my private insurance as primary, it's beginning to make me think. For all intents and purposes, I don't think that those of us with ESRD would be considered to be "well people". We have BP issues, co-morbidities and the like. I am wondering if anyone here that is still on private insurance has a 'wellness incentive' and if they have been able to meet the incentive goals so they are not penalized on their monthly premiums. I can foresee my company doing something like this in the not-too-distant future and would like to be prepared for what may happen.
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I was going to post this exact same thing, but you beat me to it.
I am going to face the same thing in 2012. Seems like all employers are switching to this type of insurance because they want their employees more healthy, but they don't talk about how they handle employees with a chronic illness, and I know I can't be the only one at JPMorgan Chase that has a chronic illness. Our firm is having a meating next week about the new plans and stuff so I'm going to attend, but until then I'd love to hear feedback about this.
By the way my medicare becomes primary in February. My concerns until then, will my dialysis be interupted in anyway? What if I find myself not being covered before my medicare kicks in as primary? Employers didn't think about their chronic ill employees I don't think.
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Sullidog, I don't think that your employer can toss you out of their medical plan just because you have ESRD as long as you are continuing to pay the premiums. That would be a lawsuit waiting to happen. The worst that I could see happen is that you would have to pay more if your employer instituted benchmarks that would have to be met. But even then, what I've seen in the industry is that companies start with a softer approach first - try our wellness program and regardless of your "numbers" you qualify for the lower premiums. That's what the City of Chicago is doing and that makes sense. Get people who may not be seeing a doctor to get a health assessment to head off any major problems at the pass. These wellness programs have been around for a couple of years - heck, even my company threw $250 in my FSA this year because we meet regularly with our PCP. And this is after I was diagnosed with ESRD.
What I'm afraid of is the next step - being penalized on premiums because you don't make certain numbers. Now I would think that something like BP as long as it is controlled with meds should be okay. From what I'm seeing, the numbers being checked are BP, cholesterol and BMI. I'd probably have some issues on the BMI side because while I met the critieria for listing at my transplant center, I could definitely stand to lose a few pounds.
One final thing - I am in no way an insurance or HR professional. Everything I have written above is what I have gleaned from reading and my own personal experience. YMMV.
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my insurance plan offers a program called silver and fit..... which includes a free membership to any health club and weight watchers..... I joined a health club and go often... swimming, some group classes, bowling and they offer alot of senior programs which fits my case....dont want to be in with a bunch of 25 years old ..... my swim suit doesnt fit that well..... anyway....it fun...its free ( except I do pay my health insurance monthly ) and I like it..... I cant use it now,, cause I cant lift anything and cant swim...... Transplant waiting time.....
More insurance programs should give their clients this benefit.... it worth the time.... and it makes me feel good.... I love to swim... and I love the Jacuzzi
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We've had a wellness incentive program for a couple of years where I work. I'm not penalized for having kidney disease. Our program asks us to have a wellness check once a year. This consists of checking blood pressure, cholesteral, and body mass. We have a medical center in the building that does the checks. After the cholesteral test comes back, we have to meet with a "coach" to go over the results. I think for "normal" people they talk about necessary life-style changes at that meeting. I always walk in and tell them that I know my cholesteral level is bad and it's because I have kidney disease and I'm monitored closely by a nephrologist. That's the end of the meeting - no pressure. I get a large discount on my health insurance for playing along.
We have an additional "optional" program to have a half-dozen calls with a lifestyle coach through the year. I do feel some pressure to participate in these and I hate them. They give us a $50 gift card for it, so I make up a goal and endure the 5-minute calls. The coaching focuses on weight loss (I'm at a healthy weight), stress (I avoid stress already), and quit-smoking (I don't smoke), so I come up with lame fitness goals.
I've been feeling coached to death between this and a couple other coaching programs. My insurance company has a nurse who calls me now that I'm on the transplant list, too. I don't mind that one as much. It isn't so much a "fix your life" program. Her calls are more about "do you have questions/issues I can help with while you're listed?"
There's another one who called, too. I don't remember what that one is from, but mostly, I'm tired of people calling to "coach" me.
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I too get calls from a health coach that I can make money off of. They seem to be familiar and understanding of dialysis and they even want to make sure that I'm getting the best care possible.
I also do the health screenings.
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All three times the insurance company's "wellness nurse' has called me and I told her everything was fine with the transplant, I have ended up in the hospital within 24 hrs. of the conversation. I am no longer going to play along because she jinxes me, lol...
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I have blue cross blue shield (NYS)
WE have what is called healthy rewards and I get my whole $525 a year for doing "healthy" things such as walking, eating right, not smoking etc. I have to log onto my account and record my activities into a program which I created and every two weeks I get my $15.00
now I think its a good deal that I get the $525 a year considering I pay $463 EVERY month for my premium!!