Let’s Talk Insurance and Worry

October 30, 2018

My health insurance is from the healthcare.gov exchange because my boss had to cancel work insurance back when the laws changed and the rates for small businesses skyrocketed.  The exchange insurance isn’t great to begin with. The deductibles and coinsurance are high. The premiums are are high compared to what I had been paying for employer sponsored insurance. For myself and my husband right now the monthly premium is $1340.00. Our exchange insurance is with Blue Cross. My employer insurance was only $370.00 per month. ANYHOOOO… Blue Cross sent me a letter 2 weeks ago to tell me they were pulling out of the exchange for the county I live in so I would not be able to renew my policy.

Side note Blue Cross was not willing to pay for the DEIP flap reconstruction surgery. Their employer sponsored policies pay for it. Just not their exchange policies.

The new company coming into the exchange to cover my county is Ambetter. None of my doctors will be in network. So they will not cover completing my chemo treatment if I take that coverage.

The chemotherapy is $10,000 per treatment. I will need one final treatment in January. The Neulasta shot for that treatment will be $20,000. Those totals do not include lab work and doctor visits associated with that chemo treatment, nor my surgical follow up in January. All these doctors will be out of network with Ambetter.

Ambetter will not cover the DIEP Flap reconstruction surgery. The cost of that surgery is $60,000. I still have to have my other breast removed. The cost of that will be about $40,000. I think Ambetter would cover that after I meet my deductible. The deductibles I saw on the offered policies today were $5,000 with 40% co-insurance or $15,000 with 20% co-insurance. Ambetter policies have prices from $957 to $1057 per month for us two.

So now I am trying to find other options. What is a person to do? I do not think I can share the avenues I am exploring just yet. Who knows what happens if an insurance company knows you are trying to find one that WILL pay. I bet they try to avoid covering you.

Have you ever felt like the establishment was telling you just roll over and die?

Please say a prayer for us as I try to find a solution.

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