My last job had health insurance through a certain company I'll call WORST COMPANY, and they capriciously decided to be assholes about pre-certifying a surgery that my husband needs, as per my husband's surgeon (the surgeon is ready to go, he's been treating my husband for this condition for years now, and he says this is what's required. We've done all the conservative measures and they didn't help). We were fighting with them for almost a year and it was a whole big thing including trying to appeal to the state (which didn't work because then we found out my then-employer had a self-insured plan). It's a long story but please take my word for it that it was capricious and not our fault. I just got a new job and thought "Thank god, we'll start over with someone else." Except my two options are a high-deductible plan through OKAY COMPANY and a regular PPO through...........WORST COMPANY. [more inside]
I just returned from West Africa and have a number of symptoms consistent with malaria - or the flu. I have no healthcare, through circumstances beyond my control (I'll elaborate) until May 1. When is it worth it to go to the doctor to get tested? How can I try to keep this from being a pre-existing condition, given that it may be the recurrent form? [more inside]
I am a trans woman. Recently, I received a job offer from a private higher education institution in New York City. I would really like to accept the job, but repeated conversations with the individual who recruited me—who has been asking questions on my behalf to the institution's Human Resources department—have left me unsure whether or not their health insurance will cover trans-related care. How do I get this information? Can I get this information? [more inside]
Given my ADHD, there is nothing more fun than filling out any kind of form. I have gone through the Covered California website and at the point where I am supposed to choose a health plan. Only I can't. I can't find any catastrophic health insurance plans on Covered California or on eHealth.com. [more inside]
I am trying to pick between two health plans. The higher deductible plan makes more sense for me except for one thing – there is no out-of-pocket limit for out-of-network treatment. This seems like a big flashing warning sign to me, but I’m not sure how avoidable out-of-network care is. For example, would being taken to an out-of-network hospital after a car accident start triggering unlimited expenses that I would be entirely responsible for? Is this a plan I should stay away from?
What's the most efficient way to get non-condom birth control without health insurance? [more inside]
I've just moved back to New York from Europe. My European health plan (which covers me for emergencies while I'm in the US) is going to run out in ten days. I am starting a US job with health insurance coverage within the next month or so. Where can I buy coverage for the next month or two to bridge the gap? [more inside]
If I go from part-time to full-time, is my employer (small business owner, <20 employees) obligated to offer me health insurance? [more inside]
I work at my local County Hospital and for the last two weeks we've had a very low census. I hear rumors that the local Giant HMO and local For Profit Hospital Chain are packed right now. I also know one Local For Profit but Independent and Unaffiliated Hospital is at risk of closing right now because of extremely low census. So for folks who actually work in hospitals (and clinics?) are you seeing a change in number of patients since Obamacare started? [more inside]
We need to pick ACA insurance in NYC and after some research are most likely going with the Gold Health Republic PrimarySelect plan (which uses MagnaCare's network.) Is there a very good reason to not go with Health Republic or PrimarySelect, considering what the other NY options are? We're not eligible for PrimarySelect EPO or else we would have gone with that. thanks so much.
So, my wife is going to give birth in Mid-to-End of June. She has a deductible "reset" date of June 1. How does this work? [more inside]
I need help figuring out health insurance. [more inside]
I see two medical providers on a frequent (weekly to monthly) basis. Neither provider accepts insurance. This means that to receive reimbursement I have to mail invoices manually to my health insurance carrier. The process is very difficult to manage. Please help me. [more inside]
Where can I find affordable health insurance? I'm on COBRA since striking it out on my own, but currently have not started making revenue, and am worried about options once that runs out. My current high deductible plan from UHC costs ~$213/mo ($2700 deductible) and includes EyeMed vision and dental (additional $35). I know I won't find anything this good post-COBRA but hoping there's something close? I know that since ACA has started that individuals can buy insurance off exchanges (I am in NYC, so will be more expensive, I know..). Will definitely be checking that out. Freelancer's Medical has come up in my searches. I don't think that entrepreneurs (who are not freelancers getting 1099s) qualify for Freelancer's, but checking with them. Not sure we qualify for HealthyNY for small business (individual option has been terminated post-ACA), since we are an LLC but I am the only full-time partner (the rest have day jobs). Are there other options I'm not aware of? Thanks for any help!
The New York insurance website said I qualify for Medicaid. This means I'm not eligible for the regular subsidized plans and must pay full price for them if I want them. This makes no sense whatsoever, but nobody will budge on this. What can I even do? [more inside]
That's pretty much the whole question. I ask because I am signing up for Covered California and am leaning toward Kaiser, as that is the health provider I will have up to Dec. 31 of this year and it would be nice to not switch everything around. But the plan I am looking at charges $19/30 day supply for generic medications, and I know that one of my meds can be bought at Target for $10/90 day supply. I know that the normal Kaiser process is to use the in-house pharmacy, but I wonder if doctors will write a prescription that you can take elsewhere. Medications form the bulk of my healthcare spending so this could potentially make a big difference to my meager budget.
Hello all, I was laid off from my job in July and went to Europe for a few months. Now that I am back in USA, I tried to sign up for affordable care act via www.mahealthconnector.org/ only to find out this site is the reincarnation of the devil. I cannot finish my application for this health insurance because I get stuck on a page that requires me to put in my employer info. Now since I am unemployed I obviously do not have an employer. This site literally will not let me complete the rest of the application without entering a whole bunch of information on my current employer which does not exist! How on earth do people without jobs apply for this?? Does anyone else run into this frustrating issue? Is there any other health insurance I can sign up for?
I've been offered to be hired where I have been a contractor. However, there is a health insurance issue that would cost me a lot of money for several months. But I would have a great retirement plan. I have nothing in savings and $100k I just consolidated in student loans, so this issue is just complicating things. [more inside]
I would love the knowledge and insights of Mefites on this decision and on my top three contenders for insurance companies and their networks: Oscar, Health Republic, and Metroplus. [more inside]
I have health insurance, and the co-pay will be about 3150. Should I do it now, or wait? [more inside]
We just found out I'm pregnant. Yay! My husband also just started a new job, which is requiring us to move states sometime between now and early spring, which means I have to quit my job and we have to change insurance. I'm not sure how best to handle this. [more inside]
I will need new health insurance as my insurance company is dropping individual policyholders in my state ahead of the new Affordable Care Act. I do not qualify for any subsidies under the new law and have no reason to think that will change. A friend suggested that I avoid buying insurance through our state exchange and buy straight from an insurance company to keep the IRS and government out of my health business. Is this a valid argument?
Under the new Affordable Health Care Act (Obamacare), can a small employer (under 25 FTE) choose who is eligible for a group plan based on merit or as an incentive? Basically, not have a set guideline as to who is eligible and who isn't?
I'm allowed to choose a health plan through my employer. Out of the nine options, I've managed to narrowed it down to five. Scanning through the comparison chart, they all look about the same. They all make you choose a primary care physician and coordinate everything through her or him. Copays are about the same. Premiums vary within $20/month or so. Does anyone have any experience with any of these? Any strong recommendations or dire warnings? [more inside]
I'm trying to help someone be in the best position with healthcare benefits. It sounds like they may be able to be covered by both their COBRA continuation plan *and* a new group plan through a spouse's employer. There's some tricky wording in the COBRA rules. Is this possible? [more inside]
I am recently unemployed (as of Sept 1st) and will be moving from Texas at California in late October. Please help me figure out what I need to do for health insurance. [more inside]
I'm temporarily unemployed in NYS. My wife's a grad student, and her college provides health insurance for the two of us for about $7500 for the year, paid up front by the end of September. That's $2500 for her, and $5000 for me. We can afford it, but it seems very steep. Can the hive mind suggest any alternatives? Amazingly, this seems like the best deal I can find. [more inside]
Does anyone have any experience with purchasing health insurance through the Freelancer's Union? Any feedback on the process and level of satisfaction with coverage would be appreciated. [more inside]
Medical mefites: How much will my pregnancy skew my employer-sponsored health plan wellness program biometric screening (blood tests only)? [more inside]
After submitting an ER claim to insurance, my bill from the hospital INCREASED. Is there any way to fight the hospital on this? [more inside]
My friend Stan (very) recently moved to the USA, and has already had a run-in with his health insurance that we are not sure how to deal with. Stan's new boss Joe invited Stan's family over for an afternoon, and at some point Stan's five year old fell and cut his arm on a rock in the garden. [more inside]
When negotiating a job offer, is it permissible to ask to see the company's health insurance policy before the salary range is discussed? [more inside]
I'm seeing a psychiatrist. I'm paying for it up front through my HSA and not submitting it to my insurance company. I switched to a new practice recently and because it's more expensive, I wonder if I should submit these claims to my insurer. Should I be? [more inside]
Which option is best for a broke student going to school out of state? [more inside]
I am newly graduated, living in NYC, and wondering what my options are for health insurance. My school offers a continuation plan, but the price seems outrageous. [more inside]
I'm looking for good resources for information about the upcoming exchanges, especially concerning eligibility restrictions, specifically in Colorado. [more inside]
I need group health insurance, but I don't know what my options are with the new potential changes in the law. I am in the East Bay, in California. Help? [more inside]
I am thinking of retiring early, relatively soon. Probably within five years, maybe much sooner. I want to make sure that I correctly understand various things, so I have several questions related to taxation, Obamacare, health savings accounts, IRAs, and SEPP. [more inside]
I had a blood test done to check for a gene mutation that my family recently discovered we may have. It was just blood work from an in-network lab so I assumed it would be covered, per my "schedule of benefits." Today I received a letter from my health insurance provider saying this testing is not covered. The cost is $1300 and I definitely do not have $1300. I haven't been billed by the blood lab, but I imagine that it's coming soon and I will be fucked. My insurance company also said that these limitations on testing are available to view in their policy bulletins, of which I have obviously never checked or even knew existed -- I was going entirely off my "schedule of benefits" and I believed that in-network blood work was just my co-pay. More details below: [more inside]
I just received a notification from my insurance company that as of July 1 they're no longer covering the brand-name version of a necessary medication I take daily. If I want to keep taking it I have to pay the full price (many hundreds of dollars per month)—or switch to the generic, which I've taken before and found that for me it is basically crap. It doesn't work as well, and has pretty unpleasant side effects, and I have documentation to that effect from my doctor of many years. Is there anything I can do to create a happy ending here?
My 61-year-old mother was just laid off and may never work again. She has no savings. What should she do? [more inside]
How do most married, dual-income couples deal with health insurance? Should I drop mine and go on his plan? I am recently married. My husband and I are both healthy and have private sector jobs that are reasonably secure. I work for a small (less than 20 employees) company that has so-so health insurance. Husband works for a larger (500 employee) company that has awesome health insurance. Adding me to his health plan would cost about the same as what I pay for my health plan now. I'm planning on joining his health plan, but open enrollment time is coming up at my job, and I'm wondering if I should keep my insurance or drop it. I can afford the premium, but I don't want to be wasting money where I don't need to. Is it good to be double-insured just in case he loses his job? We have no kids, but are planning on them in the next few years.
My partner and I have just been offered a large amount of money to leave our NYC apartment. Our plan is to pull up stakes and move to my home state. We have to make a decision by tomorrow. However, I've also just had a hinky breast mammogram/sonogram and am scheduled for a biopsy next week. Am I making a major mistake in quitting my job, going on COBRA, and moving cross country when I've got a potential health issue on the line? [more inside]
I'm self employed. I need health insurance. My main concern is a random ER visit that will put me in debt for the rest of my life, so I told my wife not to worry about deductible prices, since I only need to go in once every few years anyway. She found something with a $4,000 deductible. And that was like $80/mo. The other ones were even more expensive. Is this price range right? Is this the only way to protect myself from crippling debt?
I get kicked off of my parent's health insurance plan next month. Should I purchase my own plan and if so how and what's the worst that could happen if I don't? [more inside]
My partner and I are considering going into couples counselling. The insurance plan we share does not cover this type of counselling "except when rendered in connection with services provided for a treatable mental disorder." One of us is in treatment for a mental disorder, so this seems worth investigating. Can you offer us any experience or advice about dealing with therapists and/or insurance companies in this situation? [more inside]
I am an ABD grad student dealing with significant situational depression. My therapist has recommended I seek out a prescription for an SSRI (antidepressant). My insurance situation is a bit complex -- I'm on the university's faculty EPO plan, but don't have a primary care physician relationship established. Trying to sort out the right order of operations for making sure I get coverage, and get timely access to care. [more inside]
How do I figure out the details on a tricky health insurance situation so I am not doing anything shady, but also don't accidentally end up many thousand of dollars in debt? [more inside]
I'm talking the absolute BEST, at any price. [more inside]
My wife's mom is a widow of advancing age. She lives alone in Eastern Europe, in a country with universal health care. (More or less... thanks, austerity!) As she is getting older, we're starting to worry about her living over there, both because of quality of care and because the day that she's no longer suited to live by herself seems approaching. We live in the US and would like to bring her over here permanently. Putting aside immigration questions, how do we get health insurance for her? [more inside]