Category Archives: insurance

Pre-existing Conditions

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No, mom, the picture isn’t from now, it’s from a couple years ago… just making a statement.

Okay… let me start out by saying I’m trying really hard not to over react. I’m trying hard to think that, even in politics, there has to be some logic involved, some degree of common sense.  I’m trying to believe that a country that has progressed so far in the past dozen or so years can’t possibly slide backwards so far so fast.  I try.  I really try. I want to believe that my daughter (who has kidney stones and epilepsy) won’t be cast adrift.  I want to believe that my son with sjogrens will likewise not be put on his own iceberg.

That said… trying hard doesn’t keep me from being terrified.  I’m terrified.

I read pre-existing conditions.

I read caps on coverage.

I read the rhetoric and the realities.

If there is a million dollar cap on lifetime benefits… and I ONLY get my orencia infusions… those magic biologic treatments that keep me functional… at 10,000 billed to my insurance a month… that leaves me with just over 8 years.  8 years of being able to be a functioning tax paying contributing to society citizen.

There has to be an irony in the fact that 8 years will take me to the maximum possible term that Trump could see.

And I am one of the “lucky” ones.

I hear the people in the infusion center talk about what EACH of their treatment actually “costs” if it isn’t covered.    Fifty thousand dollars a week for one treatment.   They get to live almost 6 months (because their treatments are keeping them ALIVE not just keeping the hot glass shard feeling out of their fingers or their fingers pointing in the same directions, or their knees from being the size of volleyballs).

I’m trying to not be reactionary

Acne is a pre-existing condition

Acne

People who had cancer 15 years ago and are not clean and clear… they have a pre-existing condition.

And don’t even get me thinking about how much the fact that a woman is born with the wrong anatomy to matter.  <<it’s been a LONG exhausting week and I might just tell you>>

 

I don’t want to be reactionary… but…

States could apply for waivers that would allow insurance companies in their states to do three things: 1. Charge older people more than five times what they charge young people for the same policy; 2. Eliminate required coverage, called essential health benefits, including maternity care, mental health and prescription drugs, that were required under the Affordable Care Act; and 3. Charge more for or deny coverage to people who have pre-existing health conditions, such as cancer, diabetes or arthritis.

The waivers could also impact people with employer-based insurance, because insurers could offer policies that have annual and lifetime benefit limits, which are banned under the Affordable Care Act, and some companies may choose those policies for their workers to lower premiums.

Let’s face it… I’m really scared.

I’ve written my senators.

I’ve considered stopping my infusions because they will cost more than I make

I’ve considered moving to somewhere that will allow me to afford to exist.

Yeah… not being terrified and not being reactionary isn’t really working for me so much right now.

Hitting Insurance Thresholds

So, I got a phone call this past week.  Apparently the insurance company (or the company I work for) noticed that I hit a magic threshold in their reporting system and it triggered a call to see if there is anything they can do to make my life better (read cheaper I think).  I talked to a very understanding nurse who looked at my medical record and said… Oh… you have rheumatoid arthritis and you are taking Orencia.  I think that is probably what triggered it.

Duh

It’s like 8000 dollars a month between the infusion center bills and the medicine.

It’s difficult to think about the fact that this is going to continue for the rest of my life to one degree or another.  It’s sobering.

I keep thinking about the notification from the drug companies saying that they will help with the cost of the medication if you have private medical insurance.  If you don’t have insurance, the cost is so horrendous.  I think about where I am and the fact that I have a good job that keeps me in insurance.  I don’t know how people deal with the pain if they don’t have the facility to pay for the drugs that stave off the damage and the pain.

Updated: August 20, 2014
Author: Figment of Fitness
Keep the dreams alive