Wednesday, October 15, 2014

Choose Your Own Adventure: The Health Plan Edition

In January,we must have a new health insurance plan. (We received the "Dear Policy Holder" letter yesterday.) This came as no surprise to me,because this particular plan was too good to be true without me personally causing it to go bankrupt. This plan(Coventry) no longer covers Federal Employees,of which my husband is one. Having hit my deductible in March(thanks to that pericarditis infection),the vast majority of the year has been copay and deductible free except for sensors which I still pay 20% on) Add on weekly magnesium infusions at 1K a pop (x6 months)and yeah,that gets really expensive. I'm happy to report that said frequency of magnesium infusions is decreasing..and I think by the New Year I'll be able to maintain adequate levels without infusions. This makes me very,very happy because even temporarily, barring extreme gastric distress, I have a oral replacement  regimen that is doing the job. I also seem to have more prominent veins these days as well. Anyway,getting off infusions completely is really in our best interests because our next health insurance plan will not be covering them 100% like this one has.(two plans ago, I had a $250 copay for each infusion. That was not fun,even on a monthly basis.)  I am fortunate to have health insurance options, but trying to find one that covers diabetes crap plus infusion crap plus
lower cost general stuff makes my non-mathamatician brain explode. (Blue Cross was horrible,Carefirst was decent,
Coventry has been very lovely and I'm very sad to see it go.) May end up going back to Carefirst but I have the next 1.5 months to peruse the choices and weigh the pros/cons of each. Every year all the plans make changes and hike up the premiums.(to boot) And then you spend the first part of the year discovering the places you get supplies/meds from are no longer in network and GRRRR new RX's and whatnot have to be written and faxed and sent via Pony Express to the far corners of the U.S. (That's life in the USA)
To semi-prepare for this,I try to stock up on stuff as much as humanly possible.(RX fills strictly as often as possible to Jan.,which gives me some bumper room that I don't have to get the new stuff straightaway) Probably chiropractic will no longer be covered either,which is why I hope I'm 95-100% straightened out by then. Choosing a new plan is so stressful.(kind of like the health equivalent of "Choose your own Adventure," pick a bad one and you'll regret that choice for the next 12 months.)


Anonymous said...

Longtime reader, first time commenter. My husband is also a Federal employee and I would encourage you to look into APWU. If you do the high option you can sign up for their diabetes management program. You are required to talk to a nurse every three months and then they cover, for me at least, strips, insulin, pump supplies, and diabetes related dr. appointment at no cost to me. I think we pay %20 on dexcom.
I have no idea about your other medical concerns but this plan has saved us a ton of money. I promise I am a real person and not employed by anyone who cares about these things and would be happy to answer any questions.

mevsmom said...

I know this is a couple of years later, but I wanted to ask if you still feel like APWU was a wise choice? My daughter has Type 1. She pumps and uses Dexcom. It looks like the diabetes program would save us alot of money, but it makes me nervous to switch.