posted
I'm at a point where I need to switch insurances. The myriad options are overwhelming even without my brainfog. Does anyone have any advice on what type of plans to look at?
I currently pay out of pocket for the LLMD of which my current insurance (Aetna) pays me back around 75%. They've also covered the vast majority of my drugs (no IV). This is great, but I still pay about $1,200 a month for a family of 3 to have a very good plan (dental, mental health, some alternative stuff). I'm wondering if it wouldn't be better to take a lesser plan that might not cover a lot, but that would cut my monthly costs. That way I'd basically I'd only pay for what I use. My current plan covers many things that my family and I don't need or take advantage of.
Can anybody share some insight or personal experience on this topic?
joalo
Frequent Contributor (1K+ posts)
Member # 12752
posted
Up for help.
-------------------- Sick since January 1985. Misdiagnosed for 20 years. Tested CDC positive October 2005. Treating since April 2006. Posts: 3228 | From Somewhere west of the Mississippi | Registered: Aug 2007
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posted
We learned from past experience with limitations on HMO and PPO plans to use the "standard" high deductible plans. Though we have to pay $3k a year in deductible, we are not limited in the number of visits we are permitted, we don't have to have a referally each time we need or want to see a specialist (this saved us so much hassle, time and money when we were going through dx's before we found a LLMD), overall, for us, it is a better deal and we have a lot more freedom for treatment.
Unfortunately, we do pay a bit more for precriptions because for maintenance drugs (anything you take longer than 3 months), they mandate that we use a specific mail order or pay more. I refuse to use mail order for a number of reasons (we live in below freezing and way hot temps, forgetting to call for refills, 1 of my kids's meds can't be done by mail order as it's a controlled substance and I don't want meds at more than 1 pharmacy, the possiblity of theft once it's delivered by the post, and more reasons), so we pay a bit higher, but to me it's worth it.
It's also worth it to me to pay a bit higher and not complete their "healthy living mandates", such as see your dr, fill out the screening form, get all the testing and follow their rules for how you should live your life. Too much "big brother" for me to be comfortable.
I would look very carefully at each plan you have the option of choosing, compare it to your expenses (and type of expenses) in the past couple of years and your expected expenses. Ask questions (for example, though our plan said mail order pharmacy was avaiable, it didn't say it was required or we'd pay more), check limitations of each plan (is there a limit on the number of visits per year, or in a lifetime. Then see which meets your needs and fits your budget.
Good luck.
Posts: 19 | From Michigan | Registered: Feb 2010
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