Author Topic: Choosing Health Insurance with a Chronic Condition  (Read 1954 times)

NeilB4Zod

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Choosing Health Insurance with a Chronic Condition
« on: May 03, 2013, 10:02:55 AM »
I'm trying to choose the best health-insurance plan at my new job.

About me:

I have a chronic illness with medication & specialist-visit costs of $6K/year. Other than that issue, I am healthy. It could be worse!

I don't think it's wise to use the new employer-sponsored insurance to pay for my chronic-condition costs. It would cost them $5K + premiums. It might be wiser for me to pay those costs out-of-pocket. I have heard horror stories of employers firing people who cost them too much for health insurance. What do you think?

Aside from that issue, which insurance plan is the best for me? An HSA, a POS, or an open-access plan? The open-access plan is the most expensive at $1440/yr (if I only use plan to use it for an annual physical and unexpected medical problems).

Thanks!



Kaytee

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Re: Choosing Health Insurance with a Chronic Condition
« Reply #1 on: May 03, 2013, 10:18:17 AM »
It will be interesting to see what responses you get, as this is an issue for my family as well. I'm definitely not an insurance expert, so this is only my experience. My husband also has a chronic condition that requires specialists and regular medication. His (type 1 diabetes) pre-existing condition has meant that an employer sponsored group insurance plan is the only way for him to have insurance. Other plans have refused to cover him becaues of his pre-existing condition, and this may continue to be the case until 2014 when the law changes and insurers are required to offer coverage to everyone. I would start by finding out if your chronic condition is on the automatic exclusion list, because that will limit your options.

NeilB4Zod

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Re: Choosing Health Insurance with a Chronic Condition
« Reply #2 on: May 03, 2013, 10:25:27 AM »
It's definitely an excluded condition.

My question is, will my employer find a way to FIRE me if I wind up costing them an extra $5K + premiums? I'm not even sure what the premium would be, but it could be several thousand dollars in my case.

According to the calculator I used to compare plans, I would only cost them $134 + premiums if I do not disclose/use the employer insurance to pay for my chronic-condition costs.

 

StetsTerhune

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Re: Choosing Health Insurance with a Chronic Condition
« Reply #3 on: May 03, 2013, 10:38:20 AM »
Don't know much about this specifically from the employer's point of view, but I know health insurance pretty well so I'll chime in:

first of all, it wouldn't cost your employer 5K + premiums, it would cost them either 5K if they're self insured (larger than ~2,000 employees) OR  premiums (which may or may not increase for them because of your inclusion on the plan, it depends on the size your employer). If you have a large employer, there is very little chance that they'll ever know how much you're costing them.

secondly, 6K per year is actually not a particularly high cost person, it's actually pretty close the average, so you're not as big a risk as you think (unless your CC puts you at higher risk for a severe incident).

Given those things, if you work at a small office of healthy [healthy in this context= mostly young men] people, there's some chance you'll increase their cost significantly enough to notice, and the timing of it will make them know it's your fault. Otherwise, you're probably fine using the insurance for your care.

As for plan choice, you sounds like you have a pretty stable spend every year, so you should be able to sit down with the numbers and plan designs and figure out how much each plan will cost/save you each year.