Affordable Care Act (Obamacare)

[mitch5252]

...here is a site you can check out and you can find the cost of the medications.
I have coverage but my friend Molly gave me this information for checking out if my deductible is high...

goodrx.com

..
Thanks for the post about the site. It really does work!

Since my cancer was so new as I was leaving for the Baja trip, I hadn't made a "stockpile" of the cancer drug yet. And you know insurance - all their refill rules - I could only get a 30-day "vacation" refill! Grrrrr. So I got another prescription from my oncologist and ran it through the http://www.goodrx.com/ site at Walmart and got a really good price...

Another option is the $20 annual membership program for prescription drugs through Walgreen's - they also have good prices, sometimes even beating Walmart.
..

[Queen]

I just plugged my asthma meds into the goodrx site, WOW! I can save a bunch right now over my insurance copay! Wonder if you can get coupons month after month.

[Getupngo]

I'm still hangin' out with my current health/dental insurance -- through the State of Utah -- which costs me $750 a month. I enrolled at the healthcare.gov web site, but have not pulled the trigger. The ACA policy I prefer would save me about $250 a month but would it cover me nationwide? I suppose I could pick up the phone and ask.

I currently do not have a deductible with my state plan -- which I am eligible for because my late husband had more than 30 years service with the state.

[mitch5252]

I'm still hangin' out with my current health/dental insurance -- through the State of Utah -- which costs me $750 a month. I enrolled at the healthcare.gov web site, but have not pulled the trigger. The ACA policy I prefer would save me about $250 a month but would it cover me nationwide? I suppose I could pick up the phone and ask.

I currently do not have a deductible with my state plan -- which I am eligible for because my late husband had more than 30 years service with the state.

..
That's one of my concerns, too. However, I think they will cover emergency room service anywhere. And I don't travel enough to figure I'll be going to the doctor on the road.

You did notice the 3 levels of network availability, right? Cost goes up with each expanded level...

I also don't understand the "qualifications" of a tax deduction. My BFF's daughter doesn't make $45,000 and she did not qualify. Anyone understand what makes one eligible besides making under $45,900?

..

[VickieP]

I also don't understand the "qualifications" of a tax deduction. My BFF's daughter doesn't make $45,000 and she did not qualify. Anyone understand what makes one eligible besides making under $45,900?
..

It really isn't very clear, but I did find this. https://www.ehealthinsurance.com/afford ... sidies-faq

QUESTION: How do I know if I qualify for a 2014 health insurance subsidy?

ANSWER: Consumers earning less than 400% of the federal poverty level (about $46,000 for a single person or $94,000 for a family of four) may be eligible for a government subsidy to help them buy coverage in 2014. Whether you receive a subsidy – and the amount of any subsidy you receive – may also depend on the cost of coverage offered in your area. In order to receive a subsidy, you must also be a legal resident of the United States, not incarcerated, and not eligible for other forms of minimum essential coverage (for example, coverage through an employer-based plan or through Medicare or Medicaid).

[retiredhappy]

Be careful of Walgreens. When Sprinter was staying with me one of her major pain medications was about $1400 A MONTH and it was just a little over $500 at another pharmacy. They were also very high for my diabetic supplies.

[gingerK]

Regarding prescriptions I've heard that Costco is very reasonable and you don't have to be a member to get your Rx filled. Same with Sam's club.

[JudyJB]

Also, instead of just emergency rooms, check into their policies about using urgent care instead. Some insurance companies of all sorts, not just ACA, will not pay for an emergency room if you go there for something that is clearly not an emergency, such as a sore foot or sore throat without a fever.

That's why I looked for an urgent care facility last month instead of going to an emergency room for my migraine headaches. Usually a lot shorter wait, also. I did go to an emergency room in a very tiny town for my shoulder muscle cramp because there was no urgent care facility in that town. I was told inside that they acted as an urgent care center.

Also, over the last couple of years, I have found that Chambers of Commerce offices, if they are open and you can find one, are super at finding services of all kinds, from medical to things like propane sales. I called one via phone once for propane and the lady made a bunch of phone calls and called me back in just a few minutes. Those ladies know everything about their towns!

[MsBHaven]

This was a great post. We can definitely learn from each other. Mitch, sounds like your choice is pretty good. The ACA is good for the previously uninsurable. Judy gave good advice about urgent care. I used to need blood work every two months and luckily I could use LabCorp or Quest anywhere in the country and have 100% coverage.

My biggest problem right now is my Enbrel. My previous co-pay was $3.33 a month - it now is $670 a month. What a jump! I was getting financial help from Enbrel for several years but am now over the income level for help (Roger starting getting social security and I guess that put us over the limit). I have 2 shots left and am attempting to go thru a foundation. If approved, they will pay the entire cost for me ($2500 per month). If they don't approve me, I will have to go on a less effective drug for my RA. Enbrel is a biological with no generic available. Wonderful drug, but too expensive.

The whole insurance system is so confusing.

[mitch5252]

..
OMGosh, Margie!

I looked up your drug on my two prescription drug apps. For a 30 days supply, the range was $9,000 to $12,000 - that's for a MONTH (assuming it's one injection per day) OMGosh! What a rip.

..

[etexlady]

Wow, Margie. Sounds like you have researched and have applications in process for some payment assistance. There is usually help out there but finding it sometimes can be difficult. I like to use the website www.needymeds.org. Listed by drug, they have links to drug manufacturers, discount and coupon offers, rebates and copay assistance, etc. Hope you are able to get the help you need.

[monik7]

..
OMGosh, Margie!

I looked up your drug on my two prescription drug apps. For a 30 days supply, the range was $9,000 to $12,000 - that's for a MONTH (assuming it's one injection per day) OMGosh! What a rip.

..

I used to be on Enbrel for my RA. I did have insurance but the premium was $950 per month. My Enbrel was one shot per week, but I would have never been able to afford it without insurance. When I became eligible for Medicare, my doctor recommended I switch to Remicade infusions because the cost of Enbrel would have been impossible. The infusions are done every 8 weeks, are done in the hospital and average 2 1/2 to 3 hours, and are fully covered by Medicare - no copay. That's about the only time I've been glad I got old enough for something.
Sandi

[JudyJB]

Here is one thing that really irritates me about the drug companies--Enbrel and Humira are two drugs that are HEAVILY advertised on TV. In fact, between those two drugs, senior life insurance, and reverse mortgages, that's about all you hear about on TV. (OK, throw in a few ladders, weight loss products, and juicers.)

So maybe this is why they feel they have to charge $9,000 a month???? How much are they spending to convince us to get our doctors to prescribe them???

By the way, these two drugs have a substantial risk of causing lymphoma, pancreatitis, and some other large problems. I know they may work for many people, but there is something wrong with our health care system when something like this is so expensive that hardly anyone can afford it.

[MandysMom]

Yes Judy, and all the Biologics carry the same warnings and the warning actually reads lymphoma and other cancers. If we did not have the VA we might not have been able for husband to take Biologics, the trigger they believe for the tumor he developed but the Biologics did help his psoriatic arthritis pain. We were shocked at the prices that showed on some VA paperwork and grateful we did not get a bill. I was reading yesterday in the new Consumer Reports how companies jack up prices esp before and just after they lose patent control while they are appealing keeping patent. I have often thought RX prices went way up after they began tv advertising.
Back to the cancer warning on Biologics. If you take them or consider taking them, because they can so allow a better quality of life, make sure any strange new symptom gets fully investigated. My husband began having a constant runny nose a year or so into Biologics as if he had allergy. So doctors "assumed" he had allergy and for years treated him for allergy. When the tumor broke through into his mouth it was finally noticed and biopsied and though it appeared as a small benign looking mouth ulcer, it turned out to be a large salivary tumor in his sinus. I will always wonder if they could have found it if they looked when allergy treatment did little. Maybe he would not have lost so much in the eventual surgery. He lost half his palate, much of ability to taste, two teeth making eating difficult other than purée, and so on. So make sure any new to you strange symptoms get investigated and pay attention to those tiny afterthought words, and other cancers.
Velda

[JudyJB]

I paid attention to these two drugs because my son had lymphoma a couple of years ago. He is fine now, but he had taken another drug with a warning for lymphoma for his rheumatoid arthritis, which likely caused his lymphoma. He was in his 30s, so was young for all of this. He was diagnosed because he had one very large tonsil which did not react to antibiotics. They took it out and he started chemo immediately. Very scary, especially since he had very young children.

One good thing, if there is such a thing, is that the chemo cured his arthritis because it destroyed part of his immune system.

I also had a drug given to me as a sedative before surgery that may have caused my acute pancreatitis in Dec 2006. Seems like some drugs actually cause disease!!