Re: Beth-insurance question

[Guest guest]

Hello Sierra,

This is in VA. Insurance is a very cumbersome topic, especially for people with chronic illnesses like arthritis. If your husband is considering going to work for a company, it may be a good idea for him to pick up family coverage, but there are a few things to consider:1) how would the plans with his company differ to the one from yours? If his would create more out of pocket expenses now, do you have that extra money? When I was under MAMSI insurance, I didn't pay anything for my Remicade treatments and I got them through home health care. When I switched jobs I switched plans too. Trigon/Anthem BC/BS makes me go to the local hospital for my treatment, which costs me $100 each visit. Plus, my rheumatologist is not covered under Anthem so I pay $120 each time I see him. I work for a non-profit company, so I don't have that extra income. I see Dr. Lawson every 3 months so I have to save pennies to see him.

You may decide that the ends (being under his plan if you need to go on disability) justify the means (having to pay more money now). It's one of the many choices you'll have to make as a family. If your husband really wants to work for a company, it's probably worth switching plans.

Take care,

Steph in VA

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ My husband runs a small business. For the

>past year, his business has been slow and he is considering going to

>work for a company. Would it be wise for him to take family coverage

>in case I become unable to work? (I read that 50 percent of RA

>patients leave their jobs within 10 years of diagnosis.) Would I be

>immediately covered through his insurance? How does having double

>coverage work? Do you think I should encourage my husband to make

>this move?

>

>Lots on the brain!

>

>Thanks,

>Sierra

>

>

>

>

>

[Guest guest]

Hi Sierra,

I'm glad I was able to help. Unfortunately I didn't know about these

on-line support groups when I was first diagnosed, and I learned lots

of things the hard way!

already provided some good insights on insurance, because

each policy truly is different (even when provided through the same

company). In most cases when you have duplicate insurance, and both

policies are group ones through employers, there are

specific 'coordination of benefit' (COB) rules spelled out. For

example, while you are working, your coverage is primary for you and

your husband's would be secondary. For him, it's the other way

around. If you have kids covered by both, generally which one is

primary is determined by whose birthday is earlier in the year (yours

or your husbands).

The COB can vary as well. For example, the policy I have through

work provides 'non-duplication' of coverage. If ours is secondary,

and the primary plan picks up 80% and we would normally pay 90%, then

we'll only pay the 10% difference. Depending on the number of family

members and amount of premium involved, you may be best off moving

the family to your husband's policy (when he gets a job) and keeping

just you on your own.

There are lots of ins and outs about whether or not you would be

covered right away. Some plans don't put any exclusions on pre-

existing conditions, where others restrict them as much as possible.

When your insurance ends through your company, you'll get

a 'certificate of creditable coverage' which can be used to reduce

the waiting time for pre-existing conditions.

Lots to think about. My husband is self-employed, and I'm the

family 'corporate wage slave' so that we have benefits. I've come

close to going on partial disability at times (reducing my work hours

for medical reasons) but fortunately have been able to keep working.

I try not to think about the fact that I may have to stop working

some day (partly because I enjoy my job). I think that the

statistics about disability and RA date from the pre-biologic

medication age - hopefully they will improve dramatically with the

new treatments. I've already read one study that showed that people

on Enbrel were able to work more and longer then the control group.

If you have any more questions on insurance, feel free to write me

directly. I've worked in employee benefits and compensation for 12

years, and have a pretty good understanding of most of the ins and

outs.

Also, keep a positive attitude (hard to do when you're first

diagnosed and don't feel well and are scared about the future). You

may be one of the people who respond quickly and well, and don't have

any major issues.

Take care, beth

> Hello and thanks for the great advice! I truly appreciate it. You

> gave me a helpful answer on an insurance question in the past, and

I

> have another for you. I currently provide the insurance for the

> family through my employer. My husband runs a small business. For

the

> past year, his business has been slow and he is considering going

to

> work for a company. Would it be wise for him to take family

coverage

> in case I become unable to work? (I read that 50 percent of RA

> patients leave their jobs within 10 years of diagnosis.) Would I be

> immediately covered through his insurance? How does having double

> coverage work? Do you think I should encourage my husband to make

> this move?

>

> Lots on the brain!

>

> Thanks,

> Sierra

[Guest guest]

Thanks once again, Beth! The information was very helpful. I

discovered that The Arthritis Foundation also has some good

information on its website (sections on insurance and financial

planning).

I'm actually feeling quite good--Vioxx and Plaquenil have brought my

symptoms down to a mere whisper. I'm grateful to have found a

rheumatologist I trust. And I have a good job for a person with RA--

part-time, not physical, and in a supportive environment.

I liked your comment about Enbrel; the new developments in medicine

are extremely encouraging.

Take care, and thanks again.

Sierra

> > Hello and thanks for the great advice! I truly appreciate it. You

> > gave me a helpful answer on an insurance question in the past,

and

> I

> > have another for you. I currently provide the insurance for the

> > family through my employer. My husband runs a small business. For

> the

> > past year, his business has been slow and he is considering going

> to

> > work for a company. Would it be wise for him to take family

> coverage

> > in case I become unable to work? (I read that 50 percent of RA

> > patients leave their jobs within 10 years of diagnosis.) Would I

be

> > immediately covered through his insurance? How does having double

> > coverage work? Do you think I should encourage my husband to make

> > this move?

> >

> > Lots on the brain!

> >

> > Thanks,

> > Sierra