I’ve had very good health insurance over the years that helped me pay for very expensive prescription drugs. However, in the last 3 years I have been paying for health insurance directly because I am now self employed. I started out paying almost $250 a month for a single male through the NASE which is a group buying plan. The coverage is not even close to the level of coverage I had while working for an employer or while I was on my Mom’s medical insurance.
I don’t take any Migraine prescription medication, just over the counter Excedrine Migraine — that’s a whole other story I’ll write about later. I do have two other prescriptions for my Pituitary Prolactin Macro Adenoma. One of these prescriptions is typically around $250 for 30 days supply. The second is now down to approximately $150 (from $250+) for 8 pills which is a months supply.
My previous insurances usually required me to pay a $30 co-pay for each, but the self-employed plan requires me to pay 75% of the retail price, they pick up 25%.
The Pituitary condition requires that I have blood tests, which is one way they can determine if the medication is keeping the tumor in check. Late last year I went to a new Endocrinologist after being asked to leave the Endo that I had been seeing for about 5 years. They required that I get an MRI every year in order to be one of their patients. This new Endo talked to me for about 45 minutes, possibly an hour which is great. Then the doctor got the paperwork ready for me to go to the lab to get blood tests I’m supposed to have about every 6 months (according to some doctors) and I had my blood drawn.
I ended up getting the bill from both the doctor and the lab and was shocked. The doctor visit was approximately $320 while the blood tests were approximately $680. My insurance ended up paying a tiny portion of these bills and I was stuck with the majority of it. Whereas when I had the good insurance plans I would have paid an office visit co-pay of possibly $20.
Same thing with an MRI, I would typically pay a $50 co-pay per MRI on the good insurance plan. I’m afraid to think what an MRI would cost under my current insurance coverage! My former Endo was at a large University hospital complex, so they had their own MRI equipment. When I was a patient I asked how much the MRI would cost without insurance and they stated it would be a little over two thousand dollars per MRI. With my current insurance I think I’ll look around for a “cheap” MRI provider.
I wanted to bring up my experience with health insurance because I think I have seen both the good and bad insurances and through that experience I feel I can be objective.
I am very concerned with the current plan that the U.S. Congress and President Obama have in the works. I can only imagine it will either be really good for someone with my conditions or really bad. Currently most Endocrinologists with extensive Pituitary experience have a 30 to 60 day scheduling backlog. My biggest concern if these specialists are no longer able to get enough money out of their craft, they will either quit and do something more lucrative or else only accept patients that pay for things without the nationwide health care plan. This happened in a lot of small rural towns with medicare many years ago. I was doing computer consulting work and many clients were doctors and medical supply companies. I had conversations with several of these doctors who said they dropped all medicare patients because they were being financially drained by the low payments from the government — this was over 10 years ago.
I really would like to know how the government thinks they will keep this from happening with their new plan… Maybe at the point of a gun? Just food for thought.