November 1st is the first day of open enrollment for 2016 health care coverage through the Health Insurance Marketplace (Healthcare.gov).  The Healthcare.gov homepage is set up to help you keep or change your existing coverage as well as handle first time applicants.  We’ve written a little bit about finding a healthcare plan here on Lacuna Loft before.  You can find those articles here:

Things I’ve Learned While Applying For New Health Care Coverage

Spending My Day Signing Up For Health Care Coverage

In the mean time, I wanted to point you towards some great resources:

Health Reform FAQs

Health Insurance Explained – this video is great for helping figure out all of that insurance jargon!

Important Marketplace Deadlines

Triage Cancer answers many of your questions on their blog

Remember that this process (especially for a cancer survivor!) will take time!  You want to make sure that you write your questions down and find answers for them.  Google is a great place to get those questions answered as well as the time it takes to call the marketplace.  Spend the time now in order to find the right plan for you.  Your sanity (and finances) will thank you for the rest of the year!

Good Luck!

Applying for new health care coverage is a stressful and time consuming process.  There are definitely some tricks of the trade though, and equipped with the right information you’ll be able to apply in no time!  Didn’t see our last post about health care coverage?  Go here!

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[list_item]don’t be shy…ask questions![/list_item]
My cancer treatments and follow up appointments have all taken place at Barnes in St. Louis, MO.  The last time I was there, I started asking about health insurance plans; explaining that I would be needing to apply for new coverage before the next time I would see my physician.  I was pointed to a group of very knowledgeable women who gave me phone numbers galore to call when I started applying through the market place.  After a few hours spent comparing the plans open to me, and a few phone calls to a very awesome and nice person at Barnes, I had all of my questions answered!

[list_item]google is also a great place to ask your questions…though verifying the answer with a couple of different credible sources is a good idea[/list_item]
Google your answer then talk to someone about it!

[list_item]the insurance companies’ websites are not necessarily up to date.[/list_item]
When I was looking at plans, I routinely checked whether my oncologist was covered by the health insurance plan I was considering.  Sometimes she wasn’t in their list of providers given on the website.  When I called my trusty source at Barnes though, it turns out that starting in Jan. 2015, my oncologist did contract with some of those health insurance companies!  Like I said before, always ask!

[list_item]insurance companies are businesses.[/list_item]
I have been told downright false information from one insurance company employee (maybe she actually didn’t know she was telling me something wrong?) and I’ve been manipulated by another.  Once, I called the insurance company to ask a question, was given an answer, called back to ask another question and this second person told me that the first person should not have told me some of the information that she had…that they weren’t allowed to have told me that info, even though it was true.  Goodness gracious….I cannot begin to explain to you how mad and sad this made me.  Moral of the story, call someone with your questions who actually has your best interest in mind.  I talked with someone specialized in the healthcare issues of the hospital at Barnes.  People at Triage Cancer or the Kaiser Family Foundation can also be of great help!

[list_item]use a spreadsheet.[/list_item]
Comparing even just a few plans can get kind of complicated.  When figuring out which plans I could apply for, I input my state, projected income, age, and then filtered out only the Gold plans.  There were 14 Gold plans possible…that is a lot of different premiums, deductibles, and out-of-pocket maximums to remember!  When calculating the total cost, I put each of these plans into a spreadsheet.  Each plan got it’s own row, then the name of the plan, the plan’s ID number, the monthly premium, deductible, and the out-of-pocket maximum, each in it’s own column.  Then, to calculate my total yearly cost for a plan, I took the monthly premium * 12 and added that to the out-of-pocket maximum.  (Co-pays, Co-Insurance shares, and your deductible all count towards your out-of-pocket maximum).  Doing this calculation for each plan makes them financially comparable very quickly…and that way I don’t have to hold any numbers in my head.  From there, I started making sure which insurance my oncologist took and which she did not…quite a process.

[list_item]emergency room coverage is different than out of network coverage.[/list_item]
Yep…by law emergency room care is always covered by health insurance.  In an emergency, after they’ve stabilized you in an ER, you can ask to be moved to an in-network hospital.

[list_item]check that the prescriptions that you take are covered.[/list_item]
When considering a plan, there is a link that you can click to look at the list of ‘covered drugs.’  Sometimes this list is straight forward and you can just hit your keyboard’s Control key and then your f key (while still holding down the Control key) to search for your desired prescription.  Every once in a while though, the list of covered drugs includes the actual medical names of the medications as opposed to the name you are used to calling them.  For instance, Ortho Tri-Cyclen Lo also goes by the key words norgestimate, ethinyl estradiol.  Whew, that’s a mouthful!  I found that out by googling my question 🙂

[list_item]expect your healthcare coverage hunt to take some time.[/list_item]
You will have questions.  You will need to ask people these questions.  You will need to confirm that physicians you need to be covered by a plan, are covered by that plan (or are not).  You can either do this all in one go or, like me, you can expect to spend an hour or two over several days figuring everything out.  I find the spreading it out method to work best (at least for me) because then I’m not making a decision based on how tired I am of dealing with all of the fine print and confusion involved.  Have a nice cup of coffee or tea by your side and try not to feel rushed.

[list_item]write down questions as they come to you.[/list_item]
Have that note pad ready!  Nothing worse than having a question, forgetting it, and then realizing what it was when you’ve already signed up for a plan.

[list_item]all of this business is very complicated.[/list_item]
OMG…so complicated!

[list_item]know that this will be over soon and your work will be worth it![/list_item]
Sure, this process is stressful and confusing….but having adequate health insurance and knowing that your needed physicians take your health insurance will give you a TON of peace of mind for the rest of the year.

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Anyone out there still trying to figure out which healthcare coverage to get?  Let us know what things you’ve learned along the way!

 

Fine Print:  This post and all previous posts regarding healthcare coverage are meant to help simplify a very complicated process.  The authors of this blog are NOT medical professionals or insurance professionals.  All information and opinion given here is anecdotal.  Please do not replace expert advice from someone at your physician’s office as to what health care plan is good for you with the information found here.  Please do not replace actual medical attention with the information found here.

Yep, that’s right!  I’m in need of new health care coverage…I’m not in the middle of treatments, but with a handful of more scans in the next few years this health insurance has got to be good.  Guaranteed to hit an out-of-pocket max?…You bet!

This is an activity that I find very stressful…in fact, I’ve been building myself up for it for about a week now.  But, open enrollment time is HERE!  From now until December 15th, you can apply for health insurance through the health care marketplace for coverage that will start January 1st.  Go to Healthcare.gov to start shopping!

Now, since there are no pre-existing conditions anymore, what is the difference between calling up a health insurance company to apply for health care coverage and shopping through the marketplace?  Well, the COO of Triage Cancer, Monica Bryant, answered that question for me (and many more) at the 2014 Critical Mass Annual Conference in Denver a few weeks ago.  It turns out that, through the marketplace, there are quality controls on all of the health care plans offered…plus, it is easier to shop in the marketplace where all of the available plans are there, side by side, for your comparison.

For a bunch of information from Triage Cancer about health care reform click here and for a great post on open enrollment and health insurance click here.  The Kaiser Family Foundation also has a ton of great information about health care reform and health insurance.

Ready to start learning more now?  In one of the great posts about health insurance on Triage Cancer’s blog, they define all of those pesky terms that make shopping for health insurance so complicated.  We’ve copied them here to help you start tackling that confusing jargon!

Remember, go to Healthcare.gov to start shopping around for the health care coverage that you need.  Open enrollment goes from now until Dec 15th….during this time you don’t need a reason to switch from the health insurance that you have now to a brand new, shiny plan.  If you have questions, there is a lot of good information here (also from Triage Cancer), plus, every state has someone you can call to help you should you encounter any questions or road blocks.

Not sure whether your preferred doctor takes that new health care plan you’re considering?  Call them to ask!

Fan of the affordable care act or not, without some of the reforms that have been made (like there no longer being pre-existing conditions or coverage limits) many of us who have dealt with cancer would not have health insurance at all…

Are you shopping for healthcare coverage now too?  We’d love to hear all about it!

 

Fine Print:  This post and all subsequent posts regarding healthcare coverage are meant to help simplify a very complicated process.  The authors of this blog are NOT medical professionals or insurance professionals.  All information and opinion given here is anecdotal.  Please do not replace expert advice from someone at your physician’s office as to what health care plan is good for you with the information found here.  Please do not replace actual medical attention with the information found here.