Psoriasis Trigger: Insurance Enrollment Is Around the Corner.

Open insurance enrollment for many employer-sponsored plans will soon roll out. This time of the year brings me and a lot of our chronically ill peers a lot of stress. Utilizing a biologic treatment for psoriasis, psoriatic arthritis, and Crohn’s disease has proven expensive.

I’m lucky to have a patient assistance plan that helps with the co-pay. However, I am fearful of the $7,000 in-network deductible that my husband’s company has designated for our plan in 2020.

Here’s why.

Insurance & psoriasis

In 2013, I left the confines of a high-deductible, high-premium low-paying health plan. This health plan was known as catastrophic. Its purpose is to protect someone in the event of a health emergency. There’s just one problem. It was an expensive plan to carry and expensive to use.

Catastrophic plans prey on those of us with pre-existing conditions that couldn’t get an affordable health plan. It was even worse for individuals who lived in states that didn’t provide subsidies for the health premiums. My particular plan cost $400 a month (more than my car payment). And its deductible was $16,666. Let that sink in.

Once I qualified for disability, I went on my mother’s employer-provided plan. At the time, the deductible was $3200 and my share of the premium was $80 a month. That’s a huge difference from my previous coverage. While this new plan provided immediate relief, the damage was already done. I was in credit card debt due to paying the high-premiums and co-pays for 2012 through part of 2013.

Navigating insurance plans

In 2018, I moved to my husband’s new plan. It has felt like a maze that we were never going to be able to fully comprehend or navigate solo. If you asked one question to three people, you were going to get three different answers. The $7,000 deductible, from a healthcare company no less, was emotionally let alone financially jarring.

We made it through this year, somehow. As the information for the 2020 plan rolls out, we are holding our collective breaths again hoping that the plan remains unchanged. But we really won’t know until our first prescriptions are rung through in 2020.

I cringe when I think back on a conversation with a former employer’s HR manager in charge of employee benefits. Their corporate plan’s deductible was around $14,000, and she called it a great deal.

Employers make all the difference

Kaiser Health News recently published a piece called, “Employers Are Scaling Back Their Dependence on High-Deductible Health Plans".

It’s true; some employers are in fact offering better healthcare plan options. Offering the plans is half the battle, educating employees and their family members are the other half. It is very important to ask questions. Unfortunately, it is also scary for some employees to speak up with questions to Human Resources. A lot of us like to fly under the radar.

Research insurance options

One piece of advice I like to give people when entertaining offers from a new job - research benefits along with the salary. Sometimes the salary may be on the lower side of what you would prefer. However, the company may offer great low-deductible health plans, education benefits, and incentives like gym and wellness memberships.

This is an incredibly tense time of year for many of us. Considering checking out plans on the exchange? There are trained phone representatives who can help you. Your local library and churches may have volunteers who are trained to help explore options, as well.

Start preparing insurance options now

If you know that you will need co-pay assistance in the coming year and have a Medicare and/or Medicaid plan, you can call your medication helpline. The trained patient care representatives should have a list of organizations that help with co-pay assistance programs.

This is the time of year to start gathering that information because the application entries can fall anytime between now and next January. Organizing your health expenses for the upcoming year is stressful, I know. Creating a plan can also become empowering and help ease some of the stressful feelings associated with the reset.

What are some things you do to help cope with insurance premium and deductible resets in the new year?