Health Insurance for 2015

[its2much]

Has anyone heard anything regarding health insurance coverage for 2015? Wondering what the maximums will be for deductibles, out-of-pocket expenses, etc. Will there be limits on how much premiums will increase?
It's my understanding that the insurance companies will post this information November 1st but was hoping to get information prior to that.

[OrangeMetal]

Well was wondering the same thing. There are websites out there that have the same info as the ACA/Obamacare plans and I've sifted through them and none of them cover MS Drugs.

It's also been confirmed on this site by other people that no one is aware of any ACA / Obamacare plans that cover MS Drugs. Someone here - onlyairfare - had a good response to my query about this a few weeks ago. Not many replied.

Since Michelle Obama's dad has MS I thought maybe she would take this up as advocacy. With all the hoopla about Obama saying pre-exist is covered now, I wonder if he realizes that if his wife's dad had to use ACA none of the insurance plans cover MS Drugs.

Does anyone know anything else about this and what are we supposed to do if we don't have health insurance? Say if we work at several PT jobs that don't offer health insurance and make just over the amount for subsidies (like me- I qualify for zero subsidies) but do NOT at all make enough even for Obamacare plans. What's the point of getting the insurance if it doesn't cover the meds?

Anyone have thoughts on this? Should we all write letters to Obama? Do the rest of folks here all have employer or spouse sponsored insurance or are low enough in income on Medicaid and Medicare? I don't see a lot of chat on this.

[football-mom]

I would start a letter writing campaign directly to the First Lady, not go around her to Obama. I have employer sponsored healthcare, but I'd be happy to join in because it will affect me directly at some point.

[knuckle]

My wife (56) and daughter (19) receive health insurance through BCBS Independence (Philadelphia region) under the Affordable Care Act. I'm on Medicare through SSDI.

Through Healhcare.gov we purchased a BCBS Silver HMO Proactive and receive a federal subsidy. The plan has a $0 deductible for doctors/tests/prescriptions and so far every local doctor, the local hospital, testing facilities, accept the plan no problem.

I checked the covered drug list and all the MS drugs seem to be covered, even Tecfidera.

So I think MS drug coverage may depend on the insurance carrier in your part of the country.

Quite frankly, I found the whole process of applying for coverage through Healthcare.gov and working with BCBS a breeze, coverage excellent and the cost fantastic.

My wife has a pre-existing condition of Crohn's Disease, and though very mild, she couldn't buy health insurance on the open market at any price.

[OrangeMetal]

Knuckle,
I'm very grateful to see you posted this. I had no idea. I have been searching the formularies of the NY State site and hadn't found anything. I am not sure if what you are saying is because I wasn't searching right or if ONLY the national health.gov has better formularies.

Can one sign up on health.gov if one lives in a state that already has an exchange?

And your plan has no limits on the amount of your MS Drug? How is your co-pay/deductible? I guess I will try looking into this again come Nov and try a health navigator help person.

I will be very p**sed if this is a quirk of NY state. It doesn't make sense if it would be true that MS Drugs would not be covered in NY state. So it is heartening to hear you found something.

Is your drug copay high and does your drug company allow you to participate in a type of copay program where they pay some of your deductible?

Previously I think we all thought on this board MS drugs were not covered by ACA plans. IN the last year myself and onlyairfare and Marco had some posts on this.

[knuckle]

OrangeMetal,

Like I said, it seems to all depend on the health insurance plans offered in your state so my advice is to check-out what providers are offering through your state exchange.

Healthcare.gov just links you to the plans offered by state. In our case, BCBS and Aetna offered about 20 different plans and we selected the Silver HMO after reviewing the coverage on the BCBS Independence website.

I'm not on the plan and I don't take the MS drugs anymore. I take LDN and 4ap and Baclofen, all of which I pay cash. I also follow a supplements/diet regimen which I believe has a positive effect on the disease.

I think it's unfortunate that politics have made implementation of the ACA so difficult because for people with pre-existing conditions it has been life-changing and I credit President Obama for that. My wife would be uninsured without the ACA.