Any PPO I’ve been offered by a broker specifically excludes injectables, maternity, and mental health. I need an injectable medication, I have the ability to become pregnant, and both my spouse and I would like mental health benefits. I’ve even been offered a plan that only had set “paybacks” from prescriptions – so I’d get $10 for each 30 day of generics, but if it was more than $10 I’d have to pay the remainder regardless. Another entirely excluded prescriptions.
Anything on my state public marketplace (TX) is EPO or HMO, which doesn’t work for me since I travel across the country for work. Yes, my primary doctors are around my home, but I’m only there a little over a month out of the year. What if I need a few stitches after a hike, or my PCP wants some blood work after a telehealth? What about picking up a prescription where I am vs having someone near my home get it and mail it (and hoping it arrives soon)? There’s a lot of different definitions of “emergency.”
I’m just trying to manage my expectations.
Edit in response to automod: late 20s couple, 75075 is a nearby zip code, we can fit $600/month into a budget but have worked out up to $1800/month if it’s our only option.
submitted by /u/apatheticgraffiti
[link] [comments]
Any PPO I’ve been offered by a broker specifically excludes injectables, maternity, and mental health. I need an injectable medication, I have the ability to become pregnant, and both my spouse and I would like mental health benefits. I’ve even been offered a plan that only had set “paybacks” from prescriptions – so I’d get $10 for each 30 day of generics, but if it was more than $10 I’d have to pay the remainder regardless. Another entirely excluded prescriptions. Anything on my state public marketplace (TX) is EPO or HMO, which doesn’t work for me since I travel across the country for work. Yes, my primary doctors are around my home, but I’m only there a little over a month out of the year. What if I need a few stitches after a hike, or my PCP wants some blood work after a telehealth? What about picking up a prescription where I am vs having someone near my home get it and mail it (and hoping it arrives soon)? There’s a lot of different definitions of “emergency.” I’m just trying to manage my expectations. Edit in response to automod: late 20s couple, 75075 is a nearby zip code, we can fit $600/month into a budget but have worked out up to $1800/month if it’s our only option.
submitted by /u/apatheticgraffiti [link] [comments]Read Morer/HealthInsurance