My fiancé requires life saving medication and as a result the drug manufacturers and insurance companies charge us more than the average Americans salary for such medication. We typically can limit this cost to around 12k a year using the maximum out of pocket on insurance plans, however due to recent job changes, we have had to change insurance resulting in our current situation. We initially had signed up for blue shield (since covered ca is need based?) and was informed on the phone that the max out of pocket was for an entire year after signing up, but was later (after plan was finalized) informed it would reset in January. This means for 3 months of coverage we reached our max out of pocket of almost 10k just to have it reset today. After discovering this, my fiancé had to constantly harass HR at her work to send her the open enrollment information that they previously never offered, despite her working 40+ hours a week for almost 3 years and receiving the forms for her taxes last year stating they offered it to her. Now, after the open enrollment period has already ended, we discovered that the plan has a separate out of pocket maximum for prescriptions on her plan which is limitless. Since we’ve never had a plan which excludes prescriptions from out of pocket maximums, we completely missed this when applying.
So to summarize, I changed jobs causing us to need new health insurance. I signed up for blue shield and was told/expected to pay slightly more than 10k in a year and found out to retain coverage, I would have to pay about 20k in 6months (takes about 3 months to hit max due to cost of prescriptions). As a result, my fiancé signed up for coverage through her work, just to find out we made a mistake which leaves us with NO LIMIT to what they can charge us for her medicine.
I am honestly so tired of this mess, we aren’t even 30 years old and have lost 6 figures to this medical system that preys upon people’s desperation. At this point, it seems like our best option is to elope and use that as a qualifying event to try and change the plan we mistakenly chose, but any advice or thoughts on the topic would be so greatly appreciated.
submitted by /u/caredwolf
[link] [comments]My fiancé requires life saving medication and as a result the drug manufacturers and insurance companies charge us more than the average Americans salary for such medication. We typically can limit this cost to around 12k a year using the maximum out of pocket on insurance plans, however due to recent job changes, we have had to change insurance resulting in our current situation. We initially had signed up for blue shield (since covered ca is need based?) and was informed on the phone that the max out of pocket was for an entire year after signing up, but was later (after plan was finalized) informed it would reset in January. This means for 3 months of coverage we reached our max out of pocket of almost 10k just to have it reset today. After discovering this, my fiancé had to constantly harass HR at her work to send her the open enrollment information that they previously never offered, despite her working 40+ hours a week for almost 3 years and receiving the forms for her taxes last year stating they offered it to her. Now, after the open enrollment period has already ended, we discovered that the plan has a separate out of pocket maximum for prescriptions on her plan which is limitless. Since we’ve never had a plan which excludes prescriptions from out of pocket maximums, we completely missed this when applying. So to summarize, I changed jobs causing us to need new health insurance. I signed up for blue shield and was told/expected to pay slightly more than 10k in a year and found out to retain coverage, I would have to pay about 20k in 6months (takes about 3 months to hit max due to cost of prescriptions). As a result, my fiancé signed up for coverage through her work, just to find out we made a mistake which leaves us with NO LIMIT to what they can charge us for her medicine. I am honestly so tired of this mess, we aren’t even 30 years old and have lost 6 figures to this medical system that preys upon people’s desperation. At this point, it seems like our best option is to elope and use that as a qualifying event to try and change the plan we mistakenly chose, but any advice or thoughts on the topic would be so greatly appreciated. submitted by /u/caredwolf [link] [comments]Read Morer/HealthInsurance