US Marketplace Insurance questions
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US Marketplace Insurance questions

› Forums › General Melanoma Community › US Marketplace Insurance questions

  • Post
    • February 23, 2017 at 1:33 am
    Anonymous
    Inactive

    Hello, fellow warriors. I am an American living in Hong Kong. I was diagnosed Stage IV in June, 2016 and have been on Nivo since July, 2016. It looks like we'll be required to move back to the US due to my job loss here. Is there anyone participating in the ACA Individual Marketplace insurance out there that is being treated with immunotherapy? What difficulties in coverage have you experienced? So far it's a bit of a nightmare trying to match network providers with plans on the Marketplace website. Telephone calls with Marketplace representatives have proven fruitless. Any info would be greatly appreciated. Keep fighting!

    Regards,

    Cary

     

     

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  • Replies
      • February 23, 2017 at 1:39 am
      jennunicorn
      Participant

      My least favorite thing to do is deal with the dang marketplace! But, yes, I have individual insurance through Covered California (the CA version of the marketplace). I have Blue Shield Silver plan. Have not had much hassle with them going through multiple treatments and many scans and what not. I also have an awesome oncology team who takes care of any push back the insurance might try to give before I even know anything. So, with a good medical team and a PPO, you shouldn't have much trouble. The worst part is getting through the process of signing up!

        • February 23, 2017 at 1:47 am
        Anonymous
        Inactive

        Thanks for the quick reply, Jenn. If I may ask, has the insurance covered the cost of the meds? I suppose that's one of our big concerns, since the cost of the drug is astronomical. Have you ever had to seek treatment in another state? Thanks again,

        • February 23, 2017 at 3:26 am
        jennunicorn
        Participant

        100% of the drugs have been covered, never paid a penny for drugs. I have never had to go to another state for treatment, I consider myself very lucky to only be an hour away from one of the best places for melanoma treatment.

        • February 23, 2017 at 9:45 pm
        Hriggenbach
        Participant

        I have Cigna and they have this awesome thing where they say what the price should be and it always seems like it's under what the actual cost is and I'm forced to pay the difference that is on top of my $2500 yearly deductible 

      • March 19, 2017 at 8:19 pm
      TexMelanomex
      Participant

      Cary,

      This info might be a little late but worthwhile nonetheless. When I was diagnosed in January I quickly found out that MD Anderson no longer accepted BlueCros BlueShield of Texas HMO. In Texas, unfortunately, you cannot purchase PPO unless you belong to a group, HMOs are all that are available in the marketplace or otherwise. I quickly formed a small group (I'm a small business owner and found that you can reasonably purchase a really good plan) and bought a "Gold" PPO that is accepted almost anywhere (I'm no longer with BCBS). This actually turned out to be cheaper than my "Silver" HMO plan as far as montly premium, lower deducitble, and lower out of pocket expense. If you have an LLC, S-Corp, Partnership, or a business even with only indpendent contractors you might qualify for a much better plan than you can find in the open market. You can explore this with group health insurance brokers in your state and you might be surprised at what you find. I think it stinks that we have to do this in order to get to decent care but without talking politics, it appears to be a direct result of health care legislation…that being said, without the "pre-existing condition clause" I'd be up a creek.

       

      B

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