Avatar universal

Updated health insurance vs. No health insurance poll

Diagnosis or limbolander?
Do you have health insurance?
What out of pocket expenses do pay per year?
This includes prescription, co-pays, etc.

Outside of US....government funded health care.
What is your out of pocket expense per year for health related costs.

Just interested in hearing from everyone.

9 Responses
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Avatar universal
Diagnosis or limbolander?
Diagnosed in February of 2011

Do you have health insurance?
Yes through my employer

What out of pocket expenses do pay per year?
I pay a $3000 deductible every year and have no coverage until the deductible is met. 100% coverage there-after for most medical needs. We have annual limits on Chiropractors and mental health care and other categories.

The other option through our employer is a plan with a $4500 premium and 80% coverage. Prescription co-pay under that play range from $7-$85 per month.

Helpful - 0
382218 tn?1341181487
"spenedingt" ?  sorry, I don't know where those extra letters came from!  stupid fingers numb all the time.

ps: dx is RRMS, 2007.  Age 39 at time of dx.

Helpful - 0
382218 tn?1341181487
Alberta Health Insurance (publicly funded) covers 100% (no premiums, no co-pay) of ALL my basic health care incl. all physician appts incl. neuro, neuro-ophtha, etc; all diagnositics incl. radiology; ER visits; outpatient services incl. IVSM as needed; OT; physio, etc.

Alberta Blue Cross Group (employer) Plan covers a long list of things I don't take advantage of or don't currently need.  It provides 90% prescription drug coverage; 100% physiotherapy, massage therapy, nutritionist, etc.  The premiums for this plan are 100% covered by my employer.

Alberta Blue Cross NON-Group premiums increased recently and the family rate is now $118/month.  It is annoying to me because the individual rate is only $63/month, and that's all I need (I need to carry it for Copaxone coverage), but because my husband is listed as my dependent on my employer plan, he has to be my dependent on my non-group plan, as both are through Blue Cross and the two plans are linked.   It makes no sense to me but that's the way it is.  

The upside is that because these plans are linked,  with my group plan paying 90% of my Copaxone and the non-group paying the other 10%, I have zero co-pay for it.  actually, zero co-pay for all my meds, which currently run about $2000/month.

I also have a health care spending account through my employer benefits, which is a little complicated to explain but basically can be used for a multitude of health care related out of pocket expenses that aren't otherwise covered,  For example, I incur expenses to travel to Edmonton to see my neuro and ophtha neuro.  I can claim mileage (50 cents/km x 900 km return trip); hotel and meals, parking, etc.  Basically I can recover 50% of the out of pocket costs, which really adds up.  I actually make money on these trips due to claiming the mileage which is a lot more than it takes to fill up my car.

Bottom line, I pay $1400 per year for non-group premiums.  Everything else is covered by insurance and health care spenedingt account.

I'm very satisfied with the quality of my health care and my coverage.  I don't resent paying taxes at all.  I'm definitely getting my money's worth.

Helpful - 0
Avatar universal
I have insurance paid for me through my employer....I am lucky....My prescription copayments a month are $65 out of pocket...This is for 5 prescriptions plus avonex....I'm averaging a doctor's visit a month, so that's another $30 copayment...Mri's out of pocket were about $40 (This is because I've already made my deductible of $750)...Hospital was $500 out of pocket...
Blood work every other month runs me about $10...Again, I am fortunate enough to have an employer that is paying my insurance...I am so grateful!!!

I'm new at this so my bills haven't acquired as some of the others..

.Alex, you are a trooper..


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Avatar universal
I have health insurance I pay for myself.

Diagnosed in 2009 RRMS.  Age 61.   DMD = Rebif 22mcg.

Insurance premiums alone for me & hubby = over $15,000 per year;  plus, we have a "family" $12,000 deductible which covers both of us.  Once that deductible is paid, my $3,000 monthly Rebif bill is paid in full (it's injected, so is covered as part of Major Med, not Rx), as are most of our other doctor, tests, hospital, etc. expenses with no copay, unless I go out of network.

We got this insurance while young & healthy -- BEFORE my MS -- we're both self-employed, so pay all of it ourselves.

Needless to say, we are NOT wealthy people-- nearing retirement age, and the costs are killing us.  Our hopes were high for the new federal Health Insurance act, but now that's starting to look like a target for elimination...

We live in Florida.
Helpful - 0
429700 tn?1308007823

I have insurance, but it extremely expensive.  I pay $600/month for just the premiums (it's going up to $700/month).  I cover my family because I have two girls and my husband is self-employed.  Last year I spent about $4000 which included about three visits a piece for my girls and husband with medicine.  My medicines, MRIs, etc. of course just reach out of pocket, so I am the person responsible for making that number go up so high.  So, in all, I spent $6200 in premiums plus $4000 for a total of $10,200/year.  I'm a teacher in Texas, so this is a good portion of my salary.  

Next year, the premiums will go up and I will have to pay $200 for my Copaxone every 3 months because it is a speciality drug (they used to just charge me like a regular medicine).  So, we're looking at another $800/year plus the increase in premiums which is additionally $1,200 to make an additional $2,000/year.  So, I will be paying about $12,200/year if I get the same level of insurance next year.

Tis expensive!  I did some number crunching, and I think going down to level I will actually save me money.  However, when I first get my Copaxone, I will have to pay $3,200 out of pocket.  Then, according to my calculations and what I've read, I've met the out-of-pocket and deductible and everything will be free after that (for me).  Of course, this doesn't include my girls and my husband.  Anything that comes up for them I will hve to pay out of pocket.  I still figure I will save a little bit--coming in at an estimated $9,800/year.  

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Avatar universal
Helpful - 0
667078 tn?1316000935
I have insurance
I spend at least $15,000 with out MS care
Premium, copays, prescriptions (mostly generic) over $200 a month., no DMD, no Specialists,  no MS treatment,  no tests, no ER,  no Hospital or no Surgery. I have to pay $12,000 out of pocket before the insurance kicks in which I do not have. I basically have given up on my MS treatment I am only going to my PCP for basic needs. She is supposed to charge me 30% of the bill and my copay but she does not.

Those on private insurance subsidize those on on Medicare and Medicaid. As the government cuts provider compensation the providers pass that on to the patients not on government programs. Say an MRI costs $2,000. The government pays the Hospital a $1,000 for someone on Medicare. I get charged $3,500 for the same MRI. I have to pay $1,500 out of pocket and my insurance pays $2,000. I have one more payment on that MRI from last August. The Government is cutting providers more as we speak. That means my insurance goes up and my out of pocket charges go up. I guess it is fair. I just can't afford it anymore so I am only going to my PCP who does not charge me extra.

I went and spoke for Medicaid and Medicare patients with MS today before people think I do not care about you. I am fighting for people's health care while I am losing mine. Kinda funny.

I would drop my insurance but my medication would be thousands a month so the premiums are worth it.


Helpful - 0
199882 tn?1310184542
I have Sterling Option 1 Insurance
Sooner Care
I pay approximately $150.00 per year out of pocket mostly on medications
Helpful - 0
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