12% Back the Individual Mandate in 2014

[AllenChicago]

With he right situation meds can be very very expensive and nescessary. That is a big big hole.

I had a client who was a 34 year old stroke victim. Her meds were $18,000 per quarter. This was back in 2007. Thank goodness she took my advice and bought one of those fancy new $5,000 OOP HSA/HDHP policies. At last check, the total payout was just over $3.2 million.

The number of Seniors who don't buy Part-D prescription coverage is quite alarming.
-ac

 

[Yagents]

I have a client, 35 yr old male, diagnosed with MS. Drug costs 4k per MONTH. Owns GF Monogram plan with Humana with $7500 deductible and a 1k deductible for RX. Max OOP for RX is 3500 or so. Turns out, the drug company wants his business, and wants the insurance company to pay for their expensive drug, so the manufacturer actually pays his deductible and copays for him each month/year because their getting the rest from the insurance company.

 

[HealthGuy]

Deadhead is smoking something..."buy a stand alone Rx plan" must be good bud man.

 

[RayNY]

I like how quickly that got turned from "the government can't get this done on time" to "the government is giving big business a break and punishing individual citizens and small businesses".

I wonder how that will resonate with the low-info crowd. Hopefully that's one of those messages that doesn't make it through both ears and off into the sunset.

 

[taterpeeler]

Or just purchase a stand alone RX plan

any thoughts on where you can get one of those?

 

[Yagents]

It's not insurance, but here is something that might help:
https://www.hpainsurance.com/(S(v5xq01l2jczs4dcp1emr0dnq))/qt/RxPayCard/default.aspx?agent=WSTEFFEN

 

[taterpeeler]

It's not insurance, but here is something that might help:
https://www.hpainsurance.com/(S(v5xq01l2jczs4dcp1emr0dnq))/qt/RxPayCard/default.aspx?agent=WSTEFFEN

care to explain the limits? I could not find them... or is this a discount card....

 

[Yagents]

care to explain the limits? I could not find them... or is this a discount card....

I can't, I need navigator training first.

(info on the bottom right)

 

[somarco]

You can view list of drug tiers and participating pharmacy's here

Back in my younger days I offered this and got more complaints than it was worth. The list of participating pharmacy's was inaccurate and in some cases the copay was higher than what folks had paid before they had the card.

 

[NWBenefitProvider]

Ok, to all of you who are freaked out about the no RX on my plan. Anything administered in an office setting or while confined in a hospital, etc. is covered. Routine prescriptions are not.

Before you go nuts, this is a calculated decision I made based on a lot of factors. IF I need RX and can't afford it, my state has a plan that will provide me guaranteed issue without any pre-existing condition waiting period. Yes, it is expensive, but I could afford it. If for some reason I could not afford it, they have a sliding scale for premium assistance.

Besides, individual plans in my state cap out the maximum rx benefit at $3,000 per year. I'm not paying 100% more premium just in case I need a prescription. That's what is wrong with healthcare. If I'm willing to pay more to have prescription access, it should be good access, not a measly $3,000 per year.

Small/large group on the other hand, don't impose such a limit here. So many variables based on your situation.