Health Insurance

My husband is having a possible job change that would lead to us needing a private policy for our family. Does anyone have any recommendations?

How about insurance companies that cover alternative medicine practices? What's the best health insurance for someone with Lyme?

Under Obamacare that's a tough question to answer. Every state is now different. Private policies are most often from the government or state exchanges even if you work with a broker. Many of the PPO options were eliminated in 2017 and changed to EPO's which means no out of network at all. It's my understanding that on an EPO you can not even get an rx covered from an out of network dr but I don't know that for sure.

If you are going from a large group to a private plan you may see a very large jump in pricing with a decrease in coverage. You should be able to shop options now to see what's available at what prices.

Keep in mind most LLMD's are not covered by insurance companies so that wouldn't make a difference. If you are going to treat with antibiotics you would want a policy with great drug coverage. Most drug coverage now includes tiered pricing. Many Lyme and co drugs are non formulary or there is no generic option so they can be tier three or four or not covered at all. Tier three or four at a set co pay of $50 is much better than a % of the retail price. I hope that helps.

I'm with a group but it's a high deductible, and prescriptions fall into that too, plus the hefty premiums I pay, which is supposedly only half the premium. So I would look for a plan with a moderate deductible and if you can find one that roles the last quarter of the year into the next year, those are the best. Mine does not, so it starts over every Jan 1.

jrpsf I wish my company had that choice. We either get the high deductible plan or HMO. The HMO is pretty worthless. I'm in my 50s though so even with your plan, I'd get hit pretty hard.

I was with Blue Cross & Blue Shield individual plan for a long time. In the second or third year of ObomaCare United Health Care started to offer individual plans also, and one of their silver plans was $79 per month lower than a similar BCBS plan so I jumped. United Health was pretty tough on what meds were covered and how many they would allow per script. They withdrew from individual plans this year and I'm back with BCBS... so much for competition.

From what I see the Bronze, Silver and Gold plans are now a bit more consistent state to state than they were before ObomaCare, but beware the fine print between different insurers in your state. Might be best to contact a local Lyme Support Group and get some recommendations.