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Ulcerative Colitis
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Posted 6/17/2020 11:15 AM (GMT 0)
In my workplace we need to maintain 30hours a week to get health insurance. Due to Covid-19 my work is reducing hours and not crediting us for the 11 weeks of lost work. I am endangered to lose my insurance this year. I probably will not be able to regain the hours lost. I am looking into the Affordable Care Act and was just wondering if anyone is on this, and can let me know how this works with UC and will it cover Humira. Any experience you have with this insurance let me know. Thank you
Posted 6/17/2020 12:09 PM (GMT 0)
I haven't been personally in this situation but if your job hours are cut and they no longer offer you insurance, this is considered a life event allowing you to get a policy off the healthcare exchange. This policy should be partially subsidized by the federal government based off your income so your costs aren't greater than a percentage of your income (I forget the number exactly.)

Or sign up for Medicaid if you are income-eligible in your particular state.

Regardless of where you get your new policy it should cover your preexisting condition and thus cover drugs for your UC. However the question of Humira specifically would depend on the specific policy you get.
Posted 6/17/2020 2:38 PM (GMT 0)
You need to go to the ACA website & plug in your information to see what insurance company's are being offered in your state. Each company will vary depending on the coverage you want to purchase, it's not a one size fits all.

Good luck.
Posted 6/17/2020 3:05 PM (GMT 0)
Thank you everybody for your responses. it is just so overwhelming when you find out you're going to lose your insurance, through no fault of your own. Thanks again
Posted 6/18/2020 5:23 AM (GMT 0)
You should also look up your Congressperson's Website to see whether he/she offers info/advice RE COVID-19 employment/health insurance issues now. Some members of Congress and Senators also keep constituent services staffers available for consultation in their home state offices to help local residents with questions/problems involving federal agencies & regulations. (Such as ACA.) / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 6/18/2020 7:34 PM (GMT 0)
Talk with you GI and see if they accept whatever insurance you’re looking at. I ended up on a healthcare exchange policy due to bad advice and at the time very few specialists would accept it.
Posted 6/26/2020 5:28 AM (GMT 0)
My husband lost his job due to the pandemic, so as a result we lost our health insurance coverage too.
It will not be easy to buy a new health insurance and all my medications with nearly no income!
The government really needs to pay more attention to people with chronic illness.
Posted 6/26/2020 10:32 AM (GMT 0)
As long as you can qualify for the subsidies on the ACA you should be able to get a good policy that covers the drugs you need at an affordable price. If you make too much money to get the subsidies you are pretty much screwed because the policies will be far too expensive. In 2016 I had to use the ACA to get insurance because the company I worked for closed. I low balled my expected income so I could get the subsidies. Fortunately I got a great new job within 3 months. I had to pay back the subsidies at tax time because my income went over, but it just meant that I had a lower refund so I was ok.

The Trump administration filed papers with the Supreme Court yesterday to end the ACA. If he succeeds we are all screwed ... even those of us who have our insurance through our jobs. I well remember a time when there were limits to how much insurance covered, pre-existing conditions exclusions and lifetime limits. If ACA is eliminated all those things will return.

I don't want this to turn political because it's not about politics. It's about our ability to be able to afford all these crazily expensive medications for a disease that has no cure. Would be great if diet and supplements worked for everyone but it doesn't.
Posted 6/27/2020 10:50 PM (GMT 0)
Talk with your Humira Ambassador. They might be able to help or at least point you in the right direction.
Posted 6/27/2020 11:00 PM (GMT 0)
Self employed sustained household, so ACA is the only insurance I have had. Each state, and sometimes areas within a state, have different insurance companies that are on the exchange. My area has alliant and ambetter. There is an option on the ACA website to select a medication and see if the company covers it. I went a step further and opened the link, and looked over the actual giant list of medications covered. Be wary of any that only cover Humira or one other as you may need something different in the future. If you have more than one person on your insurance, you can group you and the other person separately. In my case, we bought my so the cheeper insurance that doesn't cover as much, and me the better one that covered more UC medications. Hope that helps.
Posted 7/1/2020 10:57 AM (GMT 0)
I hope you do not lose your insurance but if you do, ACA is not exactly cheap, and worse very few practitioners accept (at least in my neck of the woods). So while the idea of ACA is great, the application of it is definitely not great. Our employer-provided insurance is craptastic (small mom-and-pop business with only 5 employees to insure), we pay through nose but benefits are almost non-existent. The cost of medications through insurance is ridiculous. So even though we have insurance, we pay out of pocket for most of our medical needs, as in cash.

We tried to switch over to ACA many times but every time, we ended up with a similar scenario. We may pay less for the coverage through subsidy but in terms of benefits and overall costs, there is not a significant change.

Should you end up losing your coverage, I would talk to the doctor's office about paying cash and for meds, go with GoodRx. I have no affiliations with goodrx other than it saved me a ton of money over the years (for my quarterly Sulfasalazine DR, $870 using insurance vs $180 with GoodRx). For Humira, talk to them about the discounted program. Then buy the catastrophic insurance through ACA, for just in case.

I would also talk to the insurance brokers to see what they have to offer.
Posted 7/5/2020 2:59 PM (GMT 0)
I think they are planing to stop covering medications ( or most of them) under primary health insurance, as they did by separating dental and eye care , to make us paying extra to cover speciality drugs in separate plans.
Last year whenever I call my insurance asking about medications and prices, they suggested Goodrx ! I’m paying insurance to use Goodrx!
My problem is with Canasa supp! It’s around $1600(with insurance) for one month supply, I tried the generic for some reason it caused me allergic reaction and the Proctitis is active again ! I have no insurance and stuck with generic Canasa and Proctitis! I don’t have even any enema left, and Canasa program was for insured and saved me i think about $200 for 3 months supply because it was one prescription!
Posted 7/5/2020 3:41 PM (GMT 0)
I received a 3 month supply of Canasa from their free program. A lot of the drug companies have a “free” program for those who don’t qualify for the copay program (like me because I’m on Medicare). You have to find the drug manufacturer and then call to ask them if they have a patient assistance program besides the copay for people who can’t afford their medication costs. You have to fill out an application and the dr will also have to help you. Sometimes it requires being vigilant with the dr — especially his nurse who has to do all the hard work ( I took mine cookies and candy and she really appreciated that! 😏) but it’s worth it in the long run!

I’ve learned it never hurts to ask and be persistent and appreciative.
Posted 7/5/2020 5:14 PM (GMT 0)
I was planning Calling them,
Do you think it’s a good idea to tell my doctor that I lost my health insurance coverage , or Should I wait? There office visit copay with insurance was between $400-500, it was very high deductible plan, I really wonder how much they charge for cash paying patients!
Posted 7/5/2020 5:30 PM (GMT 0)
You should definitely tell your dr. It depends on your dr for their response. When I was at my sickest and found out my GI didn’t take my ACA insurance he ended up writing off my visits and saw me anyway. Not all drs will do that of course but they may have a cheaper alternative for cash payers.
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