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Health insurance with crohn's disease


Sat, August 25, 2018 6:11 AM

Hi all,
appologies if this is not approriate forum to ask the question. If not please direct me where can i get answers for following questions...
I am currently located in Europe and i won a green card, so I am planning to move to USA with my wife in a year or so.
My biggest concern is health insurance and availability of medications considering that i have crohn's disease. Can someone describe what is the process of getting health insurance and what is difference for people with and without Crohn. What is the price of insurance and is it usually paid by employer? Does it cover all expenses and treatments? Is it same in all states or every state has different rules?

My current therapy is Salofalk and Imuran. I also had surgery few years ago removing part of my large intestine.

Thank you in advance.

FPO afterburner
Joined Aug 25, 2018

Tue, September 04, 2018 1:51 PM

Reply posted for administrator.

Afterburner,
 Health Insurance is an important issues for anyone with a chronic disease.   Below are some answers to key questions:
Many new employees are “probationary”.   Meaning the employee can be temporary for a 90 or more day probationary period.  During this time you may not be eligible for health benefits.  After the 90 days you would be considered a permanent employee and eligible for benefits.   If this is your case, you will need to bring enough medication with you or have it shipped to you.   You can also purchase “gap” insurance until your employer sponsored insurance is available.
 Question/answers  # 1: Many US employers with a certain number of employees provide health insurance coverage for their employees.   The cost of insurance is covered by both the employer and employee.   Information about insurance benefits are usually included in the “job offer letter” or employment contract.
 Question/answer #2  Not all sponsored health plans are the same.   There are various levels of plan, such as bronze, silver, gold and platinum.   The bronze plan might be less expensive and would cover the least health services while platinum would be the best, but also the most expensive plan.
You will need to look at what the employer’s plan might cover.  
 Question/answer #3
The plan you choose will determine how much out of pocket cost you will pay for your care and medication.   Some employer based insurance plans can be a 80/20 split.  Which means your employer pays 80% or all cost and the patient covers the remaining 20%.   For example if you choose the cheapest plan – i.e. bronze, it might not cover the full cost of the medication and you might have to pay more in co-payments.   A platinum plan might pay for more of the medication cost, but the cost of the insurance might cost more.   The cost of medications in the US can be high in comparison to the cost in Europe.
 Before you choose a health insurance plan it will be helpful to check the “medication formulary” – this is the list of covered medication for the plan.   Keep in mind, just because you were approved for one medication in Europe, does not mean the insurance company will approve it in the united states.  The insurance plan might recommend a less expensive medication.   You will also need to bring your medical records with you so you US doctor has your treatment history.
 We have a resources available to help you make a more informed decision:

  1. IBD Insurance Checklist: http://www.ccfa.org/assets/pdfs/ibd-insurance-checklist.pdf
 If you have further questions, please email info@crohnscolitisfoundation.org

FPO administrator
Joined Oct 12, 2017

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