Question about insurance

motherofyoungtwins

I am not diagnosed but I have a problem. Will know in about 3 weeks if I have cancer and I have questions about insurance.

My insurance deductible is $3000.

Premium about $600/mo

Doctors fees (visit) not covered.

After deductible it covers 100% except for doctors fees.

Prescription maximum coverage is $2500 a year.

Maximum overall coverage is 5 million.

My question is, with breast cancer how many times in a month do you need to see a doctor and how much does the doctor charge (approximately) per visit?

How much do drugs cost.

To sum it up. Would you keep this insurance if you have cancer?.

My income is low but I do have  equity which I don't want to touch.

My insurance is an old one. They will not add anything to it even if I agree to pay higher premium.

Can I buy a separate prescription insurance if I need one?

Thanks in advance.

MiniMacsMom

I see my Onc about 1once a month.  I am on weekly taxol right now stage 3 and I am tolerating taxol well.  I see my surgeon every 3 months or so for a check up.  I haven't needed to see any other doctors post treatment.  I have rx for anti nausea meds and xanax but I don't know how much that is.  I am not sure how all the pre-existing condition laws work, I would figure out if they would even cover you BC treatment right away to find out if its worth switching . Go to ehealthinsurance.com to price out potential other medical plans   Sorry I couldn't help more. 

cycle-path

It really depends on your cancer and your treatment. I'm one year post DX -- I have two mammos per year and one MRI, though I think I'll skip the next MRI. I see the MO twice a year and take one generic prescription. 

LuvRVing

My cancer treatment to date has amounted to $380,000 in bills to my insurance company.  I'd keep any insurance I have, especially because getting new individual insurance with a cancer diagnosis will be almost impossible.   Insurance companies have pre-negotiated rates with healthcare providers. 

As to all your questions about doctor visit frequencies, prescriptions, etc., as cycle-path says, it depends on your diagnosis and treatment plan. 

motherofyoungtwins

Thanks ladies for your help. My biggest reason to be pro active is my 27 months old twins. We pay about 14k per year in health insurance. With a high deductible like this we hardly ever use the insurance. But when I delivered the twins via C-Section the ins got bill over 20k. Without it, I would have been screwed. I did buy maternity insurance one year before I got pregnant but it was worth every penny.

I cancelled my appoinment with a general surgeon. waiting to visit with a breast surgeon. Sweling is gone but breast still painful.

VJSL8

I think a lot depends of what other options you have and what state you live in. California now has an excange available (because of the Affordable Care Act) but not all states have started this process. I would check to see if because you've already seen a doctor--you now have a "pre-existing condition" and you're stuck with this insurance because a new policy will usually have a 6 month waiting period for pre-existing conditions.  

Cynthia1962

By overall maximum coverage, do you mean yearly?  They no longer can limit the lifetime coverage.  My onc charges $185 a visit.  I think I used to see him before each chemo.  Accept for your policy not paying for office visits, it's not a bad policy.  I have a $3000 out-of-pocket, and only $500 in rx coverage.  Everything was covered in full after my oop was met, if it happened at my onc's office.  So, all infusions, injections, bloodwork, etc.  I couldn't afford the very expensive rx pills for nausea so my chemo nurses gave me samples.  I have not found any available rx coverages for preexisting conditions.  There are some charities that help with copays for some medications and drug manufactures who have programs as well.  I know there are threads about them on here somewhere. 

I hope you don't have to join our group.  Let us know what you find out. 

Cynthia