Obama care - health market

When I looked for a plan I looked at monthly cost + what my out of pocket maximum would be, lets say my plan cost $200.00 a month and my out of pocket max was 3000.00, I divided the 3000.00 by 12 ($250.00) and figured my monthly cost would be really be $450.00 a month. Then tried to get a network with the most choice of physicians and hospital's. Also looking at deductible's, most deductible plan's I looked at, the deductible's, co-pays, scans and the pharmacy went towards the out of pocket max. Since I seem to reach the out of pocket max, I really had to make sure all costs were going toward's it. I ended up picking a platinum plan, even though it was a higher in cost, I thought in the long run I would save money and I wouldn't have to worry about paying a large deductible before the insurance paid anything. I hope this make's sense.

Open Enrollment is open for a few more days!!!

I was diagnosed mid-November (about 3 weeks ago).

I'm at Kaiser Permanente. I was already paying about $1,000 a month because I got the plan pre-Obama-care and I was in my 50's, buying an individual plan and had Type 2 Diabetes--so it was around $600 a month and gradually over the years went up.

I'm thinking I'm going to do what some of you did and change to a PPO and get something like a Platinum plan.

KP has been OK, but I'm not getting tests like a PET scan. They say their typical pre-chemo tests are:

CT Chest/abd/pel
MUGA scan (heart)
Bone scan

AND-- the MO at KP isn't up on the very latest treatments--or something! Since he wanted to do neoadjuvent TCH, but no Perjeta and kept saying the protocol of TCHP wasn't FDA approved, when the FDA approved P with T and H last year... and TCHP is not uncommon with neoadjuvent chemo for HER2+.

I'm wondering if it is a KP problem (not approved there), or that Perjeta isn't one of their standard drugs, although they DO use it--or at least I've talked to some KP people who have had it... not necessarily TCHP combination though.

It's SO difficult to know if I'll have to be fighting my carrier for everything. Others have said KP will come around, but you have to keep after them.

Since Open Enrollment, I might as well switch.

But heck, Plantinum plans are TWICE as much! I guess not paying all the copays will off-set, though!???

DoggieBytes -- I hope you are able to have continued coverage. It's terrible having to deal with the extra stress of not knowing or finding out you can't be covered. I think it's just inhuman! So many people just don't care unless it directly affects them. It just sad.

Well I did change plans. It's still work trying to make sure insurance will cover each little thing but at least it seems to be covering the main things like my oncologist and the chemo! And I'm lucky to have a choice.