Autoimmune Disease Support Group

Our  Mascots are Marlie and Wilson!  

Brought To "Tiers"

As I settle in to the new year I find myself near tears over my health insurance "Tiers"!  When notified at the end of last year, that my beloved medication would be moved to a new "tier", I knew it couldn't be good.  Now, looking into it further, I realize that my medication has gone from a manageable $55 per month, to now $155 per month!  And it doesn't stop there!  For whatever reason, it seems as if I have to pay the $155 for the first 3 months, even if my doctor writes the script for a 90-day supply!  (After the first 3 months I can get it for the $155 for the 90 days).

While we already have to squeeze our budget every January as it is... hubby and I now must find $200 per month extra in our budget to cover our medications! (Because this affects a medication for him as well!)

And as if that weren't enough of an insult, our out of pocket maximums have climbed way way higher than ever before!  Our maximums have gone fro $7,000 in-network and $8,000 out-of-network to a WHOPPING $10,000 in network and $14,000 out-of-network!!!!  

For various reasons, either my husband or I have had one or more surgeries per year for the last few years!  Those catastrophic maximums were extremely helpful in that, no matter how bad the year was, we could count on not exceeding the $7,000 annually (we make every effort to stay in-network).  But even that is a hefty monthly payment of close to $600 per month! Now we are being asked to absorb an additional $3,000 per year on top of the $200 per month for the prescriptions!  That's another $250 per month for a grand total of $450 per month!

The Additional $450 per month does not even take into consideration how much the monthly premiums have gone up...  I dare not look!

So it really does feel as if they are pressuring us to just crumble and drop our so-called "Cadillac policy" and go with some Obama-care plan!  

But here's the rub.  The Obama care policy is way way way too costly, and my Xeljanz is non-formulary! Which means I'd have to pay out of pocket! To change insurance might likely prevent me from the treatment that has helped me get out of bed!  

All I can say is, I am grateful for the plan I have, and that it covers me for now.  

I hope all of you are fairing better with these changes!

Love and Light to you all for 2016!

Love Jo and Pat