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You can get health insurance if you have Lupus. Under the Affordable Care Act legislation, pre-existing conditions are covered under new Marketplace plans during Open Enrollment.
Our job, as experienced health insurance brokers, is to find the plans that best meet customer needs, and compare the most affordable options. Treatment of Lupus is complex and it's important to minimize your out of pocket expenses.
Broker websites will provide you the lowest available rates and unbiased and accurate information. The .gov website has a history of glitches and security concerns.
That is a great question! One of the great things about the Affordable Care Act (Obamacare) is that insurers can no longer deny you coverage for "pre-existing conditions". All insurers must offer you policies. I suggest that you check out the www.healthcare.gov site when you are ready to shop, and see if you qualify for help in paying for your policy (another benefit of the law is a subsidy that helps pay for the policy if you qualify). Another plus the law gives us? No more lifetime caps on your treatment expenses. Happy shopping! Thanks for asking!
Yes. Pre-existing health conditions such as Lupus can no longer be subject to a pre-existing condition exclusion, waiting period or be the cause for declining to cover a person. Now comes the part where I may part company with some of my peers. Unless you know a lot about health insurance and all the ins and outs of what the Affordable Care Act has caused insurance companies to do in redesigning their products, provider networks and prescription formularies, don't go to Healthcare.gov for anything more than a cursory examination of what your options might be in the government marketplace and whether you will qualify for any subsidies. You can get a reasonable estimate of these factors without having to set up an account on Healthcare.gov through web sites such as HealthSherpa.com.
Persons with chronic diseases, such as Lupus, especially need the services of an experienced health insurance broker who knows the intricacies of the health insurance products sold both inside and outside of the government health insurance marketplace. It is not enough to just see that a particular health insurance carrier is available in the government marketplace and your decision should not be guided solely by the monthly premium.
The person with a chronic health condition generally has existing relationships with primary and specialty care providers and may have already gone through a lengthy process of finding the correct medication(s) and services for the treatment of their condition. They may even want or require access to medical facilities and providers outside of their immediate area. YOU CANNOT TAKE FOR GRANTED THAT ALL INSURANCE CARRIERS AND THEIR PRODUCTS, ESPECIALLY THOSE SOLD WITHIN THE GOVERNMENT MARKETPLACE, WILL HAVE YOUR PHYSICIANS OR FACILITIES AS IN-NETWORK PROVIDERS OR THAT YOUR MEDICATIONS WILL BE COVERED UNDER THEIR FORMULARY. Also, access to major centers of excellence like M.D. Anderson, the Mayo Clinic, Memorial Sloan-Kettering and others certainly cannot be assumed. This is a major issue especially among health plans sold in the government marketplaces where positioning your product based upon price point is key to marketing success. One of the ways that some carriers have achieved this price point positioning is through the use of so called "skinny" networks. Which, as their name implies, offer a reduced selection of providers and often a much more stringent and restrictive list of approved medications.
Before you enroll in any health insurance plan you need to confirm with both the insurance carrier and the heath care provider(s) that all or at least as many as possible of the pieces of your care system are going to be available to you. You also need to confirm in what manner they will be available to you. Can you continue to go directly to the specialists you have been using or must you have a referral from your primary care physician before you can access that specialist now? Will your current medication arrangement be honored or will you have to reinvent the wheel by going through a step therapy process of using other medications and having unsatisfactory results before your current medication is approved by the new carrier? What if you have been going to a center of excellence facility out of town once a year for follow-up exams and treatment, will the new carrier allow this? These are just some of the crucial questions any person suffering from a chronic disease needs to ask and get answered before they choose a health plan in the era of the Affordable Care Act.
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Our job, as experienced health insurance brokers, is to find the plans that best meet customer needs, and compare the most affordable options. Treatment of Lupus is complex and it's important to minimize your out of pocket expenses.
Broker websites will provide you the lowest available rates and unbiased and accurate information. The .gov website has a history of glitches and security concerns.
Persons with chronic diseases, such as Lupus, especially need the services of an experienced health insurance broker who knows the intricacies of the health insurance products sold both inside and outside of the government health insurance marketplace. It is not enough to just see that a particular health insurance carrier is available in the government marketplace and your decision should not be guided solely by the monthly premium.
The person with a chronic health condition generally has existing relationships with primary and specialty care providers and may have already gone through a lengthy process of finding the correct medication(s) and services for the treatment of their condition. They may even want or require access to medical facilities and providers outside of their immediate area. YOU CANNOT TAKE FOR GRANTED THAT ALL INSURANCE CARRIERS AND THEIR PRODUCTS, ESPECIALLY THOSE SOLD WITHIN THE GOVERNMENT MARKETPLACE, WILL HAVE YOUR PHYSICIANS OR FACILITIES AS IN-NETWORK PROVIDERS OR THAT YOUR MEDICATIONS WILL BE COVERED UNDER THEIR FORMULARY. Also, access to major centers of excellence like M.D. Anderson, the Mayo Clinic, Memorial Sloan-Kettering and others certainly cannot be assumed. This is a major issue especially among health plans sold in the government marketplaces where positioning your product based upon price point is key to marketing success. One of the ways that some carriers have achieved this price point positioning is through the use of so called "skinny" networks. Which, as their name implies, offer a reduced selection of providers and often a much more stringent and restrictive list of approved medications.
Before you enroll in any health insurance plan you need to confirm with both the insurance carrier and the heath care provider(s) that all or at least as many as possible of the pieces of your care system are going to be available to you. You also need to confirm in what manner they will be available to you. Can you continue to go directly to the specialists you have been using or must you have a referral from your primary care physician before you can access that specialist now? Will your current medication arrangement be honored or will you have to reinvent the wheel by going through a step therapy process of using other medications and having unsatisfactory results before your current medication is approved by the new carrier? What if you have been going to a center of excellence facility out of town once a year for follow-up exams and treatment, will the new carrier allow this? These are just some of the crucial questions any person suffering from a chronic disease needs to ask and get answered before they choose a health plan in the era of the Affordable Care Act.