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Moving to ACA insurance


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#1 Dom

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Posted 28 November 2015 - 10:32 AM

My COBRA will end in August 2016, but as far as I can tell the open enrollment for ACA is for the entire year.  That is, you can't get ACA insurance in any month or even in the half-year, just at the start of the year.  So ... I will need to end my COBRA and move into ACA insurance but December 15th -- Just two  more weeks!

 

Any advice from someone who has gone through this?  The web-site is a little daunting.  Is it worth getting a broker to navigate it for me?  Are there such people?  Or do I just go it alone?  

 

Does anyone on ACA now know the co-pay for Gleevec?


Diagnosed in February 2014. Started Imatinib 400 in April.
2014:     3.18     0.91
2015:     0.22     0.16     0.04     0.55
2016:     0.71     0.66

(Started Imatinib 600 in April 2016)
2016:     0.42     0.13     0.45
2017:     0.17     0.06     0.10     0.06     0.34


#2 chriskuo

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Posted 28 November 2015 - 01:02 PM

When you lose insurance, you can apply for partial year coverage under ACA.

For help, I would start with a non-profit agency in your area. You can search for them on healthcare.gov. Each state handles this differently -- you may be able to find them directly on your state exchange. This will avoid starting with the biases of a broker, but you can go to them for a 2nd opinion.

The cost of TKIs can vary substantially under various plans. However it is quite likely that a cap on out-of-pocket expenses will come into play in any case. That will be important to check with your counsellors.

Also make sure you get a good understanding from them regarding tax credits you may be eligible for.

#3 Dom

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Posted 28 November 2015 - 06:01 PM

Thanks SO MUCH for that chriskuo. All new information for me. Exactly what this board is for.

Diagnosed in February 2014. Started Imatinib 400 in April.
2014:     3.18     0.91
2015:     0.22     0.16     0.04     0.55
2016:     0.71     0.66

(Started Imatinib 600 in April 2016)
2016:     0.42     0.13     0.45
2017:     0.17     0.06     0.10     0.06     0.34


#4 Melanie

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Posted 29 November 2015 - 12:50 AM

You can apply for insurance under the ACA within 30-60 days after your Cobra runs out. Last year my husband's work insurance ended in October and we were able to sign up under ACA for Nov and Dec of 2014, then re-enrolled for 2015.

The site is fairly easy to navigate once you understand all the insurance language. It's just time consuming running all the different scenarios to find what best works for your individual situation. You may want to check it out before your Cobra runs out. We found it to be less expensive then what my husband's Cobra premiums would have been, even though we didn't qualify for any subsidies.

The counselors are good people to talk to. They'll give you some useful advice and know their way around the site to find whatever you may be looking for. Best to you!
Dx - 05/2011; PCR: 15.04; Fish: 87% Slow responder due to pancytopenia. Current - Bosulif - Nov: 2012, Mar 2016 lowered to 300 mg. 07/16 back to 400 mg. Clinical trial drug, Promacta, Feb 2013, for low Platelets.
CyCR - Aug 2014, Positive for 1 chromosome Sep 2015. PCR: 12.77 in Oct, 2012 to 0.04 (MDA) in Mar, 2016. 4/2016 - 0.126 (Local lab (IS); 05/2016 - 0.195 (local); 6/2016 - 0.07 (MDA); 7/2016 - 0.03 (local) 9/13/2016 - 0.16 (MDA); 9/26/2016 - 0.31 (MDA); 11/2016 - 0.012 (local); 01/2017 - 0.24 (MDA); 04/2017 - 0.09 (MDA); Cytogenetics show der(1:7)(q10;p10)7 chromosome mutation. Repeat of Sep 2015. PCR - 6/2017- 0.035 (local); 10/2017- 0.02 (MDA)




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