It's that time of year again! Open Enrollment! This is the time when employers let their employees in on benefits changes and when insurance companies let us all know what changes will take effect at the start of the new year.
Mr. Rix received his benefits stuff in the mail last week. Our insurance provider was sold to a much larger, national insurance provider. We've been anxiously waiting to see how things would shake out.
The preliminary stuff looks good. Our portion of the premium is going up less than $20 per month.
No lifetime cap has been implemented, nor are there any new deductibles.
The cap stuff is a big relief. An insurance company won't implement a cap mid-year...they have to wait till the NEXT open enrollment. So, we've got another year good to go. Which, might not seem like a big deal, but it is. When a cap IS implemented (and it will) this one year will be about $250K NOT applied towards it.
We haven't received any information about the formulary and/or drug tiers. That will be the next big one. Since they haven't implemented a cap or deductibles, I'm thinking they'll be bumping up co-pays. As such, Mr. Rix upped his contributions to his MSA (Medical Savings Account) to the maximum. We'll either end up spending it on co-pays or braces for #2.
We haven't found out if we will be able to purchase factor somewhere other than our Hemophilia Treatment Center yet, though. And I'm really hoping that we will be able to. The only way they are going to improve some of their practices is if consumers can hit them in the pocket book. If I have the ability to take my 100K+ business elsewhere, perhaps they will be receptive to patient concerns.
And we also don't know if we'll be able to take the boys to a different hematologist. Which, ultimately, is what we'd like to do. For now, our doc is the only game in town.
So, while my hunting friends will soon be enjoying open deer season, we've already bagged a few bucks.
YES WE DID!
AND WE DID THIS TOO!
5 comments:
I don't mean to be nosey (well kind of) but are you guys in Peoria area?? I am a mom of two boys with hemophilia and I love the guy here in town? Just wondering if you had problems? Cause I am all about bad doctor gossip! : )
Nice to see you advocating the superiority of free market competition. I wonder if that would work in areas other than factor purchases? Maybe education...
FYI, every time I leave a comment on your blog I get a "Delivery Status Notification" from your.address@insightbb.com
Sarah, yes, we are in the Peoria area. And, yes, we see the same doc you do. We were part of a far superior HTC for 10 years while we lived in Wisconsin and have been quite surprised by the HTC here. Unless you've been somewhere else, you don't know what you're missing! My kids used to have recovery studies done at clinic every six month. We started prophy at 12 months, and both boys were self-infusing by age 8...none of these things would have happened had we been at the HTC here. Ironically, my oldest's first hemo doc was the original doc at the local HTC...Dr. C. was awesome.
IDKNM, apples and oranges. And I'll check the email addy, I thought I'd fixed it.
I feel the same way about my HTC. Things are changing out there in the 340b arena. And when the community talked with $$Money$$, they will listen or loose.
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