Category Archives: Health Insurance

Having Health insurance or getting it with ulcerative colitis requires several key steps

Insurance Helped Paid for the Emergency Room Visit Because of Ulcerative Colitis

You Want Health Insurance if You Go to the Emergency Room

Back two years ago, when my symptoms were at their worst, I ended up on the floor of our apartment in horrible pain and completely out of energy.  I had just about hit the bottom of my long lasting ulcerative colitis flare.  Thankfully, the floor was covered in carpet, and my wife was awake and she knew what we needed to do.  It was time to get to the emergency room because of the colon inflammation.  The bleeding was something that was not unusual.  When it came down to it, the exhaustion and the anemia is probably what knocked me out.

Emergency Room Costs are High

I knew that the cost of going to the emergency room was usually very high. As far as health care is concerned, the emergency room is often the most expensive thing you can ever do.  Who knows what the exact costs would have been without health insurance, but I think its safe to say that our family would probably have been going hungry for a long time if we needed to pay the medical bills ourselves.

Hoping My Health Insurance is Good

One thing that I remember clearly was signing all types of forms in the bed they had me in.  They wanted me to sign away for all types of waivers and to claim financial responsibility if insurance did not cover certain costs.  When you are sick, you don’t mind signing away your life.  You don’t care what the costs will be when you have no other options.  All along I knew my health insurance was expensive, and I was just hoping that since I had paid my deductible, this emergency room expense would be covered.

Luckily, I did not have to stay in the hospital that long.  I met with several doctors, and physician assistants, and they all thought I just needed to get hydrated and take some iron supplements for the anemia.  Within about five hours I was leaving and headed back to the apartment without spending too much time in the hospital.

The Health Insurance Explanation of Benefits Arrived in the Mail

If you have lived with ulcerative colitis for a long time and you have American Health(Blue Cross, Blue Shield, Aetna, or Medicare), you are probably used to receiving stacks of envelopes with bills and benefits statements.  That is true for me also.  During flare ups when I visit the doctors on a regular basis, my health insurance company sends what are called an EOB (Explanation of Benefits).  They are delivered for every medical visit and service I have received.  One arrived for the emergency room visit, and I was shocked at what it said.  It stated that since I had already met my insurance deductible for the year, there was absolutely no cost to me for all of the expenses at the emergency room.  I looked what the emergency room billed my insurance, and it was over $7,000 and over $5,000 the insurance company ended up paying the hospital. This time, my insurance was great, and because my inexpensive health insurance was something I was worried about initially, I seems like my PPO plan was the right decision.  Everyone always says you only really like health insurance when you need it, and that is correct for me also.

Health Insurance Costs For Ulcerative Colitis

Usual Costs Associated with Ulcerative Colitis

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Everybody’s story is a bit unique, and that all depends on the insurance that is being used, but some of the main costs associated with living a year with ulcerative colitis are very standard.  There are several different procedures that most people go through on a annual basis with regards to treating their colitis, and that is what we will go into some detail on so everyone can understand what the costs might be.

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Office Visits are usually the most common type of expense that people with ulcerative colitis incur each year.  It is not out of the question to have 20-30 office visits if you suffer from severe ulcerative colitis or have several flare ups in a year’s time.  Health insurance will usually cover most of these expenses depending on the exact type of plan you have, but if you need to pay a co-pay, that might run you anywhere from $25-$40 per office visit.  The remainder of the fee is covered by your insurance.

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The Colonoscopy is another very common procedure that ulcerative colitis patients need on a regular basis.  This usually costs a reasonable amount of money.  There are doctor fees, and facility fees and nurse fees that go along with colonoscopies.  The standard cost for one is about $1500, but most of this is also covered by health insurance.  An average patient should expect to pay anywhere from $150-$300 for their portion of the procedure.  If the patient has a very high deductible insurance plan, then that person might need to pay the full amount.

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Prescription medication is one of the most costly parts of living with and treating ulcerative colitis.  Patients who need to constantly be refilling their prescriptions may find that they are paying over $300 per month for UC medications.  Certain name brand drugs such as Asacol and Colazal are very commonly prescribed to colitis patients, but they are also very expensive and often times people simply cannot afford them.  Be sure to contact your insurance company before you make any purchases and find out the exact amounts of the drugs that are covered.  Also, you can often talk to your insurance company to find out if there are alternative medications that might act the exact same but might cost only a fraction of the price.

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Changing Health Insurance With Ulcerative Colitis

There are several things to consider before you ever decide to change your health insurance.

Some of the most important things to look at are as follows:

  1. Make sure you do not lose health coverage for any point in time with colitis
  2. Make sure you are getting the best rates on your health plan
  3. Make sure you fully understand what the benefits are(office visits, co-pays, prescriptions costs etc…)
  4. Find out exactly what the annual out of pocket maximum dollar amounts are

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When anyone is considering changing their health insurance, you should first look at what is available in the marketplace.  If there are similar costs with several different insurance plans, try to uncover what the actual differences are.  Often these differences will be very minor on the grand scale of things, but you should be able to point out to someone else what the differences are.  Some of the common differences among health plans have to do with deductible amounts and covered benefits.  You might for example need to pay for ambulance rides with some health insurance, but the exact same event might be fully covered with others.

Already Met Your Annual Deductible:

If you have already paid the maximum deductible, you should find out if the insurance plan you are looking at also will allow you to move over your deductible amount.  Often, insurance companies will allow individuals to move over their current out of pocket expenses until the end of the year.  This can save you several hundred or even thousands of dollars.

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The Cheapest Insurance With the Best Benefits:

What everyone is always looking for with insurance is a good deal.  That is nothing new, and that is likely never going to change.  What everyone should also be looking for is to buy insurance from a reputable source.  There is nothing worse than purchasing a new insurance policy and then figuring out when you are in a time of need that your are actually not getting what you had expected all along.  Take time in deciding on which insurance is right for you when you are looking to change this up.  Dealing with ulcerative colitis is not a fun event, but if you are covered with proper insurance, it can make your life much easier.

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Getting Health Insurance With Ulcerative Colitis

These are the steps you want to take when finding health insurance if you have ulcerative colitis:

  1. Gather up all of your medical records
  2. Investigate where you would like to receive care and if you did need to use a hospital over the next few years, where that would be
  3. Investigate local doctors that you would like to use
  4. Contact several of the local insurance carriers (Aetna, United Health Care, Anthem, Kaiser)
  5. Receive quotes on several different plans
  6. Ask over the phone if things like colonoscopy, sigmoidoscopy, generic drugs, name brand drugs, office visits are covered or not
  7. Make notes as to what services are covered and what are not
  8. Compare the prices you receive
  9. Call back again to verify that two representatives give you the same answers

If you have a pre-existing condition, then you might find it much harder to obtain insurance.  In that situation, the hope is that you are working for a company which already offers health insurance.  That will make the insurance costs much better and easier to navigate for sure.