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Crohn's/Ulcerative Colitis and Insurance

Crohn's/Ulcerative Colitis and Insurance

Old Apr 1st 2019, 2:18 pm
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Default Crohn's/Ulcerative Colitis and Insurance

Good morning all,

I've been inactive for several years on this forum as my Texan wife and I have made our lives back in blighty thus far. Indeed she has been a UKC for over a year now.

One of the key things that has contributed to that is my illnesses; I suffer from Ankylosing Spondylitis (rheumatoid arthritis) and Ulcerative Colitis (Inflammatory bowel disease - very different to IBS). The NHS has seen me right over the years but, as a 34 year old, I currently take 9 tablets a day and 1 injection of very specialised medicine every two weeks. My injection is Humira which famously is the most expensive medicine on the NHS by far ~£2500 a syringe so approx £5000pm. There is also the very real prospect of major abdominal surgery if things were to deteriorate.

Whilst I am well now and in remission, anybody with autoimmune disease will tell you that there is no cure. I will be like this for life with varying requirements for medication or support.

My question then is simple and certainly targeted at those living with either Crohn's or UC in the US, had I better stay put or could I find a way to make it work in the US without living in poverty? I am an experienced Aerospace Engineer with a decorated resume.

Thanks for your help!
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Old Apr 1st 2019, 3:14 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Damn Dave..that's tough...I feel for you.

Certainly on the West Coast aerospace has shrunk massively but depending on your specialty there could be opportunities in places like Palmdale where Lockheed is still very much active. not really a nice place to live though. Cultural black hole.
If you could get a job you'd be on a group plan but the insurance company would still have to approve specific treatment and may balk or only approve an inferior course.
It's hard to know...
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Old Apr 1st 2019, 3:22 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by Hotscot View Post
Damn Dave..that's tough...I feel for you.

Certainly on the West Coast aerospace has shrunk massively but depending on your specialty there could be opportunities in places like Palmdale where Lockheed is still very much active. not really a nice place to live though. Cultural black hole.
If you could get a job you'd be on a group plan but the insurance company would still have to approve specific treatment and may balk or only approve an inferior course.
It's hard to know...

Cheers for the reply. I am a Systems Safety Engineer working for a large European Aerospace firm. I was originally thinking Hurst TX (Bell) but, as with most things aerospace, they seem to require security clearances and I would not be willing to give up my UKC.

The thought of receiving inferior medicine is worrying. My conditions are very sensitive to certain types of medicine. Longer term, if I were to have surgery, my requirements may be simpler. But I would need stoma bags for life and continued assistance with my AS which they can truly do nothing for.

Cheers for the suggestions!
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Old Apr 1st 2019, 5:43 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

My OH has Crohn's and has, since moving to the US 5 years ago, never been better (Remicaid transfusions every 6 weeks/Azathioprine daily). He's been on the collective health insurance programs and has never had any issues getting the treatment he needs. Of course, we take a massive hit on the co-pays/deductible (the amount you have to contribute to your treatment) but we budget for that. Regarding his health, there was some research about vitamin D and Crohns (and other autoimmune disorders) and we think that living in a sunnier clime has definitely helped with his condition.
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Old Apr 1st 2019, 6:03 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Be aware.... if Trump succeeds in getting rid of the ACA pre-existing conditions will no longer be covered as a mandatory thing. Not good for your conditions.
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Old Apr 1st 2019, 6:11 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by civilservant View Post
Be aware.... if Trump succeeds in getting rid of the ACA pre-existing conditions will no longer be covered as a mandatory thing. Not good for your conditions.
Under those circumstances lifetime claim limits could also return, and even if pre-existing conditions are not covered, given the OP's current age, lifetime limits could be very concerning.

Last edited by Pulaski; Apr 1st 2019 at 6:29 pm.
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Old Apr 1st 2019, 6:25 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

OP and spouse are both UK citizens, so theoretically at least they could return to live in the UK if reasonable access to healthcare evaporates. But, given the current political climate, I would be very wary of returning to the US with the OP's medical history. Employment-based insurance will likely be fine (except, perhaps, for a lifetime cap) but all bets are off outside of that.
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Old Apr 1st 2019, 9:44 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Thanks all. I hadn't thought of lifetime caps and the death of the ACA. If I was covered by an employer's group plan, would pre-existing conditions be problematic? Forgive my ignorance but I thought, perhaps wrongly, that this only applied to the exchanges?
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Old Apr 1st 2019, 9:48 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

The ACA applies to all health insurance, and trust me, the insurance agency will try as hard as possible to cover as little as possible if it isn't legally required.

It has grown into a major part of healthcare law - it evens affects what must be shown on menus.

It could be problematic, especially for expensive maintenance drugs/procedures.
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Old Apr 1st 2019, 9:50 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by Dave2726 View Post
Thanks all. I hadn't thought of lifetime caps and the death of the ACA. If I was covered by an employer's group plan, would pre-existing conditions be problematic? Forgive my ignorance but I thought, perhaps wrongly, that this only applied to the exchanges?
Pre-ACA, pre-existing conditions were typically not an issue for employer group policies as long as you had prior "creditable coverage" (NHS counted). However, lifetime caps were the norm for both group and non-group policies. With the ACA neither pre-existing conditions nor lifetime caps are an issue. Post- ACA, if there is a post-, who knows?
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Old Apr 1st 2019, 9:53 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by civilservant View Post
The ACA applies to all health insurance, …..
Kind of ….. it set minimums, not maximums, (IIRC there are tax penalties for so-called "Cadillac policies", but they seemed to be a rarity anyway, apparently provided by some companies for their directors, and for the super-wealthy)…. then the insurance companies have sometimes tended to reduce and eliminate anything that was above the minimum required coverage per the ACA. But exchange coverage is not precisely the same as employer- linked coverage. And how good employer-linked coverage is largely up to the employer funding it.

Last edited by Pulaski; Apr 1st 2019 at 9:56 pm.
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Old Apr 1st 2019, 9:54 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by sherbert View Post
My OH has Crohn's and has, since moving to the US 5 years ago, never been better (Remicaid transfusions every 6 weeks/Azathioprine daily). He's been on the collective health insurance programs and has never had any issues getting the treatment he needs. Of course, we take a massive hit on the co-pays/deductible (the amount you have to contribute to your treatment) but we budget for that. Regarding his health, there was some research about vitamin D and Crohns (and other autoimmune disorders) and we think that living in a sunnier clime has definitely helped with his condition.

I've been offered Remicade but opted to take Humira first as it was simpler. I take Aza too, 4 TBS daily (forgot to mention it). I also take a 5ASA known as Balsalazide. Humira got me off two years of high dosage Prednisolone which caused all sorts of issues. I've been in remission since December and I am loving it. Currently back in TX to visit family with my OH. Best wishes to your OH and I hope he continues in remission.
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Old Apr 1st 2019, 9:58 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Sounds like it would be better to wait until Trump has done whatever he will. It does seem like the ACA could be a continuing target for GOP policy though. I appreciate all the advice chaps and chapettes.
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Old Apr 1st 2019, 10:04 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Originally Posted by Dave2726 View Post
Sounds like it would be better to wait until Trump has done whatever he will. It does seem like the ACA could be a continuing target for GOP policy though. I appreciate all the advice chaps and chapettes. ...
You realize Donald Trump can't do much other than cheer from the sidelines as all legislation has to be passed by the House and the Senate, then the President gets to approve or veto, and the veto can be over-ridden by the Senate if they have a large enough majority. So, as long as John McCain and his ilk, are around to vote against changing the ACA, Donald Trump can pontificate all he likes but there isn't much he can do about the ACA other than complain about it.
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Old Apr 1st 2019, 10:10 pm
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Default Re: Crohn's/Ulcerative Colitis and Insurance

Tis all new to me and that's part of the fear I have about it all really. Truly, I hope the ACA is never abolished and it would be great to see the US make more moves towards a single payer system though I understand the hesitance.

Now to consider employment options. I have read SD guidelines in the past about security clearances for non-citizens and it usually is rejected until dual citizenship. My experience within Europe is that even largely civilian firms with civilian customers require some sort of clearance. Anybody got any experience otherwise? Cheers!
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