pommyozzy

Hello,

I've recently had a job interview in Silicon Valley, California and have been told I can expect a job offer

One of the major considerations is health care as I have type 1 diabetes. I have to inject insulin (Lantus and Novorapid) and need so see doctors regularly. I think I'm likely to want a pump at some point in the future.

The job does, of course, come with a range of options for health insurance but I don't know the details of costs and coverage.

From my initial looking around online it seems that even with insurance the costs for insulin/test strips/needles/etc are significant and increasing.

Can anyone please offer any ball park numbers for the out of pocket costs for medications and how much a visit to a specialist might cost me? I expect I'd be wanting a more expensive insurance for better coverage...

Am I likely to be covered for my pre-existing condition by insurance from day 1 or will I have a waiting period?

If anyone can share their experience I'd be grateful. Lots of what I have found on-line is a couple of years out of date.

Thanks very much,
pommyozzy

Guindalf

You'll have coverage from day one. That's been standard since Obamacare was introduced and often a factor in company insurance programs before that.

As for costs, it's impossible to answer accurately because every insurance is different. I am type 2 diabetic and with my company plan, my insulin (I have a pump, but more on that later) was $200 a month*, but on my wife's plan, which costs us an extra $47 a month, it costs $5! The company plan was recently updated, but it was still $65 per month. Strips are $40 per month with work and $5 on the wife's plan. Also, the deductible is $2000 from work as opposed to $750.

I have a friend whose insurance plan from work covers ALL diabetic supplies 100%, so he pays absolutely nothing for his pump, supplies, test strips, insulin, etc.

I got my pump while on the company plan, so it ended up costing me abut $2800 all in. It would have been considerably cheaper on the wife's plan, so I carried both for some time (until the new year, when I was on the hook for a new deductible, and then found out I can't opt out until the new business year on July 1st). The work plan is only $15 a month, so it's not too bad.

Doctor's visits are a flat $25, which, I think, is fairly standard. Specialists usually cost from $25-50.

Hope this helps.

petitefrancaise

Unless your wife is working you probably won't be in the same situation as Guindalf - ie you won't have a choice.

Our prescription insurance is separate to medical insurance. So, whilst there is a bit of choice regarding what type of medical insurance plan we have, the only choice for prescription insurance is to take it or not. So, first off, you need to find out whether your new company has separated insurances like this.

Look at the prescriptions you currently have and plug them into this website:
Prescription Prices, Coupons & Pharmacy Information - GoodRx.

Our insurance plan requires that we take the generic unless there is a medical reason why it isn't suitable and the doctor tells them. So, put in the generic as well as the brand name and see what the difference is. GoodRx tells you the price without insurance and so doing this will tell you what the maximum you will pay is.
Next up ask to speak to the benefits person at HR responsible for medical insurances and ask them to give you the prescription plan details, if you can't gain access to the website then ask that person if they can help you out with figuring out the costs to you of your medication. They can usually contact the insurance companies directly.

For your health insurance you will probably have a bit more of a choice. Since you will definitely need doctor's appointments, maybe a few more tests than others I would be more comfortable with opting for the lowest co-pays for dr/hospital visits, the insurance cost of this will be higher but in my mind, when you move here, there is so much uncertainty about what you will actually end up paying out that not worrying about paying for a drs appointment is worth the extra cost of the insurance. In our first 2 years here both my son and I needed out-patient surgeries and physical therapy afterwards and I was really, really glad that we were only paying $20 a visit, that we only had to pay 10% of the hospital bill (about $400 each). Each surgery ended up costing us about $1k out of pocket and even with the higher insurance premiums we were still better off than going with the higher deductible.

chawkins99

Both myself and wife are type 2 diabetic.
I use the pre-filled pens which cost me $50 a month. Retail cost is about $1600.
My wife uses the vials and pays $15 a month. Retail on hers is about $800.
My wife (somehow) got on a program for free test strips which we had for a couple of years but after we moved, they wouldn't continue it. My insurance charges $50 for test strips but Walmart have their own meter for which strips cost $10 per 50 so we use those now.
As has been said, it all comes down to the insurance you're on.

rbackhouse

I did the Walmart meter for a while but moved over to the iHealth BG1 smart phone monitor at $17. 50 strips from Amazon run from $10-$12. All my results are now stored in my phone and are easily accessible and exportable. Plus its another reason to never have to step foot in Walmart

kodokan

Another 'you may not have a choice' datapoint. Our current company insurance was one of three that we could have chosen; two were traditional (expensive premium) co-pay models, where you pay nominal amounts like $20 to go to the doctors, but the monthly premiums run well into the hundreds.

Our chosen one is a high deductible plan, with low monthly premiums ($170) but we pay for everything out of pocket until the deductible is hit; in this case, it's $1,300/ $2,600 for an individual/ family. Then we pay a proportion of costs over that to a maximum annual amount, which I vaguely think is about $4k (we only use doctors for vaccinations and 'oops, one of the kids has broken something').

But hubby's last company only offered one plan, a high deductible one, with premiums of $550 a month and a deductible of $3k/ $6k.

If you eyeballed it at around $1k a month for premiums and access payments, you'd probably be ok budget-wise, and might be pleasantly surprised if the company is generous and picks up a lot of the tab.

debbie1992

I'm Type 1 and currently between insurance plans (hopefully through Obamacare I get coverage March 1st). Currently I buy my insulin, strips and syringes directly from Walmart, no prescription needed and very affordable. $24 for a vial of 70/30 insulin and $12 for 100 syringes.

Hope that helps.

scrubbedexpat099

[QUOTE=kodokan;11857958]Our chosen one is a high deductible plan, with low monthly premiums ($170) but we pay for everything out of pocket until the deductible is hit; in this case, it's $1,300/ $2,600 for an individual/ family.

High deductible is usually defined as much higher than that.

kodokan

[QUOTE=Boiler;11858314] It's legally the lowest it can be, and still be considered a HD plan that's eligible for a HSA. The company is very nice

pommyozzy

Thanks very much for the information I've got a better feel for the likely costs and the questions I need to ask.