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Matt74

Colorado Exchange Effects

I am living in Virginia and considering a move to Colorado Springs. I live with my mother, who is moving to Florida next year, at which point I will need somewhere to go. I have a job, but have never been able to support myself, hopefully this will change, and the Springs should be less expensive than the DC area. My question:

Does anyone have any knowledge of the new Health Care Exchange in Colorado, coming in October 2013?

I am worried about several things. I am most concerned about the simple existence of the exchange, because theoretically, with an insurance exchange in state it will be assumed that I have access to insurance, but this is not necessarily the case...

I cannot afford insurance, and even if my situation were to improve dramatically, I do not expect this to change. I had insurance for a time with an employer, but it was an high deductible plan and actually made my health costs go up. Nothing related to epilepsy was covered. I had to pay for all my expenses, meds, high deductible, AND insurance. Some things cost more simply because I had insurance, even if it wasn't covered or was only partially covered. Conversely, I had great insurance while living in Boston (because of mandated coverage), but for it to make any financial sense I had to get one of those evil "cadillac" plans, because it was the only thing that would cover my all my meds, tests, and doctors. My family paid for it, otherwise it would have been out of my price range.

Currently I get my meds for free from the drug companies. Will this be possible when there is an exchange in state, whether or not I actually have drug coverage?

I take Keppra, Tegretol, and Felbatol (transitioning to Felbatol and Keppra). Will I have access to these particular meds with insurance from an exchange? Is it possible for example, that certain medicines like Felbatol will simply not be available in a state with an exchange, since they are too "expensive" or "risky"?

Will I be able to see a good epileptologist of my choice? Many insurance plans make out of network physicians expensive. Even if I were to have insurance, I may have the additional expense of paying entirely out of pocket to see them, or they may charge a different rate because I have insurance, even though my insurance doesn't cover it.

Finally, will I be forced onto a government plan which could prove even more restrictive than cheap insurance?

Currently I have some limitations because I don't have insurance and can't afford certain things, but I can live with that. I pay for my doctors, and am blessed to get my meds for free. I am terrified of what might happen if I lose the options I do have, especially if they start telling me what meds I can and can't take, or what doctors I can or can't see, and then charge me for the privilege.

Comments

Re: Colorado Exchange Effects

Looks like it should be up by October 2013. You can check out this link for more information: http://www.coloradohealthinsuranceexchange.us/

Re: Colorado Exchange Effects

Update: Open Enrollment has started in Colorado. Not all Exchange rates ready. You can request quote at www.majormedicalhealth.com Off-Exchange plans will no appear on .gov website.

Re: Colorado Exchange Effects

I have read up on how some of the rates have been lowered. Basically they have created HMO plans. In odrder to get lower premiums they made the networsk smaller which means fewer doctors. The deductables are higher and if you have to see an out of network specialist they will be cahrging out of network rates. DOctors have already agreed to get paid at a lower than commercial rate also. SO if you live near a hospital it might now be on the network becasue to network may hand say Presbyterian hospital and the closet hospital may be Baylor. I hate HMO's even commercial ones and in companies that offer insurance to their employees only 15% want HMO plans. I have 3 dofferent doctors and they are with 3 different hospitals and in some HMO plans I would lose 1 or 2 of them. I will not lose my doctors because I have had them for many years.

You said you had insurance thru the company but you dropped it. Well understand I too got my insurance thru my employer and my epilepsy was not covered for a certain period of time. After that time period everything was covered medications tests everything. If the company changed carriers I was covered with the new carrier becasue I had already been covered. 

They are still having issues with the exchanges but you can bring them up with the sites others have listed

Hope this helps