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Discussion about insurance, treatment costs, and patient assistance programs

Additional insurance for out-of-state second opinion?

by kuntrylover on Mon Dec 01, 2014 12:00 pm

Good morning,

I am not sure this question will make sense but I'm going to give it a shot:

My current health insurance is that which I have through my job. However, open enrollment was before my diagnosis, so my plan covers only a few states.

Does anyone know if I am allowed to purchase my own insurance that would cover me if I wanted to go for a second opinion in another state (that is not covered under my current health insurance?)

I'm still confused / learning about how to get second opinions, so this question may make no sense, but it is my understanding that whatever my insurance does not cover (i.e. out-of-network hospitals), I will be responsible for the cost? Meaning: out-of-network is out-of-network; my insurance company won't make exceptions just because it is a second opinion (vs. receiving all treatment at the out-of-network hospital).

Had I known I was going to get this diagnosis I would have selected the top plan instead of the second highest coverage plan. D'oh! :cry: Hindsight is 20/20, I suppose!

kuntrylover
Name: Kuntrygal
Who do you know with myeloma?: Me

Re: Additional insurance for out-of-state second opinion?

by Multibilly on Mon Dec 01, 2014 3:57 pm

Kuntrylover,

I might suggest you consider the difference between getting a second opinion and being treated by a doctor outside of your current insurance plan.

If all you want to get is a second opinion by a doctor outside of your current network, it would be easier and less expensive if you just got all your tests through a current in-network doctor and then just pay out of pocket for a non-network doctor's visit for a second opinion regarding those lab results. You would only be looking at $100+ doctor visit versus paying another set of insurance premiums just to cover that one doctor's visit.

Once you have that second opinion, you can then examine your options based on whether or not you would require treatment or not. Note that several folks on this forum also use specialists that are out of state to help direct their drug and treatment choices, but then just use their local doctor to administer those treatments (which would probably be the route I would go if I should ever need treatment).

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: Additional insurance for out-of-state second opinion?

by kuntrylover on Mon Dec 01, 2014 4:10 pm

MultiBilly,

I've only been on this forum for about a week, and you are a Godsend. Seriously. That is EXACTLY what I was confused about (second opinion versus treatment and how to approach it), and you explained it perfectly; even when I didn't ask the right question!

Thank you so much for your reply!

kuntrylover
Name: Kuntrygal
Who do you know with myeloma?: Me

Re: Additional insurance for out-of-state second opinion?

by mikeb on Tue Dec 02, 2014 11:55 am

I wish there was a way to "Like" a reply here. I would like kuntrylover's reply a hundred times!

I have been on the Beacon forum for a couple of years. I'm amazed at the depth of Multibilly's knowledge and the range of topics that he helps clarify. I also appreciate the care and concern that are evident in all of his replies. Multibilly, you are a role model for us!

mikeb
Name: mikeb
Who do you know with myeloma?: self
When were you/they diagnosed?: 2009 (MGUS at that time)
Age at diagnosis: 55


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