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MGUS progression question
Hi - since the passage of the new health care law our insurance costs have tripled. Now, it appears our insurance may be dropping spouses and dependents. I tried to find health insurance on the exchange webpage, but the costs were high and info inconsistent. We have always had insurance, but now are considering possibly paying the penalty. I have MGUS (profile = IgMGUS, trisomic 7, kappa, and no CRAB) and my first spike 2 years ago was 1.5 and now is .9. Every 8 months I have blood tests. Given my current profile, can multiple myeloma suddenly develop and if it does are there specific times one can buy health insurance? I realize pre-existing conditions can no be denied. Did learn the two annual dr appts I have both accept cash payments, so at least I'll have consistency with my doctors. I have no symptoms from MGUS. Thanks, Diane
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Dianem
Re: MGUS progression question
....are there specific times one can buy health insurance?
You can in fact game the AHCA system and only sign up when you become symptomatic, if you so choose to, provided you are in an open enrollment window. But remember that bone marrow biopsy/FISH tests can be expensive (~$20K), so it may be the need for that particular event that would cause you to think to get on to an insurance plan, not becoming symptomatic. The open enrollment windows vary from state to state (if the state offers its own exchange) and then there is the fed exchange if your state does not have its own exchange. For my state, the enrollment window is up until March 31, 2014 for the first year and then it becomes October 15 through Dec 7th going forward. This is when you either sign up for or switch plans.
If you have a life change event (i.e. lose your job, have a kid, current insurance premium goes through the roof, etc), you can sign up at any time based on that life change event. But becoming ill or requiring treatment is not a life change event. So, if you play this game and you end up needing treatment outside of the enrollment window, you may need to wait until the next enrollment window or figure out how to incur a life change event (quit your job, etc).
And, you would have to pay the financial penalties each year at tax filing time during the years you aren't insured.
I sympathize with your situation and the financial dilemma you face.
You can in fact game the AHCA system and only sign up when you become symptomatic, if you so choose to, provided you are in an open enrollment window. But remember that bone marrow biopsy/FISH tests can be expensive (~$20K), so it may be the need for that particular event that would cause you to think to get on to an insurance plan, not becoming symptomatic. The open enrollment windows vary from state to state (if the state offers its own exchange) and then there is the fed exchange if your state does not have its own exchange. For my state, the enrollment window is up until March 31, 2014 for the first year and then it becomes October 15 through Dec 7th going forward. This is when you either sign up for or switch plans.
If you have a life change event (i.e. lose your job, have a kid, current insurance premium goes through the roof, etc), you can sign up at any time based on that life change event. But becoming ill or requiring treatment is not a life change event. So, if you play this game and you end up needing treatment outside of the enrollment window, you may need to wait until the next enrollment window or figure out how to incur a life change event (quit your job, etc).
And, you would have to pay the financial penalties each year at tax filing time during the years you aren't insured.
I sympathize with your situation and the financial dilemma you face.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: MGUS progression question
Thanks Multibilly - as mentioned we've always had health insurance and never dreamed of being dropped. I feel like the system 'gamed' us. Since I visit my oncologist once year for about 5 minutes, I learn about MGUS, SMM, and multiple myeloma from this webpage. In fact, you have provided some excellent links. Trying to understand my risks and if my MGUS profile is more likely to progress rapidly or slowly if it does because of the insurance issue. When I asked the oncologist she said not to worry about it and focus on the fact the numbers (Ig and spike) are going down. Yes, aware of the $95/year penalty for not having insurance and hope plans offered are realistic and understandable regarding coverage. Thanks, Diane
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dianem
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