Question about Insurance

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Veteran Member

Date Joined Jul 2008
Total Posts : 674
   Posted 1/8/2009 5:00 PM (GMT -6)   
I just recently ran out of insurance that I was getting through the state, they gave it to me for 6 months because I was unable to work because I was in the hospital.  Now since Im able to work again I do not qualify to be covered by them because I make more than 150 dollars a  Anyways, in February I get group insurance through my job however, its a 250,000 lifetime limit.  For most people thats fine, but us Crohnies know 250k is not that much.  My last hosptial bill was 90k.  So basically if I end up in the hospital 2 more times, plus other things that may come up...Im cut off. And I plan to go to the hospital in February for this flare, I'm just trying to hold off until Im covered. Im only 22 years old, and honestly I dont follow or understand insurance and all that comes along with it, my mother has taken care of everything for me thus far.  Im not trying to get ahead of myself, but what does one do when they reach the limit?  There is no possible way I would be able to pay hundreds of dollars a month to get insurance on my own, and I dont want to live my life questioning if I think Im bad enough to go to the hospital in fear that I might get worse later on and not have the funds from my insurance to cover me then.  I just really dont know what to do or think at this point.
Dianogsed with Crohns: At 16 years old. 22 years old now.
Surgeries:2 Bowel Resections, Gallbladder Removed.
Current Meds: Humira (bi-weekly)

Veteran Member

Date Joined Jul 2005
Total Posts : 733
   Posted 1/8/2009 5:28 PM (GMT -6)   
I hear ya... I'm a relative "young'in" too, and it sucks to have to worry about this stuff all the time at such a young age. I'm hoping an insurance expert will be along shortly, but in the mean time...

I would guess that when you reach that $250k lifetime limit at your new job, you would then be re-qualified for some type of state or federal medical assistance. I remember quite a few gov't applications that asked if I had insurance through an employer and how much they covered... maybe there's some wiggle room when the employer funds run out.

Also, especially with the expensive biologics and such, make sure that you work with your Humira provider to get the lowest possible cost... and apply for as much free/reduced medicine as possible. Minding your regular, recurring expenses might make that $250k go a little further.

And last, but not least - you're 22. I think the average person changes CAREERS 3 times in their life, not to mention how many individual JOBS some of us try. I do truly hope that you've landed a job that you love and plan to retire from, but... chances are you'll move on down the road at some point. And with any luck, the next employer will have new insurance with a new limit.

Don't get yourself too stressed about it. I was diagnosed in my early twenties and racked up absurd hospital bills and collections because my employer didn't even offer insurance. Even with all that nonsense, I've come out the other side just fine. I've had particularly good luck with hospitals themselves "forgiving" large portions of my debt once my financial situation is explained, etc. Bottom line is - no matter how discouraged we may get - there ARE reasonable and compassionate people in the health care industry, and many will work with you to keep things under control. Just stay on top of your bills and insurance (which it sounds like you are!), and you'll be fine.
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
(miscarried at 13 weeks, now waiting to heal before trying again)
Stopped Humira August 22nd, 2008.
Went Gluten-Free, noticing some definite improvement.
Started LDN October 27th, and already LOVING IT.

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

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