Schizophrenia.com

Good Insurance for Schizophrenia?


#1

Just wondering what everyone’s experience with insurance has been. My wife and I both have sz but we are trying pretty hard to stay of Medicaid here in the states. I have what they call a Medicare Advantage plan which is ok but sometimes has high copays for mental health ($30 a visit). My copay for a hospitalization is like $600. My premium is about $50/month.

My wife has better coverage… She has supplemental insurance (Medigap F) through AARP but her premium is like $177 dollars a month. It’s been great as far as dr. copays go. She sees a therapist once a week and doesn’t have a copay. She also didn’t have any copays for her back surgery. She also has another prescription plan that we pay $50 a month for. Some of her rx copays are $45. Unfortunately she just hit the donut hole so we are going to apply to the pharmaceutical cos. directly for help with some of her most expensive meds (she has some other health issues).

The thing that sucks is that we don’t qualify for extra help for our rx because our combined income from SSD as a married couple is a couple hundred dollars a year higher than the FPL limit. I am thinking about taking a low paying job as long as I can to see if I could knock my SSD payment down so that my wife’s drugs could be covered or if I could earn enough to make up the difference.

I guess I am just a little frustrated because we typically spend at least $600 a month (about 30% of our income) on medical expenses and we have to rely on a lot of help from our families (they give us some money in exchange for getting groceries or driving them). Our only source of income is SSD. If our expenses go up to $800 or $900 a month it will probably make sense for us to go back on Medicaid since our spenddown will be what we are paying out of pocket for med care.

I was just wondering what insurance has worked out best for everyone and even how people manage their med expenses outside the US or without any insurance. Or if you are working if your employer’s insurance has been good enough. Even though my wife and I both have sz we are pretty much trying to manage our care ourselves and don’t get any help from our families in trying to figure this stuff out.

Getting a divorce and staying secretly married is probably not a good option for us :smile:


#2

In sweden we have a general insurance for all ppl. You pay max 2200 SEK (220€) for your medicin every year. And 1100 SEK (110€) for health care.