Author Topic: Not diagnosed yet, Australia plans? need advice  (Read 274 times)

megs rn

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Not diagnosed yet, Australia plans? need advice
« on: July 15, 2019, 03:40:09 pm »
This is the most important thing: I'm scared if I discover AN with this temporary insurance, I won't be able to get new insurance in the US or treatment in Australia because I have a preexisting condition. Explained in last paragraph

Hello! I am in a weird position with health insurance, I have not yet been diagnosed or done imaging (I hope this doesn't upset anyone, I will add details about my history below in case anyone is interested). I just left a full time job as an inpatient nurse to be a travel nurse. I don't remember details of that insurance but I wasn't very impressed at the time. Now my travel agency does offer insurance but it's not great for what I'm looking for. I'm going to start seeing doctors and insist to have an MRI. The lowest deductible plan is 1000, 20% coinsurance.. So I'd pay 1000, I think the premium is pretty low. I've been looking at private insurances but I don't think I'll save much there

Here's the personal
I'm 26 years old, ever since I was 15-16 I had a constant headache related to my gross hours of cell phone use. I was told by everyone I was imagining it. At 19 I got serious and went to a doctor by myself and said I really want to get it checked out. He laughed at me and said So what, you have an incredibly slow-growing brain tumor?

Fast forward to now, The headaches are worse and radiate. There is tooth pain and my vision has gotten blurry, especially on one side. I'm having a harder time swallowing and I've had vertigo a long time, it's getting more frequent now. And tinnitus in one ear. The tinnitus gets especially bad with 2 activities that I do, I had googled it before but decided it was time to dig deeper. Which is how I found AN. I'm not diagnosing myself but everything connects.

Incredibly scary and sad to me. I was already at a crossroads in my life and with this revelation I feel more forgetting my plans of "building a future" and living out my bucket list before I potentially lose senses/have brain surgery etc. I had thought about doing long term backpacking/travel before this. I am thinking about going to Australia on a work visa and getting healthcare there.

For now, I don't know what to do about the MRI. If I use the company's insurance and meet my copay, I will only have the insurance for a few months (because it's a temp nurse job) Private plans more expensive but at least I can keep it after the 3 months. And I'm scared if I discover AN with this temporary insurance, I won't be able to get new insurance in the US or treatment in Australia because I have a preexisting condition

Would it be smarter to go private? Wait it out? Ditch my travel contract for a job with benefits in my home city? Or go straight to Aus and pay smaller out of pocket costs?

I know this is absurd but I hope anyone who's had some experience with the insurance game can help me

Thanks so much for reading, happy to answer any questions
Megan

chrisabbott

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Re: Not diagnosed yet, Australia plans? need advice
« Reply #1 on: July 16, 2019, 11:29:42 am »
I don't know anything about Australian health plans, but I know this much:  if you don't put your health first, everything else is likely to either not happen, or be much more difficult to enjoy with that cloud hanging over your head (unless it doesn't bother you much of course!)  Keep that 20% copay in mind (is there an annual out of pocket max?) because that is on top of your $1,000 deductible.  What that means is if you have (for example) $5000 of treatment this year, you pay $1,000 plus 20% of the remaining $4,000.  You may already understand this, but it didn't seem like it from your message.

If you have an AN, and if it is causing problems, you might be gambling away the opportunity to have things fixed before they get worse, but you aren't necessarily about to lose all your senses (lots of people here haven't).  I can see why you may want to delay obtaining a diagnosis before settling on what are the best health insurance/care options available to you - if you do have a brain tumor, you may be looking at much more than the cost of an MRI at some point (for me, that would indicate looking at the best long term solution) but this is something you really have to decide.  If you have a good friend to share this with, you might make a list of pros and cons for different options and have someone that knows you help flush out all the possibilities. Putting it all on paper, sleep on it and looking at it again might help you come to a decision that you will be at ease with.
VS = 3.1 x 2.8 x 2.5 cm diagnosed 3/2019
Translab June 13th Dr Bien & Dr Dunn in OKC
No change in facial numbness, dry eye (not worse!)

megs rn

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Re: Not diagnosed yet, Australia plans? need advice
« Reply #2 on: July 16, 2019, 09:56:32 pm »
Keep that 20% copay in mind (is there an annual out of pocket max?) because that is on top of your $1,000 deductible.

So it's not a copay it's coinsurance. I totally appreciate you saying this because yes, I am just learning this stuff. So from what I read I thought coinsurance is what you pay after meeting deductible, so I will pay the 1000 deductible and then 20% of anything after that? Out of pocket max is $5000, so does the deductible/coinsurance/copayments not apply towards that? Yikes. I see no indication in the EOB.

Quote
If you have an AN, and if it is causing problems, you might be gambling away the opportunity to have things fixed before they get worse, but you aren't necessarily about to lose all your senses (lots of people here haven't).

Good point.. so, are symptoms ever reversed? Are there cases where vertigo/tinnitus could possibly go away?

I honestly am hoping gamma knife is an option. I don't know how I would ever afford it.

I do want to think long term.
Let me clarify, I took a contract travel RN job 3 months. I will be covered during that time, and for 30 days after, if I don't take a new contract by day 30 I lose coverage. I wasn't planning on starting a new one/staying with this company. and If that is the case, I will now have a preexisting condition and have paid off a years deductible for 3 months of coverage, and I'm assuming won't find good coverage having a preexisting condition at that point

Which is why I was thinking, maybe I should get private insurance now. I don't know that I could even afford that. I have about $4000 saved. I can make decent money on these contracts but woof.

I don't want to put off the MRI. Maybe my best bet is to enroll in this benefit and get the MRI done while I have this coverage, if I get bad news and it makes the most sense to keep the coverage, bite the bullet and take another job with them. If I don't need treatments, it won't be an issue. I don't know if FMLA would apply, if COBRA would be an option, if I would be able to work while getting radiation (if that was the treatment chosen). I did make a pros and cons! Agree with that.

I appreciate your thoughts though, truly.
« Last Edit: July 17, 2019, 05:39:43 am by CHD63 »

chrisabbott

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Re: Not diagnosed yet, Australia plans? need advice
« Reply #3 on: July 21, 2019, 08:54:25 pm »
Your coinsurance or copays count toward your annual out of pocket maximum.  Note that only the procedures covered and approved by your insurance count toward the out of pocket (so if you pay for something that they denied or wasn't filed with them, it won't count). 

FMLA generally covers employees if you've worked a minimum number of hours (I think its 1,200) and if the employer has over a certain number of employees.  It is only job status protection for up to 12 weeks of leave and does not provide any pay.  Individual states in the US sometimes have higher requirements, and some employers offer more than FMLA as part of their benefit packages.  I am currently on FMLA which means my employer can't sack me or demote me just because I'm off work for medical reasons.  I also have short term disability paying me my normal salary for up to 11 weeks, then 85% for another 12 weeks (if I need it).  I believe my employer is above average for benefits compared to other US companies. 

With COBRA - you get to continue your health insurance after terminating employment, but you pay the full premium vs getting your employer's contribution toward the cost.  Continuity of coverage and no preexisting condition can be a big factor, but it may be expensive - you might be able to find out how much it would be (my company's HR office provides a statement each year letting us know how much they paid toward these types of benefits).

I'm sure availability varies according to location, but it took me 13 weeks just to get an appointment with a neurologist once my GP and I decided my symptoms indicated a referral was needed - they were booking 17 weeks out and I took a cancellation.  Add another 4 weeks to get some lab work done, and an MRI authorized and scheduled.  If that's the kind of timeline you're looking at, it may factor into your employment decisions. 

Also, if you have an AN, surgery is not necessarily going to have a horrible impact.  I had a large (3.1 cm so too big for radiation treatments) tumor removed translab last month, and presently my main concern is my left eye doesn't make tears - its a bigger pain than I thought it would be, but that started happening before the surgery.  I'm still resting up, but I have not had a worsening of senses or nerve function, I'm just hoping to reverse what happened in the 6 months prior to surgery.  From what I have gathered here and from my neurosurgeons, both radiation and neurosurgery have advanced in recent years - I say this so you won't worry unduly if you are diagnosed with a tumor.  Frankly, I was concerned my symptoms might be Lyme disease or MS.  I'd take an acoustic neuroma or quite a few forms of cancer over MS if I had a choice. 

You would do very well to ask about benefits, options, costs, and so on - call your insurance company and ask them to explain your EOB.  I know quite a lot about these things, and yet likely call and ask for explanations more than most because I'm not shy and feel it is their duty to help me if I don't understand their communications.  I've uncovered quite a few mistakes along the way so don't be afraid to ask - you'll need to know this stuff some day, even if you find out there's no tumor after all.

Good luck!

VS = 3.1 x 2.8 x 2.5 cm diagnosed 3/2019
Translab June 13th Dr Bien & Dr Dunn in OKC
No change in facial numbness, dry eye (not worse!)

 


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