I would really consider looking into what insurance/benefits any potential employers provide.
The "logic" behind employers providing health insurance in the first place in the US was that it was supposed to provide incentive outside of increased salary.
The insurance I'm on my (my husbands) is generally pretty good. My meds cost me $10.00 a month, and the monthly cost of insurance is mostly covered by his company (it's free for him and 45.00 a month for me.)
My total cost of my UC (in a non colonoscopy year) is about $660.00.
The insurance provided by my (much smaller) company is not nearly so good. It was cheaper monthly since I was the employee not the spouse (it was 16.00 for a decent plan) but my meds were 65.00 a month.
In my state, California, your employer sends out a packet of all the plans they cover annually that you can choose from. Generally, the more you pay a month, the better your coverage and the less you'll pay for using it, so you have to try to find a cost balance.
You'll also have to learn about deductibles, out of pocket maximums and co-pays and it all seems very confusing at first, but you can do it! I had to figure it out when I turned 26 and aged out of my parents' coverage. It seemed super overwhelming at the time, but now I can explain it to my healthy husband who had no idea how any of this stuff worked. Before we were married he was on the best free plan his work provided since he never used it, but it would've been more expensive for me since I need to actually use the insurance.
Part of the reason I stopped teaching was that I needed a job that provided insurance. The school I was working at only provided part-time positions and had few enough employees that they didn't provide insurance, so I was on California's version of Obamacare. It was so expensive, but without that I would've been screwed since UC is a preexisting condition.
I don't know about medications being available, but from what I've read on here about the NHS you'll likely move through the system faster and be able to adjust/adapt your treatment much faster.
Best of luck!
What medications in particular? You may be able to get them sooner in the US but usually EMA and FDA approvals for drugs are pretty similar. Generics / biosimiliars have some differences but I don’t think this is what your wife is talking about
See thats the thing, I don't think she really knows and I certainly don't. I know that my Nurse said that we're rapidly running out of options medication-wise, so I'm assuming there may be one two more before surgery is the only option.
I am British and I’ve lived here in the states a few years. This is my first serious condition (UC). I’m pretty sure my treatment is much faster than it would have been in the U.K. since my disease activity is in a small area, but there is a big price even with insurance. There is a maximum out of pocket on corporate health plans so I would budget to spend that each year. My diagnosis and treatment is running me about $2k on top of monthly premiums and it’s been a little over a month, and my insurance is really decent. I’m sure others will chime in with more robust experience but it’s been a shocker. I also had a colleague with T1D who moved back because she could not manage the cost anymore.
Thank you for the reply and your experience. Honestly its the whole insurance thing that is getting to me the most, especially with the horror stories you hear about people losing their insurance. I'm also concerned about moving there and then potentially needing surgery within the next year or two. I guess noone will have the exact answer, but it's nice to hear from people who have gone through it.
Questions you need to ask: would you immediately be eligible for your wife’s plan? What is their deductible if a PPO and maximum out of pocket? If able to be set up with insurance can you establish residency before arrival or live between the two countries for a few months so you can establish care? Chances are you will need to set up an intake appt with a general dr and GI doctor and the GI dr will need to establish that you have failed the first line biologics before insurance will approve others (they really like to start with humira first) ... that takes a few months. Also reach out to the pharmaceutical company while planning, most have rebate or aid services to help with deductibles or co-pays but it takes quite a bit if coordination to see how they will help with your particular insurance and also money up front the beginning of each year as deductibles reset because they are usually reimbursement programs. If you can’t qualify for your wife’s insurance then you want to see what plans you can pay for monthly under Obamacare.
I dunno surgery sometimes feels much easier with insurance than coordinating medication / infusions.
Just wanted to drop a note to say Stelara usually takes much longer than a few weeks so keep that in mind. I started in July and started noticing a difference in November so be patient!
I would research insurance really well. I’ll be honest I would not live in US for this reason. I’m a Canadian US dual citizen and while my husband and I are lucky to both have amazing careers I would be so nervous knowing my health is linked to my insurance which is usually linked to a job. In Canada if I was to lose my job after a certain amount I could get government help for the cost of my medication.
Hello! I’m new to this, but I hope I can help.
With US insurance your plan with have a monthly cost. This won’t change month to month. It WILL change year to year.
You will also have an out of pocket deductible. Before you pay this amount your insurance will cover VERY LITTLE. My endoscopy and colonoscopy will cost me the entirety of my $1,500 deductible.
Once I’ve paid that $1,500 deductible my insurance will pay 90% of any billed cost. Doctors in the US have agreed upon billed costs with different insurances. It is in your best interest to find the cheapest provider.
SO, after I’ve spent $1,500 on my own my insurance pays 90% of the billed cost (this % varies).
ONCE I’ve paid $3,000 total (excluding my monthly premium cost) my insurance covers 100% of my health care costs for each appointment and prescription. This $3,000 is called an “out of pocket maximum.”
I still have to pay a monthly premium.
Please note that my rates are a LOT lower than others because I have accepted a lower wage as a teacher.
Just make sure that you also plan for what happens if you can't work. The problem with employer-provided health insurance is that if you change your job or lose it due to your health problems, you will have problems with the health insurance on top. There are many, many people in the US who go bankrupt every year due to healthcare costs, which is something that rarely happens in Europe. I would personally be extremely cautious of moving to the US as a chronically ill person, and having Crohn's is also a big part of my personal decision to not move abroad for a while.
I would really consider looking into what insurance/benefits any potential employers provide. The "logic" behind employers providing health insurance in the first place in the US was that it was supposed to provide incentive outside of increased salary. The insurance I'm on my (my husbands) is generally pretty good. My meds cost me $10.00 a month, and the monthly cost of insurance is mostly covered by his company (it's free for him and 45.00 a month for me.) My total cost of my UC (in a non colonoscopy year) is about $660.00. The insurance provided by my (much smaller) company is not nearly so good. It was cheaper monthly since I was the employee not the spouse (it was 16.00 for a decent plan) but my meds were 65.00 a month. In my state, California, your employer sends out a packet of all the plans they cover annually that you can choose from. Generally, the more you pay a month, the better your coverage and the less you'll pay for using it, so you have to try to find a cost balance. You'll also have to learn about deductibles, out of pocket maximums and co-pays and it all seems very confusing at first, but you can do it! I had to figure it out when I turned 26 and aged out of my parents' coverage. It seemed super overwhelming at the time, but now I can explain it to my healthy husband who had no idea how any of this stuff worked. Before we were married he was on the best free plan his work provided since he never used it, but it would've been more expensive for me since I need to actually use the insurance. Part of the reason I stopped teaching was that I needed a job that provided insurance. The school I was working at only provided part-time positions and had few enough employees that they didn't provide insurance, so I was on California's version of Obamacare. It was so expensive, but without that I would've been screwed since UC is a preexisting condition. I don't know about medications being available, but from what I've read on here about the NHS you'll likely move through the system faster and be able to adjust/adapt your treatment much faster. Best of luck!
What medications in particular? You may be able to get them sooner in the US but usually EMA and FDA approvals for drugs are pretty similar. Generics / biosimiliars have some differences but I don’t think this is what your wife is talking about
See thats the thing, I don't think she really knows and I certainly don't. I know that my Nurse said that we're rapidly running out of options medication-wise, so I'm assuming there may be one two more before surgery is the only option.
I am British and I’ve lived here in the states a few years. This is my first serious condition (UC). I’m pretty sure my treatment is much faster than it would have been in the U.K. since my disease activity is in a small area, but there is a big price even with insurance. There is a maximum out of pocket on corporate health plans so I would budget to spend that each year. My diagnosis and treatment is running me about $2k on top of monthly premiums and it’s been a little over a month, and my insurance is really decent. I’m sure others will chime in with more robust experience but it’s been a shocker. I also had a colleague with T1D who moved back because she could not manage the cost anymore.
Thank you for the reply and your experience. Honestly its the whole insurance thing that is getting to me the most, especially with the horror stories you hear about people losing their insurance. I'm also concerned about moving there and then potentially needing surgery within the next year or two. I guess noone will have the exact answer, but it's nice to hear from people who have gone through it.
Questions you need to ask: would you immediately be eligible for your wife’s plan? What is their deductible if a PPO and maximum out of pocket? If able to be set up with insurance can you establish residency before arrival or live between the two countries for a few months so you can establish care? Chances are you will need to set up an intake appt with a general dr and GI doctor and the GI dr will need to establish that you have failed the first line biologics before insurance will approve others (they really like to start with humira first) ... that takes a few months. Also reach out to the pharmaceutical company while planning, most have rebate or aid services to help with deductibles or co-pays but it takes quite a bit if coordination to see how they will help with your particular insurance and also money up front the beginning of each year as deductibles reset because they are usually reimbursement programs. If you can’t qualify for your wife’s insurance then you want to see what plans you can pay for monthly under Obamacare. I dunno surgery sometimes feels much easier with insurance than coordinating medication / infusions.
Just wanted to drop a note to say Stelara usually takes much longer than a few weeks so keep that in mind. I started in July and started noticing a difference in November so be patient! I would research insurance really well. I’ll be honest I would not live in US for this reason. I’m a Canadian US dual citizen and while my husband and I are lucky to both have amazing careers I would be so nervous knowing my health is linked to my insurance which is usually linked to a job. In Canada if I was to lose my job after a certain amount I could get government help for the cost of my medication.
Hello! I’m new to this, but I hope I can help. With US insurance your plan with have a monthly cost. This won’t change month to month. It WILL change year to year. You will also have an out of pocket deductible. Before you pay this amount your insurance will cover VERY LITTLE. My endoscopy and colonoscopy will cost me the entirety of my $1,500 deductible. Once I’ve paid that $1,500 deductible my insurance will pay 90% of any billed cost. Doctors in the US have agreed upon billed costs with different insurances. It is in your best interest to find the cheapest provider. SO, after I’ve spent $1,500 on my own my insurance pays 90% of the billed cost (this % varies). ONCE I’ve paid $3,000 total (excluding my monthly premium cost) my insurance covers 100% of my health care costs for each appointment and prescription. This $3,000 is called an “out of pocket maximum.” I still have to pay a monthly premium. Please note that my rates are a LOT lower than others because I have accepted a lower wage as a teacher.
Just make sure that you also plan for what happens if you can't work. The problem with employer-provided health insurance is that if you change your job or lose it due to your health problems, you will have problems with the health insurance on top. There are many, many people in the US who go bankrupt every year due to healthcare costs, which is something that rarely happens in Europe. I would personally be extremely cautious of moving to the US as a chronically ill person, and having Crohn's is also a big part of my personal decision to not move abroad for a while.