I’ve been using my company’s old Kaiser plan via cobra since June 2018. My coverage will expire at the end of the year, though it’s possible I can extend it via Cal-Cobra.
I’ve talked to a Kaiser representative and she recommended either of the Catastrophic/Minimum Coverage plan or the Bronze 60 plan. The plan I’m currently on has no deductible and set prices for everything. Both of these plans have a similar deductible/out of pocket max to each other (~8k) and for both I pay out of pocket until the deductible is reached except for ~3 doctor’s visits a year and any preventative work. The premium for these two plans is around 250, the premium for my current plan $400.
My recurrent medical expenses are fairly low - I’m a mid twenties guy without chronic health conditions, mostly visit the hospital for group therapy and STI tests (both of which are free), and have 3 prescriptions, one of which is Truvada. However, there’s a mild possibility I’ll ram into a tree while skiing and I ride public transit, which increases my COVID exposure.
My questions are as follow: 1. How do I figure out the formulary price for drugs for a plan that I do not currently have? (Most notably Truvada, because that supposedly costs 1.5k) I’ve asked Kaiser’s member services, sales, and pharmacy and they all keep redirecting me toward each other. 2. Which of the deductibleless cobra plan or the deductibled individual plan (where the out of pocket max is the same as the deductible) seems more appropriate for my use case? 3. Is there anything I’m missing or might want to know?
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