California insurance cost--need advice

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California insurance cost--need advice

Postby kareng7 » Tue Jan 03, 2006 4:33 pm

For anyone who lives in California and can offer advice, please contact me.

We are a small business group of two. Both my husband and I need injectables for different diseases (mine is Avonex for MS; his is Enbrel for Psoriatic Arthritis). The out-of-pocket costs between the insurance plan itself and Blue Shield PPO requiring us to pay 30% of the cost of the drugs is coming to around $1,500 a month. (That's not a typo.)

I'm thinking of switching us to an HMO or Kaiser to try to get the costs under control, but both those options don't exactly have stellar reputations.

Any one have any experience with HMOs and MS? Anyone got a primary care physician for their HMO that they like? Kaiser? Any other plans that could help?

All help greatly appreciated.
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CA Insurance costs

Postby SlowI » Sun Jan 08, 2006 7:04 pm

Karen,
I live in TX, but I work for a small CA company, and end up with a BC/BS small company CA plan. I take Avonex, and under BC/BS, now I pay $402 for 4 syringes. I would love to hear if someone on BC/BS gets this "self injectable " for less out of pocket cost. For me this is a fancy monthly car payment, without the car!

Sounds like you can relate to this in a big way.

I can't help with any other options however. I would love to hear if you find an alternative that gets your cost down. I really wish that BC/BS would just agree that this is like any other prescription, but of course we know it's not. It's just that others on different plans seem to be able to acquire this for just a typical co-pay.

How you and I would appreciate a financial break!!! Good luck.
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