America specific, Filipino wife (via K1) medical insurance question.

[Hank_ 9,173]

4 hours ago, The Conqueror said:

Hi!

 

I have no answer for your regarding PhilHealth but let me share something.

 

My Husband is self-employed all his life and it was to expensive for him to get insurance through O###care.

Anyway his accountant suggested to check CHM "Christian Healthcare Ministries" https://www.chministries.org/ he did thorough research and it's seems legit.

Quote from the website "Christian Healthcare Ministries is not a health insurance company. Rather, we are a group of thousands of Christians across the United States and around the world who share each other’s burdens in the area of health care costs. We also pray for and encourage one another. "

 

I came here from Philippines last 2013, it took a while before we found CHM. So we became a member last 2014. We only pay $150 each per month. the deductable is only $500. 

October 2016 I was diagnosed of Stage 3 Endometrial/Uterine Cancer, as a member of CHM,  we were able to find a doctor ASAP without waiting for an approval from a health insurance.  We chose our own doctor, we connected to Seattle Cancer Care Alliance, and refererred us to University of Washington immediately, as I need an URGENT attention because I had High Grade Cancer.  Having that said they interview my husband regarding his financial situation.  We only paid $500 for initial deposit through credit card when I had my surgery.

 

Overall from the surgery (October 2016), Chemotherapy December-April 2017 and Radiation Treatment (June 2017) my total bill was estimated $150,000++.  It was overwhelming because the medical bills were huge. I started submitting all the bills to CHM, according to them the reimbursement will start in 3 months.  While the medical bills were accumulating from 4 different hospitals.  They Hospitals gave us an option to pay our bills by monthly payments without interest, and paid them through Credit Card. (advantage of paying credit card - we got a lot of points hahaha).  Anyway after 6 months of submitting our bills, we started receiving "Reimbursement Cheques/Checks".  As of this month of October 2018, we received 99% of all the reimbursement.  99% because, 1% is the percentage that I apply for existing bills, like I have 3 months & 6 months follow up.

 

Now, I don't know if it makes sense to you why I share this.  But if it is safe and cheaper option while waiting for her to find a work in the future.

 

We actually shared this to our friends and they were so convinced and became a CHM too. (Of course they were only convinced after I started receiving $$$ reimbursements  )

 

Cheers,

 

 

 

 

I hear CHM advertising on the radio .. states exactly what you said.  

[John & Rose 7,237]

Sometimes I realize how blessed and how lucky I am.  First finding Rose, Aira and AJ from halfway around the earth and second working for a company that offers great healthcare along with other benefits.  As soon as I had my marriage certificate I was able to add Rose, Aira and AJ to my existing policy.  I pay less than $400 a month to cover myself, my two kids, Rose and her kids with a PPO, dental and glasses and my total max out of pocket is $5000.  They just offered an APO and it is cheaper than the traditional PPO with much greater benefits.  I know that they won't be covered until they get here but it is a burden off my mind that they are fully covered once they arrive.

 

I also used my insurance card with their names on it as part of my proof of relationship for the CR-1.  As much as this journey has been stressful, there are points when I still have to count my blessings.

Edited October 19, 2018 by John & Rose

[Balamban 113]

10 hours ago, The Conqueror said:

 

Overall from the surgery (October 2016), Chemotherapy December-April 2017 and Radiation Treatment (June 2017) my total bill was estimated $150,000++.  It was overwhelming because the medical bills were huge. I started submitting all the bills to CHM, according to them the reimbursement will start in 3 months.  While the medical bills were accumulating from 4 different hospitals.  They Hospitals gave us an option to pay our bills by monthly payments without interest, and paid them through Credit Card. (advantage of paying credit card - we got a lot of points hahaha).  Anyway after 6 months of submitting our bills, we started receiving "Reimbursement Cheques/Checks".  As of this month of October 2018, we received 99% of all the reimbursement.  99% because, 1% is the percentage that I apply for existing bills, like I have 3 months & 6 months follow up.

 

 

Thank you.

 

I did a quick look using yelp and other sources and it seems that either people love your suggested place, or hate them.  A few things that I did learn was: If you have a big issue, do NOT reduce from Gold to Silver or Bronze, and do every bit of paperwork in the time required.  What does confuse me is that their model appears to require that you pay up front, in cash, to acquire the often available self-pay rate which some say is as much as 60% off the bill.  In your case did you have to pay the $150,000 before submitting receipts for reimbursement?  A requirement appears that you have to prove Christian church affiliation (which we can do) and it is an interesting concept, they don't allow smokers, but as an RN I've seen companies that give employees that do not smoke a lower insurance rate--but I've never, ever seen any random nicotine testing so I'd imagine that most smokers (Christian's included) will lie about that.

 

It is an interesting option, thank you for taking the time to share it here--I appreciate that and hope that your CA is permanently gone.

[Balamban 113]

18 minutes ago, John & Rose said:

Sometimes I realize how blessed and how lucky I am.  First finding Rose, Aira and AJ from halfway around the earth and second working for a company that offers great healthcare along with other benefits.  As soon as I had my marriage certificate I was able to add Rose, Aira and AJ to my existing policy.  I pay less than $400 a month to cover myself, my two kids, Rose and her kids with a PPO, dental and glasses and my total max out of pocket is $5000.  They just offered an APO and it is cheaper than the traditional PPO with much greater benefits.  I know that they won't be covered until they get here but it is a burden off my mind that they are fully covered once they arrive.

 

 

Thanks John & Rose.  $400/month for a family seems quite reasonable.  Perhaps the real issue with Obamacare (aka ACA) is where one is lucky or unlucky enough to live.   I just read about a couple who lived in a section of AK whose monthly payments jumped to $1500 and that with a large deductible.  We have a triplex that we own and believe it or not I'm toying with the idea of simply renting out our unit and moving to the next, nearby state.  So if we rent out unit out at $1000/month, and then rent a unit in the next state for $1000/month but save $800/month to obtain superior insurance, well, that's a $12,000+/year.  What an odd place America has turned out to be.

 

Perhaps my age comes into play.  Having spent decades with low insurance costs and really not much of any sort of "max out of pocket" that $5k seems horrible to me.  I imagine we get used to things and maybe people just get used to a $5k out of pocket as a matter of routine.

 

I'm an RN and I was shocked that Trump (love him or hate him as you wish) just passed a bill forbidding "gag" contracts on pharmacists.  It seems that the pharmacy companies had "gag" inclusions preventing a pharmacist from telling a person "you can get that med lower than your insurance co-pay by (whatever method exists and I've seen many that do exist).  At least there is some movement in the right direction.

[The Conqueror 47]

14 minutes ago, Balamban said:

Thank you.

 

I did a quick look using yelp and other sources and it seems that either people love your suggested place, or hate them.  A few things that I did learn was: If you have a big issue, do NOT reduce from Gold to Silver or Bronze, and do every bit of paperwork in the time required.  What does confuse me is that their model appears to require that you pay up front, in cash, to acquire the often available self-pay rate which some say is as much as 60% off the bill.  In your case did you have to pay the $150,000 before submitting receipts for reimbursement?  A requirement appears that you have to prove Christian church affiliation (which we can do) and it is an interesting concept, they don't allow smokers, but as an RN I've seen companies that give employees that do not smoke a lower insurance rate--but I've never, ever seen any random nicotine testing so I'd imagine that most smokers (Christian's included) will lie about that.

 

It is an interesting option, thank you for taking the time to share it here--I appreciate that and hope that your CA is permanently gone.

You're Welcome!

 

I'm sure there other options out there.  I'm only paying $150/month($1800/year) for it so it's no brainer :), big issue or not.  

 

I just did initial downpayment for each hospital when I started (maybe $135-500?). Oh yes I forgot to tell, yes I always tell "I don't have an insurance and I'm a self pay".  I pay through my CC and as CHM member they encourage you to ask for discounts and I got different % from 15-30.  If you read the testimonials, you can call them if the Hospital refuses or give you a hard time, they will help you negotiate. My current bills from 1 hospital after the office visit and flushing, I call them and pay upfront and not include in the monthly payment so that I can get discount from it.

Edited October 19, 2018 by The Conqueror

[John & Rose 7,237]

11 minutes ago, Balamban said:

Thanks John & Rose.  $400/month for a family seems quite reasonable.  Perhaps the real issue with Obamacare (aka ACA) is where one is lucky or unlucky enough to live.   I just read about a couple who lived in a section of AK whose monthly payments jumped to $1500 and that with a large deductible.  We have a triplex that we own and believe it or not I'm toying with the idea of simply renting out our unit and moving to the next, nearby state.  So if we rent out unit out at $1000/month, and then rent a unit in the next state for $1000/month but save $800/month to obtain superior insurance, well, that's a $12,000+/year.  What an odd place America has turned out to be.

 

Perhaps my age comes into play.  Having spent decades with low insurance costs and really not much of any sort of "max out of pocket" that $5k seems horrible to me.  I imagine we get used to things and maybe people just get used to a $5k out of pocket as a matter of routine.

 

I'm an RN and I was shocked that Trump (love him or hate him as you wish) just passed a bill forbidding "gag" contracts on pharmacists.  It seems that the pharmacy companies had "gag" inclusions preventing a pharmacist from telling a person "you can get that med lower than your insurance co-pay by (whatever method exists and I've seen many that do exist).  At least there is some movement in the right direction.

Less than $1000 max out of pocket per person sounds better than that it really is.  $5000 is a lot of money but I have a friend who's  insurance company just notified him that they will not cover the meds for his Crohn's disease.  He has to pay $4500 a month just for the required drugs to keep him in check.  He told me last night that his entire savings is now gone so he will have to stop taking those meds.  I know he isn't alone.  

Edited October 19, 2018 by John & Rose

[Balamban 113]

3 hours ago, John & Rose said:

Less than $1000 max out of pocket per person sounds better than that it really is.  $5000 is a lot of money but I have a friend who's  insurance company just notified him that they will not cover the meds for his Crohn's disease.  He has to pay $4500 a month just for the required drugs to keep him in check.  He told me last night that his entire savings is now gone so he will have to stop taking those meds.  I know he isn't alone.  

Check out what I wrote earlier.

 

Methotrexate is a common med for Chrohn's.  Average pharmacy cost is $79/2.5mg pill.  Goodrex has a discount through Costco at $26/pill.  Pharmacychecker has many Canadian pharmacies shipping from overseas usually India the cost  25-98 CENTS/pill.  America's pharmacy industry is simple thievery.  Suggest that his doc consider alternative meds such as cyclosporine or Imuran--you might ride in style in a BMW but you'll still get there in a Ford.

 

[John & Rose 7,237]

Just now, Balamban said:

Check out what I wrote earlier.

 

Methotrexate is a common med for Chrohn's.  Average pharmacy cost is $79/2.5mg pill.  Goodrex has a discount through Costco at $26/pill.  Pharmacychecker has many Canadian pharmacies shipping from overseas usually India the cost  25-98 CENTS/pill.  America's pharmacy industry is simple thievery.  Suggest that his doc consider alternative meds such as cyclosporine or Imuran--you might ride in style in a BMW but you'll still get there in a Ford.

 

I am going to forward that info!  Thank you.