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[IP] Health Alliance Ins.
I am wondering if anyone has ins. through Health Alliance - to be specific
this plan is called "Iowa Plus 200 with $7/$12/$25 RX". My husband's company
is merging and this is what they are proposing for health ins. The cost of
$1,152.00 per month for a family plan. Obviously I think the price is
outrageous to start with; but when reviewing the coverage worksheet and list
of formulary prescriptions I note the following and would like to know if
anyone has actually dealt with this company and/or this plan:
1. Contract year maximum they will pay for pres. drugs if $2,000.00. (never
heard of that one on any other plan).
2. The only meters/strips it says it will pay for are the One-touch Ultra.
(My BCBS will pay for any kind I chose and this new plan is not a HMO).
3. The co-insurance you pay on Durable Medical Equipment and and pres. drugs
does NOT apply to the Contract year out of pocket maximum that the subscriber
4. I printed the pres. formulary off the internet and it makes it very clear
that the MDL (maximum daily limit) for strips is 100 per month and ins. is 6
vials for month. Now I have no problem with the ins. limit, but the strip
limit is another thing as I use about 12 per day. On my BCBS all the endo has
to do is write a presc. for the strips and put "dispense 400 per month for
approx. use of 12 per day" and the BCBS pays what its limit is for a 30 day
supply. Is it that easy to get the MDL changed on Health Alliance? My BCBS
formulary did not show any limit at all on strips, however I did have the endo
write the pres. that way just to be safe because prior to this year I just got
strips whenever I needed them and after my deductible I always had a 20%
co-pay no matter how many I used but as of 1-1-03 they will only dispense a 30
day supply at a time so I got the presc. written up just so there weren't any
questions on the amount.
If anyone can help me out who has this same plan it would be appreciated.
Right now we are on individual BCBS we applied for and received prior to my
getting type 1 at age 37 so I was thinking this was the perfect time to switch
to a group but we currently pay 607.00 per month for family coverage so I am
not sure it is worth switching. My allergy shots of $27.00 per month are not
covered under my current plan as it was a pre-existing condition and I had to
sign a waiver to obtain the ins and obviously if we switch to the new group
the allergy shots would start to be covered again, but it looks to me like my
diabetes scripts, etc. would not be paid nearly as well.
Thanks for any help and info.
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