Advice on health care providers in WA, please.

[merwin]

My family of 3 (myself, my wife, and my 3 year old) have been using Regence Blue Shield's Breakthru plan for the last several years, as I was self-employed for a couple of years and my current employer doesn't pay health insurance. My wife is unemployed, but we apparently are too rich to qualify for any state plans. Seems odd, since we can't afford to live as it currently stands.

Bitterness aside, Regence decided to up our plan by another 15% this year (last year it went up 20%), and we can't afford it. Having chronic physical as well as mental illnesses, we need a plan that has both prescription and doctor benefits. Our Regence plan has a $500 deductible, which we hit every year. The most likely explanation for the rate increases is that they're trying to get everyone off of the $500 deductible plan, since I can't find that one on their website anymore. Minimum of $1000 now, which we probably wouldn't hit in a year, as both of our health issues have somewhat stabilized. If we change plans to the $1000 deductible, the insurance will pay for jack aside from Dr visits and prescriptions.

Would it be more cost effective for us to just go up to the $3000 deductible plan? As it stands, it's completely overwhelming and I really don't know where to begin on the alternatives.

Things are so tight right now that we've made the decision to only using our current plan for the necessary Dr visits (every month or two), the bare minimum of blood work (usually every couple of months), and prescriptions. We've managed to get most of the 6 of the prescriptions that we collectively take as generics. All of this still amounts to an insane amount of out-of-pocket each month, and we're more likely to get even more sick by not doing all of the recommended tests and visits.

The ridiculous part is that if the state operated on income after medical expenses, instead of gross income, we would qualify hands down.

I am just praying that we fix our health care problems before my son needs them. He's healthy right now, but verbally and emotionally about a year behind. 3 years old, can barely understand what he says most of the time aside from the ones we've translated from Sam-speak (words that sound almost nothing like the intended word but we know what it means). The emotional part... lack of attention (however, when we can occasionally get him to focus, his receptive language capabilities and memory are amazing), constantly swinging emotions, occasional uncontrollable rage, etc could be chalked up to being 3 years old or poor parenting (which is what we usually get told). However, he's right in line with the mental issues of my family currently, which is not a great sign. He was right on the line for speech therapy last year, however in the fall we're getting him re-tested and put in speech and developmental therapy, so I'm not so much worried about medical costs for him since the state will cover the developmental stuff after the diagnosis.

I apologize for the rant, but I'm a bit flustered by everything going on and physically and mentally drained from doing flood relief work in Chehalis the last 3 days (why would ANYONE choose to build on a 25 year flood plain?!?!). The last thing I wanted to come home to was the bill that will officially push us over-the-edge financially.

Any clues on where to start with health plans?

[eridani]

1. I'd say Basic Health, but it just got cut. Other possible options

http://www.healthcareforallwa.org/helpline/
Former Health Care for All-WA chair ran this as her pet project, but she died of cancer and maintenance has fallen behind. There may be useful information around still, however.

http://www.pnhpwesternwashington.org/
Check out PNHP. They may have members in your area who could see you for reduced fees.

http://www.rxassist.org/
Try the above for help with meds.

Also, please tell your story to Cantwell, Murray, and the presidential contact sites. Cantwell is having a meeting on health care in Vancouver 7/1--details on Cantwell thread below. Don't know if you have Norm Dicks or Brian Baird. The former has cosponsored HR 676 and HR 1200, and may have some clues. The latter needs to have is butt kicked hard on this issue.

[Buzz cook]

2. Community Health is ok

They have a fairly low deductible plan. Still your out of pocket will be high.

20 years ago I had Group Health. Good coverage but way expensive now.

[quiller4]

3. We have a Lifewise plan with the $3,000 deductible . So much

is exempt from the deductible and they've been paying 80% of usual and customary charges on all my recent tests. I have no prescription benefit except a discount card. I went to the $3,000 plan from the $1,500 plan and really haven't experienced any change in what they pay for. It doesn't make much sense I know but is the way it has worked out.