How to Navigate Health Insurance Changes with Psoriasis

When I was offered a new job at a nonprofit last May, I felt conflicted about taking it. I was ready for a career change after essentially doing the same kind of work for over two decades at four different places. But switching jobs would alter my life in many ways, including requiring me to select a new health insurance provider.

I liked my doctors and didn’t want to lose them. My dermatologist, Christie Carroll, MD, takes great care in helping me manage my psoriasis and eczema. I also had good pharmacy benefit coverage for my medications, such as my biologic for psoriasis, Skyrizi. Any time I have an insurance change I’m concerned about whether the new provider will cover my biologic or make me try and fail other medications before I can get it.

Another complication of the new job: The nonprofit couldn’t bring me onboard until I’d personally raised the funds to cover the cost of both my salary and benefits. I didn’t know how quickly I could meet this goal.

I did end up accepting the new job and am set to start utilizing my new health insurance with Anthem Blue Cross Blue Shield this month. Things worked out well overall, but the process of moving over to the new health insurance took patience and effort.

Continuing Health Insurance After Leaving My Job

In May, my wife, Lori, and I made the decision to submit my resignation at my previous job. Before sending it to my supervisor, I needed to figure out where I would get health insurance until coverage at the new job kicked in. Two options emerged: Cal-COBRA and Covered California.

Cal-COBRA would allow my family to stay on my previous employer’s health plan for up to three years, but it was expensive: I would incur the total cost of the premium plus an added administrative fee. The high cost would allow us to stay on that plan for only a few months before our savings ran out.

Covered California is the Affordable Care Act health insurance exchange for my state. I opened an account on its website and ran health plan scenarios based on my financial situation. Since I didn’t reach the income threshold for the subsidized metal-tier health plans, I was directed to Medi-Cal programs for those with lower incomes.

I ultimately decided to stay with my current health insurance through Cal- COBRA. I liked the stability of leaving my existing insurance in place. Since I would already have the stress of a job transition, I didn’t want to take on any changes to my health insurance provider at the same time.

Choosing an Employer-Based Health Plan

The employee benefits booklet presented two health plan choices. Thankfully, both allowed me to keep my healthcare providers, including my dermatologist and allergist.

The high deductible health plan would cost less in monthly premiums, but I would need to pay a much higher amount out of pocket before insurance would start coverage. I would no doubt pay the entire deductible quickly with the cost of prescriptions and regular doctor visits.

The preferred provider organization (PPO) option would give me more flexibility in choosing doctors. Even though the premium was higher, the deductible was lower and the copays for doctor visits were reasonable: For someone managing chronic illnesses, this cost structure worked better. The prescription plan with the PPO also fit our family’s needs better, with set costs for prescriptions versus paying 20 percent coinsurance.

With that decision made, I added a flexible spending account (FSA) to help cover out-of-pocket healthcare expenses. Through the FSA, I set aside a certain amount from my paycheck before taxes, but I need to use it by the end of the calendar year or I lose that money.

Evaluating the Emotional and Financial Cost

The emotional and financial cost of taking the new job and switching health insurance providers turned out to be more than I expected. I spent hours researching plans, checking websites, and making calls. Cal-COBRA coverage cost me thousands of dollars in premium payments during a time I didn’t receive a paycheck, leaving me worried about when I could start on my new employer’s health plan.

Now that it’s 2021, I can say that changing jobs was worth the cost. I’m excited to finish fundraising and start my new job full-time, all with the knowledge that I have a strong healthcare team supporting me every step of the way.

You can read more about my experiences in my blog for ishonest and on my website.

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