Need Help Choosing Health Insurance for My Heart Condition…What’s the Best Option?

General Discussions Forum
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Hello everyone,

I’m looking for the simplest advice on finding the right health insurance plan for my situation. I have a congenital heart condition that’s gotten worse over the years and has now become a disability. I need coverage that will handle frequent visits to specialists (at least 4 times a year), ER visits (also around 4 times a year), and procedures (I’ve had two over the past two years totaling about $450,000). I also need a heart cath procedure about every three years, which costs around $60,000. My medications would cost roughly $800 a month out of pocket, with my Xarelto alone costing around $500.

I don’t qualify for Medicaid, and I’m not old enough for Medicare yet. I’ve applied for SSDI, but I’m unsure if I’ll be approved or when. Any advice on finding the best plan is welcome…thanks so much!

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EDIT I don’t know how to edit, but I forgot to mention that I usually end up hospitalized once or twice a year, and I’ve been in the ICU twice in the last two years. If nothing else, prayers are appreciated.

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What’s your location, income, and family situation? Are you considering employer plans or Marketplace options?

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Casey said:
What’s your location, income, and family situation? Are you considering employer plans or Marketplace options?

I’m in West Virginia, married with a 22-year-old son. Our income is about $50,000 a year. Looking at Marketplace plans.

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@Dallas
Is your son a tax dependent? Have you already started the application process at healthcare.gov?

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What’s been your source of insurance up to now?

With your situation, you’ll want an ACA-compliant plan, which is available either through an employer or through healthcare.gov.

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Corey said:
What’s been your source of insurance up to now?

With your situation, you’ll want an ACA-compliant plan, which is available either through an employer or through healthcare.gov.

I had Medicaid (I think it’s MAGI Medicaid), but I no longer qualify for it.

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Corey said:
What’s been your source of insurance up to now?

With your situation, you’ll want an ACA-compliant plan, which is available either through an employer or through healthcare.gov.

What does ACA-compliant mean?

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@Dallas
ACA stands for Affordable Care Act (also known as Obamacare). Basically, it means your insurance plan can’t deny you because of your pre-existing conditions.

Go to healthcare.gov for your plan options. Depending on your income, you may get tax credits to lower your premiums. Only use healthcare.gov or your official state marketplace—be careful of other sites that might not be legit.