Skin cancer and health care coverage...

Driftwood

Well-Known Member
Dec 2, 2014
1,320
916
France
This isn't a altogether new topic, though it's a new twist on the Annual Skin Cancer thread...

Knowing that some of you have issues as well, how does your health care cover skin care Stateside - maybe especially in Califfornia?

In a given year, I might have sixty or more KA's and tiny basals burned off, plus several PDT/PDT daylight sessions, plus maybe three to five classic MOS surgeries ranging from easy (15 stitches on my shoulder this week) to more complicated (rebuilt my ear last year, that was fun).

I rarely miss any work as I try to schedule things during school vacations, but am still wondering about pre-existing conditions, coverage - ceilings, co-pays, etc... Do HMO's try and steer you towards cheaper options rather than better?

Not looking for a political debate about systems, just wondering what the current reality is.

Many thanks!
 

SeniorGrom

Well-Known Member
Mar 20, 2012
3,219
2,157
USA New Jersey
It’s so complicated that you almost have to be in the industry to know the specifics. First order of business is you ‘must’ apply for medicare parts A&B 90 days before you turn 65. I’ll be helping my wife apply end of April. From there you have the option of purchasing additional coverage plans to protect against additional costs. There are medicare ‘advantage’ and ‘supplement’ policies available. One has prescriptions included the other not and must be purchased separately. My medi-gap type is slightly more expensive monthly but no restrictions on Drs. no co-pays, and if I remember no networks. I do not so far need any ‘specialty’ medications so my ONLY out of pocket has been for pharmaceutical co-pays for routine BP or cholestrol meds for instance.
 

Surfnfish

Well-Known Member
Feb 6, 2015
1,754
2,195
PNW between here and there
A decent HMO plan will cover all costs, excluding co-pays, for services performed by an 'in plan' practioner. If you wanted those service performed by an 'out of plan' practioner, however, the HMO would likely deny treatment reimbursement, even after appeal. It's how capitated organizations like Kaiser Permanente keep their costs reasonable.
Conversely a PPO, more expensive due to it's higher co-pays and service deductibles, will offer a greater range of practioners in plan, and as long as an 'out of plan' practioner is willing to perform services for the same reimbursement as if 'in plan', the PPO will usually pay those costs after pre-approval prior to services.
Medicare and PlanF/PlanG a whole different deal
 

Driftwood

Well-Known Member
Dec 2, 2014
1,320
916
France
Thanks. Last time I looked into health care Stateside I was in my twenties and all of this was a non-issue. Now it's probably the issue.
 

Artz

Well-Known Member
Nov 22, 2018
939
762
Florida
Are you US citizen, or French? When I was living in a Ski town there were a lot of foreign Ski Instructors. When it came to insurance most had Coverage by their home country. Some paid a small amount for a policy to cover their stay in the US.
 

Driftwood

Well-Known Member
Dec 2, 2014
1,320
916
France
US citizen with the French equivalent of a green card. At this point, pre-retirement by a long shot, I'd be looking at a plan offered through an employer plus whatever would have to be added if necessary.
 

Driftwood

Well-Known Member
Dec 2, 2014
1,320
916
France
Just wondering how it would play out. I'm planning on leaving my current position at the end of the academic year. Since our kids are now in college themselves, we can look pretty much anywhere where I can land a job and still take care of my skin. My folks in San Diego are no longer young and it might be a good time to be closer for a while.
 

poidog

Well-Known Member
Sep 7, 2010
554
476
Maryland
This is a bit off-topic, but skin cancer is imminently treatable if you catch it early. I go for a full-body exam every year -- every inch of the rambling wreck, including scalp -- because my doc's practice has zero fatalities with patients who go at least once a year. I get stuff removed every year, but it keeps me alive.
 




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