Long List Of Questions?

Hello everyone this year has been a bit wild for me. I have had healthcare through my full time job which is very good insurance. My job pays for the insurance which is nice. My OOP is low($1800). Good deductible as well. (PPO)

This year I was diagnosed with what seems to be Crohns(Thought to be UC, but inflammation isn’t just my large intestine). I am now recieving monthly infusions of Remicade and weekly Methotrexate. I haven’t even been billed at all for any of my infusions nor has the company that makes the meds who has a plan for affordability since it is a med that is $5000+ a dose I have read.

I am having a lot of anxiety and sleepless nights because this job is a bit labor heavy and requires me to work 6 days overnight and I am losing the will to continue a dead end job just for insurance. I still continue to push, but have plans to run for my own mental/physical health. I have had no time for friends or family and now my health is a bit iffy. I feel like my choice is to fight to keep my good insurance or take a risk in hopes of a better life in the next few years. I am 30 and can’t see myself doing this much longer unless I have no option due to the insurance trapping me here.

The Pre-Authorizations scare me because we had to switch me from 8 weeks to 4 and that itself took time to be approved. I essentially have 4 weeks if I get a new job and most have 90 day waits. Remicade is a medication that without it I may have a bad flair up randomly and end up back in the hospital and it seems I can only go 6 weeks without it at the moment. If you stop it entirely you can develope antibodies and never be able to take it again. This will mean surgery or living in the hospital again. I was looking into NJ.GOV marketplace insurance to have as backup but the deductibles and oops suck. I use Virtua to see my IBD specialist and infusion center. I am scared that a new insurance would mean not being able to see them anymore and specialists have long waiting times.

I was told if anything goes wrong the infusion center or Jannsen can help during a lapses, but I don’t want to end up in debt. I am stressed about needing a new preauthorization and referral or even worse not be in network anymore. I would still be able to message my doctors on the MyChart app. I want to do better for myself and am still young, but don’t want to hate myself if I lose my good insurance to find out I ruined my life by leaving a job that is ruining my life. Do I just accept this quality of life and work there until I die because life isn’t fair for us all? I realize some people don’t have jobs or insurance so I am not crying the blues. I just want my life back and my health back.

Any advice on the US healthcare system is appreciated or anyone who has dealt with pre authorizations/biologics please reach out I am available to to talk or message. The support means a lot. My health is returning to normal on this med combination and frequency of 4 weeks with the methotrexate and I don’t want to lose my progress or need surgery, but this overnight grunt work 6 days a week has me feeling hopeless. I can’t see my friends often and have no family to support me. I can’t imagine a woman would want to be with me either with this schedule lol

I have also read about pre existing conditions laws with things like Crohns and to just fight with insurance if things ever move too slowly or my health is at risk. I have a good head on my shoulders, good credit and am ambitious but I fear not finishing college has me stuck at this job for life now that I am chronically sick now for life and at the mercy of my employer/insurance. Unfortunately we don’t have a cure yet for Crohns/UC. They also hate me at my job now for being sick so I also don’t get treated well at work which makes me want to leave more. It is a union job so I don’t think retaliation will be tolerated against me if I am showing up every night and doing my job even if they hate me.

submitted by /u/_MementoM0ri
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