Tumor on MRI but switching from Cigna to Kaiser on September 1st
Hello all, I am looking for some advice for my situation. I am a teacher in the Bay Area in CA and recently switched jobs from a charter school to a district school. In March, I developed back pain following an athletic injury. Shortly after, I signed a contract with my new employer and elected for Kaiser HMO, because the cost is 100% covered by the employer, so it would be free for me. With my previous employer, I had Cigna OAPIN which is an HMO-lookalike plan, set to end on July 1st. Zero deductible, low co-pays.
The back pain continued. Getting in with the specialists took a long time, as did getting in with physical therapy, partly because I got Covid and everything had to be rescheduled. After I saw a specialist for the first time in June, I considered waiting to continue treatment till my Kaiser insurance kicks in on September 1st, so I didn’t have to start treatment with one set of doctors then switch to another, and so that I wouldn’t have to pay for COBRA in July and August.
Unfortunately, the pain worsened and I was completely unable to sit down for about two weeks. I decided to keep my appointment with a physiatrist and do physical therapy with Cigna network doctors, and it seemed that the treatment would be mostly complete by September 1st when I would switch to Kaiser. My COBRA payment is $911/month. I worked over the summer to help cover it.
The pain progressed throughout the month of July and I developed numbness in my leg. I had an MRI this past week expecting a herniated disc, but instead they found a rare tumor called an Aneurysmal Bone Cyst that grows quickly but isn’t necessarily cancerous. I’ll discuss with my doctors this week, but it seems likely that I will need biopsy to confirm that it’s not cancer, and I will need complex surgery to resect the tumor, and possibly additional treatments to prevent it from recurring. Such a treatment course spans several months to two years.
I am meeting with my doctors on August 11th to discuss a treatment plan, and obviously insurance is relevant to what this will look like. From what I understand, my options are to keep paying the COBRA fee or to switch treatment over to Kaiser. I am concerned about the implications for continuity of care if I were to switch to Kaiser, and also because this is a rare condition, switching to Kaiser means I can’t be treated at orthopedic oncological research centers like Stanford or UCSF, where they have the most expertise in this type of tumor. On the other hand, the COBRA premium is almost a quarter of my after-tax income and it will be tough to handle financially, and I’ve had a lot of stress coordinating between different doctors and insurance already in this process. If I end up having to miss work for an extended period due to surgery, the financial stress will be even more pronounced. I also don’t know which one will be slower: potentially getting referred to another new specialist under Cigna or starting over with Kaiser.
Are there other options for me in this situation? Any advice for changing insurance during treatment of a complex medical condition?
