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Insurance question- About lifetime maximums

rcq925

New member
I have an insurance question. My 2 year old daughter, Hayley, has CF and we have a pretty good insurance plan through my employer. However, it does have a $2 million lifetime maximum and my question is what happens when she goes over it? I have no idea and I am very concerned because she is already at around $200,000 at age 2 and everything dealing with CF meds, hospitalizations, ect. is so expensive. I am wondering if any of you or your parents have had to deal with insurance problems when you went over your lifetime maximum and what you did after that. Thanks in advance for all replies!!!
 

LouLou

New member
My understanding is that there will be no more coverage. Think of it this way though, if you continue at this current rate she'll be 20 by the time you hit your max. The way most people don't stay at the same job for more than 5-10 years anyways the liklihood of it starting all over with a new plan is on your side. Just remember never go without insurance for her. COBRA, COBRA, COBRA...
 

Landy

New member
First of all, 2 million is great. Most of the policies I've ever had are 1 million max.
Another thing to mention, with my husband's employer it seems they are always switching from Blue Cross to Preferred Health to something else and from what I understand every time they switch to a new ins co, my maximum starts over again. (someone correct me if I'm wrong here)
If worse comes to worse, your husband may have to switch jobs when/if that time comes (you get close to the lifetime max).
I wouldn't sweat it out too much. Chances are his employer will switch insurance companies at some point & you'll start over again.
 

JazzysMom

New member
That amount really isnt a lot when dealing with the cost of CF care. Sorry I dont have any personal experience. My hubbys insurance doesnt have that, but if it did then the expenses would go to my Medicare. I suppose there is a chance your daughter could be on disability benefits by age 20 or possibly eligible for Medicaid. However; if she was to persue a career etc than those benefits wouldnt last forever & she would have to face insurance changes yet again. I hope others have more of an answer for you!
 

Ratatosk

Administrator
Staff member
Our son is on my husband's insurance with a $2 million maximum. It's my understanding if he gets close to that amount or circumstances change, we'll be able to switch him over to my insurance during our annual open enrollment. Currently I have a single policy that is paid by my employer with a $2 mil max, but I can pay 25% for a family or single with dependents policy.

Plus, when your child is older, she may have a job by then with her own benefits. L
 

NoExcuses

New member
I just about had a heart attack when I learned of my insurance plan's lifetime max.

I've had Blue Cross since I was 2 months old (4 months prior to be diagnosed with CF).

I'm 24 and I still haven't hit the lifetime max. Granted I've been in the hospital about 5 times for IV's, had 2 surgies, and I've been on Pulmozyme and TOBI forever.

Many CFers are healthy enough to work. I have 2ndary insurance through my work, which also has a lifetime max.

But if I ever need to, I can just switch jobs. Or if/when I get married, I can go on my hubbie's insurance.

Lifetime max's suck...there's no question about it. But I'm sure you'll be just fine - things that like always have a way of working out.
 
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