Choosing a health insurance plan can feel overwhelming—especially if you’re living with a chronic illness like inflammatory arthritis. In this episode, Dr. Isabelle Amigues breaks down insurance in simple, practical terms so you can stop guessing and start choosing confidently. She explains how to compare plans, what “max out-of-pocket” really means, and how expensive medications (like biologics) can actually work in your financial favor. If you’ve ever stared at open enrollment options and felt lost, this conversation is for you.
What You’ll Learn in This Episode:
- Who this episode is for
- When this guidance applies (not for Medicaid; partially for Medicare).
- How it helps people with chronic conditions, especially rheumatologic diseases.
- Heath insurance basis explained clearly
- The difference between premium, deductible, and maximum out-of-pocket.
- Why Dr. Amigues focuses more on max out-of-pocket than on deductibles.
- Why planning as if you’ll hit your max out-of-pocket can actually protect you.
- Plans for healthy vs. chronically ill individuals
- When a shared health plan or emergency-only style plan might be reasonable.
- Why people over ~35 or with chronic conditions should think differently.
- Using high-cost medications to your advantage
- How biologics and other expensive medications often trigger drug company copay programs.
- How these copay programs can help you hit your max out-of-pocket early in the year.
- Why this can mean you pay mostly just your monthly premium while insurance covers more.
- How to compare insurance plans step-by-step
- Setting up a simple spreadsheet with:
- Plan name
- Monthly premium
- Maximum out-of-pocket
- Calculating your true annual cost: (12 × monthly premium) + max out-of-pocket.
- Comparing plans realistically instead of just chasing the lowest deductible.
- If you’re trying to minimize your total costs
- How some drug companies provide medications for free if you’re uninsured (and why she still recommends having insurance).
- Why insurance should be viewed as protection and peace of mind, not just an expense.
- Smart ways to invest in your health care
- Why pairing insurance with direct primary care and direct-care specialists (like Dr. Amigues) often leads to better care and long-term savings.
- Using tools like GoodRx, Mark Cuban Cost Plus Drugs, and copay programs to reduce medication costs.
- Bonus: Using HSAs strategically
- How high-deductible plans + HSA can be a tax-advantaged way to prepare for health costs.
- Why every dollar in your HSA is essentially worth more because it’s pre-tax and can roll over year to year.
- Upcoming free webinar & resources
- Dr. Amigues introduces her free webinar on the autonomic nervous system and inflammation—how understanding your nervous system can help you reach remission faster.
- Encouragement to register, ask questions, and use education as a form of empowerment.
If you’ve ever wondered “Which plan should I actually pick?” or “How do my meds affect what I choose?”, this episode gives you a concrete, physician-backed roadmap to make the smartest choice for your health and wallet.
#UnabridgedMD #HealthInsuranceTips #RheumatologyCare
