How an Employee
With a Chronic Condition Navigated ICHRA
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The Challenge
Find an individual plan for an employee living with MS that would not disrupt her ongoing treatment.
When an employee with MS's company switched to an ICHRA with SureCo, she was concerned her ongoing treatment wouldn't be covered. Coverage for regular MS infusion treatments was essential for managing her condition, but many plans required a much higher out-of-pocket cost than she had previously paid. She had never shopped for an individual health plan and needed help finding comparable options she could afford.
The Solution
Consult with a licensed SureCo specialist to identify comparable plan options.
The employee called SureCo's dedicated Employee Experience hotline and talked to a licensed agent who specializes in helping high medical utilizers. She was able to identify two plans that closely matched the employee's traditional group plan.
Both plans would save the employee money, but one covered her infusions as a medical procedure instead of a prescription benefit. Without contacting SureCo, she never would have known that option was available to her.
“SureCo made me feel fully supported, informed about my options, and never rushed throughout the process.”
The Results
A 42% annual savings and better treatment access for the employee
Despite the employee's complex care needs, SureCo was able to help her find a new plan that offered both the treatment coverage she required as well as financial relief.
By electing the Mass General HMO plan, she cut her yearly coverage expenses by over 40%. She had been paying $3,957 on her company's previous group plan. Her new ICHRA plan is just $2,304 and providers her with everything she needs to manage her condition.
"I never would've known my infusions were covered as a procedure without SureCo's help," she says. "The team found me a plan that saved me a lot of money and gave me peace of mind. I felt fully supported, informed about my options, and never rushed throughout the process."
