usvi-on-line
Update on trying to get Insurance
Update on trying to get Insurance
So, we've done alot of research for my Daughter (who's 30)
From what I can understand, unless you are on a "group" plan that you can not get behavior health insurance included in your plan. This is a story that I don't wish to include in this post, but she definetly needs it.
She will lose her Cobra 11/30/2009. It was costing her about 163.00 a month and it will go up to around 480.00 at month if she wants to continue it.
So, if we want to go with Cobra, her monthly bill will be:
480.00 Cobra
166.00 Medication
260.00 Doctor
So that brings it to 906.00 a Month.
If we go other insurance, her monthly bill will be
175.00 Insurace
378.00 Medication
260.00 Doctor
So that brings it to 813.00 a Month.
It just makes me sick that you can't get any behavior health benefits UNLESS you go with the state.
Any ideas or health experts here? We just don't know what to do.
It also really aggravates me that the price for her medication would double.
From what I can understand, unless you are on a "group" plan that you can not get behavior health insurance included in your plan. This is a story that I don't wish to include in this post, but she definetly needs it.
She will lose her Cobra 11/30/2009. It was costing her about 163.00 a month and it will go up to around 480.00 at month if she wants to continue it.
So, if we want to go with Cobra, her monthly bill will be:
480.00 Cobra
166.00 Medication
260.00 Doctor
So that brings it to 906.00 a Month.
If we go other insurance, her monthly bill will be
175.00 Insurace
378.00 Medication
260.00 Doctor
So that brings it to 813.00 a Month.
It just makes me sick that you can't get any behavior health benefits UNLESS you go with the state.
Any ideas or health experts here? We just don't know what to do.
It also really aggravates me that the price for her medication would double.
"Paradise...it's a state of mine"
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mindehankins
- Posts: 3014
- Joined: Fri Mar 06, 2009 8:21 am
- Location: Western NY State
Dear Connie,
I'm all too familiar with your quandry, and am so sorry you are going through this.
Is it possible that your daughter would qualify for medicaid? Does her doctor have fee adjustments based on income? Many do! If not her doctor, then another clinic? Can she hit up her doctor for samples of her meds or have them changed to generic alternatives?
I'm all too familiar with your quandry, and am so sorry you are going through this.
Is it possible that your daughter would qualify for medicaid? Does her doctor have fee adjustments based on income? Many do! If not her doctor, then another clinic? Can she hit up her doctor for samples of her meds or have them changed to generic alternatives?
Connie,
Pharmaceutical companies have patient assistance plans just for this sort of thing. The plans are real and they do work. Really. I know everyone thinks drug companies are evil, but I worked for two extremely large ones and the vast majority of people did have the patient/medical advances at a priority at least as high as the desire for profit.
These requests are not hard to do. She will probably have to prove she can't afford it, which shouldn't be hard.
It has been a long time since I was in the industry, so I can't remember how the process starts (it isn't hard)-maybe someone else can help?
I would recommend calling the drug company. They may refer you to the doctor to start the process, but I don't think so.
To reach the drug company just google the name and get the main number. There should be a menu choice for that (patient assistance) or ask the operator.
I highly recommend pursuing this to at least reduce the sting of all of these expenses.
Pharmaceutical companies have patient assistance plans just for this sort of thing. The plans are real and they do work. Really. I know everyone thinks drug companies are evil, but I worked for two extremely large ones and the vast majority of people did have the patient/medical advances at a priority at least as high as the desire for profit.
These requests are not hard to do. She will probably have to prove she can't afford it, which shouldn't be hard.
It has been a long time since I was in the industry, so I can't remember how the process starts (it isn't hard)-maybe someone else can help?
I would recommend calling the drug company. They may refer you to the doctor to start the process, but I don't think so.
To reach the drug company just google the name and get the main number. There should be a menu choice for that (patient assistance) or ask the operator.
I highly recommend pursuing this to at least reduce the sting of all of these expenses.
"Sponges grow in the ocean...I wonder how much deeper it would be if that didn't happen."
Hey dj.....I did call the drug company and I got the information. She would qualify, but the rules are that if the practive has less then 60 patients, then it would be 2 people who would qualify...if it's over 60, then its 3 people who would qualify. That's not great chances, but she's trying today.
She's working on it!
She's working on it!
"Paradise...it's a state of mine"
Hi Connie,
I'm just getting caught up on posts. I frequently work with clients trying to get them the most affordable coverage possible. Is your dtr healthy from a physical standpoint? Does she qualify for one of the plans that is catastrophic?
If you wanted to PM more details about her situation, specific behavioral health needs, I might be able to offer some suggestions on how to get those met.
If she has been on meds for awhile and is stable on them, I would suggest trying to get her doctor to write a script for 90 days-6 months or whatever they will do. That would save on doctor's appts. If she isn't stable on the meds, that won't work. Also, will her insurance allow her to order 90 days worth of meds (again, it depends on the med most likely) that would get her meds to stretch further.
Hopefully the drug company assistance will help. For more help, I would suggest contacting whatever hospital in your area is considered to cover the indigent. I would contact a social worker or discharge planner there and see if they can offer you options. I know the resources for my state and could fairly easily get someone connected with quality mental health care at a low cost. Then, they would just use a BCBS plan for any major health event.
Checking out Medicaid is also a good option. Please feel free to PM if you'd like me to see if I can assist you more.
Take care,
Nicolle
I'm just getting caught up on posts. I frequently work with clients trying to get them the most affordable coverage possible. Is your dtr healthy from a physical standpoint? Does she qualify for one of the plans that is catastrophic?
If you wanted to PM more details about her situation, specific behavioral health needs, I might be able to offer some suggestions on how to get those met.
If she has been on meds for awhile and is stable on them, I would suggest trying to get her doctor to write a script for 90 days-6 months or whatever they will do. That would save on doctor's appts. If she isn't stable on the meds, that won't work. Also, will her insurance allow her to order 90 days worth of meds (again, it depends on the med most likely) that would get her meds to stretch further.
Hopefully the drug company assistance will help. For more help, I would suggest contacting whatever hospital in your area is considered to cover the indigent. I would contact a social worker or discharge planner there and see if they can offer you options. I know the resources for my state and could fairly easily get someone connected with quality mental health care at a low cost. Then, they would just use a BCBS plan for any major health event.
Checking out Medicaid is also a good option. Please feel free to PM if you'd like me to see if I can assist you more.
Take care,
Nicolle
Connie,
I hope it works. If it doesn't I would suggest laying on the drama to the drug co. This is just based on the fact that these companies, believe it or not, are generally quite compassionate.
You should tell them how well the medication is working and how worried you are if she goes off, etc....etc....
Then if that doesn't work, as someone suggested, go to the doctor and ask for samples. Ask them to ask the rep and tell them you are very worried about her, etc. etc. etc...
Then finally, see if there is an equivalent drug from another company. There are lots of similar drugs that are sometimes almost interchangeable, with slightly different side effect profiles. Many times they will work just as well, especially if the patient switches willingly.
I hope it works. If it doesn't I would suggest laying on the drama to the drug co. This is just based on the fact that these companies, believe it or not, are generally quite compassionate.
You should tell them how well the medication is working and how worried you are if she goes off, etc....etc....
Then if that doesn't work, as someone suggested, go to the doctor and ask for samples. Ask them to ask the rep and tell them you are very worried about her, etc. etc. etc...
Then finally, see if there is an equivalent drug from another company. There are lots of similar drugs that are sometimes almost interchangeable, with slightly different side effect profiles. Many times they will work just as well, especially if the patient switches willingly.
"Sponges grow in the ocean...I wonder how much deeper it would be if that didn't happen."