insurnace/RX coverage?

[Rob_s_Wife]

**Okay we’re nearly at the deadline to having no insurance (end of this month is his lay-off date)

the kids can get state assistance if neccessary (no currently known medical issues with any of them so far thank God! )

I can do without (h*ck for the last 2 years having insurance didn’t make any difference anyways, even when having a baby!http://www.welltrainedmind.com/forums/images/smilies/glare.gif)

but dh has been a type 1 diabetic since age 6 and is on an insulin pump.
this is his only health issue and it’s very well maintained.

We can’t find a single carrier to cover him individually. Don’t even suggest Cobra, that’s not a reasonable option.

Ideally we’d like full insurance coverage for him, but if we could only get a decent RX plan for him, that would be a great relief.

Can anyone offer suggestions for affording this? Sources to try?**

 

[rayne89]

**Okay we’re nearly at the deadline to having no insurance (end of this month is his lay-off date)

the kids can get state assistance if neccessary (no currently known medical issues with any of them so far thank God! )

I can do without (h*ck for the last 2 years having insurance didn’t make any difference anyways, even when having a baby!http://www.welltrainedmind.com/forums/images/smilies/glare.gif**)

but dh has been a type 1 diabetic since age 6 and is on an insulin pump.
this is his only health issue and it’s very well maintained.

We can’t find a single carrier to cover him individually. Don’t even suggest Cobra, that’s not a reasonable option.

Ideally we’d like full insurance coverage for him, but if we could only get a decent RX plan for him, that would be a great relief.

Can anyone offer suggestions for affording this? Sources to try?

Well actually right with Cobra the government is paying 65% of the payment so you only have to 35%. It’s good for 9 months.

 

[Irish_Becca]

Have you tried Catholic Social Services?

I’m sorry you’re being faced with this. I am praying for you.

 

[Rob_s_Wife]

Well actually right with Cobra the government is paying 65% of the payment so you only have to 35%. It’s good for 9 months.

my understanding is that was only good for those who were laid off prior to February 28th? that’s even what the website says?

---

altho even at 35% would still make it several thousand dollars up front. that’s a lot of funds.

---

 

[Godfollower]

my understanding is that was only good for those who were laid off prior to February 28th? that’s even what the website says?

---

altho even at 35% would still make it several thousand dollars up front. that’s a lot of funds.

---

From the Department of Labor’s website:

Q16: If I elect COBRA, how much do I pay?
When you were an active employee, your employer may have paid all or part of your group health premiums. Under COBRA, as a former employee no longer receiving benefits, you will usually pay the entire premium amount, that is, the portion of the premium that you paid as an active employee and the amount of the contribution made by your employer. In addition, there may be a 2 percent administrative fee.

While COBRA rates may seem high, you will be paying group premium rates, which are usually lower than individual rates.

Since it is likely that there will be a lapse of a month or more between the date of layoff and the time you make the COBRA election decision, you may have to pay health premiums retroactively-from the time of separation from the company. The first premium, for instance, will cover the entire time since your last day of employment with your former employer.

You should also be aware that it is your responsibility to pay for COBRA coverage even if you do not receive a monthly statement.

Although they are not required to do so, some employers may subsidize COBRA coverage.

Note: If your qualifying event was involuntary termination of employment that occurred on or after September 1, 2008 through December 31, 2009, you may be eligible for a premium reduction under the American Recovery and Reinvestment Act of 2009. For more information see the questions below or visit the COBRA Premium Reduction FAQs or call 1.866.444.3272 to speak to a Benefits Advisor.

dol.gov/ebsa/faqs/faq_consumer_cobra.HTML

Obviously, we don’t know your specific situation. But I can tell you that it’s an absolute disaster to be uninsured. Check out everything that you can (including any suggestions by people on this thread), then choose what’s best for you. But I can’t imagine voluntarily going without health insurance.

Another possible help: some “big box” stores have pharmacies that charge low rates for ongoing medical supplies and generic drugs (don’t know whether insulin counts). If you combine that with using the same company’s credit card to pay for the prescriptions, you might get a rebate at the end of the year, which results in a net lower cost for the prescriptions. Some pharmacies charge a lower rate if you renew your prescriptions by mail.

If you absolutely cannot get good coverage, at least consider getting catastrophic injury coverage. It won’t pay for routine visits, but at least if you get hit by a bus or need an emergency appendectomy it will help.

Remember, there are two ways health insurance helps with medical costs: first, it pays a portion of the amount due. But, second – and sometimes more importantly – it reduces the amount due in the first place because of the insurance company’s bargaining power. If you’re insured and need an appendectomy, for instance, you might have to pay 20% of $6,000 (or $1,200). But, if you’re uninsured, that same appendectomy might cost you $18,000. The uninsured patients are charged more money than the insured patients are. So just being insured brings your costs down.

 

[rayne89]

my understanding is that was only good for those who were laid off prior to February 28th? that’s even what the website says?

altho even at 35% would still make it several thousand dollars up front. that’s a lot of funds.

No my husband was laid off on Holy Thurs. If you don’t need it for your children can’t you just get it for you and him. When we filled out the forms we had to write in who we wanted covered. You have 45 days to make the first payment from when he’s laid off. Ours for the three of us is $360.

 

[MadameButterfly]

According to the Department of Labor:

“The premium reduction applies to periods of health coverage beginning on or after February 17, 2009 and lasts for up to nine months for those eligible for COBRA during the period beginning September 1, 2008 and ending December 31, 2009 due to an involuntary termination of employment that occurred during that period.”

dol.gov/ebsa/COBRA.html

Dh’s company is being bought sometime in the 3rd quarter and we don’t know if he’ll have a job or not. I’ve been looking up info. on unemployment and COBRA insurance and I found the above information.

Hope this helps.

MB

 

[purplesunshine]

try fidelas care I dunno what state you’re in but they are GOOD and sometimes you can get it cheap or free

Also try Atena

 

[journey137]

I lost my health insurance December 08 because I graduated, and at that point and my health insurance had been through my university. However, I was able to use COBRA to get an extension of six months (til this month actually) and I did not have to pay anything over the usual fees (coughstill outrageous*cough). We had hoped that during those six months of extended coverage, DH would be able to find a job with insurance but no such luck so we went to daveramsey.com/sa/health/index.cfm?fuseaction=dspStep1 and searched for a local insurance agent. I’m not a big Dave Ramsey fan because I’m a total tightwad and don’t need help saving money at all, BUT the insurance agents that he endorses are good. They have to be. I was able to find a high deductible plan with a maternity rider for myself, my husband, and our infant daughter for $144 per month through a place that I didn’t even know offered insurance (Cox Health Insurance if you’re interested). We got a health savings account (HSA) too, and since neither one of us, or the baby so far, have any health issues we can save $$ in the HSA that would normally go to a traditional health insurance premium and we’re still covered in the case of a high cost medical emergency. I don’t know if a high deductible plan would be right for your husband considering his diabetes, but I do think if you plugged your location in that website above and got some recommendations for insurance agents, they could answer your questions and help find the most cost effective route.

 

[Rob_s_Wife]

No my husband was laid off on Holy Thurs. If you don’t need it for your children can’t you just get it for you and him. When we filled out the forms we had to write in who we wanted covered. You have 45 days to make the first payment from when he’s laid off. Ours for the three of us is $360.

wow. $350 a month. we so aren’t anywhere in that ballpark. not even in that city.

 

[Rob_s_Wife]

okay, my mistake… spoke to dh about the COBRA thing.
I was thinking that the numbers his company were giving for COBRA were because we didn’t qualify for that benefit subsidy.
No. I was wrong. (sure ain’t the first time!)
that several thousand is our portion AFTER the subsidy. gulpgaspsputter
I’m going to ask dh if they can tell him what it woudl be for just him.

---

off to look at that site you suggested journey.

 

[Lariena]

Depending on what state you live in you might search for an “insurance pool” option. An insurance pool comes into play for those who are denied by another agency. (With his diabetes as a preexisting condition I am assuming that he would be denied by another company. If not, a pool will not work…) We just put my Dh on the NM Insurance pool because he was uninsurable because I was expecting. NM’s is managed by Blue Cross Blue Shield and has been great so far. They also offer an amazing sliding scale payment option. Depending on your income, you may only have to pay 25% to 75% of the actual premium. FYI: We pay $102 per month for his coverage.

Be persistant because insurance companies are NOT quick to tell you about the pool options. You have to specifically ask them if there is one in your state for those with preexisting conditions. They also reevaluate your eligibility each year and if you are insurable with another company they will not continue to insure you.

Good luck!

 

[rayne89]

okay, my mistake… spoke to dh about the COBRA thing.
I was thinking that the numbers his company were giving for COBRA were because we didn’t qualify for that benefit subsidy.
No. I was wrong. (sure ain’t the first time!)
that several thousand is our portion AFTER the subsidy. gulpgaspsputter
I’m going to ask dh if they can tell him what it woudl be for just him.

off to look at that site you suggested journey.

Martha does your insurance plan charge for each child? Ours is a Blue Cross plan and its either a single, married or family plan -whether you have one kid or 8. So without the subsidy its approximately a grand. Several thousand just sounds outrageous.

 

[Rob_s_Wife]

Martha does your insurance plan charge for each child? Ours is a Blue Cross plan and its either a single, married or family plan -whether you have one kid or 8. So without the subsidy its approximately a grand. Several thousand just sounds outrageous.

his company plan has more than one family size level.
there’s couple + 1kid
couple + up to 3 kids
**couple w/ 3kids plus **

---

obviously we ar ein teh plus section.

 

[kage_ar]

I was laid off before the gov’t help with cobra. Cobra for DH, DS and I would have been 1800 per month. Had we been able to get the 65%, it still would have been far more than we could afford.

Of course, if you have a pre-existing medical condition like your DH, he will have little choice. If he goes without coverage, and goes more than 30 or 60 days uninsured then gets a new job he will not have had prior coverage and the new policy could exclude him for up to a year

You can get medicaid for the kids, try to keep his Cobra if there is any way.

Pray pray pray .

 

[Godfollower]

Several thousand a month is awfully high. By any chance are you currently in an HMO? They tend to be more expensive. If so, you could consider a regular insurance plan. They tend to cost less.

 

[kage_ar]

Several thousand a month is awfully high. By any chance are you currently in an HMO? They tend to be more expensive. If so, you could consider a regular insurance plan. They tend to cost less.

The issue is her DH medical condition. If he is not on a group plan, he will be considered uninsurable or maybe one will let him pay a kajillion dollars for an individual plan. Those with medical issues cannot just go get an insurance plan.

 

[whatevergirl]

*Hi Martha;

I work in corporate insurance and COBRA is very high. I agree it wouldn’t be the best option, if an option at all.

Ok, I am home not feeling well today, and just went to:

www.ehealthinsurance.com* and I plugged in stats for a 45 yr old otherwise healthy diabetic man. The rates were from $90 to $200 per month, and the carriers ranged from Aetna to United Healthcare. I don’t know how severe your husband’s illness is, but that at least gives you a range. Maybe try going to that site, and calling them? We network with ehealth (my company) and they have been very good to deal with. Oh, I didn’t include dependents in my quote, just got a quote for a diabetic man, around 45 yrs of age, and a non smoking rate. Not sure how old your husband is, but again, that gives you a range. Not too bad of pricing?

Just food for thought. I will keep you and your family in my prayers.

 

[Rob_s_Wife]

The issue is her DH medical condition. If he is not on a group plan, he will be considered uninsurable or maybe one will let him pay a kajillion dollars for an individual plan. Those with medical issues cannot just go get an insurance plan.

Exactly. I used that Dave Ramsey link, btw. I sen the guy recommended an email and he responded by calling us within 15 minutes. Very nice guy too. But he said in 20 years in the business he hadn’t been able to ever get a type 1 diabetic covered on an individual plan. (at best dh might get very high end coverage, but it woudl not cover any diabetic related treatment or meds or caused conditions) He recommended we try the state insurance plan.

www.ehealthinsurance.com and I plugged in stats for a 45 yr old otherwise healthy diabetic man. The rates were from $90 to $200 per month, and the carriers ranged from Aetna to United Healthcare. I don’t know how severe your husband’s illness is, but that at least gives you a range. Maybe try going to that site, and calling them? We network with ehealth (my company) and they have been very good to deal with. Oh, I didn’t include dependents in my quote, just got a quote for a diabetic man, around 45 yrs of age, and a non smoking rate. Not sure how old your husband is, but again, that gives you a range. Not too bad of pricing?* *

we have Aetna and or United now via his work (his company lets us choose which carried, but the cost is the same) so they were the first we called.

---

IF they would cover him at all, they will exclude any and all diabetes care or related treaments or conditions.

---

We need his diabetes covered as that is only current health issue.
altho dh half-joked that he see’s an on-coming ulcer in the future.

 

[kage_ar]

Does he have a job prospect lined up?

If not, he might look into SSDI then at least he could get Medicaid