I seriously need help with insurance

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LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 9/26/2008 6:51 AM (GMT -7)   
Right now I am under my father's policy with blue cross blue shield, and they are covering quite a bit. There are still a few things they won't cover like the 13,000 one because it was related to pregnancy, or the 1300 one because...well, I don't know. It's from an anesthesia place.

ANYWAY.

My dad's contract runs out in November so at that point I have no insurance. I'm worried that most companies won't even cover me because of my condition and the fact that I am on:
pentasa
alinia
prednisone
omeprazole
tandem plus
bentyl
and of course humira

Not to mention the many appointments I have to have while we're keeping an eye on things. I really am kind of worried because I cannot afford these without insurance...I can barely afford it WITH insurance. Money is extremely tight, but I can't fall back into what I used to be just because I can't take my medicine...


Also, geared toward the females, I am taking BC pills called Loestrin but will run out in about a week and a half and have absolutely no idea how to get them. I would ask my obgyn except I owe their office about 400 dollars and, you guessed it, can't pay it right now. Is it safe to just stop taking this kind of pill?
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 9/26/2008 6:55 AM (GMT -7)   
From what I have heard is the only way to get insured with having a Crohns diagnosis is to get the insurance from a employer. You don't have to deal with the pre-existing condition problem. As for just going off BC the problem you will have is the chance of getting pregnant. I have quit BC many times cold turkey and never had a problem. Good luck!
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 9/26/2008 7:01 AM (GMT -7)   
Is there anyway you/your Dad can sign up for COBRA? As long as you maintain some coverage, you can't be denied coverage down the line. I know COBRA is expensive, but it is less expensive than unexpected hospitalization or the full cost of our meds? I'm not an insurance expert by any means, but I know there are some people on here who work in that industry. Hopefully they will be able to give you some more help.
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 9/26/2008 7:04 AM (GMT -7)   
I have looked into different employers but a few problems with that are that I am unable to drive, am still very weak so a lot of preeexisting stipulations for getting hired are ones that I can't fulfill, and of course I'm a 20 year old student so finding a job with a large company is...not as easy unless I were graduated. I know Starbucks might be a good option, but that's a last resort for me.
I wanted to try a place called Tuesday Morning since it is right down the road from my fiance's work, but of course you have to be able to lift 50 lbs and I can barely lift his laptop!
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 9/26/2008 7:05 AM (GMT -7)   
I haven't looked into COBRA....I definitely will though!!
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 9/26/2008 7:27 AM (GMT -7)   
My daughter works for Starbucks and they are pretty accommodating as far as her schedule, she is a student. She is covered for insurance through my husband, so that isn't an issue, but she can basically tell them when she is available and they work around it.
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


Roxette
Regular Member


Date Joined Aug 2008
Total Posts : 63
   Posted 9/26/2008 8:08 AM (GMT -7)   
Once again i have to say how sorry i feel for americans. We have a free healthcare system in ireland (not without its problems of course).
I myself still pay for private insurance just because id rather go into a private hospital if i need treatment.
Annualy i pay about €550 for good health cover. Thats around the €400 dollar mark id say.
Hugs and prayers to you all having to deal with crap like that on top of having a chronic illness. xx

Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 9/26/2008 8:15 AM (GMT -7)   
LMills said...
I have looked into different employers but a few problems with that are that I am unable to drive, am still very weak so a lot of preeexisting stipulations for getting hired are ones that I can't fulfill, and of course I'm a 20 year old student so finding a job with a large company is...not as easy unless I were graduated. I know Starbucks might be a good option, but that's a last resort for me.
I wanted to try a place called Tuesday Morning since it is right down the road from my fiance's work, but of course you have to be able to lift 50 lbs and I can barely lift his laptop!

If you could get into a company like Best Buy full time they offer good health care.
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's.
Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow
through, diagnosed with Crohn's (23 years old 180lbs). Off predisone and on tysabri 4/3/2008
============================================


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 9/26/2008 8:27 AM (GMT -7)   
That's where my fiance works hah...I had thought about it before, but I have seen how employees are treated and it isn't so pleasant sometimes...they're not very accommodating for student schedules(they've put my fiance on 2 am truck many a school night...). Not that I've erased the option completely from my mind...

As far as starbucks goes, what are the hour requirements in order to qualify for the insurance? I am going to school full time and that alone is giving me enough trouble, but I know I have to work a lot harder if I want to take care of myself. Especially where this is concerned...

Argh I'll continue this later. I'm off to see someone at the office of disabilites and career services so...hopefully she can give some insight too.

Thank you guys for your responses by the way. You've given me a lot to think about.
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 9/26/2008 9:26 AM (GMT -7)   
Re: your BC pills...

In my experience, the people who would be refilling your prescription are NOT people that usually have any idea how much money you owe their office. Billing departments are usually completely separate I guess. Even if you do owe them $400, I would be willing to bet that they would refill your script no questions asked. And if you're due for an exam, you can usually agree to a payment plan on your balance, go see the doc, and then worry about whether or not you can handle the payment plan... I know it sounds kind of sneaky, but I don't feel guilty "working" a system that doesn't work for people like us.

Re: Insurance

Are you a student? My college offered low-cost health plans through a company called Mega Life and Health Insurance (they also do individual plans I think, but I don't know how their prices would compare with COBRA). I carried the insurance well in to my crohn's diagnosis by carrying just ONE credit hour per semester. Even if you're NOT a student now, it might be worth becoming a one-credit-hour student if it comes with cheap insurance.

Also, whatever happens with your insurance, make sure you have a paper trail of coverage. Before you're no longer on their plan, make sure you call Blue Cross and receive a "Statement of Credible Coverage" for future insurance purposes - they'll know what you're asking for. Make COPIES. EVERY insurance carrier for the rest of your life will ask for this piece of paper.

Good luck with everything.
26f, dx'd CD July '05 after 6 fistula/abscess surgeries
Currently running on Humira and Hope.
(miscarried at 13 weeks, now waiting to heal before trying again)

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

~Marianne Williamson


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 9/26/2008 9:28 AM (GMT -7)   
I think at Starbucks its 20 hours a week for insurance coverage. But as mentioned above, what about student coverage?
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3110
   Posted 9/26/2008 10:30 AM (GMT -7)   
School is important, but what about reducing your load-to be able to work the hours needed(and much needed rest)-to have the healthcare that is vital to keep you going?  Unfortunately, I have had to do that myself, it takes longer to get through school but you'll have the necessary CONTINUAL health coverage which will allow you treatment for your Crohn's....not perfect, but nothing is easy with this disease:(

Jen77
Veteran Member


Date Joined Mar 2006
Total Posts : 2691
   Posted 9/26/2008 12:01 PM (GMT -7)   
Sorry your having to face this. I was just saying to DH that without insurance my Asacol comes to $567 a month! Unreal! No way would I be able to treat my Crohn's without insurance. And I have several prescriptions as well. It's quite scary. Not to mention I've landed in the hospital before, and can really happen at any time. That could bankrupt anyone.

I always thought as long as you don't have a 90 day gap of having insurance, that they couldn't look at pre-existing conditions? Of course that doesn't leave much time to get a new plan. Cobra is quite expensive unfortunately.

I hope you're able to find a plan to get on to somehow! We really need to do something about health care in this country.
~Jennifer
 
Diagnosed with Crohn's Disease 2/06 after sever GI bleed. Has been suffering since 1998. History of rectal fistula and gallbladder removal. Taking Asacol, Questran, Toprol XL (for high blood pressure). Tapered off prednisone a month ago!


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10392
   Posted 9/26/2008 12:08 PM (GMT -7)   

The insurance is a problem for those of us with IBD, I hope you can work something out. If you are able to get a job that has coverage, do everything you can to keep it until you find and start the next job so your benefits are not interrupted.

As far as the birth control pills go, you should be able to get them at Planned Parenthood - they'll need to see you first, though. They do work on a sliding payment scale and provide excellent contraceptive services.


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 9/26/2008 12:11 PM (GMT -7)   
Even with insurance, it can be costly. I've always teased my two daughters. The older one we had when we were on a traditional 80/20 plan and she was a complicated birth, she cost well over $10,000, the other one cost my $10 copay.

Is there anyway you can get coverage through your fiance, domestic partners or such, get married at town hall and then have the wedding later? I know it takes the romance out of it, but so does starting marriage with hundreds of thousands of dollars in debt and not being able to pursue your college dreams because you had to get a job for insurance. Just my practical side, obviously not my girly side.
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


Illini
Regular Member


Date Joined Dec 2007
Total Posts : 298
   Posted 9/26/2008 1:13 PM (GMT -7)   
As a full-time student you should be eligible for student insurance? Just thought I would add...

I am a student and have the Mega Life / PCHS policy. If you can try to get it--do. For me the annual out-of-pocket is only $1800, so it's a great policy in terms of appointments and procedures.

HOWEVER for me it offers no drug coverage. Not sure if that is universal or only my school. So I fill my scripts at Sam's Club. The savings on drugs far exceeds the membership fee.
July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Currently trying...
Entocort, Enteral Nutrition, Omega-3 (Flax Oil and Fish Oil), VSL#3, Vitamin E


Glad Bag
Veteran Member


Date Joined Mar 2007
Total Posts : 699
   Posted 9/26/2008 2:16 PM (GMT -7)   
Roxette said...
Once again i have to say how sorry i feel for americans. We have a free healthcare system in ireland (not without its problems of course).
I myself still pay for private insurance just because id rather go into a private hospital if i need treatment.
Annualy i pay about €550 for good health cover. Thats around the €400 dollar mark id say.
Hugs and prayers to you all having to deal with crap like that on top of having a chronic illness. xx


I say everyone here votes for Obama!!!!!!!!!!!!!!!!!!! lets all get the health care we need....
"I am he as you are he as you are me and we are all together!" - The Beatles

doesn't that just sound cool when you sing it?

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