What would you do?

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vestabula
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Date Joined Nov 2008
Total Posts : 2855
   Posted 5/5/2009 7:10 AM (GMT -7)   
As I have said before a bazillion times, the hubby and I lost our health insurance when we moved from VA to NY as we were 'out of network'.  Got to NY and the premiums for new policies for folks our age were outrageous.  We still have a 'catastrophic policy' that will cover us if we get his by a bus at high noon headed south on the NYS Thru Way in a red car.  You know what I mean, but even it is $500 a month.  Anyway, one of the Universities my hubby teaches for sent us info that they will offer health benefits to on-line professors in June or July.  The memo said they don't know what the cost will be yet as they are trying to get eveyone in a 'group'.
 
I have been in the god awful flair since November.  Hubby keeps telling me to go to the doc and see if there is something else he can give me for the pain...I'm allergic to almost everything.  All I can take at the moment is Tylenol.  My problem is that I'm afraid if I go and he starts with all the blood work and scans and we try to get this health insurance in a few months, it will make us ineligable or the premiums will be so high we won't be able to afford it because they will see how many disorders I already have.
 
The Rheumy I go to now is NOT the one who dx'd me with fibro.  He is also a tennis buddy of my husband and has been giving me samples of all the meds I am on so I don't know if that will show up when we apply for the insurance. He hardly charges me anything for an office visit but has no control over the tests he might want to run before he starts prescribing something for the pain.  You know...to make sure 'nothing else is going on' or my disc compression discs are giving me some of this  pain.
 
When we got insurance before, health issues were never a problem because neither hubby or I were on any prescription  meds.  So here I sit, in agony every single day wondering if I should just go and take my chances.  I know Doc's have to document every thing.  We are too old to be without health insurance(in our early 60's).  Too old to insure, according to all the companies I have contacted. (unless we can afford $1800 a month, which we can't).
 
Sorry I am rambling, but this is really upsetting  me.  I keep thinking about how all my boys and my grandchildren are coming in July and I won't be able to even pick up Isabel who is 9 months old.  How I only see them once or twice a year due to distance.
 
 
If you were me, would you just go to the doc and take the chance that they will insure me?
 
I have picked up the phone twice this morning...then put it back down.  Doc is playing tennis today with hubby...how cool would that be if I went to the court and just asked him what I can do???
 
Sorry this is so long.  Maybe some of you have had more interaction with insurance companies and know how they work better than I do.  I might be over reacting????  Never in my life would I have ever believed I would be looking forward to being on Medicare!
 
huggies and pampers too
 
Donna


fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: Lexapro and valium

Post Edited (vestabula) : 5/5/2009 8:25:59 AM (GMT-6)


lost in philly
Regular Member


Date Joined Jan 2009
Total Posts : 243
   Posted 5/5/2009 7:42 AM (GMT -7)   
Wow Donna that is a rock and a hard spot!
Have you two looked online for cheaper health insurance that is not in a group or dependent on your husband's work? I have had good luck finding plans by googling "affordable health insurance". Its gotta be cheaper than $500/month!
If I were you, I would go to the doctor b/c you want to be in good shape for your grandchildren etc. (I can sympathize, my family lives 3,000 miles away and if they visit during a flare...oh boy!) PLUS...dont you imagine that whether you say anything or not, the insurance company is going to assume that you and your husband have a certain amount wrong (detected or not) due to age?? There is ageism in health insurance for sure. You are paying so much money for your coverage now, it would be a waste to not use it.
I do know that new insurance plans will do the wont-cover-previous-issues-for-first-6-months, but that time flies by and there are ways around that.
My vote is live for today b/c you never know what tomorrow might bring.
lost in philly

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Fibromyalgia, Endometriosis, Migraines, Asthma, Chronic Fatigue

Topamax, Morphine, Effexor, Abilify, Crestor, Resoril, Loestrin, Imitrex

B12, Magnesium, Melatonin, Omega3
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Knowing without doing is like plowing without sowing."


vestabula
Veteran Member


Date Joined Nov 2008
Total Posts : 2855
   Posted 5/5/2009 7:48 AM (GMT -7)   

Hi Lost in Philly...the coverage I have now does not pay for any tests or office visits, or I would use it.  Only hospitization and even then, we have a $5000 deductible and it only pays 80%.  I have googled and researched through local insurance companies for three years.  We are just too old!

Hugies

Donna


fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: Lexapro and valium


Marlee2
Veteran Member


Date Joined Aug 2007
Total Posts : 6067
   Posted 5/5/2009 7:56 AM (GMT -7)   
Hmmmm, what to do, I think I would talk to the doc he may know more about what ins cos. ask for. I know when I talked to my GP about disability he knew what SSI would ask for from him and he said there is no way I am able to work. Doctors deal with this stuff all the time.
 
Believe me Donna we are so thankful Ken had our military ins and medicare when he had all the heart stuff done over the winter or we would be deep in debt.
 
luv and hugs
Marlee
Forum Moderator Fibromyalgia
 
Fibro,Sjogrens, Anxiety, Gastroparesis, IBS, Gastritis, Allergies, High Blood Pressure, Low Blood Sodium and Osteoarthritis
 
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Agmaar
Regular Member


Date Joined Jan 2009
Total Posts : 376
   Posted 5/5/2009 9:26 AM (GMT -7)   
Can you find the current group policy info for the university that will be offering the new group plan?  You could see what provisions the plan has for pre-existing conditions.  The new insurance might not be the same, but at least it might give you an idea.  It seems like once the employee is accepted into the group, then dependents are covered (except for pregnancy, which ya know, I hope is not an issue for people our age).  At least that's how it worked for the industry I've been in.
Rich
 
Lyme, anxitey, depression, chronic C. Pnuemoniae
 
"... expect the unexpected ..."  (O. Wilde)
 
"I am an old man and have known a great many troubles, but most of them never happened." (Mark Twain)
 
 


Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17101
   Posted 5/5/2009 9:44 AM (GMT -7)   
These are wonderful suggestions.  I would definitely talk to the doctor because he knows more about what insurance accepts.  Rich's suggestion about finding out about the possible policy is good too.  I know that any policy I have had had a 6 month preexisting illness clause in it.
 
Sherrine
Forum Moderator/ Fibromyalgia
***********************
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
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God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7


vestabula
Veteran Member


Date Joined Nov 2008
Total Posts : 2855
   Posted 5/5/2009 9:46 AM (GMT -7)   
Rich..good idea and we tried that yesterday.  It's through the University of Maryland and we e-mailed the site that came in the memo.  'We can not respond to any questions about our upcoming health insurance plan until the end of May."  In the mean time...Tylenol?  OWIEEEEEE!
 
huggies
Donna
fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: Lexapro and valium


Dagger
Veteran Member


Date Joined Apr 2008
Total Posts : 1522
   Posted 5/5/2009 10:10 PM (GMT -7)   
There may not be a preexisting clause during "open enrollment". At my current job, you are completely covered for everything on day one. It doesn't matter what you have or when you were diagnosed, you are covered for everything that would normally be covered. My previous job (in another state) was the same way.

Can you think of something that will get you pain coverage that is temporary and not related to fibro? Some of your other ailments cause pain that could require treatment. If it's in your records that you are receiving pain meds for your TMJ, you won't have fibro in your records. Plus, your insurance probably won't cover TMJ anyway so an exclusion for 6 months won't hurt you. I'm not saying you should lie, just focus on your TMJ pain instead of your fibro pain. This could buy you some time so you can enjoy your grandchildren.

Your doc might not want to give you meds for 3 months without running more tests but you might be able to get enough for a few weeks. If you can only get enough for a week or two, save them for when your family visits.

donnaeil
Veteran Member


Date Joined Jun 2006
Total Posts : 1156
   Posted 5/5/2009 11:17 PM (GMT -7)   
Can you take muscle relaxants? Maybe you can get a script for zanaflex. No xrays or other tests required. Just fibro

Donnaeil

K9
Regular Member


Date Joined Nov 2008
Total Posts : 263
   Posted 5/5/2009 11:23 PM (GMT -7)   
If I were you, I'd move to Canada. Or the UK!
I have Fibromyalgia, and nothing else!
I take Lyrica 225 mg/day and Tramadol (150mg time-released) and amytriptilene 7.5mg


vestabula
Veteran Member


Date Joined Nov 2008
Total Posts : 2855
   Posted 5/6/2009 7:24 AM (GMT -7)   

Hi K9...I live an hour from the Canadian Border and you would not believe all the cars from Ontario that are parked in our hospital parking lots and in front of doctors offices here.  It's because they have to wait months for 'non-essential' treatment and surgeries that are considered 'elective'.  I have a friend from Toronto who had been waiting for almost 18 months to have a scan on her ovary...it was so big you could see it through her clothes.  She finally came here and had it removed.  On the good side, however, we get the hubby's Lipator from Canada.  It's one third the price.

Unfortunatley, we are too 'rich' to qualify for any kind of assitance and too poor to be able to pay outrageous insurance premiums. There was just an article in the paper that said the CEO of our local Blue Cross and Blue Shield makes $18,000,000 a year.  I have a problem with that!  No wonder a Tylenol in an ER costs twenty bucks!

 

Donna 


fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: Lexapro and valium


doodie
Regular Member


Date Joined Apr 2009
Total Posts : 67
   Posted 5/6/2009 7:30 AM (GMT -7)   
Don't move to Canada! You will just get put on a waiting list. Trust me. It is a 2 year wait to see a specialist for fibro. That's only if you can find a GP that will take you.

Donna, I am so sorry you are going through this. I don't have any answers for you, but please know that I will be praying for you. Hang in there.

Sincerly
Doodie

doodie
Regular Member


Date Joined Apr 2009
Total Posts : 67
   Posted 5/6/2009 7:48 AM (GMT -7)   
Canada is that bad. I injured my knee the day before Christmas. My Dr sent me to Physical Therapy. She did not want to order an MRI because it would take at LEAST 10 months to get it. After a month of PT she sent a referal to the Sports Med Dr. Had to wait 6 weeks to see her. When I finally did she only confirmed what I already knew, I have a torn menicus (cartlige) and need surgery. The Dr said she would send the referal to the Surgeon. I should hear from them in about 2 months just to set up the appt. I can look to have surgery 6 to 12 months from now. In the mean time now physical activity. about the only thing I can do is ride a stationary bike. Even when I walk alot it swell.

It is very hard to find a GP that is excepting new patients. Then when you do find one you have to do a Meet & Greet. If a Dr thinks you will take up to much of their time they can not accept you as a patient. Being a person w/ fibro that freaked me out.

Just be sure to watch out what our new president wants to do in the states.
 
Sorry for going off.  It is kind of a sore subject for me.

Post Edited (doodie) : 5/6/2009 8:51:21 AM (GMT-6)


vestabula
Veteran Member


Date Joined Nov 2008
Total Posts : 2855
   Posted 5/6/2009 8:07 AM (GMT -7)   

Update!  Just got a print out the insurance plans offered by the University of Maryland...It is 93 pages long in very very small print!  Holy Moly!  There are 29 different web sites to contact if interest is shown in any one plan.  My head is spinning!  I hope I can read through all of this....

Donna


fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: Lexapro and valium

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