Hey I have another question..

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Kobrocki
New Member


Date Joined Nov 2008
Total Posts : 17
   Posted 3/11/2009 3:52 PM (GMT -6)   
Hello,
So first off thanks for reading this! I am concerned I have been on Remicade for almost a year now and they charge my insurance 7,500 bucks every 8 weeks, fortunately my insurance has been paying all but 300 bucks.

I got a bill yesterday for my last infusion and they want me to pay them 600!! I am curious if I have more options I should be looking into. Also I am on my dads insurance right now but when I turn 22 this year I cant be on his insurance anymore.. Has anybody had to go thru getting insurance while having a pre-exsisting condition? Im scared! I dont know where to even start.

Thanks again!
Life is not measured by the amount of breaths we take, but by the moments that take our breath away.


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 3/11/2009 4:19 PM (GMT -6)   
It sounds like something changed with your dad's policy at the start of the new year that requires you to pay a higher percentage of the treatment. You should ask your dad if he's aware of any changes that were made, and if he's not, ask him to contact his insurance company and check. Sometimes they do make billing errors!

I've been told that if there is no lapse in your insurance coverage, they can't refuse you and/or charge you differently because you have a pre-existing condition. Are you going to have to get a private policy or will you be able to get a job with insurance?
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, Culturelle probiotic, and Zoloft (25 mg).


Kobrocki
New Member


Date Joined Nov 2008
Total Posts : 17
   Posted 3/11/2009 4:30 PM (GMT -6)   
I will have him call and ask, I was shocked.. I would love to get a job with insurance but in this economy its hard enough just to keep my little retail job.

I am in school full-time so its hard to work full-time.. I think my better option would be a private policy I just didnt think I would be able to get anything, I have been told that pre-existing conditions make it really hard to get onto insurance and that it is really expensive
Life is not measured by the amount of breaths we take, but by the moments that take our breath away.


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 3/11/2009 4:44 PM (GMT -6)   
As a full-time student, it would be extremely hard to find a job with insurance benefits.

You should check with your school and see if they have an insurance plan for students. Out of curiosity, I went to my old university's website, and they are contracted with an insurance company that has a policy for ~$1500/year. I'm sure it's not a super-duper deluxe plan, but at least it's something! I just typed "health insurance" in the search box on the university's main page, and it came up.


Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, Culturelle probiotic, and Zoloft (25 mg).

Post Edited (fruitgirl) : 3/11/2009 3:49:21 PM (GMT-6)


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 3/11/2009 4:46 PM (GMT -6)   
An individual policy would be hard to get, true, you need a group policy. Even some of those require a time without treatment to eliminate the pre-existing. Most of rules depend on what state you live in. Just don't get a temporary policy, with regular renewals, then they will tag you for the pre-existing for sure. Read the fine print.
Some states are extending student policies to 26, to keep young people insured since so many try to go without insurance. Make sure that rule didn't change with your Father's policy. Does your school offer student insurance?
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated all wheat/gluten from my diet. Probiotics (Ultimate Flora, 50 billion), trying Curamin. 
Flaring, seasonal? or supplements too harsh? Back on prednisone, trying 15/20 mg. Appt 3/6 to discuss Humira, etc.   


Kobrocki
New Member


Date Joined Nov 2008
Total Posts : 17
   Posted 3/11/2009 5:12 PM (GMT -6)   
I will check into my school and see if they have some kind of insurance.. This is such a crappy situation
Life is not measured by the amount of breaths we take, but by the moments that take our breath away.


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16403
   Posted 3/11/2009 5:18 PM (GMT -6)   

Can't you stay on your parents insurance if you're in school fulltime? Either that or try to get something through your school. LAst case, see if the pharmaceutical company that makes remicade has a program for low income individuals. There also may be group insurance plans available through your state. If you qualify for them, that would be fortunate. Here in NY you can get this plan called Healthy NY but I am not eligible because I don't meet the requirements. There are also freelance worker unions that provide insurance to people who can prove they make income freelancing. The monthly fees can be quite steep but a lot better than paying for remicade out of pocket. I get all my drugs for free from the manufacturer. Look for patient assistance programs.


Diagnosed with proctitis in March 2007 - Treated with Canasa 2x Daily
Diagnosed with UC December 08 but had symptoms months ago - Treating with Asacol 400mg (9 a day)


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 3/11/2009 5:33 PM (GMT -6)   

Our son is having to deal with coming off of my husband's insurance soon. He could stay on as a full-time student. However he went to community college and graduated (yea). My husband's employer extended the insurance for 3 months. They also sent us the COBRA form (which will be very expensive). However in NY there is an insurance called HealthyNY. It is for lower income or part-time work. As long as he qualifies, they will accept his pre-existing condition. The cost will still be high but about 1/2 of what COBRA would be. There is a choice of insurance companies. The one we are looking at is the most expensive but it is an offshoot of what we have now. The strangest thing I found is that he will have to go to his primary care for a referral (which we don't have to do on our insurance). That means to go to his future GI appointments (with the GI he is currently with) he will have to go to the primary doctor first just for a referral. Makes no sense to me but whatever.

Whatever you do, research now. Don't let your insurance lapse. I think there is a 63 day grace period. That will be the key to covering a pre-existing condition.


--Mom of bratcat (17 years old) and nonamejames (20 years old)--
Daughter bratcat was diagnosed with pancolitis October 2006
Flared Fall 2006, Fall 2007, Spring 2008
Asacol, Rowasa, hydrocortisone enemas, prednisone, 6-mp, Remicade
7/3/08-Step 1 j-pouch surgery and no more meds!
11/10/08-Step 2 reconnect!
 
Son nonamejames was diagnosed with Crohns in Spring 2008
Asacol, Pentasa, 6-mp


Kobrocki
New Member


Date Joined Nov 2008
Total Posts : 17
   Posted 3/11/2009 5:36 PM (GMT -6)   
Thanks everyone.

My dad has called his insurance before on this and they said 22 was the extened age for a full-time student. I havent heard of any programs like the HelathyNy one. I will just have to do some research and hopefully come across something. Thanks again
Life is not measured by the amount of breaths we take, but by the moments that take our breath away.


betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 3/11/2009 9:20 PM (GMT -6)   
COBRA is probably your best bet. I was forced off my dad's insurance in Nov 2007 because I graduated from college. I looked into buying insurance straight away, with no lapse of coverage and not a single insurance company could offer my anything less than $800 a month and none of them would cover any expenses incurred by my UC because it was still considered pre-existing. COBRA for me is a little over $400 a month but it will cover my UC unlike any private insurance i could buy. Once my COBRA lapses, in 2 years, I'll have to get a job that offers insurance because jobs can't deny you for pre-existing conditions. Sucks don't it?
diagnosed with UC Dec 2006 at 22
diagnosed with IBS at 15
5mg prednisone
weekly accupuncture, probiotics, l-glutamine, and a combo of digestive enzymes. Staying gluten and dairy free as much as possible to avoid hard to digest proteins.
allergic or intolerant to all 5ASAs, sulfa and 6-mp


Kobrocki
New Member


Date Joined Nov 2008
Total Posts : 17
   Posted 3/11/2009 10:51 PM (GMT -6)   
Man it really does suck.. I just wish they could keep you no matter the age if you still want to pay more.. I am thinking Cobra is my best bet, I guess they will cover me 18-36 months.. That'll buy me some time.. I hope I can find a job by than but that's tough enough as it is too.. Thanks for the info

Thats good that job benefits cant deny you for pre-exsisting.. Now to find a job :D
Life is not measured by the amount of breaths we take, but by the moments that take our breath away.

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