POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: peanutbutterjelly on May 23, 2011, 01:13:44 pm
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Hello everyone! I hope everybody is doing great!
I was diagnosed last December 2010 and just started my Atripla treatment last April 2011. I am looking to move from NYC to Boston, MA and I suppose like anybody who is looking to move out to a different state, one of the main concern is health coverage.
I am still confused with all this, how the government (state/federal) assists HIV positive individuals and how insurance really works in terms of this condition. Currently, I am covered and I'd like to think I have a great insurance. My co-pay for my Atripla is about $130/month and I availed of the Atripla Copay Assistance Program and I was advised that that program is ending this year (to which I am covered up to $200/month). The $130 is pretty steep but I just try to make it work.
I have a great opportunity in Boston but what bothers me than the actual job is medical/prescription coverage. My main concern and I would appreciate your advice and input as to how I can go about this transitional process.
1. I've heard about COBRA but I am confused as to how it really works. How can avail of this to "extend" my current health insurance before my new insurance kicks in?
2. Is anybody familiar with Boston/Massachusetts HIV state assistance program and how can one avail of it?
3. Has anybody had similar experiences moving from one state to another that is not in the ADAP waiting list? I may not be qualified because I am going to be making a lot more than the limit they set. But just the same it sucks because if all else fails, all my salary would just go to my medication.
4. What other important questions am I missing? :)
Thank you all for your help.
PBJ
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I'm confused -- are you saying that this new job in Boston offers no medical/prescription insurance as part of a benefit package?
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Welcome to the forums PBJ!
With COBRA, you pay the full amount of your health insurance premium (the amount you currently pay plus the amount your current employer pays) directly to the insurance company. You will be offered the opportunity to elect COBRA coverage when you leave your current job. It can be an effective bridge to keep you insured until the policy with your new employer kicks in.
Here's a link to the Massachusetts Office of HIV/AIDS (http://www.mass.gov/?pageID=eohhs2terminal&&L=5&L0=Home&L1=Government&L2=Departments+and+Divisions&L3=Department+of+Public+Health&L4=Programs+and+Services+A+-+J&sid=Eeohhs2&b=terminalcontent&f=dph_aids_g_aids_landing&csid=Eeohhs2) with information about their programs.
When a state has no waiting list, it means you can enroll and receive benefits as soon as you qualify. If you have a high income, you may not qualify. Check your eligibility here (https://service.hhs.state.ma.us/ierhome/LandingPage.do?method=displayConsumerHomePage&pageSwitch=HOME).
You have to weigh the cost of your COBRA coverage against what you stand to pay out for meds without coverage during the period of time between when you leave your job and when your new insurance policy kicks in. If you will enroll in the new insurance policy right away, COBRA coverage may not be the best option.
If you have a specific question about your situation, PM me and I'll try to address it.
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PBJ
How long will it be until your new health insurance kicks in? ( If you are relatively new to the workforce, by the way, it is perfectly normal to ask your new employer this question -- it won't give anything away if you haven't talked to them about having HIV -- lots of people ask this question all the time )
If it is a short interval, can you sign up for mail order drugs with your current plan before you quit? That will usually give you a three month supply which may carry you over, expecially since employers in Massachusetts tend to offer health care coverage that starts quite promptly (Romneycare and all that).
Good luck
A
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@ Miss Philicia - They have insurance, I was just very concerned about the transition period between jobs. I will be taking this job and this will be project based. Meaning, Say I start with them July 1, 2011, I'll be training for a month or two. After I get placed in a project, that's the time I'll be paid and be under their insurance. So, based on my understanding, getting COBRA might be helpful since my salary will not cut it for state assistance.
@JR Gabbard - This is one of the concerns since I have to go through training for a month or two before I get actually placed in projects, then I get my salary and insurance. So to be safe, let's say my last day at my work is July 1, 2011 (so at least to cover for the month of July, assuming my insurance does it that way), and I train from July - August and start work say between September and October (the most, I was advised I could get in a project within a month after training but just trying to paint the worst case scenario). I was also concerned about HIV treatment coverage, insurance companies MUST cover my insurance needs especially its in Massachusetts. My current company pays for all my insurance, which is about $400 or so. Do you suggest COBRA is ideal in this situation?
@ Assurbanipal - I'll definitely get more info from the employer. Its just that it makes me anxious asking information about the insurance but I do understand everybody asks for it.
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Say I start with them July 1, 2011, I'll be training for a month or two. After I get placed in a project, that's the time I'll be paid and be under their insurance.
Something about this arrangement is setting off little alarm bells for me. Maybe it is just because you are summarizing it quickly for us, but are you sure that these guys are legit? If they are training you to work for their company why aren't they paying you during the training?
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@ Assurbanipal - Yes, they are legit. I get a stipend during the training, then I should be all set after a month.
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So to be safe, let's say my last day at my work is July 1, 2011 (so at least to cover for the month of July, assuming my insurance does it that way), and I train from July - August and start work say between September and October (the most, I was advised I could get in a project within a month after training but just trying to paint the worst case scenario). I was also concerned about HIV treatment coverage, insurance companies MUST cover my insurance needs especially its in Massachusetts. My current company pays for all my insurance, which is about $400 or so. Do you suggest COBRA is ideal in this situation?
In reading this this post a couple of things struck me --
1) Is there a guarantee of your getting a project following your month or two of training?
2) The max your employer's insurer can charge you for COBRA is 102% of the cost to the group health plan (including employer and employee contribution) for a similarly situated active employee and or 'their dependents'. So if your employer is currently paying $400 monthly the cost to you would be $408
which depending on the extent of your coverage might be a relative bargain.
Only you can do the math with respect to the relative ROI for taking it.
3) Since you are moving from NY to Boston you should check on whether that move means you will be moving 'outside your current plans service area' an how that might impact your potential benefits under COBRA.
4) As the laws vary you will want to be aware of what impact having a break in coverage might have on your new insurance -- the last thing you wanna hassle with is having to deal with a clause pertaining to 'preexisting conditions'.