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Author Topic: Loosing Health insurance, what to do???  (Read 2776 times)

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Offline missmac2009

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  • Posts: 9
Loosing Health insurance, what to do???
« on: August 17, 2009, 08:56:34 AM »
I am recently new to the forums, well actually, new to this whole new life I have come into.  Up until now, I had little worries with being positive... I was under a physicians care and taking good medication.  The only thing I ever really worried about was what if I didn't have health insurance, what would I do...  Well, that time has come.  My job actually is loosing our group benefits next month and I'm not sure what I'm supposed to do to continue getting the medical treatment I need.  Mainly, how to pay for the meds (mine cost about $1600/month).  I mean really, who can afford that without insurance.  I need some suggestions, anything will help.  I read all these forums, and you guys always seem to help with your thoughts and words, I'm just hoping for the same!

Offline Dachshund

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Re: Loosing Health insurance, what to do???
« Reply #1 on: August 17, 2009, 09:11:17 AM »
You should be covered under COBRA for the time being. You'll have to pay a premium, but it should be cheaper than trying to pay out of pocket. Check with your local ASO about coverage using ADAP/Ryan White.

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Loosing Health insurance, what to do???
« Reply #2 on: August 17, 2009, 09:14:17 AM »
You should make an appointment to talk to a counselor at a local ASO about coverage options.  Depending on your state of residence and income you may be eligible for ADAP coverage.  If not, there are patient assistance option.  You can look for ASO's near you at this link.  http://directory.poz.com/

Note, usually when someone loses coverage at work they are eligible to buy continuing coverage from the plan under COBRA.  But no COBRA coverage is available if the company is cancelling medical insurance for everyone.  It sounds like that is what is happening with your job -- but you should make sure you know whether they are keeping insurance in place for anyone.  If so, they are probably required to offer you a chance to buy back into the medical plan for 18 months (under COBRA).  It is not cheap, but it can be a temporary solution, especially if you are not eligible for ADAP for some reason.

Best wishes
A

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline missmac2009

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  • Posts: 9
Re: Loosing Health insurance, what to do???
« Reply #3 on: August 17, 2009, 09:26:21 AM »
Since the whole company is getting dropped then we are not elegible for COBRA.. you can only do that if you loose your job, I have already looked into that.  I can take a conversion plan but still have to come up with $900 a month and don't know how to pay for that either... I will look into the ADAP program as well as any other assistance programs they have for people like us... This is just so frusturating, I don't know how people deal with it, it becomes such a headache! 

Thanks guys for your input and anything else you got I will take, this is so nice to have a place to come and talk like this!!!

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Loosing Health insurance, what to do???
« Reply #4 on: August 17, 2009, 09:33:50 AM »
n.b.  Speaking to an ASO counselor is your best first step.  But if you can't access ADAP here's a summary of the HAART assistance programs with the phone numbers to call. http://positivelyaware.com/2009/news_briefs/news_briefs_09_02_03.shtml
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline gregftl

  • member
  • Member
  • Posts: 204
Re: Loosing Health insurance, what to do???
« Reply #5 on: August 17, 2009, 05:48:21 PM »
Where do you live? Every state has an ADAP ....Aids Drug Assistance Program. You go an apply for it thru your county health department. You can also google your state and put in ADAP after it and get info. So say if u lived in florida.....google "florida adap" and u can get some info on it. Also look at your local county health department website they should have an HIV/AIDS contact you can either email or speak with. In terms of medical and dental care your county health department should also have clinics setup for people with HIV. All you have to do is find out where the clinics are.......go there and go thru eligibility and enroll in Ryan White Program to get completely free health care.....and in most places free dental. I'm providing u with a link also with aids hotlines for each state. Now both ADAP and Ryan White have income restrictions. ADAP normally is anywhere from u cant make more than like 30-35000 for a household of one. The restriction is alot looser for households of more than 1. Same for the Ryan White Program. Funny thing is with all this talk of "government takeover" of healthcare.....well my healthcare comes thru gov't programs and it's the best healthcare i've ever had. And it's free.

If you dont qualify for ADAP or Ryan White you can get your hiv meds thru Canada at a website candrugstore.com. There are tons of Canadian websites out there that sell perfectly good generics that work.....at about 1/5 the cost. Then u can also find out from your county health dept to give u some info on local regular clinics that might go on sliding scale fees so u can get ur bloodwork done and see a doctor.

http://www.thebody.com/index/hotlines/state.html
« Last Edit: August 17, 2009, 05:52:27 PM by gregftl »

Offline BlueMoon

  • Member
  • Posts: 665
  • Calling from the Fun House
Re: Loosing Health insurance, what to do???
« Reply #6 on: August 17, 2009, 08:04:15 PM »
Missmac, bummer about your insurance.  I agree that you should discuss it with your local AIDS service organization as soon as possible. 

You might also start calling around for a personal insurance policy.  Try to stay insured if you can.  Sometimes ADAP works by subsidizing your premiums and HIV drug copays.  That's how it works for me.  I just pay the deductible and copays for doctor visits and non-HIV drugs. 

Since those deductibles and copays are considerable, I save some money by participating in a research study at the local university.  They do a full set of labs twice a year, for free, and send the results to my doctor.  All it costs me is an hour of chatting with the research nurse.  Your ASO should be able to tell you of such programs in your area.

Good luck, and tell us how things work out. 
« Last Edit: August 17, 2009, 08:28:23 PM by BlueMoon »
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline missmac2009

  • Member
  • Posts: 9
Re: Loosing Health insurance, what to do???
« Reply #7 on: August 18, 2009, 09:10:10 AM »
You guys have been the upmost help...REALLY!!! When I first got diagnosed, like most I'm sure, I thought I was gonna be doing this whole thing alone.  Then I found places like this where I can be myslef and ask the questions that many of you have already gone thru or are going thru or know someone that is dealing with it... It makes the biggest difference so THANKS!!!

Offline madbrain

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  • Posts: 1,208
  • No longer an active member
    • My personal site
Re: Loosing Health insurance, what to do???
« Reply #8 on: August 18, 2009, 06:51:25 PM »
Hi,

Since the whole company is getting dropped then we are not elegible for COBRA.. you can only do that if you loose your job, I have already looked into that.  I can take a conversion plan but still have to come up with $900 a month and don't know how to pay for that either... I will look into the ADAP program as well as any other assistance programs they have for people like us... This is just so frusturating, I don't know how people deal with it, it becomes such a headache! 

Thanks guys for your input and anything else you got I will take, this is so nice to have a place to come and talk like this!!!

If your company dropped all health insurance and thus you don't get COBRA, you are automatically eligible for a HIPAA policy, as if you had elected and exhausted your 18 months of COBRA coverage.

Call your insurer and ask about a HIPAA policy.

There is no pre-existing condition exclusion as long as you were covered at least 12 months. Keep your HIPAA certificates of coverage to prove it.

And the rate depends on age only, not medical conditions. It shouldn't be anywhere near $900/month.

Offline Inchlingblue

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  • Chad Ochocinco PETA Ad
Re: Loosing Health insurance, what to do???
« Reply #9 on: August 18, 2009, 08:37:38 PM »
 madbrain is such a whiz (wiz?) when it comes to these things....and he plays a mean piano, too!

Offline pinkadam

  • Member
  • Posts: 76
Re: Loosing Health insurance, what to do???
« Reply #10 on: August 23, 2009, 10:08:49 PM »
Freiends

How reliable is www.candrugstore.com
Generic medicines seem to be very inexpensive. How do we know if this company follows guidelines of FDA.

How reliable these cheap medicines ?

Pink

Offline Inchlingblue

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  • Chad Ochocinco PETA Ad
Re: Loosing Health insurance, what to do???
« Reply #11 on: August 24, 2009, 12:14:25 AM »
Freiends

How reliable is www.candrugstore.com
Generic medicines seem to be very inexpensive. How do we know if this company follows guidelines of FDA.

How reliable these cheap medicines ?

Pink

pharmacychecker.com has a section where they rate different pharmacies.

I think http://www.aids-drugs-online.com/ got the highest ratings of the ones that sell ARV meds.

As far as the FDA guidelines to follow you want to know who the manufacturer of the medication is. If it is Cipla, they are reliable.

Also, check out this thread:

http://forums.poz.com/index.php?topic=28334.0
« Last Edit: August 24, 2009, 12:16:19 AM by Inchlingblue »

Offline missmac2009

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  • Posts: 9
Re: Loosing Health insurance, what to do???
« Reply #12 on: August 24, 2009, 10:34:03 AM »
To reply to gregftl ... I live in Ga, where it seems that there is not as much help here for people like us, unless you are disabled or make under a certain amount of money.  I havr been applying for various things and so far no luck, because I make a whooping 200 bucks too much a year, but I don't make enough to pay for all this... My employeer is still trying to figure out a way for us to keepp group coverage, but we wont know for sure just yet... I will keep you guys posted and again THANKS for all of your helpful hints, its been great! 

Offline gregftl

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  • Member
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Re: Loosing Health insurance, what to do???
« Reply #13 on: August 27, 2009, 02:29:00 AM »
candrugstore.com is good. i just got my first order from them. i got generic combivir and viramune. cost was 199 total for both. meds are made by cipla .....which is approved by both the WHO and FDA. i've read on wikipedia too that cipla is the biggest supplier of hiv meds in the world. i got my order from candrugstore in 2 weeks. the customer service folks are VERY nice.

so u live in GA? are u far from atlanta b/c i bet u could find some clinic in atlanta and u could enroll in an hiv drug study. i've done a study before and not only do u get ur meds for free....but all your bloodwork etc. also you should apply for patient assistance programs thru whatever company makes your hiv meds. then also u could just get ur meds thru candrugstore.com. it's really easy u call them. they setup an account for u. ask u what meds u need and they even call your doctor for you to get approval for the presriptions. they do all the work.
« Last Edit: August 27, 2009, 02:31:37 AM by gregftl »

Offline randym431

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Re: Loosing Health insurance, what to do???
« Reply #14 on: August 27, 2009, 09:56:27 PM »
I hope something works out.
The thread and info should be a "sticky" (permanent) because a lot of employed people
will be going thru this very soon i.e. company healthcare insurance.

Offline missmac2009

  • Member
  • Posts: 9
UPDATE!!!!! Loosing Health insurance, what to do???
« Reply #15 on: September 16, 2009, 01:29:30 PM »
First and foremost I want to THANK YOU GUYS from the bottom of my heart for all of your help and support through this incredibly frustrating process... The good news is, that for now, I was able to get my health insurance figured out through my employers!!!  It came at the absolute last minute, as I am needing to start a new month of pills this weekend and as of yesterday we got all the small details in order and I was even able to go ahead an get my policy number so I could go ahead and get my prescription filled!!!  I know you can all understand how happy I was that it worked out as I was almost at a giving up point, but I kept my faith and head up and it worked out, at least until around this time next year when we may be faced with the same issue, but as least I'm okay for now and I will be more on top of it before the last minute in the future, I promise!!!
I know I am not the only person that will have to and is having to deal with this, so for everyone out there, know that help is available even if it's only a support team to make you feel better! 
Again guys, THANKS FOR EVERYTHING!!!
God Bless  :-* :)  :-*

 


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