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Author Topic: Parents Insurance.... Don't know what to do  (Read 2601 times)

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Offline Clavas

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  • Posts: 1
Parents Insurance.... Don't know what to do
« on: December 14, 2011, 12:42:23 PM »
So i was diagnosed with HIV about 9 months ago. Just recently after my last visit my doctor strongly recommended i started treatment. Problem is that im 21 and with my current job im still stuck under my parents insurance. They have no idea about my status and i feel like telling them at this moment would just completely devastate them. If i choose to start medication though im sure my parents would be able to see the charges on their plan and if they can they would be able to find out what that medication is really for or they would ask me about it.

Im torn about what i should do. I want to start medication because its my life im talking about and want to be healthy but also dont want my parents to find out by checking their bills. Im not ready in the least to let me parents know especially while im living with them. Who knows if they might even let me still live here if they found out.

I am posting this to see if anyone out there went through something similar and how they got through it or better if there is anyway that i can get medication without having to go though my parents insurance.

PLEASE HELP ME!!

Online Jeff G

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  • How am I doing Beren ?
Re: Parents Insurance.... Don't know what to do
« Reply #1 on: December 14, 2011, 01:23:59 PM »
Welcome to the forums Clavas . It sounds like you are dealing with multiple issue . You have an insurance issue and a disclosure issue with your parents running concurrent .

When I was your age I tested positive for HIV and was covered under my parents insurance . I decided to disclose my status to them when I over heard them discussing changing insurance company's . It was too late by the time I disclosed to them what was going on and I lost my insurance coverage . This was a long time ago and there were particular reasons I cant remember now why my HIV condition was considered a preexisting condition , but it was and I paid for the mistake up until now and I'm 50 years old .

Its good you are thinking long term and how to protect your self and your health care . The only good advice I can give you is to consider all your options and be very protective of your insurance and health care options , it may be more important than your realize at this time . Good luck .
« Last Edit: December 14, 2011, 01:25:45 PM by jg1962 »

Offline liketheboat

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  • Posts: 44
Re: Parents Insurance.... Don't know what to do
« Reply #2 on: December 14, 2011, 04:47:50 PM »
As a medical billing specialist i cannot stress how important it is that you do everything in your power to keep your insurance coverage, and make sure that you do not find yourself in a preexsisting condition. I have am very lucky myself to work in a profession that comes with medical insurance. It is so important for anyone, but espically us pozzies, to make sure we are covered.
Aaron
Memorial Day 2010 Seroconverted
Labor Day 2010 tested positive
Oct 2010 cd4 359 vl 6,500
Dec 2010 cd4 vl 306
Jan 2011 started Atripla
Feb 2011 cd4 250 vl ud
April 2011 cd4 399 vl ud
June 2011 cd4 293 vl ud
October 2011 cd4 354 vl ud
March 2012 cd4 561 vl ud

Offline Assurbanipal

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  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Parents Insurance.... Don't know what to do
« Reply #3 on: December 14, 2011, 04:49:40 PM »
Clavas

Welcome to the forums.

You are about the same age as my children.

It sounds like you have a loving relationship with your parents.  That is wonderful, and no doubt a comfort to them.

You might want to consider that, if they would be devastated to hear that you are HIV+, how would they feel if you later tell then that you put your health at risk (and didn't start meds) because you didn't want to hurt them?

You don't want to panic them, so you should make certain you are up to date on the current state of treatment and the current prospects for someone who is newly infected in 2011.  This site has lessons you can use to educate yourself on this.  Click on the box labeled "treatment" up above and you will find them.

But if they love you, they'd rather know, especially if you are putting your health at risk in order not to tell them. 

Telling them is an expression of your confidence in their love for you.

Best
Assurbanipal

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 buginme2

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Re: Parents Insurance.... Don't know what to do
« Reply #4 on: December 14, 2011, 05:02:46 PM »
I agree with the above postings however,

If you decide that at this time you do not want to disclose your HIV status to your parents I suggest you not start medication under their insurance plan.  They can find out.  Each month my health insurance company sends me an "Explanation of benefits" that list what doctors were vistited, how much it costs, how much the insurance pays, etc.  Also at any time I can go online and see what medicatons the insurance company has paid for.  My lists clearly states "Atripla" each and every month.

With that said, I do not think you should delay treatment if you need it.  I assume your in the states.  Contact your local ASO (Aids Service Organization) and ask them about seeing if you qualify for your states ADAP (Aids Drugs Assistance Program) or any other insurance program they may offer.  Each state is different and some are more generous than others.  You may qualify for a program that will cover the costs of your medication.

Good luck.
Don't be fancy, just get dancey

Offline liketheboat

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  • Posts: 44
Re: Parents Insurance.... Don't know what to do
« Reply #5 on: December 14, 2011, 06:00:22 PM »
I agree with the above postings however,

If you decide that at this time you do not want to disclose your HIV status to your parents I suggest you not start medication under their insurance plan.  They can find out.  Each month my health insurance company sends me an "Explanation of benefits" that list what doctors were vistited, how much it costs, how much the insurance pays, etc.  Also at any time I can go online and see what medicatons the insurance company has paid for.  My lists clearly states "Atripla" each and every month.

With that said, I do not think you should delay treatment if you need it.  I assume your in the states.  Contact your local ASO (Aids Service Organization) and ask them about seeing if you qualify for your states ADAP (Aids Drugs Assistance Program) or any other insurance program they may offer.  Each state is different and some are more generous than others.  You may qualify for a program that will cover the costs of your medication.

Good luck.
I just want to add my two cents on this. Since there are issues across the country with wait lists for ADAP, and may ASO's are under funded, i think it woud be wrong for you to try to use those programs since you are covered by insurance. You already have coverage for your medication and there are tons of people out there that need that money who have no other options. Please dont try to use that money because you are too scared to tell your parents. You are lucky to have insurance, and it would be wrong to take options away from others who are not as lucky as you are.
Aaron
Memorial Day 2010 Seroconverted
Labor Day 2010 tested positive
Oct 2010 cd4 359 vl 6,500
Dec 2010 cd4 vl 306
Jan 2011 started Atripla
Feb 2011 cd4 250 vl ud
April 2011 cd4 399 vl ud
June 2011 cd4 293 vl ud
October 2011 cd4 354 vl ud
March 2012 cd4 561 vl ud

Offline LongTimeSurvivor

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  • Posts: 195
  • I don'no...there may be Zombears...in theres...
Re: Parents Insurance.... Don't know what to do
« Reply #6 on: January 04, 2012, 08:06:17 PM »
I was 19 when I told my parents I was gay...Christmas day actually. AIDS wasn't on the radar at that time. The reason I told them was because I found out, through therapy at the university I attended, that I hated lying to them about my life.

Skip six years ahead and I find out I'm HIV+. This time I choose not to tell my parents because at the time my mother was very ill and I didn't want to add to the stress going on at the time. Of course, that my T-cells were high and viral load low, the decision to hold off wasn't that hard to make. Anyway, I figured within about two years they'd find out anyway as I began to get sick.

Well...that didn't happen...never got sick other than an episode with thrush. But the years have gone by and I've never gotten around to telling them. Now they're in their late 70s, early 80s and I figure why burden their last years.

All that said...the reason things went this way was because I never got sick. Even now that I'm on Atripla it is not because I suddenly got sick but because the guidelines changed.

Okay...sorry...had to set this up...

You on the other hand are being told you need to get on meds by your doctor. I would suggest contacting any AIDS/HIV+ organizations and see if they have counseling services you can use because you have some decisions to make. One is whether or not you're going to start on medications. I'd say that should be a yes.

Now you have to decide how to pay for those medications. They're very expensive. If I remember correctly I think my Atripla runs $30,000 a year but I could be wrong (I'm old)...in any case it costs a lot of money. That's not counting all the other drugs I take. Being that you're 21 I assume you aren't making a lot of money so the option to pay for it yourself doesn't seem possible.

So...how do you pay for them? Well...as mentioned earlier, you could try ADAP. I happen to disagree with "liketheboat" on this issue. You are as needy as anyone. But he does have a point. You do have the option of insurance if you choose to go that way.

There aren't a lot of good options...actually there aren't any good options (mentally or emotionally much less financially)...based on what you've written. So here are some scenarios.

1. You don't tell your parents, so no insurance, apply for ADAP, put on waiting list, get sick, go in hospital, parents are told you have AIDS.

2. You tell parents, they throw you out, apply for ADAP, put on waiting list, etc...

3. You tell parents, they ask questions after sitting stunned for an hour, you're put back on insurance, get meds, stay healthy.

I'd go for scenario 3. Better to chance it and find out it will turn out okay. If it doesn't then you go with scenario 2 and hope you some how get meds quicker. However I wouldn't tell your parents by yourself in your home. If you trust your doctor have him call them in for a conference. Let him explain to your parents your situation. If a social worker can be there...even better. They can answer most of the questions except the one that your parents may hesitate to ask...how did you get it?

You don't want to get sick. Read some of the postings in Long Term Survivors. Understand what it means to put off treatment. I would hope your parents would still love you...it just might take them time to wrap their heads around how their, and your, world has changed.

Hope for the best, prepare for the worst...you could get lucky and be hit by a truck tomorrow and not have to worry about any of this. But I think you'd prefer to live and see what life has to offer you. At the age of 21 the possibilities can be endless if you give them a chance to happen...

Of course it's important. It's an email...

Offline liketheboat

  • Member
  • Posts: 44
Re: Parents Insurance.... Don't know what to do
« Reply #7 on: January 05, 2012, 05:13:04 PM »
One more thing that i thought about.......... i think that ADAP is considered payor of last resort (like Medicaid). If you are on ADAP and have private insurance such as i do. They will pay for your copay or your coinsurnace, but they will not do that until private insurance has paid, they will require a copy of the primary eob (explination of benefits) before they will issue payment. (i have been doing medical billing for 7 years, so i am pretty well versed in the ins and outs of medical insurance)
Aaron
Memorial Day 2010 Seroconverted
Labor Day 2010 tested positive
Oct 2010 cd4 359 vl 6,500
Dec 2010 cd4 vl 306
Jan 2011 started Atripla
Feb 2011 cd4 250 vl ud
April 2011 cd4 399 vl ud
June 2011 cd4 293 vl ud
October 2011 cd4 354 vl ud
March 2012 cd4 561 vl ud

 


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