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Author Topic: New Health insurance at work is bad. need advice,  (Read 809 times)

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Offline cozinator

  • Member
  • Posts: 6
New Health insurance at work is bad. need advice,
« on: June 28, 2014, 05:45:43 PM »
Insurance from my company has changed. 6500.00 out of pocket every year then 1000.00 for my meds per month. 12000.00 per year. almost 20,000.00 a year out of pocket there is no way I can do that. anyone have any advice Are you allowed to refuse coverage from work and get it yourself?

Offline emeraldize

  • Member
  • Posts: 3,348
Re: New Health insurance at work is bad. need advice,
« Reply #1 on: June 28, 2014, 06:00:05 PM »
Are you using the co- pay program (s) available from all of the pharmaceutical manufacturers of ARVs ?  This is KEY to your financial survival.

http://www.aidsmeds.com/articles/PAPs_Copays_19740.shtml

Read up. This is meant specifically for people with insurance  !!!

I've used it for four years. One card for Isentress and one for Truvada now instead using Epzicom. I receive $4800 in co-pay assistance and am extremely grateful for these important programs.
« Last Edit: June 28, 2014, 06:07:38 PM by emeraldize »

Offline cozinator

  • Member
  • Posts: 6
Re: New Health insurance at work is bad. need advice,
« Reply #2 on: June 28, 2014, 06:08:54 PM »
is there a way to get insurance to cover some of  the 6500.00 medical out of pocket?

Offline emeraldize

  • Member
  • Posts: 3,348
Re: New Health insurance at work is bad. need advice,
« Reply #3 on: June 28, 2014, 06:32:28 PM »
Dunno. I've reached the limits of my knowledge to help you lower your costs. 

Offline cozinator

  • Member
  • Posts: 6
Re: New Health insurance at work is bad. need advice,
« Reply #4 on: June 28, 2014, 06:47:54 PM »
Thank You for you help.

Offline emeraldize

  • Member
  • Posts: 3,348
Re: New Health insurance at work is bad. need advice,
« Reply #5 on: June 28, 2014, 08:55:56 PM »
You are most welcome!!

What are your meds? ALL if them not just HIV meds. I ask because I might be able to tell you how much less you'll pay per year using co-pay assistance. That might help you put the $6500 in reach and may I suggest you figure out what you typically spend per year? $6500 is a lot of medical expenses. You might not spend anywhere near that.
« Last Edit: June 28, 2014, 09:08:05 PM by emeraldize »

Offline johnnaus

  • member
  • Posts: 1
Re: New Health insurance at work is bad. need advice,
« Reply #6 on: June 29, 2014, 04:30:03 PM »
I recommend you speak to your benefits rep in HR to make sure you understand your benefits.  The limits you stated seem to be much higher than the new health care law allows. Here is a link with the information from healthcare.gov.

https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/

If your employer does not provide coverage that is compliant with the law, you may be able to get assistance to purchase insurance on the health care market place.

Offline cozinator

  • Member
  • Posts: 6
Re: New Health insurance at work is bad. need advice,
« Reply #7 on: July 12, 2014, 07:22:05 PM »
I just take atripla. I have been trying to figure out if prescriptions are part of that 6350. max out of pocket a year.

Offline skyeblue

  • Member
  • Posts: 13
Re: New Health insurance at work is bad. need advice,
« Reply #8 on: August 03, 2014, 12:41:02 AM »
You can refuse insurance from your employer and go find it on your own. The problem is, it will cost you more and you will not qualify for any of the tax credits from the Affordable Healthcare Act. I know this because I work for them. You will also find out that most insurance companies have, or will go to the high deductible and high out of pocket since they now have to cover pre existing conditions. I am going through the same thing, but the Ryan White program has sent my insurance a check to cover my three month co pay twice and the insurance still says they have not received it. Neither check has been returned either. So I have been trying to get my meds for over a month and still no luck.
So, good luck on your insurance and meds. Get co pay assistance cards, and find your local Ryan White program for help.

Offline Since1993

  • Member
  • Posts: 108
Re: New Health insurance at work is bad. need advice,
« Reply #9 on: August 06, 2014, 07:42:13 PM »
Insurance from my company has changed. 6500.00 out of pocket every year then 1000.00 for my meds per month. 12000.00 per year. almost 20,000.00 a year out of pocket there is no way I can do that. anyone have any advice Are you allowed to refuse coverage from work and get it yourself?

Every state offers Ryan White Part B/ADAP assistance which would pay your insurance premiums and co-pay for HIV-medications listed on their formulary.  Some states go further and pay all co-pay for any outpatient service.

RWPB and ADAP assistance are means-tested programs.  As long as your income doesn't exceed 200-500% (what % depends on each states individual requirement) of the Federal Poverty Level (FPL) and meet other requirements (proof of HIV status, assets, insurance coverage, etc.) they will assist you.  Typically, they can at LEAST provide assistance through your annual deductible and/or maximum out-of-pocket.

Contact your local AIDS Service Organization (ASO) and ask for assistance.  They will be able to help direct you towards a path of relief from burdensome insurance and outpatient medical expenses.

Offline skyeblue

  • Member
  • Posts: 13
Re: New Health insurance at work is bad. need advice,
« Reply #10 on: August 07, 2014, 01:57:53 AM »
Call 1-888-281-8981 to sign up for an Atripla copay card. It will pay $6800 per year of your copay, there is no set monthly amount and it automatically renews every January. I got mine set up on Tuesday and it covered the whole $1300 that my insurance didn't pay for a 3 month supply. I received my Atripla on Wednesday morning.
 This also freed up the money that RW was going to pay for something else in their program.

Thank you Emeraldize for the tip  :)

Offline mrtoad

  • Member
  • Posts: 48
Re: New Health insurance at work is bad. need advice,
« Reply #11 on: August 14, 2014, 01:22:02 AM »
drug companies are crooks
Lee
prezista with a kick from norvir,
Truvada, Intellence. celexa,xanax.Revolving statin

 


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