health insurance changed to an HSA

[Lis]

Well, i am freaked... we need to come up with 4000.00 US $  my meds are 2500 US$ a month.. the company that my husband works for , without notice, changed the insurance... and i suppose it is what it is.. i spent the day on the phone being turfted out .. I finally called UHC and got the sweetest man named Ricky that answered my questions.. I called the local ASO.. and I am not eligible for Ryan White because my husband makes over 30 grand a year... I just feel SICK!!! I knew the end would come.. but i gotta tell ya.. i didn't want it to come from the system.. my husband says not to worry. we can get a loan for 4000.. I feel like such a burden... Manageable.... only if you have the money!!

thanks for listening...

lisbeth

[Nico]

Lisbeth,
I hear you loud and clear!!  HSA's (health savings accounts) and CDHP's (consumer directed health plans) are the new way to screw the employee who is well enough to work, but is costing the company money.  Yes, health care costs are out of control, however these plans are only geared to the healthy not the person with HIV, Cancer or any other controllable illness.

I have passed up two very lucrative job offers since the company only offered the crappy plans.  If there is any good news is that employers have not totally embraced them and I hope the uproar from employees will change their minds.

I wish and hope your husband's company will offer an EPO, PPO or HMO next year.  I feel your pain and pray for the best for you.  Hang in there!

Roger

[AlanBama]

OMG Lis, what else is going to happen?   

If you weren't "legally married" to him, would you be eligible for Ryan White and/or ADAP assistance?   Is that $4000 the out of pocket maximum before they start paying anything, or what?   Insurance is getting to be a joke.

I've just left my caseworker's office, getting on the Alabama ADAP list and Med Gap program....SHEESH, what a nightmare.   By having an intelligent 'significant other' who is already 'in the system', I am able to know what I need to have them do for me...it is basically me finding out about my own care, and manipulating them to try to achieve it.   Same thing is true with the psychiatrist at our clinic.....my last visit, he made no notes....had no clue what new meds he had started me on (Cymbalta).......I could star in an episode of the Twilight Zone.....let's call it "Stranded on Planet Alabama"......

 

[Iggy]

.

[Robert]

Hi Lis...

This really sucks.  Just to double check I'm showing below the Federal Poverty Guidelines for Nebraska and the ADAP qualifications for Nebraska as well.

Number of people in family/household

Family Income

         

1 person                               $9,800

2 people                               13,300

3 people                               16,600

4 people                               20,000

5 people                               23,400

For each additional person add $3,400.00

What this table shows, for example, is that if your household income for a family of 3 is at or below $16,600 then you are at or below the Federal Poverty Guideline for the State of Nebraska.


According to the ADAP State Monitoring Program if household income is at or below 200% of Federal Poverty Level, then you qualify for ADAP.

So if there are 3 people living in your household, then household income must not exceed $33,200.

God I wish there was something we could do.  Does the state of Nebraska have a program to help pay premiums?  Maybe there is a sliding scale.  I hope there's something.

Good luck liz....robert

[libvet]

I'm really sorry to hear that.

I've always thought that universal health care would be the way to go for the US, but the lobbyists, for-profit insurance companies, and greedy politicians have latched on this bizarre notion that tax free savings accounts are just the best thing since sliced bread and that promoting these things will do something about the 45 million people with no insurance at all.

In reality, all they usually do is pull the healthiest people out of group coverage pool and jack up the premiums for those of us who need real insurance instead of the sick joke that HSA's.

Of course, the other issue is that a huge portion of the people without any coverage are people working in jobs that barely pay enough to survive.  Who the hell has money to put aside in an HSA when you are already choosing between putting food on the table and paying the electric bill?

The US has some really great people in the health care field, but for all intents and purposes, the system that provides health care services is broken.

[Moffie65]

To All,

fyi......    The poverty measure that is used for ALL Ryan White services is based on the Federal Poverty Level, which now hovers between $9000 and $10,000.  The states do  have the liberty to change that in the upward direction to accomidate ADAP, which can then boost the availability of drugs.

In Lis' case however, there is little hope outside of her divorcing her husband and becoming a renter in the home.  In that case, she would also qualify for food stamps, housing assistance, and a plethora of other bennies, due to her young daughter that still depends on her care.

SO MUCH FOR THE SANCTITY OF MARRIAGE!!!!!!!!!!!!!!!!!!!!!!!!!  This country is made up of too many sleepwalkers!

Back to my room in the alcove again!

[Christine]

I am afraid this is going to happen to us some day too. We decided we would divorce, then I could qualify for ADAP. I don't know if that will be the right answer or not.

Have you contacted the drug companies themselves? Some of them have assistance programs. Also, I know the hospital I use has an assistance plan based on income. Can't hurt to ask.

Lis, hang in there. You'll get through this.
Christine

[Lis]

Thanks for reading... Things will work out the way they are supposed to, and worry wont help... SOOOO.. I guess I'll just try and go with the flow and see where I end up..

Thanks again

lis

[Boo Radley]

Lis,

That is insane!!  I'm so sorry to hear about this recent development and hope you can find a compassionate use program or some way to get meds without having to go bankrupt first! 

I know this isn't the place but please excuse me for venting -- the USA should hang its head in shame for allowing so many people, those with HIV and other diseases, to go without treatment because they fall into some "coverage gap."  That's a load of BS and everyone knows it.

Good luck!  You have the right attitude, babe!!

Boo

[Matty the Damned]

Hey Lisbeth!

Matty the Damned doesn't have an answer for this -- smart mouthed motherfucker that he is. You'd think he would! But, he has a picture to which you might relate:

 

MtD

[allanq]

Lis,
I am really sorry to hear about your situation. It's a reminder to us all how screwed up it is to tie health insurance to employment and how precarious everyone's situation is with regard to employer-sponsored health coverage. As health care costs continue to escalate, I fear that it will become more and more common for employers to do what yours has done.

HSA's really are a joke for anyone dealing with a major medical condition like HIV. The tax savings to the employee are insignificant compared to the cost of frequent visits to the doctor, regular lab tests, and high-priced meds.

I hope the new Democratic congress will make some headway in guaranteeing health insurance to everyone. I'll be sending letters to Senators Feinstein and Boxer and Congresswoman Barbara Lee to urge them to push for universal health care.

Good luck to you.

Allan

[Cliff]

Sorry Lisbeth, I don't have any advice or suggestion, but am sorry to hear your financial/insurance difficulties.

Cliff

[skeebo1969]

   For all the politicians out there...  Where the fuck is Lee Harvey Oswald when you need him?

  Lis,

     I feel ya..  Health care just fucking sucks here!    Since I just hung up with ya... I'll just leave it at that.

  Love ya girl!

  Thomas

[AlanBama]

Lis,

Thanks for calling me honey, as always you cheer me up immensely.   I feel the pain of your predicament, and pray that y'all will be able to work it all out.

You know how they always say "someday we'll have a big party and look back on all this and laugh?"   I am so ready for that party, but I wonder how many of us will make it there to celebrate.......just sayin.   

[Eldon]

Hey Lis,

THIS IS NOT A COIENCIDENCE!

This is the very thing that I have been discussing as this is a MAJOR concern for ALL of us in this country and it needs to be addressed with a SOLUTION.

I am with Rob, what's Gods plan for this? The answer to that is that he will use someone as a tool in order to get the job done the right way and very soon too.

In the meantime, try your best to keep your inner anxiety down as much as possible and there will be a way somehow. You have my support 100%. Here comes a wave of positive energy..catch it!

"What can I notice right now that makes me smile?"

[randym431]

Lis
This is shocking. And just the reason employer based insurance is for the birds.
And also, how you have to be totally devastated and put to the ground to get any gov help.
Everyone working in the US will face this, one way or another. Many in 2007 will have a child or spouse become ill with cancer
or whatever. They will discover the cold reality of the good old US way of insurance.

I hope the new Democratic congress will make some headway in guaranteeing health insurance to everyone

I wouldn’t count on it. The democrats were in power for many many years and did nothing, except accept $$$ from the med and
drug lobby to keep from doing nothing. Things like that wont change. They will just think of better ways to spin why nothing can be done. Talk about the term "staying the course". And all the while, the senators and reps have the best coverage one can have. And its
not employer based. Go figure.

All I can say is do whatever you need to stay on top. And seek as much professional advice as you can.
Myself, I often wonder why I still work. If I went on my short, then long term disability, while applying for SS disability,
I'd bypass the terror of employer based insurance.
Oh well, I don’t want to bring you down by going on so, but we are hear to listen. Sometimes that helps a little just knowing others
feel just as you do. And are mad as hell about it. Makes me want to leave the US for a more civilized country, somewhere?
Keep the old chin up, and fight on!

[aztecan]

Lis,
Tim was right about most agencies using the federal poverty level, which doesn't help you at all. I don't have the chart with me, but I do remember that 300 percent of poverty stands at $2,480 a month, which is what the cutoff is for assistance from the ASO I am employed with.

Others have already suggested this, but there is a difference between legally and morally married.
I recently advised a client's wife to not accept any additional raises .
If she does, her husband will be disenrolled and there is nothing I can do about it. I did broach the subject of divorce, because that may be the only way this man will be able to survive.

I wish there were something I could do to help.

My heart will be with you.

HUGS,

Mark

[MSPspud]

Hi Lis -  I totally fear this situation with my employer too.  I breathed a sigh of relief when the 07 plans came out and they still had fixed co-pays (safe for another year).  The only thing that comes to mind with this is the possibility of using an HSA card which takes money out each month pretax and puts it on a credit card.  It spreads the pain over a year and makes it manageable.  I'd be surprised that the company would switch to this type of plan and then not offer an HSA card.  This would be a separate program than UHC, perhaps through a company called WageWorks? 

You're in my thoughts. 

Jason