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Main Forums => Living With HIV => Topic started by: ga1964 on May 08, 2008, 02:31:52 am

Title: What do I do if I loose my insurance?
Post by: ga1964 on May 08, 2008, 02:31:52 am
I'm not a long-term survivor ( a year and a half now. ), but I need some advice on what I should do if I can't afford to keep my insurance.  I'm self-employeed and have supply my own insurance.  At the last renewal they went up over $150.00/mo. on my premiums, and I don't know how much longer I can afford to keep paying for it.  My ID told me I need to do what ever I can to keep insurance, but I cannot financially keep it up, especially if they go up any more at the next renewal.

If I loose my insurance, I don't know how I'll be able to afford the doctors and meds.  I have already borrowed money from my parents and I just can't ask them for more.  I don't  know when or how I'm going to be able to pay them back the money I have already  borrowed and I don't want to be the next defendant on Judge Judy being sued by my parents for their money.  :(

Any advice would be greatly appreciated.

Thanks.
Title: Re: What do I do if I loose my insurance?
Post by: ubotts on May 08, 2008, 02:46:25 am
You should check out the Ryan White site...
They have helped me when I was very needy for my meds..
I hope this will help you and there will other members here to add more ways of not
losing your insurance.....
Title: Re: What do I do if I loose my insurance?
Post by: Dachshund on May 08, 2008, 07:46:34 am
I know it's tough but try and keep your insurance for as long as possible. Unfortunately you won't be able to access the system as long as you do carry a policy. Requirements fo Ryan White/ADAP vary from state to state.

I've asked the mods to move your post to Living With where I think you'll receive broader feedback.
Title: Re: What do I do if I loose my insurance?
Post by: David_CA on May 08, 2008, 08:56:32 am
I know not all jobs provide insurance, but most full-time jobs at very large companies and governments do, so maybe this is an option if your premiums become completely unaffordable.  I know I'm going to do my best to stay employed by the State (and therefor insured).  It does limit my job opportunities, potential places to live / move, etc, but that's a small price to pay to have good coverage.

David
Title: Re: What do I do if I loose my insurance?
Post by: Robert on May 08, 2008, 11:08:58 am
Talk to your local ASO (aids service organization).  You might not qualify for ADAP but some states find it better to help people with their insurance premiums.  It's far cheaper to pay a premium than to subsidize the cost of HAART.  It depends on where you live.

robert

Title: Re: What do I do if I loose my insurance?
Post by: darwin on May 08, 2008, 02:05:54 pm
Hi ga1964 - I am also self employed and have been researching this lately.  If you make less than whatever your state's ADAP requirements are, you can get your meds for free (and often lots of other services too). 

If you make more, then I think the best options are either 1) go work for a company with good insurance or 2) your state's high risk pool insurance (if they have it).

IMHO - $150.00/mo is extremely cheap and you are very, very blessed with such a low rate.  I will be paying twice that with high risk pool. 
Title: Re: What do I do if I loose my insurance?
Post by: bleueyes on May 08, 2008, 02:09:46 pm
I did not do this but, a friend has, I can not name him!!!
Put your business in a trust worthy person's name and anything else you own. Than go to medicare or Ryan white, etc...
I do not know if this can work as I am afraid of the consequences anyways.
Title: Re: What do I do if I loose my insurance?
Post by: darwin on May 08, 2008, 05:43:25 pm
I should add that some state's High Risk Pool actually want you to have decent insurance.  Other state's give you horrible, horrible, horrible plans (like 50% coinsurance on meds!).  So where you live definitely counts.  Actually, where you live also counts on if you qualify for ADAP.  You can make $50k per year in some places and still get ADAP.
Title: Re: What do I do if I loose my insurance?
Post by: bear60 on May 09, 2008, 02:46:03 pm
Darwin said:"IMHO - $150.00/mo is extremely cheap and you are very, very blessed with such a low rate.  I will be paying twice that with high risk pool.  "

I think ga meant ...the premium was increased by $150 a month....but he does not say what the total is.

For the record: I am self employed and pay for my own insurance ( which is a tax deduction) and have seen increases like this. I however have my insurance through a group plan with the Chamber of Commerce here.  My total monthly is around $467 ( for a Blue Cross HMO that has a prescription plan).  Its not the best of plans but it's better than nothing.

Title: Re: What do I do if I loose my insurance?
Post by: Florida69 on May 09, 2008, 03:50:02 pm
I did not do this but, a friend has, I can not name him!!!
Put your business in a trust worthy person's name and anything else you own. Than go to medicare or Ryan white, etc...
I do not know if this can work as I am afraid of the consequences anyways.

Although this may be good advice, my concern would be dealing with fraud if it comes back on you.  Besides you have no control over anyone but yourself.  Good luck, D
Title: Re: What do I do if I loose my insurance?
Post by: darwin on May 09, 2008, 08:08:30 pm
Quote
have my insurance through a group plan with the Chamber of Commerce here

Does your Chamber plan require your company have 2+ employees?  Idaho is like that - unfortunate for freelancers.
Title: Re: What do I do if I loose my insurance?
Post by: BT65 on May 09, 2008, 08:48:28 pm
I did not do this but, a friend has, I can not name him!!!
Put your business in a trust worthy person's name and anything else you own. Than go to medicare or Ryan white, etc...
I do not know if this can work as I am afraid of the consequences anyways.

I would not recommend this as a first-line of action.  You've gotten some other good advice here to check into.
Title: Re: What do I do if I loose my insurance?
Post by: bear60 on May 10, 2008, 09:17:51 am
Darwin....
No, the chamber does not require me to have two employees.  They have a catagory called "Entrepreneur" that is different than "small business".
My former partner who died in 1995 had his own business and he had a small business group plan with Blue Cross.  He had me and several other people on his group plan as" independent sub contractors."

Good luck
Joel
Title: Re: What do I do if I loose my insurance?
Post by: Miss Philicia on May 10, 2008, 09:34:08 am
Without knowing what your assets are and income it's impossible for anyone in the internet to comment on this issue, regardless of the advice from your doctor.  Please go to a local ASO and be insistent on jumping over the usual first line of volunteers and talking to only a upper level staff member knowledgeable about such issues.

You will not be the first person that has been in this pickle.
Title: Re: What do I do if I loose my insurance?
Post by: madbrain on May 10, 2008, 07:43:39 pm
Hi,

I know it's tough but try and keep your insurance for as long as possible. Unfortunately you won't be able to access the system as long as you do carry a policy. Requirements fo Ryan White/ADAP vary from state to state.

I've asked the mods to move your post to Living With where I think you'll receive broader feedback.

Not all government healthcare benefits consider you having an existing insurance policy to be an exclusion criteria. For example, the California ADAP doesn't exclude you, but it requires that you use any insurance benefits that you have available first, before ADAP will pay anything. ADAP can work together with a health insurance policy.

Case in my point - my partner qualifies for ADAP due to his income. But my employer and I pay for his Kaiser health insurance policy. Kaiser covers most of the cost of his meds, and ADAP pays the copays for his meds, so that he has nothing to pay for them. He has 3 name-brand prescriptions that would normally cost $30/month copay each under the insurance plan, and one generic that would cost $10/month. So ADAP pays $100/month in copays for him. The only inconvenience is that he has to refill his meds every 30 days, on the ADAP schedule. The Kaiser plan normally allows you to get up to 3 months supply at a time, and gives a 33% discount on the copays if you do so through the mail-order pharmacy. But ADAP only pays for 30 days at a time.
Title: Re: What do I do if I loose my insurance?
Post by: BlueMoon on May 11, 2008, 10:09:17 pm

Not all government healthcare benefits consider you having an existing insurance policy to be an exclusion criteria.  ADAP can work together with a health insurance policy.


If you qualify in Ohio, the state Drug Assistance Plan will pay your insurance premium, and HIV-related drug copays.

In my case, that amounts to over $8,700 a year at current prices.

Title: Re: What do I do if I loose my insurance?
Post by: ga1964 on May 12, 2008, 01:54:04 am
Thanks all.

I asked my ID about ADAP here in Ga. and he gave me the number to a case worker here.  I'll be calling her tomorrow to set up an appointment.

The confusion about my Insurance premium is the company went up #150.00 on my premium from $350.00/mo to $500.00/mo.  Sorry if I didn't make myself clear.

If I could get ADAP to pay my premiums and co-pays that would help out tremendously. 

$250.00 deductable on meds plus $35.00 co-pay after. 

Doctor office visits $40.00.

Labs and hospital bills $2000.00 deductable.

$50.00 co-pay per CT Scans, MRI, etc.

total for 07:  roughly around $10,510.00

This is just under half of my income and I'm getting futher behind in keeping up with the cost to keep myself alive.  I'm hoping to be able to get thru till Dec. 08 and I'll have my truck paid off, but I'm not sure I can make it that long.

Thanks again for all the input...If it gets to the point that I need to put my assets into someone elses name, I know I could trust my parents or my partner.  I want him to have it if anything happens to me.  He has been with me for 25 years and has stood by me this past year.  He deserves to have the assets liquidfied so that he can move on with his life and atleast have a safe home of his own that is paid for.
Title: Re: What do I do if I loose my insurance?
Post by: Dachshund on May 12, 2008, 07:47:51 am
I know there are several forum members from Georgia accessing ADAP. I'll send them a couple of PM's and see if they can help you. Like I said, each state has different requirements for ADAP and I know you need information specific to the state of Georgia.

I know you have quite a bit on your plate but you mention your partner of twenty five years. If you're gay and you haven't done so already you guys really need to sit down with an attorney and make out a will, living will, etc. Maybe your local ASO can suggest a lawyer. This is a very important thing to do to protect you and your lover.

Good luck,
Hal
Title: Re: What do I do if I loose my insurance?
Post by: ga1964 on May 13, 2008, 02:51:22 am
Thanks for the advice Dachshund. 

I do need to make a both a living will and a will so that my partner is protected, but the thought of doing it scares me a little.  I don't know if its actually talking to the attorney, ( I live in a small town and gossip runs wild here. ) or that it makes me face my mortality.  Either way, I still panic at the thought of doing it.

I had planned to call the ADAP case worker today to make an appointment, but I didn't.  I started feeling anxious when I started to call and could not go thru with it.  I'm still having issues talking with people, even if they are there to help, whether it is a doctor or ADAP case worker, even my partner and parents.  I feel like I'm being judged and looked down upon for getting HIV, the anxious feelings come flooding in and I start to panic.  I know it is stupid to panic, but I can't control it.  I just want to run and wish it would all go away.  I don't want to live like this for how ever long I have. 

I guess I'm just tired of dealing with all the crap that comes with HIV.  The fear of people finding out, the financial expense, remembering whether or not I've taken all my meds, the fear that I might take too many because I can't remember if I have taken them or not, pausing before I hug one of my nieces or nephew to make sure I don't have an open sore or anything, feeling like my blood will kill somebody if it was to get on them ( Like the alien in Aliens).  I'm a Cosmetologist, so I constantly worry about cutting myself when working with clients.

Sorry about rambling on, just needed to get it out I guess.

Thanks again for all the input. ;)