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Author Topic: APIC anyone?  (Read 3197 times)

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Offline buca45

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APIC anyone?
« on: October 29, 2013, 02:57:15 AM »
As I mentioned on an earlier message (thanks for the info  guys, much appreciated) I will be losing my domestic partner coverage due to move to a new job and decided to seek either medicare/caid and was told today that I make too much $$$ from SSDI to qualify for Medicare. I currently have the part that covers hospitalization and ADAP and my DP policy split the script cost.
Today I went it to see if they could help me sort out the whole Obamacare deal and was told that since my income is so low...but not low enough for Medicare, that they will help me get registered for my own BCBS plan with APIC (NY State Plan) will cover all premiums and copays for full coverage with dental, scripts, Doc visits, hospitalization, ER....the whole range of what we need.
So ?....is anyone on this APIC program and is it true that not a dime will come out of my SSDI check? It all sounds too good to be true but after verifying over and over again my ASO case manager is guaranteeing that I will never see a bill and it will all be an easy transfer from DP coverage to my own plan with no bills ever arriving for me to fret over.
I went into this thinking the worst and it seems that it all is going to go smoothly with no reason to worry about anything.
Too good to be true and am I getting myself into living on $200 a month???
Supposedly APIC will pick up every cent of premiums and copays for full coverage

 I am so used to being confused and seeing the surprises after the fact so I enter these negotiations thinking the worst!!
Appt tomorrow at 1 PM when all is revealed!!
Will post what I am told and hopefully others can learn from this experience.

Thanks as always my buds. You never fail to disappoint in getting me going in the right direction.
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Offline BT65

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Re: APIC anyone?
« Reply #1 on: October 29, 2013, 04:41:43 AM »
I do not understand.  You mean you make too much for Medicaid? (not Medicare).  Because Medicare is automatic with SSDI.  So I'm guessing you mean Medicaid.
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Offline Habersham

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Re: APIC anyone?
« Reply #2 on: October 29, 2013, 06:27:09 AM »
I know APIC is a New York state program and I believe you do not pay anything for it.


I don't of course know it is available in Texas.   Have you moved yet?
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Offline oksikoko

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Re: APIC anyone?
« Reply #3 on: October 29, 2013, 07:10:25 AM »
For what it's worth, I used APIC (hell, I might still be using it - the plot thickens) to continue my COBRA coverage last January. I didn't pay anyone anything.

It's all too confusing. I recently got a new insurance card from my previous insurance company in the mail, even though I didn't think I had insurance through them anymore. It seems that COBRA is still active, even though I've been using Medicaid (and ADAP and PAPs). I don't ask any questions and just hope I never get a big bill.

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Offline Miss Philicia

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Re: APIC anyone?
« Reply #4 on: October 29, 2013, 12:09:48 PM »
I was on APIC for a while when living in NYC. I think you're getting the correct information for someone residing in NY state, but I don't understand how this will apply for you if you're moving to Texas.
"Iíve slept with enough men to know that Iím not gay"

Offline buca45

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Re: APIC anyone?
« Reply #5 on: October 29, 2013, 06:30:54 PM »
Thanks all for your replies!
So I went in today for my apt with the financials man to get signed up for a health plan.
As expected the marketplace is down for the next few weeks so they were absolutely zero help. They did however make an apt for 11/15 to talk to me about getting signed up for a plan.
So then Ken went directly to several insurance co websites to check on what they had to offer before we went to BCBS where I currently have a domestic partner policy that will expire on 11/30. They are offering me a comprehensive one month policy for December that expires on 1/1/14, at which time I will reapply with them for a new year long policy. Cost for this one month policy? $1153.00 and no guarantee of the same price come 1/1.
APIC will pay the entire premium and the rep actually encouraged Ken to get me the most expensive policy to include EVERY THING as ADAP will no longer provide any support. 
They wanted me to chose the COBRA plan and were willing to pay the entire premium just for me, but since my partner will be covered by his new employer's insurance, that is not an option at all. They combine his income with my SSDI and that puts us WAY over the limit, so even if that were an option it would not have been approved.
As far as me moving with him to Tx, we have decided that I will remain here in NY for about 6 months so we will be able to put his house on the market come spring at which time, if it sells I will join him there. Maybe.
So again thanks all for your encouragement, it was mind numbing as I expected but I lived through it all.
"Love and Laughter and Happiness Ever After"

Offline Miss Philicia

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Re: APIC anyone?
« Reply #6 on: October 29, 2013, 07:33:54 PM »
Yeah, when I applied for APIC they presented me with two wildly different premium costs. I asked if it was really possible that I was not being forced to take the cheapest one, and they said by law they couldn't force me to take one over the other, so I took the expensive one as it made my co-pays reasonable (though it was still more than I'd ever paid for the first decade of HIV treatment as I had such a good policy I never had office copays and my medication copays were laughable amounts like $3.

How times have changed.

ps: Good luck in selling your house. Are you ready for the culture shock of moving from New York to TexASS?
"Iíve slept with enough men to know that Iím not gay"

Offline buca45

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Re: APIC anyone?
« Reply #7 on: October 29, 2013, 09:48:29 PM »
Massive culture shock!
The worse part of it is having Ted Cruz as my Senator. To be living in the worst red state in the country is just depressing....and could be dangerous as well. I am sure he is as far away from being concerned about HIV/AIDS causes and resources as can be and would just love to have funding cut immediately....along with the possibility of having 'the gays' rounded up and put on Galveston Island during a hurricane.
I will definitely miss NY...the people, the fun summer festivals every weekend and the close proximity to Toronto and of course the 6 hr drive to NYC. Houston just will not cut it!!
"Love and Laughter and Happiness Ever After"

Offline Miss Philicia

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Re: APIC anyone?
« Reply #8 on: October 30, 2013, 07:30:30 AM »
I think Texas must be OK if you live right in the city, definitely Austin which is as progressive as anywhere in more liberal enclaves -- plus evidently they have a great dining scene. And Houston has a liberal lesbian mayor so how bad can that be? I think it's once you venture out in the suburbs that things get dicey, and of course the rural areas -- but the rural areas like the Hill Country are where you'll get the best BBQ so just travel incognito and report back.

Mississippi would be way worse. :P
"Iíve slept with enough men to know that Iím not gay"


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