Now I know life isn't fair..... but this really isn't FAIR!
That said.
We will lose our COBRA on 10/20/10. About the same time his chemo needs to start. After searching and searching (any suggestions welcome) the only thing I can find to do is put him on the hish risk pool insurance through our state. (ks)
I called for the application,the premium page in the packet states premium will be 780.00/month. As I got deeper into the questions one of them was to verify that he had NO coverage for the last 6 months. Called, was told I was sent the wrong packet, seems that packet was for the NEW high risk pools that came along with Obamacare.
Got my new packet friday. His premium will be 1420.00/month with a 2500 ded., and 30% copay until we pay 5000.00.
Same insurance, same department. We just get to pay more because we have been responsible for the last 16 years and always had health insurance.
( I AM NOT saying everyone that hasn't had it was NOT responsible!!!)
I am referring to that we have made sure we had it all these years, even though we never really used it, and now that we need it, it's yanked away and hubby has a pre-existing condition so getting any on him ( affordably) is now impossible.
We don't qualify for medicaid, he is 2 years away from medicare, and would never be considered disabled. (thank god)
What I wish is that insurance companys who have clients on COBRA should HAVE to offer conversion coverage when the COBRA is ending. Some states are that way, I think...but not Kansas.
I wish that if we could prove that we are losing insurance due to COBRA ending that the NEW high risk pools would allow us to have the more reasonable premium....actually, I think everyone should qualify for the more reasonable premium...the insurance agency said they didn't want people jumping on that insurance because it would be cheaper than what they were already paying.
I wish cancer didn't exist.
I went to our hospital to pay our payment and asked to speak to a social worker re how to work this out. We honestly cannot afford this premium, another deductible and more co-pays and the kicker is IT STARTS OVER IN JANUARY! She handed me a flyer with BCBS and Coventry phone numbers on it. I started crying and told her I had already called them, they don't do pre-existing condition policies, she looked confused and told me to call them again. I left.
My house is on the market....anybody want to move to Kansas? (o; And...let me and my family live with you? haha
Thanks for listening. I was sitting here at my desk writing the check for 1015.00 for our next month of COBRA (that covers the whole family). Then I have to write a check for the 1400+ for the high risk pool,(that covers only my husband, guess me and the kids will be SOL, there's no more money.) Guess I just feel pissed and needed to let it out.
I know in my heart that there are people with much bigger problems today and my thoughts and prayers go out to you!
Chriss
Comments
-
Thank you! I have always hadAnneCan said:Chris
I am so sorry you are going through all this! Because I live in Canada, we have a totally different health care system, + I won't pretend to understand all the ins + outs of your issue, but I do understand this sucks! Sorry I can't be of any help!
Thank you! I have always had a hard time with UNfair...(o:
I have to kick and scream a little before I settle down, just the way I tick.
I really appreciate this board to be able to do that on!0 -
Chriss
I will resist to go on an on about things, but I wanted you to know that having cancer and insurance issues really stinks.
A friend here in Texas is on high risk pool because of a Lymphoma 10 years ago, now she has breast cancer. She will have to pay high out of pocket stuff and really won't get much help financially. I will stop there because I could really get wound up!!!
You and your family are our thoughts,
Jan0 -
i was dx may 2010 with colon cancer had 70% of colon removed now on chemo folfox...i didnt have insurance..couldnt afford it...i tried the high risk but they have a clause saying you have to wait 12 months before they will cover pre-existing....that insurance only last for 2 years...try talking to the hospital or doctors about a charity plan...they have them also file for medicaid or a spin down...also when they deny you file an appeal..i know what you are going through....hope this helps...prayers and best wishes for you0
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Chris...
Not sure how much this will help, but you could try to peruse this site and see if any of the places are a fit for you and your situation. I really hope so.
https://cissecure.nci.nih.gov/factsheet/FactsheetSearchResult8_3.aspx?~UHViTG5rPTguMyZGaW5Bc2lzdD02-BH07xH/JQz8=
There is this site as well, however, we didn't qualify.
http://www.cancercarecopay.org/eligibility.html
I am so sorry you're going through this. I wish I could be more help to you.0 -
Check again
Dear Chriss,
My daughter handles the insurance for her company and she was telling me that with the Obamacare that insurance companies can no longer keep from insuring you for a pre-existing condition.
I don't know any details, but it would not hurt to check it one more time.
Also not sure why you would not qualify for the New High Risk pool since you had not belonged to it before. I would question that too. As for having no coverage for 6 months, does that include having COBRA?
You might try to contact a patient advocate. They may have some suggestions. Also check with your local American Cancer Society, they may also have suggestions.
Is your husband working? If not he and he is over 62 he can qualify for early Social Security benifits. If he does some work or later gets a full time job they can suspend the payments again until he again applies.
I understand your situation as I am one who is also too young for medicare and have not had insurance for the last 5 years. My state does not have a high risk pool, but I was fortunate enough to have a not for profit hospital and associated doctors so that much of those costs were 'forgiven' as charity. There were still plenty of outstanding bills, but it helped.
Good luck with your search for financial assistance or reasonable insurance for you all.
Hugs,
Marie who loves kitties0 -
Obama Care pre-existing conditionsLovekitties said:Check again
Dear Chriss,
My daughter handles the insurance for her company and she was telling me that with the Obamacare that insurance companies can no longer keep from insuring you for a pre-existing condition.
I don't know any details, but it would not hurt to check it one more time.
Also not sure why you would not qualify for the New High Risk pool since you had not belonged to it before. I would question that too. As for having no coverage for 6 months, does that include having COBRA?
You might try to contact a patient advocate. They may have some suggestions. Also check with your local American Cancer Society, they may also have suggestions.
Is your husband working? If not he and he is over 62 he can qualify for early Social Security benifits. If he does some work or later gets a full time job they can suspend the payments again until he again applies.
I understand your situation as I am one who is also too young for medicare and have not had insurance for the last 5 years. My state does not have a high risk pool, but I was fortunate enough to have a not for profit hospital and associated doctors so that much of those costs were 'forgiven' as charity. There were still plenty of outstanding bills, but it helped.
Good luck with your search for financial assistance or reasonable insurance for you all.
Hugs,
Marie who loves kitties
This plan already went into effect for children. However, the same plan is not available to adults until Jan. 1, 2014.
In the meantime there has been a federal high risk insurance pool plan set up whereby the feds subsidize your costs that are over the regular costs for your insurance plan. Under the law, the premiums for this pool will be the same as would be charged for a standard population of people with varying risks. Maximum out-of-pocket cost sharing for enrollees will be $5,950 for individuals and $11,900 for families, per year. However, you have to have been without insurance for 6 months already. Also, while I'm not sure about other states, I know that in Nevada, there is a limit of only 3,000 spots available to take advantage of the federal program. Within 20 days of the announcement of the pool, the state had already received over 7,000 eligible applications.0 -
OKthenLori-S said:Obama Care pre-existing conditions
This plan already went into effect for children. However, the same plan is not available to adults until Jan. 1, 2014.
In the meantime there has been a federal high risk insurance pool plan set up whereby the feds subsidize your costs that are over the regular costs for your insurance plan. Under the law, the premiums for this pool will be the same as would be charged for a standard population of people with varying risks. Maximum out-of-pocket cost sharing for enrollees will be $5,950 for individuals and $11,900 for families, per year. However, you have to have been without insurance for 6 months already. Also, while I'm not sure about other states, I know that in Nevada, there is a limit of only 3,000 spots available to take advantage of the federal program. Within 20 days of the announcement of the pool, the state had already received over 7,000 eligible applications.
Maybe this website might be of help. http://www.coverageforall.org/. They have some pretty comprehensive information.
Also, Since I can't fix your problem ... I did just want to let you know that I totally understand your frustration. Dealing with this disease is tough enough without having to battle with the insurance and financial problems.0 -
Thank you all SO much!Lori-S said:OKthen
Maybe this website might be of help. http://www.coverageforall.org/. They have some pretty comprehensive information.
Also, Since I can't fix your problem ... I did just want to let you know that I totally understand your frustration. Dealing with this disease is tough enough without having to battle with the insurance and financial problems.
Was busy the last few hours having BDay cake for my husband...it was funny, when we got to the "And MANY More..." part of the song the whole family sung a little louder. (o:
Your responses and advice really touches my heart, god bless you all!
The way we decided to handle the forced early retirement was to take a larger payment on his pension that will last until he is 65, and he did start collecting early Social Security when he turned 62. Our thoughts were we would pay down the house with the pension, so that when it stopped (or lowered) we could refinance our home and not have to move.
That was BC, before cancer. We had no clue the financial issues that were ahead with this disease. If we had taken a life time payment on his pension, we would probably qualify for medicaid. But there is no going back on it now, its a done deal. The fact that our income is temporary is not a factor, I guess in a sense everyones is.
I did talk to ACS and they hooked me up with patient advocate, they sent me some information and we might qualify for a 100 grant for transportation costs. Every little bit helps. (o:
I'm sorry to go on and on...this whole thing just boggles my mind. I have the hardest time believing this is how it is. My biggest fear is he will be refused a treatment until we can pay for it. That happened to me when my ovary was twisted and was KILLING me, I say that literally, I would have died if they didn't remove it (they just didn't know that until they got in there) I was asked to bring my deductible of 3500 by the surgery center. When I said I didn't have it, they offered to charge it. I still am paying that off.
Anyway, scared he won't get what he needs.
I will look at all the links suggested tonight, gotta get the kids in bed and take a pain pill for my right sided pain that no one can figure out...sure hope they do before Oct 20. (0:...but then again it would be a pre-existing condition and I would have to come up with another 1400 for high risk insurance...*wink*0 -
Ohokthen said:Thank you all SO much!
Was busy the last few hours having BDay cake for my husband...it was funny, when we got to the "And MANY More..." part of the song the whole family sung a little louder. (o:
Your responses and advice really touches my heart, god bless you all!
The way we decided to handle the forced early retirement was to take a larger payment on his pension that will last until he is 65, and he did start collecting early Social Security when he turned 62. Our thoughts were we would pay down the house with the pension, so that when it stopped (or lowered) we could refinance our home and not have to move.
That was BC, before cancer. We had no clue the financial issues that were ahead with this disease. If we had taken a life time payment on his pension, we would probably qualify for medicaid. But there is no going back on it now, its a done deal. The fact that our income is temporary is not a factor, I guess in a sense everyones is.
I did talk to ACS and they hooked me up with patient advocate, they sent me some information and we might qualify for a 100 grant for transportation costs. Every little bit helps. (o:
I'm sorry to go on and on...this whole thing just boggles my mind. I have the hardest time believing this is how it is. My biggest fear is he will be refused a treatment until we can pay for it. That happened to me when my ovary was twisted and was KILLING me, I say that literally, I would have died if they didn't remove it (they just didn't know that until they got in there) I was asked to bring my deductible of 3500 by the surgery center. When I said I didn't have it, they offered to charge it. I still am paying that off.
Anyway, scared he won't get what he needs.
I will look at all the links suggested tonight, gotta get the kids in bed and take a pain pill for my right sided pain that no one can figure out...sure hope they do before Oct 20. (0:...but then again it would be a pre-existing condition and I would have to come up with another 1400 for high risk insurance...*wink*
Happy Birthday to him!0 -
Happy Birthday!okthen said:Thank you all SO much!
Was busy the last few hours having BDay cake for my husband...it was funny, when we got to the "And MANY More..." part of the song the whole family sung a little louder. (o:
Your responses and advice really touches my heart, god bless you all!
The way we decided to handle the forced early retirement was to take a larger payment on his pension that will last until he is 65, and he did start collecting early Social Security when he turned 62. Our thoughts were we would pay down the house with the pension, so that when it stopped (or lowered) we could refinance our home and not have to move.
That was BC, before cancer. We had no clue the financial issues that were ahead with this disease. If we had taken a life time payment on his pension, we would probably qualify for medicaid. But there is no going back on it now, its a done deal. The fact that our income is temporary is not a factor, I guess in a sense everyones is.
I did talk to ACS and they hooked me up with patient advocate, they sent me some information and we might qualify for a 100 grant for transportation costs. Every little bit helps. (o:
I'm sorry to go on and on...this whole thing just boggles my mind. I have the hardest time believing this is how it is. My biggest fear is he will be refused a treatment until we can pay for it. That happened to me when my ovary was twisted and was KILLING me, I say that literally, I would have died if they didn't remove it (they just didn't know that until they got in there) I was asked to bring my deductible of 3500 by the surgery center. When I said I didn't have it, they offered to charge it. I still am paying that off.
Anyway, scared he won't get what he needs.
I will look at all the links suggested tonight, gotta get the kids in bed and take a pain pill for my right sided pain that no one can figure out...sure hope they do before Oct 20. (0:...but then again it would be a pre-existing condition and I would have to come up with another 1400 for high risk insurance...*wink*
Please wish your husband a very happy birthday (+ many more!) from me.0 -
Insuranceokthen said:Thank you all SO much!
Was busy the last few hours having BDay cake for my husband...it was funny, when we got to the "And MANY More..." part of the song the whole family sung a little louder. (o:
Your responses and advice really touches my heart, god bless you all!
The way we decided to handle the forced early retirement was to take a larger payment on his pension that will last until he is 65, and he did start collecting early Social Security when he turned 62. Our thoughts were we would pay down the house with the pension, so that when it stopped (or lowered) we could refinance our home and not have to move.
That was BC, before cancer. We had no clue the financial issues that were ahead with this disease. If we had taken a life time payment on his pension, we would probably qualify for medicaid. But there is no going back on it now, its a done deal. The fact that our income is temporary is not a factor, I guess in a sense everyones is.
I did talk to ACS and they hooked me up with patient advocate, they sent me some information and we might qualify for a 100 grant for transportation costs. Every little bit helps. (o:
I'm sorry to go on and on...this whole thing just boggles my mind. I have the hardest time believing this is how it is. My biggest fear is he will be refused a treatment until we can pay for it. That happened to me when my ovary was twisted and was KILLING me, I say that literally, I would have died if they didn't remove it (they just didn't know that until they got in there) I was asked to bring my deductible of 3500 by the surgery center. When I said I didn't have it, they offered to charge it. I still am paying that off.
Anyway, scared he won't get what he needs.
I will look at all the links suggested tonight, gotta get the kids in bed and take a pain pill for my right sided pain that no one can figure out...sure hope they do before Oct 20. (0:...but then again it would be a pre-existing condition and I would have to come up with another 1400 for high risk insurance...*wink*
Insurance in the country stinks! For all you people out there against some kind of reform try going without insurance or having this pre-existing crap thrown at you. Imagine paying for car insurance that doesn't pay until your car is worth nothing! etc .Sorry touched a big nerve for me. I am sorry you are going through this. I am doing the cobra thing as well because my company has an 18 month pre-existing clause give me a BREAK! The almighty dollars rules in the good old US even with life and death.0 -
Another option?okthen said:Thank you all SO much!
Was busy the last few hours having BDay cake for my husband...it was funny, when we got to the "And MANY More..." part of the song the whole family sung a little louder. (o:
Your responses and advice really touches my heart, god bless you all!
The way we decided to handle the forced early retirement was to take a larger payment on his pension that will last until he is 65, and he did start collecting early Social Security when he turned 62. Our thoughts were we would pay down the house with the pension, so that when it stopped (or lowered) we could refinance our home and not have to move.
That was BC, before cancer. We had no clue the financial issues that were ahead with this disease. If we had taken a life time payment on his pension, we would probably qualify for medicaid. But there is no going back on it now, its a done deal. The fact that our income is temporary is not a factor, I guess in a sense everyones is.
I did talk to ACS and they hooked me up with patient advocate, they sent me some information and we might qualify for a 100 grant for transportation costs. Every little bit helps. (o:
I'm sorry to go on and on...this whole thing just boggles my mind. I have the hardest time believing this is how it is. My biggest fear is he will be refused a treatment until we can pay for it. That happened to me when my ovary was twisted and was KILLING me, I say that literally, I would have died if they didn't remove it (they just didn't know that until they got in there) I was asked to bring my deductible of 3500 by the surgery center. When I said I didn't have it, they offered to charge it. I still am paying that off.
Anyway, scared he won't get what he needs.
I will look at all the links suggested tonight, gotta get the kids in bed and take a pain pill for my right sided pain that no one can figure out...sure hope they do before Oct 20. (0:...but then again it would be a pre-existing condition and I would have to come up with another 1400 for high risk insurance...*wink*
I don't know where you live, and this might cause you to have to make major changes in docs, but do you have a not for profit facility near you? It might be that you could get the services for free and just have to pay for meds. Still a big cost I know, but as you said every little bit helps.
Hugs,
Marie who loves kitties0 -
Hi Marie who loves kitties.Lovekitties said:Another option?
I don't know where you live, and this might cause you to have to make major changes in docs, but do you have a not for profit facility near you? It might be that you could get the services for free and just have to pay for meds. Still a big cost I know, but as you said every little bit helps.
Hugs,
Marie who loves kitties
Hi Marie who loves kitties. (o: Hope your doing well today!!!!
I believe our hospital right here in town is not for profit, that is where hubby will be doing chemo, but twice now when I've tried to talk to them about our situation they look at me like they don't know what to say. I finally asked for a financial social worker, they sent me to the lady that collects my payment for my surgery...they have help for people that have not had insurance in the last 12 months...that seems to be whats killing us, that we've had coverage. I don't understand why losing COBRA isn't looked at a little different. It's not our choice.
I just spoke with the HealthWell foundation, they will send us an application for premium and co-pay help, but do I dare to hope? Sounds kinda dramatic but these ups and downs can really play on your heart and soul.
Wishing everyone here a beautiful day!
(*:0 -
Right on sista!462lt said:Insurance
Insurance in the country stinks! For all you people out there against some kind of reform try going without insurance or having this pre-existing crap thrown at you. Imagine paying for car insurance that doesn't pay until your car is worth nothing! etc .Sorry touched a big nerve for me. I am sorry you are going through this. I am doing the cobra thing as well because my company has an 18 month pre-existing clause give me a BREAK! The almighty dollars rules in the good old US even with life and death.
Right on sista!
462it- I obviously don't know your whole situation, but wanted to add that if you had group coverage before (the one your on COBRA with) and you moved to another group coverage, then they have to give you credit for your previous coverage on any pre-existing condition. (that's the way I understood it anyway)
You may already know this but it just doesn't fit your situation, but thought if I had the opportunity to help vs just whine about things I would. (o:0 -
Confused, your plan shouldokthen said:Hi Marie who loves kitties.
Hi Marie who loves kitties. (o: Hope your doing well today!!!!
I believe our hospital right here in town is not for profit, that is where hubby will be doing chemo, but twice now when I've tried to talk to them about our situation they look at me like they don't know what to say. I finally asked for a financial social worker, they sent me to the lady that collects my payment for my surgery...they have help for people that have not had insurance in the last 12 months...that seems to be whats killing us, that we've had coverage. I don't understand why losing COBRA isn't looked at a little different. It's not our choice.
I just spoke with the HealthWell foundation, they will send us an application for premium and co-pay help, but do I dare to hope? Sounds kinda dramatic but these ups and downs can really play on your heart and soul.
Wishing everyone here a beautiful day!
(*:
Confused, your plan should be what you had when he was employed. Did you ask if there is still an OBAMA subsidy available? I am on cobra and my husband and I pay 280 a month. Please go back and ask about the subsidy. Did you meet any of deductibles because they would be the same for 2010, you have to meet new deductibles in 2011. My cobra is for 18 months.0 -
Hi Nana b. We have been onNana b said:Confused, your plan should
Confused, your plan should be what you had when he was employed. Did you ask if there is still an OBAMA subsidy available? I am on cobra and my husband and I pay 280 a month. Please go back and ask about the subsidy. Did you meet any of deductibles because they would be the same for 2010, you have to meet new deductibles in 2011. My cobra is for 18 months.
Hi Nana b. We have been on COBRA for 18 months as of Oct 10 2010. That is why it is ending. We did have the same health care for all those months as before, and we did qualify for the subsidy up until August, we were paying 350 for family and then in August it went to 1015.00. The new deductibles and copays I was referring to are with the High Risk insurance through our state that seems to be my husbands only option. It is confusing, and I talk (write) to much half the time so probably even more confusing than it has to be. (o:0 -
Not fair for sure!okthen said:Hi Marie who loves kitties.
Hi Marie who loves kitties. (o: Hope your doing well today!!!!
I believe our hospital right here in town is not for profit, that is where hubby will be doing chemo, but twice now when I've tried to talk to them about our situation they look at me like they don't know what to say. I finally asked for a financial social worker, they sent me to the lady that collects my payment for my surgery...they have help for people that have not had insurance in the last 12 months...that seems to be whats killing us, that we've had coverage. I don't understand why losing COBRA isn't looked at a little different. It's not our choice.
I just spoke with the HealthWell foundation, they will send us an application for premium and co-pay help, but do I dare to hope? Sounds kinda dramatic but these ups and downs can really play on your heart and soul.
Wishing everyone here a beautiful day!
(*:
I don't understand what the deal is about how long you have been without insurance...the 'bean counters' who manage these funds obviously don't understand what it is to have a financially catastrophic disease.
Yes, dare to hope and hope some more. You are not being dramatic at all, just doing your best to keep the wheels on the track. I totally understand about how difficult the ups and downs, the hopes that are then dashed, the emotional drain this can be because of the financial aspect of treating this disease.
Hang in there. If anyone here can come up with other suggestions you know you will be first on their list to share with.
Hugs,
Marie who loves kitties
P.S. I am doing well, thanks!0 -
HealthWell Foundation
Hi Chris,
I am hopeful that the HealthWell foundation will be able to help you and your family. I am an oncology nurse (who's son has Stage IV colon cancer....at 19, but I'll post our story later) and I work with an Oncology social worker. The foundation has given our patients HUGE amounts of money for insurance and copays. She just got a patient one for $10,000, but the largest so far was $14,000!!!! I don't know the particulars, finacial consideration, etc. but I just wanted to give you hope. I've lurked on here since my son was first diagnosed with Stage IIIC in August 2009, but I just HAD to respond to your post. I know those feelings of helplessness and how they can put you in a bad place sometimes.
Best wishes to you with this. Cancer sucks and so does our health insurance system!!!
Dee0 -
Thank you Dee, that is greatWhatsA_Mom2Do said:HealthWell Foundation
Hi Chris,
I am hopeful that the HealthWell foundation will be able to help you and your family. I am an oncology nurse (who's son has Stage IV colon cancer....at 19, but I'll post our story later) and I work with an Oncology social worker. The foundation has given our patients HUGE amounts of money for insurance and copays. She just got a patient one for $10,000, but the largest so far was $14,000!!!! I don't know the particulars, finacial consideration, etc. but I just wanted to give you hope. I've lurked on here since my son was first diagnosed with Stage IIIC in August 2009, but I just HAD to respond to your post. I know those feelings of helplessness and how they can put you in a bad place sometimes.
Best wishes to you with this. Cancer sucks and so does our health insurance system!!!
Dee
Thank you Dee, that is great to know!
Bless your heart for working in Oncology, I too am a nurse (havn't worked full time in 10 years) but most of my background was in OB/GYN. I thought I knew too much to stay calm sometimes, I can only imagine what you struggle with. Sending you and your son hopes and prayers!0
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