Post New Topic

I need some support and help

TrueLoveIn2008 Posted:

I need some support and help

HI girls. The past few days have been very trying on my patience and I need some help This might be a little long, but I'd love advice.

I don't have insurance. I don't have anything MAJOR wrong with me - no diabetes, no terribly horrible chronic illness that needs care - but I have psoriasis, which does require maintenance and upkeep, and occasional visits to the dr.

I tried to get Healthy NY insurance, but I was denied (DH makes a certain amount on the books, the rest off, and even the measly amount he makes on the books was too much when combined with my unemployment). So I then looked into Cobra - which is going to be subsidized from the govt. starting March 1. However, in order to get cobra, you need to get it from the day you were laid off - which for me was Jan 7 - it has to be continuous coverage. That means I'd need to pay $1000 just to get it from that date - I didn't use any medical services then, it's in the past, and I think it's crazy.

My parents want to pay for it, but I feel like they have given me so much lately - my wedding, my school loans (my mom has always wanted to pay for them, and has paid for most of them since I graduated, with a few breaks when she couldn't - my sister's wedding year and mine, basically) - and they are helping my sister out too now with some things. PLUS, it's the principle for me - why do I have to pay $1000 for coverage that has PASSED, that I don't need????

My alternative is this discount health plan that's $241 a month but doesn't cover dr visits and all of that fully. They cover $100 per visit, I pay the rest - and they only cover 5 visits a year. If this was a FULL insurance plan, I'd take it - but it doesn't seem worth the money since it only covers PART of a visit.

So I am thinking about not getting insurance at all. I will get dental and vision through cobra because it's cheap - $30 a month for both, and it'll be subsidized by the govt too, so it'll be like $7 a month when it's all done. However, I am concerned that when I do get insurance, the pre-existing clause will not allow me to get treatment for my psoriasis (in the meantime I'd just go to my dr less than normal, pay him in cash and hope he gives me a deal). AND, what if I get into an accident? What if I get really sick???

What would you do????? I need advice!!!

Thanks for reading - you girls are the best
TrueLoveIn2008 Posted:

Re: I need some support and help

If any of you are insurance experts, I'd love to hear more about pre-existing clauses!!

TommysWife08 Posted:

Re: I need some support and help

i was in the same boat as you when i had the lag between health ins when i started my new job

i would NOT not have insurance... GOD FORBID you get into an accident or something!!

i would either A - go under DHs insurance

or sign up for Infinity Health Flex + thats what i did and its $200 a month for FULL hospital coverage!! for dr visits, they make you pay a portion of the visit.... and they have Rx coverage too!

i'll give you the info if you want!

EsquireBride Posted:

Re: I need some support and help

I guess my first question is:

Does DH have insurance? If he does, can you sign up with his insurer because you are now married?
nifheim Posted:

Re: I need some support and help

i ran with out insurance for YEARS and it didn't really cost me too much roughly $500 a year depending on what services I needed. The only thing I did do was physicals and gyno exams yearly. If i was sick - didn't go to the doctor unless i was dying.

NickandTara426 Posted:

Re: I need some support and help

I'm sorry you are going through this! Ins. stinks IMO BUT I think it's important to have for the what if's in life.
Normally pre-existing conditions are like you said your psoriasis and you have to fullfill your pre-existing condition for a year and then they are obligated to cover you. I had a pre existing condition and it was fullfilled in a year and thank god nothing happened as far as that. If you are in an accident (i.e. break your leg, appendicitis(sp), etc.) you are covered because it isn't 'pre-existing'(my mom asked the ins company about this). DH and I are looking at HIP smart start with no prescription plan. I'm not a fan of HIP because most of my drs now don't take it but it's better than no insurance. I was under my parents policy up until my wedding day. I have until 3-16 to get ins. or I have to fulfill my 1 year pre-existing condition again. HTH.
TrueLoveIn2008 Posted:

Re: I need some support and help

DH has no insurance either - he works at an autobody shop and most don't offer it.

Michelle, please tell me more about Infinity - I have thought about hospitalization only.
bluekat16 Posted:

Re: I need some support and help

Oh Jenn I'm soo sorry this is going on with you. Honestly I've always opted to take Cobra becasue I'm always afraid something might happen and then I'm not covered. I think ti's soo sweet of your parents to want to help...maybe you can take this help but pay them back when you find a job...this way it feels like a loan and not them giving you more.

I think the best thing is to run the math for Cobra vs. the alternative plan. Call your Dr. and ask how muh and out-of -pocket visit costs, find out from the pharmacy how much whatever you use for the psoriasis costs out-of-pocket. Also think about how often you get sick in a given year worst case scenerio. I think once you run the numbers you'll be able to pick which plan suits you the best.
NickandTara426 Posted:

Re: I need some support and help


Posted by JBoothIn2008

DH has no insurance either - he works at an autobody shop and most don't offer it.

Michelle, please tell me more about Infinity - I have thought about hospitalization only.



DH wanted hospitalization only and they don't cover CAT scans, X-rays, etc.
TrueLoveIn2008 Posted:

Re: I need some support and help


Posted by NickandTara426

I'm sorry you are going through this! Ins. stinks IMO BUT I think it's important to have for the what if's in life.
Normally pre-existing conditions are like you said your psoriasis and you have to fullfill your pre-existing condition for a year and then they are obligated to cover you. I had a pre existing condition and it was fullfilled in a year and thank god nothing happened as far as that. If you are in an accident (i.e. break your leg, appendicitis(sp), etc.) you are covered because it isn't 'pre-existing'(my mom asked the ins company about this). DH and I are looking at HIP smart start with no prescription plan. I'm not a fan of HIP because most of my drs now don't take it but it's better than no insurance. I was under my parents policy up until my wedding day. I have until 3-16 to get ins. or I have to fulfill my 1 year pre-existing condition again. HTH.




I have until 3/14 - 63 days after 1/8 -- I know what you are going through!!
TommysWife08 Posted:

Re: I need some support and help


Posted by JBoothIn2008

DH has no insurance either - he works at an autobody shop and most don't offer it.

Michelle, please tell me more about Infinity - I have thought about hospitalization only.



i will FM you!!
AR31 Posted:

Re: I need some support and help

I am sorry that you are going through this.. when I graduated from college, there was a lag, and I had to get insurance asap b/c I have chronic food allergies and I had to carry an epi w/ me at all times.. and needed zyertac everyday (it was a prescription back then). I joined Health Plus and I had to pay a nominal fee b/c I lived at home and I had a coop position w/ the company i did my senior project and that made me have too much money..

I have seen Health Plus handing out applications, and when I applied a few years ago, I got everything within a few weeks..
Toucan311 Posted:

Re: I need some support and help

There are so many discount plans out there that perpetuate the myth that they are insurance plans - They are NOT. For the most part, what most offices would charge their cash paying patients is less than what a lot of these companies offer. Have you contacted your doctor's office and ask if they have a special rate for non-insurance patients? Often, they'll also even call a drug rep to see if they can get you bulk samples of any medications you're on. You'd be surprised how much offices will work with you if you ask.

I'm not sure what kind of doctor you need to go to for psoraisis - if you see a PCP or you go to a derm or an autoimmune guy - but if you needed to see a PCP, I work for one, and I'm the billing supervisor, so I could easily talk w/the doctor about getting you a discounted rate, delayed billing, whatever you'd need.

Have you looked into Family Health Plus for you and your husband? I know that there are a lot of health plans available, and you don't necessarily have to be eligible for medicaid or anything like that - you just have to be unable to get insurance on your own for some reason (ie you're unemployed and your DH's job doesn't offer it)
TrueLoveIn2008 Posted:

Re: I need some support and help


Posted by AR31

I am sorry that you are going through this.. when I graduated from college, there was a lag, and I had to get insurance asap b/c I have chronic food allergies and I had to carry an epi w/ me at all times.. and needed zyertac everyday (it was a prescription back then). I joined Health Plus and I had to pay a nominal fee b/c I lived at home and I had a coop position w/ the company i did my senior project and that made me have too much money..

I have seen Health Plus handing out applications, and when I applied a few years ago, I got everything within a few weeks..

]

The name of the plan is Health Plus? Or is it the same as Michelle is talking about, Infinity Health Plus??

I like the infinity plan, but I plan on getting dental and eye care through cobra because it's a full plan and cheaper -- so I don't really need that ... but I am still thinking about it.
AR31 Posted:

Re: I need some support and help


Posted by JBoothIn2008


Posted by AR31

I am sorry that you are going through this.. when I graduated from college, there was a lag, and I had to get insurance asap b/c I have chronic food allergies and I had to carry an epi w/ me at all times.. and needed zyertac everyday (it was a prescription back then). I joined Health Plus and I had to pay a nominal fee b/c I lived at home and I had a coop position w/ the company i did my senior project and that made me have too much money..

I have seen Health Plus handing out applications, and when I applied a few years ago, I got everything within a few weeks..

]

The name of the plan is Health Plus? Or is it the same as Michelle is talking about, Infinity Health Plus?? .



http://www.healthplus-ny.org/en/118_ENG_HTML.html

Family Health Plus
Family Health Plus is a New York State program that provides some adults with affordable healthcare. Residents of New York City can apply to Family Health Plus through Health Plus. Health Plus is a New York State facilitated enroller. With Family Health Plus through Health Plus, you can select a doctor that works in our plan.

Adults, with or without children, can join if they:


Are between the ages of 19 to 64
Meet income criteria
Are a New York State resident
Are a US citizen (or have certain immigration status)
Have no health insurance
Are not eligible for Medicaid
Live in New York City
Health Plus/Family Health Plus members can receive:


Regular checkups
Inpatient and outpatient health care
Prescriptions drugs and smoking cessation products
Dental services
Eye, speech and hearing services (some limits apply)
Durable medical equipment
Emergency Room and emergency ambulance services
Drug, alcohol, and mental health services (some limits apply)
Diabetic supplies and equipment
Radiation therapy, chemotherapy and hemodialysis
Short-term rehabilitation
Home healthcare (some limits apply)
Family planning and reproductive health
Prosthetics
and more

There is no cost to join Health Plus/Family Health Plus. Co-payments apply for some services.

If you have children, they may be eligible for Child Health Plus. Child Health Plus is a New York State program that provides FREE or affordable health insurance for children under the age of 19. This program is available through Health Plus.

I like the infinity plan, but I plan on getting dental and eye care through cobra because it's a full plan and cheaper -- so I don't really need that ... but I am still thinking about it
TommysWife08 Posted:

Re: I need some support and help


Posted by JBoothIn2008


Posted by AR31

I am sorry that you are going through this.. when I graduated from college, there was a lag, and I had to get insurance asap b/c I have chronic food allergies and I had to carry an epi w/ me at all times.. and needed zyertac everyday (it was a prescription back then). I joined Health Plus and I had to pay a nominal fee b/c I lived at home and I had a coop position w/ the company i did my senior project and that made me have too much money..

I have seen Health Plus handing out applications, and when I applied a few years ago, I got everything within a few weeks..

]

The name of the plan is Health Plus? Or is it the same as Michelle is talking about, Infinity Health Plus??

I like the infinity plan, but I plan on getting dental and eye care through cobra because it's a full plan and cheaper -- so I don't really need that ... but I am still thinking about it.



hmm.... im not sure if they are the same... i know they did not base anything on how much money i had or what i owned
AR31 Posted:

Re: I need some support and help


Posted by TommysWife08


Posted by JBoothIn2008


Posted by AR31

I am sorry that you are going through this.. when I graduated from college, there was a lag, and I had to get insurance asap b/c I have chronic food allergies and I had to carry an epi w/ me at all times.. and needed zyertac everyday (it was a prescription back then). I joined Health Plus and I had to pay a nominal fee b/c I lived at home and I had a coop position w/ the company i did my senior project and that made me have too much money..

I have seen Health Plus handing out applications, and when I applied a few years ago, I got everything within a few weeks..

]

The name of the plan is Health Plus? Or is it the same as Michelle is talking about, Infinity Health Plus??

I like the infinity plan, but I plan on getting dental and eye care through cobra because it's a full plan and cheaper -- so I don't really need that ... but I am still thinking about it.



hmm.... im not sure if they are the same... i know they did not base anything on how much money i had or what i owned



it might have been for my medications then.. long time ago..
TommysWife08 Posted:

Re: I need some support and help


Posted by AR31


it might have been for my medications then.. long time ago..



i got the info from DH's aunt who deals with insurance... she said that NO ONE gets turned down... so maybe its not the same thing

i filled out a basic application (name, DOB, address, phone number etc..) and i got the insurance info within a week
Toucan311 Posted:

Re: I need some support and help

There's Infinity, Affinity and Definity. Three different plans.

RadiantBride Posted:

Re: I need some support and help

I would try Health Plus. Also is your DH in an union? If he is sometimes the unions have their own insurance which is more affordable then anything outside.

Out of the two options that you listed above I would choose the first one. Although it seems that you have to pay more I think that in the long run with treatments you will save more money. (As long as they cover everything for you)

Reply to this topic

Log in to reply or quote a post.