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I need some support and help

Original post by TrueLoveIn2008

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

Family Health Plus is an income-based plan, only available to people who make under a certain amount. It's state sponsored - very similar to the Healthy NY I tried to get.

I'll look into the infinity a bit more. I know the individual ins co's offer hospitalization only too, i'll look into that.
TrueLoveIn2008 Posted:

Re: I need some support and help

Posted by RadiantBride

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)



No union .. thanks nelly.
futuremrsfab Posted:

Re: I need some support and help

Sorry I dont have any advice but just wanted to send hugs & if you need anything fm!
TrueLoveIn2008 Posted:

Re: I need some support and help

Posted by futuremrsfab

Sorry I dont have any advice but just wanted to send hugs & if you need anything fm!



Thanks MB
LuvMyAlfonse Posted:

Re: I need some support and help

Jenn - take Heather up on her offer.

Psoriasis is a skin condition right? What do you need? A topical steroid creme for it? A PCP could prescribe that - or you could tell the PCP what meds already worked for you.

What Heather's offering sounds like the best course for you. Why pay thousands of dollars when you're not going to need it?

squeekietoy Posted:

Re: I need some support and help

Have you looked into Health First, AmeriChoice, Neighborhood Health Plan, HIP Family Health Plus, Affinity? These are all a part of Family Health Plus.

I work for Stony Brook and I see people come through here ALL the time with these plans. I know that you need to have a certain amount of income and once you're approved they cover pretty much all doctors and prescriptions with little or no copay.
TrueLoveIn2008 Posted:

Re: I need some support and help

Posted by Mimacat

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)



I totally did not see this Heather - sorry!

That is my feeling about the discount health plans - they just seem like so much money for hardly anything. The infinity sounds good though - but I might be better off calling HIP, whoever and see what they charge for hosp. only. That's my main concern - me getting REALLY sick and then having huge bills. Sore throats, earaches, etc I could go to a clinic for. Or your doc - thank you for that offer! Please FM the practice name.

Family Health Plus has a very low threashold for income - I think it's the same as the Healthy NY (we couldn't get family I don't think since there are no kids) and I was denied Healthy NY.

Here's what kills me (beware, vent coming): Now that I am unemployed, our monthly income on the books is $400 more than the threshold they want you to be under in order to get the ins. How does the govt expect us to pay for insurance, which is $500-1000 a month if you go through cobra or a carrier themselves - on $3400 a month???? With car insurance, rent, car payments, other bills??? Their 'low income' threshold is too low. And while I think it's GREAT that under the recovery act, the govt is picking up 65% of cobra costs for applicable persons, the fact that they would require me to pay FULL PRICE for the last two months, before this subsidy went into effect, is nuts. I know they can't make the subsidy pay for everyone's insurance no matter when they were laid off - I know there has to be a start date - but they should allow me to get the insurace as of today if I want - I should be allowed to have a break in coverage. I mean, I couldn't afford it, that's why I idn't get it in Jan. What makes the govt think I can afford it now?? ANd why should I have to pay for coverage I DON'T NEED ANYMORE BECAUSE THE DATES HAVE PASSED????

Ok, vent over....
Browneyesncute Posted:

Re: I need some support and help

i'm sorry i just wanted to send you some hugs!
Toucan311 Posted:

Re: I need some support and help

Believe me, I feel you. Until I got married, I didn't have insurance. What I used to do just to keep SOMETHING was take a class every semester at Stony Brook and buy the student health insurance there. You have to go to their doctors, but at least visits & rx were covered.

I work for Dr's Blyskal, Ruggiero, Ladinsky, Stambler, Jaeger & Northorn. We're in East Islip and the # is 518-0090 - but please let me nkow if you need anything b/c I can pull lots of strings.
skinny237 Posted:

Re: I need some support and help

I'm sorry u r going through this. Awhile back I was without insurance for awhile and it suck*d just keeping your fingers crossed that nothing happens.

I'm not sure of your situation-----do you think you could be working in the next few months? If so, I'd probably wait and keep my fingers crossed.

My DH has a similar issue w/ his income...he didn't have insurance for many years. He's in construction too and I was always so worried that he would get hurt.
MnM182008 Posted:

Re: I need some support and help

I had no insurance for the past couple of years since I am self employed and was far to expensive. When I got married I was so exciting thinking I was going to get insurance through dh. Well to add me to his insurance was another 750 a month in addition to the 500 a month my DH pays for himself , I couldn't see spending that especially since we are saving for a house. I ended up being able to get insurance through school even though I only go part. Its not the best but its something. I did look into purchasing insurance for myself through GHI and I believe it was about 420 a month, not cheap but its not insanely bad.

TrueLoveIn2008 Posted:

Re: I need some support and help

Thanks girls. I think I am going to go for hospitalization only (if I can find a reputable company that offers it directly) and get eyecare and dental through cobra ... I might pick up a prescription plan too, there are lots of those for like $10 a month.

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