Tired Of Health Inusrance Companies

[nanookadenord]

There were a few resources on that page I shared earlier, one was this non-profit. I hope there's change soon with our national health care. This is horrible that, even though you're paying a LOT out each month, you aren't able to afford the meds you need:



When health insurance is not enough.®
501(c)(3) independent non-profit organization providing financial assistance to adults and children to cover the cost of prescription drug coinsurance, copayments, deductibles, health insurance premiums and other selected out-of-pocket health care costs. ~ About HealthWell Foundation and the underinsured

I had looked into that one specifically. They are not accepting new applications per this:

Our Open Funds are now accepting grant applications. Our Re-enrollment Funds are open only to patients who have had and used a grant with HealthWell in the past three years. While we continue to manage the existing grants in our Closed Funds, they are no longer open to new applicants because we lack sufficient donations to approve new grants.

Open funds doesn't cover asthma.

 

[mkgal1]

While we continue to manage the existing grants in our Closed Funds, they are no longer open to new applicants because we lack sufficient donations to approve new grants.

Open funds doesn't cover asthma.

Okay. I hadn't actually checked out the page. This really upsets me on your behalf. It's not as if asthma is a superficial health issue - it can be fatal (without warning, either).

 

[mkgal1]

What about the other phone numbers on that page?

Welcome to PPA

RxAssist – This is another database of patient assistance programs.

There's a procedure called "bronchial thermoplasty". I wonder if your plan would cover that procedure?

Healthcare Plans <------- Information about BT and health care plans that cover it.

 

[Kit Sigmon]

What type of inhaler do you require?

 

[Tropical Wilds]

Contact the maker of the inhaler and apply for a drug card. That should help pretty significantly. I have one for all my meds. And since it’s insurance season, it might be time to switch plans. The monthly premium might be higher but it will be dramatically less than trying to stay on a health plan that’s a poor fit.

 

[nanookadenord]

What type of inhaler do you require?

Symbicort Maintenance inhaler.

 

[nanookadenord]

Contact the maker of the inhaler and apply for a drug card. That should help pretty significantly. I have one for all my meds. And since it’s insurance season, it might be time to switch plans. The monthly premium might be higher but it will be dramatically less than trying to stay on a health plan that’s a poor fit.

I did this morning. The only thing they have available because my insurance doesn't cover any of the cost is $100 off. Which brings it down to $241.

The only other thing I can move into plan wise will be $400 more per month which is way out of my range. If I do that, I cannot pay for any of my other responsibilities such as my apartment, electric, gas, car payment, etc...

My company only offers insurance through one insurance company and that's Florida Blue. I have to go through my employer as that is all the state of NY will accept insurance for the kids through.

 

[Tropical Wilds]

That’s a rebate, which is very different. You’ll want a drug assistance plan via the parent company of your inhaler. Federal law requires companies who make generics of prescriptions have a drug plan for people who are under-insured, have financial need, newly diagnosed, or in urgent need and the cap is $15 a month for at least 6 months of the medication (but up to a year or $10k worth of the medication). Almost everybody qualifies for the at least the 6 months. Also, contact your insurer as by law they have to furnish you with a patient advocate. Then I’d file a petition with the court about your need and the financial strain, see if you can switch insurers. Unless somebody is on food stamps and collecting on behalf of the kids, the state that issues the insurance doesn’t matter that much. A de facto ruling seems to entail a “in the state where they reside” clause, but when circumstances are explained along with a means to verify insurance granted to the court, they will usually let you work around it. My husband did it when he divorced... They required same-state insurance because his ex got food stamps in the state he lived in, but his insurance is via his work and thus based in another state. They issued the decree as part of the parenting plan, but he petitioned and explained the issue with the help of the mediator and the exception granted. I’ve known a few people who’ve done the same. It’s a hassle, but a necessary hassle.

 

[nanookadenord]

That’s a rebate, which is very different. You’ll want a drug assistance plan via the parent company of your inhaler. Federal law requires companies who make generics of prescriptions have a drug plan for people who are under-insured, have financial need, newly diagnosed, or in urgent need and the cap is $15 a month for at least 6 months of the medication (but up to a year or $10k worth of the medication). Almost everybody qualifies for the at least the 6 months. Also, contact your insurer as by law they have to furnish you with a patient advocate. Then I’d file a petition with the court about your need and the financial strain, see if you can switch insurers. Unless somebody is on food stamps and collecting on behalf of the kids, the state that issues the insurance doesn’t matter that much. A de facto ruling seems to entail a “in the state where they reside” clause, but when circumstances are explained along with a means to verify insurance granted to the court, they will usually let you work around it. My husband did it when he divorced... They required same-state insurance because his ex got food stamps in the state he lived in, but his insurance is via his work and thus based in another state. They issued the decree as part of the parenting plan, but he petitioned and explained the issue with the help of the mediator and the exception granted. I’ve known a few people who’ve done the same. It’s a hassle, but a necessary hassle.

I am going to petition the court for them to drop the insurance all together. I have talked with their mom explaining the situation and she is okay with me doing just that. There is no divorce decree because the mother of my children in NY and I were never married. The kids were on Medicaid when she wanted to be with someone else and I ended up moving away because the relationship was over. There is no parenting plan in place either. I pay child support and now health insurance and I can see them whenever I want. She has never restricted me from seeing them and so no parenting plan was needed.

As for the inhaler itself. There is no generic. As far as I am aware there are no generics for any inhalers at this point. So, the plan that I have doesn't cover anything that isn't generic. It is a generic plan. That is what was explained to me today by the insurance company and the third party company that handles the pharmacy aspect of Florida Blue. It's because I have the generic plan that I cannot get my inhalers covered as there are no generics available.

I have been on the phone all day trying to get an inhaler covered in some way.

 

[dqhall]

I have asthma. Pretty bad asthma especially with the extended summer we have had here in Florida. I have had to use my rescue inhalers more times than I should as I ran out of my maintenance inhaler. My mom was giving me hers for the past couple of years because she has COPD, but hasn't really needed them. Now, her COPD has gotten worse and the doctor is taking her off of the one that I use and putting her on one that she absolutely needs.

So I went to urgent care on Saturday because I thought I had found a way to get my inhaler through the medication manufacturer for free. However, when I got to the pharmacy I found out that's not the case. Because my health insurance won't pay for any part of this inhaler the program won't cover the rest to make it free. They take $100 off leaving me with $241.00 to pay. I cannot afford that each month. I cannot afford that at all. That is just for the maintenance inhaler. My health insurance will not pay for any inhalers at all. They only pay for pills, which I already do take and nebulizer treatments. I cannot bring a nebulizer with me on an ambulance and if I am having an asthma attack I cannot do a nebulizer treatment in front of a patient or while I'm driving and some of our transports are upwards of two hours or more.

I pay $600 a month and it is likely going up to $700 or more next month because not enough people take advantage of the insurance and they have to spread the risk across who does have it. I am required to have it because of my kids in NY and the state of NY wanting me to pay for health insurance for them. To pay for the health insurance and child support $800 comes out each month, which is more than one full paycheck of take home pay for me with 4 1/2 hours of overtime on that paycheck. So, next month my monthly payment will be from $900 to $1000 and would put me at over $300 to $400 more than I get paid in one paycheck with 4 1/2 hours of overtime. If I didn't have to have the insurance I could literally pay for three years of these inhalers by not paying one year of the health insurance. I figured that out yesterday.

I am just so frustrated that these insurance companies don't care whether I can breathe or not. I almost cried in front of the pharmacist. He felt so bad that he couldn't do anything to help me.

In 2019 health insurance will not be mandatory.

 

[nanookadenord]

In 2019 health insurance will not be mandatory.

It will still be mandatory through New York Child Support for the kids as part of the child support decree.

 

[NW82]

Have you tried patient assistance programs?

 

[nanookadenord]

Have you tried patient assistance programs?

I have looked and am still looking. So far there are none that help.

I am thinking my best bet is to have NY drop the requirement as it is not reasonable. That is the stipulation in the decree that the health insurance must be a reasonable cost. Now mind you that there idea of reasonable is 65% of your income if you're not supporting another family and 55% if you are. Since I do pay child support for my two kids with my ex-wife as well and have my 5 year old living with me, I support another family. What I am paying is well above the 55% and even above the 65%.

This is probably my only real option. Once I can have the health insurance requirement dropped for the kids, I can get a single plan for me that I can afford and have my inhalers covered.

 

[Blade]

I would offer.. lets pray agree that nanookadenord gets finds a INS that can meet all their needs. We have a Father aka GOD that can do anything and if we agree together He will do it.. if we ask ANYTHING in Christ name He will do it. Since this involves mans heart...yet our Father moves nations like He does streams. "The king's heart is in the hand of the LORD, as the rivers of water: he turneth it whithersoever he will". So God can weed out the unjust and show you the just the ones that can help..

Its just He has never failed ..nor ever failed me

 

[Kit Sigmon]

I would offer.. lets pray agree that nanookadenord gets finds a INS that can meet all their needs. We have a Father aka GOD that can do anything and if we agree together He will do it.. if we ask ANYTHING in Christ name He will do it. Since this involves mans heart...yet our Father moves nations like He does streams. "The king's heart is in the hand of the LORD, as the rivers of water: he turneth it whithersoever he will". So God can weed out the unjust and show you the just the ones that can help..

Its just He has never failed ..nor ever failed me

Agreed...let us pray.
Lord, you know the needs and we ask that you make away for the OP to
have his met in Jesus' name, amen.

 

[Sparagmos]

I have asthma. Pretty bad asthma especially with the extended summer we have had here in Florida. I have had to use my rescue inhalers more times than I should as I ran out of my maintenance inhaler. My mom was giving me hers for the past couple of years because she has COPD, but hasn't really needed them. Now, her COPD has gotten worse and the doctor is taking her off of the one that I use and putting her on one that she absolutely needs.

So I went to urgent care on Saturday because I thought I had found a way to get my inhaler through the medication manufacturer for free. However, when I got to the pharmacy I found out that's not the case. Because my health insurance won't pay for any part of this inhaler the program won't cover the rest to make it free. They take $100 off leaving me with $241.00 to pay. I cannot afford that each month. I cannot afford that at all. That is just for the maintenance inhaler. My health insurance will not pay for any inhalers at all. They only pay for pills, which I already do take and nebulizer treatments. I cannot bring a nebulizer with me on an ambulance and if I am having an asthma attack I cannot do a nebulizer treatment in front of a patient or while I'm driving and some of our transports are upwards of two hours or more.

I pay $600 a month and it is likely going up to $700 or more next month because not enough people take advantage of the insurance and they have to spread the risk across who does have it. I am required to have it because of my kids in NY and the state of NY wanting me to pay for health insurance for them. To pay for the health insurance and child support $800 comes out each month, which is more than one full paycheck of take home pay for me with 4 1/2 hours of overtime on that paycheck. So, next month my monthly payment will be from $900 to $1000 and would put me at over $300 to $400 more than I get paid in one paycheck with 4 1/2 hours of overtime. If I didn't have to have the insurance I could literally pay for three years of these inhalers by not paying one year of the health insurance. I figured that out yesterday.

I am just so frustrated that these insurance companies don't care whether I can breathe or not. I almost cried in front of the pharmacist. He felt so bad that he couldn't do anything to help me.

I’m so sorry. Truly. People, vote democrat, so we can get good single payer health insurance like the rest of the developed world has.

 

[nanookadenord]

I’m so sorry. Truly. People, vote democrat, so we can get good single payer health insurance like the rest of the developed world has.

That is the way I am starting to lean myself. Our one senatorial candidate here in Florida, Rick Scott, has voted or will vote to get rid of the pre-existing conditions clause. That is no good for anyone!

 

[FireDragon76]

Have you tried taking fish oil supplements? I have exercise-induced asthma (and I also live in Florida) and I find that helps.

 

[nanookadenord]

What about the other phone numbers on that page?

Welcome to PPA

RxAssist – This is another database of patient assistance programs.

There's a procedure called "bronchial thermoplasty". I wonder if your plan would cover that procedure?

Healthcare Plans <------- Information about BT and health care plans that cover it.

So I have looked through these the information you provided.

PPA doesn't match Symbicort with any patient assistance programs.

RXAssist says that you must not be covered with any commercial health insurance with drug coverage. That is what they told me yesterday on the phone as well.

Looking at who the BT is good for, I don't qualify as my asthma is controlled when I am using a corticosteroid inhaler. I just have to be able to get one.

 

[nanookadenord]

Have you tried taking fish oil supplements? I have exercise-induced asthma (and I also live in Florida) and I find that helps.

I take them everyday and have been for about three years.

My asthma is both environmental and activity induced. It used to just be activity induced.