My new job has a waiting period of three months for health insurance but we need medical treatment now!?
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My wife has been having serious difficulties with her joints, fatigue, etc. Got bad enough that she ended up losing her job. Doctor told her a couple weeks ago she has rheumatoid arthritis, and that he wanted to do more tests for fibromyalgia. He started her on some medications, but then I got laid off from work! I found a new job, but I learned today that they have a three month waiting period before health benefits kick in (this is the first time an employer of mine did that, came as a surprise). She has medications for pain, as well as psychiatric medications to treat bipolar disorder and anxiety. Some can be found generic, but others are insanely expensive (Seroquel = $800 for a months supply? Really?). I also don't know what medications her doctor will prescribe, or how much her doctors appointments will be. In addition, we have a four year old son. Luckily I had enough notice before I lost my last job to get him completely up to date on his physical/immunization/etc. I also have anxiety issues myself that have been treated in the past, but I tried not to medicate. Things have been very tough lately, though, and I was thinking of going back for treatment. We live in NY state. I'm worried social services is going to see I'm employed and make a decent salary ($48k) and tell me to shove off, but even with my salary I can't afford all these medications or doctors appointments! Any suggestions? Options?
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Answer:
Most people out there with good jobs and group health insurance benefits have no clue how much their health insurance really costs until they become unemployed and get notice from Cobra and think wow, I can't pay that, but your employer did. It is unclear how long you have been unemployed before getting this new job. I believe with Cobra you have up to 63 days to keep it. But if over that time, you are S O L. But if you are still w/in the eligibility period of 63 days, then buy it, even though it is $1,600 per month. Think about it this way, the one RX is $800, 1/2 of your premium. Since she is seeing specialists, then they might charge her upwards of $150 just for an office visit. Now start totaling up the costs and might find that you are "even". You will only have to have for 3 months and is pricey, but in some employer plans, if you are uninsured, then they "might" have a 1 year or 18 month before they will cover all the pre-existing conditions that you wife has. You better check out with HR, since if they have this "waiting period" then you will be out of pocket for her RX and doctor visits. Other options to consider from personal experience married to a spouse with Parkinson's Disease and losing my group coverage from an employer. Many providers and pharmacies when you do not have insurance may charge you sometimes double the cost. Now that my husband is on Medicare, the cost for 1 drug was $99, but now only costs us $35 since we have insurance. Another generic was $79, but now only $35. This is the cost we pay under our deductible. Another option is to ask her doctors if they have any free samples, which many get from the pharmaceuticals for 3 months pending new coverage. Just explain and most will. http://www.canadapharmacyonline.com/DrugInfo.aspx?name=Seroquel2033 Seroquel is available in Canada in generic form. Until my husband got on Medicare, we used this pharmacy for over 5 years. We still do on 1 drug, since the cost on his plan puts him into the donut hole, so do to keep the costs down. One last option to consider. Make an appointment with a social security lawyer for your wife. She has many medical conditions that "might" qualify her for SSD or SSDI. good luck
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Other answers
Many drug companies have programs which will help you get your medications either free or at a reduced price. The place to start is at your doctor's office. Call and give them the details, and maybe they can help you. It would also help if you would ask if they could give you some free professional samples.
TedEx
Because you live in New York State, you and your wife can purchase any health insurance that is sold to individuals where you live, for the same amount of money as everyone else between age 19 and age 64 pays for individual health insurance where you live. You do not have to wait the three months and you do not have to pay the $1600. Unlike most states, New York does not allow health insurance companies to reject anyone (or charge extra) because of existing medical problems. If you do not get any health insurance until three months from now, then you will have to pay for all the medicine, yourself, with your own money, for the first 6 to 18 months after you do get insurance, without using insurance for it during that time. If you have no insurance for more than two months in a row, then, for the first 6-18 months after you do get insurance, it only covers new medical conditions that first develop after you get insurance, and does not cover existing conditions during that time. Existing medical conditions will be covered as soon as the new insurance starts ONLY if you had other insurance during the time between when your insurance from the old job ends and when the insurance from the new job starts, so that there were no periods of more than two months in a row without insurance.
StephenWeinstein
That is what COBRA is for. Your previous employer should have told you about it. Under COBRA, you can continue your insurance from your old employer (you have to pay the premiums). If this all just happened a couple of weeks ago, can you still sign up, now that you have income? They usually have to give you so many days to decide. I realize the insurance is expensive, but so is medical care. $1600 a month is about the going rate for a good family policy. You would be better off buying the insurance. What are you going to do if you or your family have a really catastrophic expense? Lynn is right. If you go too long without insurance (I think 60 days) your new insurer will consider this a break in coverage and offer even less coverage or a longer waiting period.
lak
Wife's condition is preexisting. If she didn't take COBRA coverage, she's uninsured, and even your new employer can make you wait before covering the preexising condition. The exact time of wait, depends on how long she's been uninsured, and what state you live in. You're right, you sure won't qualify for Medicaid. $1600 a month for family coverage isn't insane, it's a realistic price. I think you have an UNREALISTIC expectation of what you should pay for health insurance. Obviously, as you're seeing now by estimating your current medical and prescription USAGE by the month, it's not unrealistic. You should contact your pastor, and see if your church family can help. You can also contact Catholic Charities - you don't have to be Catholic. You should also apply for prescription assistance through www.rxassist.org and www.pparx.org if you can qualify. And you can check with your local school district to see if they offer routine immunizations at free or reduced cost for qualifying children. Quite plainly, it's way, way cheaper for you to pay for one or two doctor visits for your son, than to pay for that family coverage. But wife is going to be wracking up huge medical bills, at her current rate. She DEFINATELY needs to talk to her pharmacist about getting generic substitutions, or see of her doctor has any free samples to hand out for a few months.
mbrcatz
When you got laid off did you sign up for Cobra? If so, your old policy continued. If you didn't there's no coverage for medical treatment and prescriptions until the coverage kicks in with your new job. There will be no retroactive payments. Coverage is from acceptance date forward. When there are preexisting conditions this serious, it's critical not to let insurance lapse. Based on how you described your wife's medical issues, she is pretty much uninsurable under a private policy. You didn't mention how long you were unemployed. If it was a very short period of time you may still be able to pick up Cobra and continue that until your new policy kicks in. I can't remember the time frame allowed. Call your former employer's HR dept and ask if that's an option. EDIT NOTE: OUCH. The reason Cobra is so high is that the total premium for group plans (employer + employee contribution) is that those plans MUST accept everyone in the group regardless of their health. So that $1600 was the total premium for the coverage you were getting before. You're in a tough spot. Medication samples from the DR's office might help for the meds. For the DR bills themselves maybe they will take payments. Good luck. :)
Lynn
Ask her doctor for generic medications or for some samples that will tide her over for 3 months. Or, take her to a county or community medical clinic and pay cash. Get prescriptions filled for generics at Walmart, Walgreen, Costco for $4. Do what other uninsured people do. Get creative.
Flower
FMS is highly over diagnosed...most people diagnosed with it actually have something else--some aren't physically ill at all....it in not appropriate to consider the diagnosis until the RA is under treatment... RA causes widespread pain and fatigue....its tiring being in pain and it can affect sleep quality is it 1600 for just you and your wife? maybe you can leave your son off and hope for the best... many people have had to do without for a few months---you make due the best you can... you can try www.pparx.org but when I looked into it, it took a month to get the meds
jmitw
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