Parkinson's Disease Support Group

i am trying to find some insurance at this time. it is unreal what we have to pay for pd drugs. my husband just got layed off from work. i have 1 month to find some insurance and a med card. it would cost me over 20,000 dollars a yr. if i can't find something. i am going to talk to my neuro mon about my med. hope he can help

Dede - surely he has more than one month to find insurance. Most COBRA plans offer 18 months. Check on that quick. Don't rush out and buy anything without following up on COBRA. Most employers have to offer that. Speaking as someone who was on 18 months of COBRA and had to find insurance, it is almost impossible to find a good rate....my exclusions are migraines and anxiety. If you can't get COBRA, check with your Health Care District and as you mentioned, even check with your neuro. Good luck. Ro

To follow up on the note about COBRA. As a self-insured person I can tell you that while the rate you pay into COBRA might be high the coverage you'll get will be head and shoulders above what you'll get paying the same amount for your own policy elsewhere. The VERY MOST IMPORTANT thing - DO NOT LET INSURANCE LAPSE OR GO WITHOUT - even if you only stay with the COBRA plan for a few months while you continue looking. Once you let insurance lapse and go without it becomes nearly impossible to get and THEY CAN THEN EXCLUDE PRE-EXISTING CONDITIONS! If you never let it lapse they can't do that. Also, you'll get a letter from your employer or current insurer (can't remember which) stating that you've been covered. DO NOT LOSE THIS LETTER. My suggestion is to make it easy on yourself and take advantage of the COBRA so you can do a better job of finding just the right coverage for yourself. Even when you find something you want it might take a month or two to be accepted, etc. Opt for the COBRA.

dede - I found this info re: health insurance coverage in NC where you've indicated you live. I've included a few snippets below and at the end I've included the link to the complete document.

Additionally, you might find it easier, as we did, to get a good independent insurance agent who represents multiple lines. They can help wade through the different plans and companies for you. Believe me, it's a complicated jungle.

Good luck and good health to you. Here's the snips from that article.

[For many years, people have been concerned about changing jobs and the effects it has on their health insurance. Previously, medical conditions covered under a prior plan often were not covered under replacement plans. HIPAA’s increased portability guarantees that insureds get "credit" for the time covered under a previous plan, provided there is no lapse of more than 63 days. Specifically, insurers must reduce any pre-existing condition limitation periods by the amount of time the insured was covered under prior creditable coverage.

Any coverage under a group plan, individual health insurance policy, Medicare or Medicaid, or North Carolina’s Health Choice program or comparable children’s’ health plan offered by another state is considered "creditable coverage". As proof of coverage, employers and/or insurers are required to provide a certificate of creditable coverage to insureds to document the duration of their coverage. That certificate is used to show a new health plan how much pre-existing credit they are entitled to.

Benefits for pre-existing medical conditions cannot be denied under any plan’s pre-existing condition limitation provision if the insured has had creditable coverage for at least 12 months without a break (or lapse) in coverage of more than 63 days.

You can reach the North Carolina Department of Insurance (NCDOI), Consumer Services Division at:

800-546-5664 (toll free)
919-807-6750 (outside of North Carolina)
919-715-0319 (TDD) Telephone Device for Deaf Caller
919-733-0085 (Fax)

You can find additional information including our complaint form on the North Carolina Department of Insurance Web site at www.ncdoi.com.

The address for the North Carolina Department of Insurance, Consumer Services Division is:

Consumer Services Division
North Carolina Department of Insurance
1201 Mail Service Center
Raleigh, NC 27699-1201

Where Can I Find Additional Information?

Centers for Medicare and Medicaid Services (CMS)
???? call 1-404-562-7500
???? visit the HIPAA web site at www.cms.hhs.gov/hipaageninfo/

US Department of Labor, Employee Benefits Security Administration (for COBRA questions)
???? call 1-866-444-3272
???? visit USDOL’s web site at www.dol.gov/ebsa

NCDOI 603 (June 08)]



http://www.ncdoi.com/consumer/cons...~.pdf

aliveo,

Sorry for derailing your thread earlier but I thought it was of utmost importance to get that info re: COBRA to dede.

To answer your question re: meds. They are very expensive and for those not over 65 and on Medicare (govt. healthcare for retirees) or with the very best insurance it's an onerous burden.

Because my husband is self-employed we're also self-insured. Our monthly premium for just the two of us (59 years old) is over $1200/month. It goes up about $100-200 a year. Even then we still have high deductibles and co-pays. Our meds are 60/40 copay and that's only after we each pay $400 deductible every calendar year for meds. Up to that first $400 we pay 100%. And this is not because of my husbands PD or any sickness that I have. This is just a normal plan/policy.

He was diagnosed about a year ago and is just starting on Azilect - his first of any type of PD meds. For 14 days of .5 mg tablets it cost him $113 - this was with insurance! We figure the Azilect will cost from $8 to $10 a day. I don't even want to think what any other drugs will cost.

The middle class gets squeezed in this country. If you are very poor you get govt. healthcare (Medicaid) and if you're very rich - well, then you don't have to worry about it.

With a form or letter from your doc the meds may be free. Call the drug companies to see what you have to do.