Health Insurance before Diagnose

[ohgreat]

I was diagnosed a few weeks ago as + with HepC Antibody, and was told that I indeed have been exposed to the HepC Virus.  I am planning on going in for my test to see if I have the virus in me and what the count is.  Then I most likely will have to have a liver biopsy. I am pretty much planning on having HepC and not getting hopes up for the 20% chance that my body has gotten rid of it naturally. (I was never very good at Vegas odds anyhow)

I am independently employeed and I dont work at one place for very long, mainly working from home.  But the problem is I make decent money.  Not outrageous money... but more than enough money to put me well above the poverty %s that most of the assistance programs require.  But I am also at a level where expensive medical realities are going to hurt me financialy.

1.Should I get some kind of health plan or health insurance before I go in for this test?  So that way I will be able to absorb the costs of this thing if/when they find stuff out?

2.Is it possible to get some kind of health insurance after being diagnosed?  And not through a company but as an individual through a health plan?

3.Does anyone have any links about this kind of thing?

4.I know it depends on the state of my liver damage, but what kind of costs am I looking at.  What is a yearly ballpark cost (sans insurance) of average tx??  < not texas :) >

(rant:can we please have a govt. that provides med insurance for its working class citizens who arent poverty stricken?!?)

[can-do-man]

kalio1 is right on getting the meds free. But having a liver bx. plus other test and doctors cost will not come cheap. Good luck to ya. As for getting insurance now, that might be a problem.

[amirtracy]

Just so you know, in the state of florida anyway, the commitment to care program's cut-off for income is $68,000 for a family of four. I found myself in the same situation, no insurance/self-employed. Once you've tested positive for the antibody it's too late to get insurance. Commitment to Care is wonderful. It took 48 hours for me to get approval. (I over-nighted the application and they called the next afternoon to tell me the news!) They send the med's right to my house, a months supply at a time. I just started treatment Wednesday. I'm 1/48...
The hardest part is waiting but there are solutions and hope so find out what's going on and then ask the wonderful people here for support and knowledge. good luck to you.

[strator]

ohgreat- that's a pretty complex dilema. Find out if you have it first or get insurance somehow before knowing if you'll even need it for that. There's a few people on here seem pretty knowledgeable about insurance stuff, maybe they have some advice. I was in a similar spot but somehow all the stars lined up and I basically fell into coverage through a program in CT. There is probably a way for you though finding it will be the tricky part.

amirtracy- How's the first week going? Been lookin to hear from you.

Don

[NYgirl]

Treatment is VERY expensive to begin with and then during treatment the cost of the add on drugs (rescue drugs called Procrit or Neupogen and sleeping pills and antidepressants) all add in too.

Plus you will need weekly/monthly blood tests of different types.

I would DEFINITELY get some sort of insurance at all if possible.  If you qualify for any sort of state insurance program go for it.

I could not handle the cost of treatment on my own - even the cost of all of the deductibles is now starting to get to me.

[ohgreat]

thanks for the advice friends...

"Once you've tested positive for the antibody it's too late to get insurance. "

is that the case for every insurer? Like Blue Cross Blue Shield?  because i did this.. http://www.ehealthinsurance.com and it didnt look that bad of a cost.  :(

shoot!  I new I should have got insurance before going to the stupid doctor to get a check up.

So does anyone have any guesstimates on what they paid for Biopsy? I am looking at another 220$ on next blood test.

why am i crying again now? i thought i got over that! i am such a wimp. :(

[amirtracy]

hi strator! i sure hope you're doing well. Thanks for asking about me...it's been...okay. Not too bad. The first night was kinda sucky and the next day was achy and wierd. "behind the glass" feeling if you know what i mean. every now and then i get a little nauseous and light headed. but the good news is it's okay. i'm just glad to get started. you take care of yourself. i always look for your wisdom when i'm scanning this site. :) tracy

ohgreat,
I found out i had hepc when i tried to get insurance. i was told and it might be different in different states, but i was told to forget trying. so i did and looked for other avenues. nygirl is right, there are other expenses to consider, labs and dr's visits,.. but there are programs for other meds if you need those too, so realistically if you make okay money it's not out of sight to treat. for me anyway. i wish you the best.

[amirtracy]

My biopsy cost $1900. Florida Hospital discounts for people without insurance. Most do but you have to ask....

[ohgreat]

Eisbein: Yes that was extremely rude.  I have had health insurance many times in my life and I have provided it for myself.  I even provided it for 4 of my employees and myself (WITH NO MATCHING!) before my business collapsed for reasons out of my control.  I have been working extremely hard all my life but lately I have had a lapse of money due to personal financial problems and have been struggling to get back on my feet.  While my yearly earnings are higher than poverty, I have 2k in the bank and my contract job(no benefits) ends in two weeks.  I appreciate you hoping I come back neg, but I dont appreciate your offhanded comments about me and insurance.  I come here for support not to be 'taught lessons'.

amirtracy: thanks for that valuable info.

Kalio1: Thanks for the link and kind words.  My clinic offers a discount card on mail in perscriptions and visits of about 25%. I am not enrolled but my clinic has been giving me those savings which helps.

[jmjm530]

Insurance criteria for the self-employed is often defined by state regulation.

If you're lucky, your state may mandate the various insurers to cover pre-existing conditions with or without a waiting period, depending on how long your insurance lapse was.

There's often lots of 'hurry up and wait' in the normal tx process, so the potential wait period (sometimes only 6-months) may not affect you that much.

You should really get on the phone and call several of the larger insurers in your state -- ask about their programs for the self-insured -- and get the specific answers you need. Call anonymously if you feel more comfortable, although in the end it probably won't matter.  

As a back-up, both Shearing and Roache offer assistance programs that some report are quite flexible. And depending on your individual case history, you may even qualify for an appropriate trial.

Very few people can afford to pay for treatment out of their own pocket, but fortunately there are a lot of options available.

All the best luck and let us know how things work out.

-- Jim

[beamishboy]

harsh words for sure...now,if the test is positive& the "for profit" medical system doesn't(because they closed that" loophole") cover the costs of providing health 'care'...she will certainly have learned a Very Important Lesson-go away you're all used up!!......i paid for excellent healthcare for many years&never used it......now i'm scrambling myself! the whole byzantine structure is an incredible shellgame,and plenty of profit is being earned by corporations...Feds are giving companys billions to maintain their retiree med plans;pharma got huge windfall when feds failed to include provisions to negotiate prices...Pharma lobby doubled their annual influence money,from 100 million to 210,000,000$$$$-to make darn sure the new medicare program reflected their interests...Their interests are big profits!!!...The real crime,the real lesson is that our system represents Monied interests not the best interests of citizens..Remember poor,sick people who maybe make a 'bad' financial decision:maybe paying for childs college education?-are just as worthy&valuable as" some born into the right family" CEO or politician-all things are not created equal,we need laws to do a little adjusting......i don't mean to lecture,but sometimes we need to think about WHY ? i really just hope the best for all;easy trx& SVR,oh and a more equitable,less complicated healthcare system...I don't think profit from others illness is moral

[amirtracy]

I don't have insurance because my restaurant business and my life savings dissapeared after 9/11. I found out i had hepc trying to get a new policy. I'm above the poverty line but don't make enough to afford these meds without assistance. That doesn't make me a bad person does it?

[bobbyullc]

JUST A THOUGHT,

I AM EXTREAMELY GRATEFUL THERE ARE BILLIONS TO BE MADE BY THE DRUG COMPANIES OR THERE WOULD BE NO RESEARCH OR CURES. AS FOR THE PROFITEERS THEY SENT ME MY LAST 20 SHOTS FREE OF CHARGE,NOT EVEN SHIPPING COSTS. THANK YOU, THANK YOU, THANK YOU, COMMITMENT TO CARE. I HAVE BEEN PAYING $1,100 A MONTH FOR INSURANCE ONLY TO FIND "INJECTABLES" ARE NOT COVERED.
PS. LYING TO THE INSURANCE COMPANY CAN BE CONSIDERED FRAUD.
BOBBY

[ohgreat]

no one has lied to an insurance company, that is why I came here first.   P.S. The capslock light on your keyboard can be your friend.

thanks for all the advice.  glad to know i'm not the only one without insurance.  Not glad that people have come to conclusions about me (i.e. i am trying to scame my way into insurance at the last minute)

I probably won't be able to get insurance and I will have to deal with it.  Just like in life sometimes you have to deal with rude people.

[Alady1620]

You could look for a research study in your area.  I am getting all my drugs and doctor visits for free.  I only pay for my anti nausea medicine, antidepressent, and birth control.  The expensive drugs (interferon) are covered.  They're also paying me to participate in the study.

[FlGuy]

Eisbein writes..."Don't mean to be rude to you,"  Please let me know when you intend to be rude, should make for an interesting read.

[MissMiss]

I just want to say that this country is made up of self-employed people.  My husband and I have been self-employed most of our 27-28 years together.  We could never afford insurance either and had three children.  I am very lucky that my husband decided a few years back to let me run the business and he take a job in the public sector with benefits.  

If you actually do test positive, you may find out you have some time to find the best way to handle it.  This isn't a death sentance so to speak.  

Kalio-Thank you for your comment below.  YEs, my hands hurt a lot.  I haven't noticed anyone else saying their "bumps" hurt.  Decided to pull out my Acyclovor and see if it makes a difference.  If it is shingles, it should help right away.  IF not, off to the doc.  Thanks again.

missmiss

[cuteus]

please take notes on the numbers you have gotten, and, you can add this one for possible inclusion in a clinical trial. Maybe all you have to pay for right now is the PCR test for viral load and if positive, it could qualify you for a trial. I think I posted it before, but in case you missed it
clinicaltrials.gov
will show ongoing research on hep c, and maybe has a link to others.  Also, Roche has a ton of links in their site that might be useful, but get the PCR first so that you know once and for all whether you need to worry any further. You can't make any plans until you know for sure.
good luck to you
btw, bobby has always written with caps, is not personal. I have come to accept it as just another literary style.

[Moniker]

There is another hep c forum which has mostly English people. I've read that forum sometimes, and it seems that the English don't have access to Neupogen or Procrit. If their blood counts fall, they have to lower their dose of Peg and Riba. The people on that English web site seem to be less knowledgeable about treatment, they just do what the docs tell them to do - they don't seem to act as their own advocates or demand treatment as people on this forum do. The English do get what they get free, but maybe they don't get everything we can get.

You need to find a way to pay for drugs. The drugs are not affordable. You need to find a way to get around the loopholes the insurers have made for themselves, and the small print.

I don't know if somebody could get a job at a company that has a good health plan and get in on that health plan. I understand that Stop and Shop doesn't pay much per hour, but does have health coverage. I don't know if it might be a way to get meds. We have to be creative. There is plenty of time to figure a way, hep c is a slow disease. Take your time and find out what you can do. The other suggestions, get in on a trial, or contact the drug companies for free meds are good suggestions too.

Good luck, Bob

[Dale_Ray]

If you could become employeed by a company that provides group then possibly the pre existing condition MIGHT not factor in. At our company if you make the 90 days then you would be covered as long as you are not under treatment for an existing condition. Then it takes one year before those cost are covered. Just a thought. Dale

[can-do-man]

Hello, First this place is one of the best places to come for help. People here are very caring people and go out of there way to be helpful. But you need to realise thats a two way street there. Your first post on 02/14/06 im pretty upset. The question was very limited on how to give you an answer. Yet 15 out of 33 posters responded directly to your question.

On 02/19/06 you came back under a thread by nygirl. You still didn't know any more then you did on 2/14/06 but was upset with 'veteran posters' and them talking about other things that was important to them at the time instead of just you. Even though like i said eariler 15 of 33 posters had responded. Which i seen as rude on your part. Even though people again went out of their way to make you feel welcome.

Then again this sunday 02/27/06 you came back and still you don't know any more then you did on 02/14/06. But once again several of us tried to give you some answers. Then you spoke of a certain poster being rude. But look at your responce to bobby who goes out of his way to help people here. Not only were you rude to him but made it a point to say this.... Just like in life sometimes you have to deal with rude people.

Im not trying to give you a hard time but you should realise just like this site the people here try to be helpful and are doing it out of kindness and caring for others. Im in no way trying to make you mad just realise were all in the same boat and for alot of us the boat seems to be sinking. I've said this before there is sites where everything is hugs and love. But if its knowledge you want i strongly recommend this place. Best of luck to you, and i do hope you come back.

[NYgirl]

One of the reasons I can't leave a job that I HATE is because I have to keep my insurance = not only for now but for my kids.

It's a sad world........but it's just necessary like having a car to have insurance.

And of course can't quit now because this is pre-existing junk.

They get you coming and going and coming again.

[NYgirl]

One of the reasons I can't leave a job that I HATE is because I have to keep my insurance = not only for now but for my kids.

It's a sad world........but it's just necessary like having a car to have insurance.

And of course can't quit now because this is pre-existing junk.

They get you coming and going and coming again.

[Dale_Ray]

dejavu = I read it then I read it again and then I remember I too tell the same exact stories twice or maybe more. Family overlooks my nuttiness right now. I just thought it was cute you repeating the message. Been there done that ha!

There are a lot of us stuck for your same reasons. No insurance is not an option for me right now. No insurance treatements stop - period.

I'm having a better few days lately but the temperature this weekend was warm and I was able to be out doors. I hope this continues like it is. I checked out the fudge pops and gosh do they feel good on my throat at night. Just don't lay on on the couch and forget about it.:) Dale

[NYgirl]

Oh man are the fudge pops just the BEST?  They last for a long time and make your throat so GREAT. And they taste so GOOD.

I went out and got the one's made with low fat milk because Rocker is always talking about how bad dairy is for us. Now...I let myself eat one then another one after it hee hee.

You know I HATE when it posts twice. I know better than to hit send more than once but everyonce in a while it does it.  Especially when I'm not talking about anything IMPORTANT.

Now........if it was a fudge pop post well thenI could accidentally post over and over and it would make sense!

I'm so glad you got them and enjoy them as much as me.

It's little "treats" like that during tx that really make it tolerable.

:)  Debby

[GoofyDad]

should make for an interesting read.

No Sh!t.

[NYgirl]

Can't wait - might put it on a best seller list. :)

[can-do-man]

you said....Oh man are the fudge pops just the BEST? They last for a long time and make your throat so GREAT. And they taste so GOOD.
____________________________________________________________

They last for a long time??? Were not back to double the fun thing are we? Don't make me ask if you refreeze them to.

[NYgirl]

NO on the refreezing...I gobble them right up.  :)  I've found anything that you can lick on a stick really does make the throat feel better

Whether it be ice pops or lollipops or whatever ;-)

[can-do-man]

LOL, way to funny girl, that shut me up

[can-do-man]

Well maybe not... Here Kitty Kitty