Newcomer needs help!

Hello! I am new here, my husband has HepC and has yet to get any kind of treatment. We are not eligible for insurance as this is a preexisting condition, and we do not qualify for medicaid in our state as we make just $100 past the cutoff. We have tried going to a dr and paying cash, but we are now at risk of loosing everything we have. We got as far as getting ready to have the liver biopsy done. I need help to figure out what we can do to get some help with all this.I am so worried and it seems like everywhere I turn we cannot get any help. any suggestions would be appreciated.

[spectda]

Does the preexisting condition have a time period before you can seek treatment or is it for the term of the insurance? I had to purchase the very expensive HIPAA insurance, they can't turn you down if you meet the requirements. Perhaps you have already looked into this, or you don't qualify or have the money for it but here is some information if it helps:

HIPAA and Individual Coverage

There are situations in which you might like to or need to purchase your own insurance policy. This may be the case if you can't find a job and any other coverage you have has expired. You may also be hired by an employer who doesn't offer a group health plan or you may decide to become self employed. It is generally not a good idea to go without health insurance. A catastrophic illness can decimate your life savings. Furthermore, if you are without health insurance for 63 or more days, you will lose some of your HIPAA rights and protections. HIPAA-eligible individuals are guaranteed the right to purchase individual coverage. You are considered HIPAA-eligible if:
you have had at least 18 months of continuous coverage without any significant breaks
your most recent insurance was under a group plan
you aren't eligible for coverage under another group plan
your coverage wasn't terminated due to non-payment of premiums or insurance fraud
you aren't eligible for Medicare or Medicaid
you purchased and exhausted COBRA, Temporary Continuation of Coverage, or State Continuation Coverage, if they were offered to you
What HIPAA Doesn't Do

It doesn't require that employers provide group health insurance for their employees.
It doesn't require a company's health insurance plan to include family or dependant coverage.
It doesn't regulate the coverage group plans offer.
It doesn't regulate premium rates.
Additional Information About HIPAA

A break in insurance coverage of 63 days or more will cause you to lose some of your HIPAA rights and protections.
You can request a free certificate of creditable coverage from your prior insurance carrier; it will state the length of time you were covered by that carrier.

[Bill1954]

I read last week that states are now beginning to put together major risk medical pools to help people in your position. Supposedly, these are modeled after California’s MRMIP (major risk medical insurance program); and I’ll bet there will be changes to insurance infrastructure before November’s general election.

Addtionally, if you have no insurance, the manufacturers provide patient assistance programs to the public to help cover the cost of HCV meds:

Pegassist (Roche Pegasys system): 1-877-734-2797

Commitment to Care (Schering- Plough PEG-Intron system): 1-800-521-7157

Hep C treatment isn’t usually urgent; take the time to learn about the disease, and welcome to the discussion group—

Bill

[Cory255]

Welcome to the Hep C Board!

What I would do if I were you would be to 1st.-- Find a good Gastronenterologist or Hepatologist fairly close to home that you can trust.  AND THEN talk with your Dr. to discuss treatment options.

Good Luck!

[nygirl7]

Wow that would be great advice if that wasn't their problem - they dont have insurance and no way to get any.  Most doctors dont let you in the door if you can't pay for all the zillions of appointments and tests they order let alone the cost of the meds.

[kittyface]

Good news!  As part of Obama's health care reform those with pre-existing conditions who do not have insurance will be eligible for affordable health insurance through a federal high risk pool starting around July 1, 2010.  This high risk pool will provide gap coverage until the permanent health care provisions concerning pre-existing conditions are implemented in 2014.  

The feds have asked the states to run this program so if your state has an existing high risk health insurance pool that will be your source of information for the upcoming program.  Visit your state's website for more information.  If your state has declined it then it will be run by the federal government for your state.  So if you can't find state info then google federal program information.  Good luck!  

[mnash777]

Yea, I livein Virginia and Our state is sueing saying that government health care is taking away peoples rights and that it is unconstitutional. It would really help us right about now. I will check into that thank you!! Also, thank everyone else for your help.

[Diane12855]

A couple of years ago I was trying to find insurance because I have a pre-existing condition called narcolepsy. Someone told me that the state had something for people who couldn't get insurance so I checked it out. It was going to cost me $1200.00 per month! A year later I met a wonderful independent insurance agent who got me on with AETNA. Their rates are only a little higher than the Blue Cross my husband has but the cuts they are able to make in my medical bills are amazing! Doctors and hospitals don't give them any trouble, and often what they saved me on procedures paid for my insurance that month. Plus once I reach my deductible, they pay 100%... even prescriptions! You may want to check them out.

One last thing. When they found out I was diagnosed with hep c, they called me on the phone to encourage me to get treated, and have a 24 hour service if I have any questions when the doctor isn't at his office.

Sorry... sounds like I'm one of their agents. I'm really not... they have just made my life so much easier since they accepted me when nobody else would.

Diane

[WriteItDown]

One option nobody has mentioned is for your husband to enroll in a clinical trial.  Some of these trials are very good, and will offer you the option of treating with the newer drugs, some of which have much better success rates than standard of care (this is assuming your husband has genotype 1 -- though there are also trials for other genotypes).

A clinical trial will not cost you anything, except for maybe the drugs you might need to take to treat the symptoms of the treatment itself, i.e. depression, anemia, et cetera. Usually a biopsy is required, and if you don't already have one, they will do it for free.

I would suggest trying to find out which hospitals in your area do clinical trials,and then try to speak with the person who coordinates them.  Explain your situation, and see if they have anything suitable.  Also, you want to make sure you choose only a good trial.  Some of them are terrific; some of them less so.

www.clinicaltrials.gov