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insurance ran out

I am in week 17 of triple tx. Been und since week 4.
Yesterday I called my insurance co and asked how much longer I had coverage, since I haven't been able to work since starting tx and they said my coverage ended 12/31/11.
Lucky I ordered a 90 supply of the ribavirin and pegasys at the end of the incivek, so I do have all my tx meds.
I have about a months supply of my ondansetron that I will have to try and stretch out.
I'm mostly concerned about the epo shots and how much they cost.
My hgb was down to 8.5 and 3 weeks later is now up to 11.5.
Hopefully they aren't too much.
My unemployment is running out too in a week.

18 Responses
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179856 tn?1333547362
Epo costs about $6000 for a box of ten unfortunately, quite expensive stuff.  :(
Helpful - 0
Avatar universal
Try this,

http://patientassistance.com/profile/orthobiotechproductslp-266/

cando
Helpful - 0
1815939 tn?1377991799
It may be too late to try and continue coverage via COBRA since the insurance co. said your insurance ended 12/31, but you could look into it and see if there is any way to continue the coverage.

http://cobrainsurance.com/COBRA_FAQ.htm#How long must COBRA continuation coverage be available to a qualified beneficiary?

Others on the forum may know more about this type of situation than I do.
Helpful - 0
1747881 tn?1546175878
Rescue drug help-assistance
US specialty care
7472 S.Tucson way suite 100b
Englewood CO 80112
Contact-Karol Seidel
800-641-8475
Fax 800-550-8589
Helpful - 0
Avatar universal
When I spoke with my insurance co. they said my cobra payment would be $960.

I have 6 weeks after the insurance coverage ends to decide on making the cobra payment. Then they would go back a pay and costs retro.

With my unemployment running out, making a cobra payment is out of the question.
Helpful - 0
1815939 tn?1377991799
I am sorry to hear that this problem is occuring for you. I don't have any more suggestions or ideas. I see others know more about this than I do so hopefully some of their suggestions will help.

$960 is a lot for the insurance ($960 a month or $960 until treatment ends?). I have no ideas on that either unless there is some financial assistance someplace for making these payments.

I hope you can find a solution and help.
Helpful - 0
446474 tn?1446347682
Sorry to hear about your situation. Treatment is not cheap. Are you still employed or did you quit work? Have you talked to your HR department about this? It won't be the first time HR dropped the ball. Maybe you still can continue coverage?

So you are doing 24 weeks of treatment?

You must have had a unique employment situation. If your company had normally employed fewer than 20 employees than these state and Federal benefits may not be available.

If you were employed but became too ill to work...most people with an illness can go on FMLA (The Family and Medical Leave Act) for up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible where all coverage including medical insurance remains in effect. Maybe you used FMLA up?  You should have been offered COBRA from your employer if they employed 20 or more employees. This allows you to maintain the exact coverage you had at work but have to pay the entire cost instead of your employer paying for part of it. The cost could be hundreds of dollars or more if you have family coverage. But compared to the cost of treatment it is less expensive. COBRA lasts for a minimum of 18 months. Many people use COBRA to maintain health coverage between jobs.

Good luck to you. Others had good ideas if your employee health insurance is truly over. Good luck with your treatment.

Hector
Helpful - 0
446474 tn?1446347682
Sorry I missed your post regarding COBRA. I would just check to be sure if the cost $960 will be more than you will have to pay to complete treatment. Don't want to have to stop treatment after coming so far.

Good luck!
Hector
Helpful - 0
Avatar universal
Thanks everyone for the suggestions.

I became unemployed due to a reduction in force. Meaning just a regular lay-off.
I didn't do the FMLA paper work, mostly because I don't think it would apply to me. I work through a full referral union and am not with any single company permanantly.
I am doing the 24 week tx.
I do consider myself lucky to have had the insurance up to now.
I do have all my treatment meds.
The $960 is per month.
Helpful - 0
Avatar universal
Another risk to consider is not having health insurance if you become ill in these last 7 weeks of treatment or if you need hospitalization or a transfusion.  Hopefully that wouldn't happen, but that could be financially devastating as well.  Is it possible for you to take out some type of individual health insurance, say through Blue Cross or Premera or something?  I don't know if that would be less costly than COBRA?  Would you be eligible for Medicaid or SSD?
Advocate1955
Helpful - 0
1654058 tn?1407159066
This is scary stuff. So glad you're set up with 90 days. You have 30 to activate cobra. Mine was 500 a month. My state has a Medicaid type program that is for uninsured folks. 30 a month. Check out w ur state or health department.
I had to go back to work to get transplant coverage during tx tho.
It's worth checking into. We don't like to think about it, but stuff comes up. Karen :)
Helpful - 0
Avatar universal
I would definitely pay the cobra payments until you finish. Like others have said anything could come up until you are off all medication and you want insurance no matter what it cost. Then you can drop it when you are done. I'm sure wondering if anyone had tried to get PCIP. You have to be uninsured for 6 months and not be insurable which most of us will not be insurable if not through a job. You just need to get a doctors note or be denied by a private insurer. We are all still going to need follow ups even if we have to wait the 6 month to get on the pre existing insurance being offered our states.It you can get back to work that would be great but if not I would look into PCIP.gov
Helpful - 0
179856 tn?1333547362
Unfortunately when your Cobra = half a months unemployment and you have a car payment and rent and food and lights and all that.....that $960 is tremendous. I mean they know most folks can't afford that a month, I certainly couldn't if i were to lose my job. They get ya coming and going these days.
Helpful - 0
1654058 tn?1407159066
@ NYgirl - that's why I had to go back full time ASAP...  I haven't been this poor in years. Borrowed gas $ for Dr trip so I could pay copayment on Promacta. I'm working w state insurance commissioner to help me. I think this lady is gonna be a good advocate. I'm even gonna try n turn in my wig expense. Prosthesis? Lol
Helpful - 0
179856 tn?1333547362
Oh Crossroads just know you aren't alone, there are a lot of us in the boat with you rowing together just to keep us all afloat. I wish I could win the lotto it would be so nice just to be able to help out a little bit!!!!!!!!!!
Helpful - 0
223152 tn?1346978371
marty
I am so sorry this happened.  As I understand it, since you are doing the 24 weeks, you have enough of the SOC drugs to complete treatment -- it is just the procrit (and neupogen?) that you will have problems with?

If in a severe crunch, since your hemoglobin is so low, you might be able to go to the hospital for a transfusion if you need to.   I think the info that horspwrguy gave you is probably the way to go.  I think orphanhawk told me about that company so I hope you call them.

I am sort of in a similar boat right now, as my insurance company changed my coverage on the resuce drugs - procrit and neupogen - to be covered under my medical/surgical plan, not the pharmacy plan.  That means to continue to do my injections at home I will have to pay the deductible and then 20% of the retail cost until the stop pay has been reached.  In effect, it will cost me $5500 for those meds in the first few months of the year. However, if I get the shots in a doctor's office it will be covered by my copay of $25.

So I am trying to work all of that out right now.  Meanwhile, I haven't done a shot in about 2 weeks.  I hate to lose the benefit the procrit has done for me. I hope I can get this resolved soon.

frijole

I
Helpful - 0
Avatar universal
The only thing I need to finish my triple tx is the epo shots and I think I may have a couple options through my NP.

Plus, from what I've read here, doing a riba dose reduction would also bring up hgb levels without lowering my chances of long term success.
Helpful - 0
223152 tn?1346978371
marty, since you are UND you probably could dose reduce, but I am afraid to to do that .  I have read all the studies and the drug recommendations and the PI information too.  I just think I have a better shot at this not dose reducing.  Your hemoglobin got awfully low.  I think you need the epo, myself.  I hope you can work it out.
frijole
Helpful - 0
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