I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: bleija on September 05, 2012, 07:42:20 PM

Title: question, post transplant ppl with medicare only in US
Post by: bleija on September 05, 2012, 07:42:20 PM
my question is what kind of insurance can i get for whenever medicare drops me at the 36 month mark. i am 22 years old, and when i first found out all my renal problems, i had so many issues wth the insurance i had, they refused to cover anything because they claimed it was preexzisting, know the fact thaht there was no record of anything renal related in my charts growing up. i ended up droping them bc what was the point of having insurance if it refused to cover anythign and at that point i could use the extra money. i just want to know is there anythign i need to look for, who would cover me anyway, and is there some kind of waiting period before they will cover me. i know i have plenty of time my transplant was not even 2 months ago.
Title: Re: question, post transplant ppl with medicare only in US
Post by: Rerun on September 05, 2012, 09:34:47 PM
Any Federal Job will have good insurance and there is no preexisting condition caluse.  There is Department of Agriculture, Department of Defense, Homeland Security etc....  Maybe Post Office too....

Title: Re: question, post transplant ppl with medicare only in US
Post by: jeannea on September 06, 2012, 10:19:05 AM
The only way I know to have insurance at the 36 month time is to have a job with insurance. If the job offers a group plan they usually cannot deny you for preexisting conditions. Your medicare will be primary and the job insurance secondary until the medicare ends. Then the job insurance will take over.

Most states now offer a plan that you can sign up for no matter what your health. I forget what they call them. Unfortunately they cost around $1500-2000/month.
Title: Re: question, post transplant ppl with medicare only in US
Post by: bleija on September 06, 2012, 01:51:35 PM
now this last year i tried to get on my husband's insurance. he works for a hospital. they said they couldnt cover me bc i had a part d plan too. i love my plan it covers a lot, but from what they were telling me i would have to drop my pt D plan to be able to get on his insurance. my only concern with that is these pills are expensive theres no way i could afford that.  his enrollment period is in october, but doesnt begin to cover til jan. and i work technically part time so no benefits
Title: Re: question, post transplant ppl with medicare only in US
Post by: justme15 on September 06, 2012, 02:09:34 PM
are you able to look at his plan and see what meds are covered and how much they might be? with my transplant I get a lot of my meds through 90 day mail order which is pretty reasonably priced.  $40 for 90days of cellcept, 40 for 90 days of prograf and the other are significantly cheaper than that.  these were the  prices when I had  BCBS and UHC through my job.
Title: Re: question, post transplant ppl with medicare only in US
Post by: bleija on September 06, 2012, 02:29:20 PM
i am not sure... how do u get the 90 day mail in stuff, bc that would be awesome!!! 40 for 3 months, ha right now i pay 172 for 1 month, and 242 for prograf just one month as well. but then that is still the original prescription from my transplant and they last m=longer than a month.
Title: Re: question, post transplant ppl with medicare only in US
Post by: justme15 on September 06, 2012, 03:18:45 PM
well my insurance has medco for its 90 day prescription coverage.  so I had my doc fax the prescriptions to medco and that was it!  I don't know if medicare D uses a 90 day service, you might want to find out.  but i'm pretty sure your husband's insurance has 90 day coverage. most private insurances do.
Title: Re: question, post transplant ppl with medicare only in US
Post by: KarenInWA on September 06, 2012, 05:50:46 PM
bleija, if Obamacare does not get repealed, then you should be okay by the time your Medicare runs out, because insurance cannot deny you or charge you more for havng a pre-existing condition. I don't have time to find a link to it right now, but I will do more research when I get home.

KarenInWA
Title: Re: question, post transplant ppl with medicare only in US
Post by: bleija on September 06, 2012, 07:45:20 PM
thank you, this has been the one big issue that kept me from getting a transplant bc i ddnt know what i would do at the encd of the 36 pass... but finall convinced myself that plenty of ppl have found a way so i can find one too.
Title: Re: question, post transplant ppl with medicare only in US
Post by: KarenInWA on September 06, 2012, 09:17:29 PM
I found this link - http://www.healthcare.gov/law/timeline/index.html#event46-pane

That's a start, anyway. I'd like to find more detail, but I'm too tired to dig for it right now!

KarenInWA
Title: Re: question, post transplant ppl with medicare only in US
Post by: jeannea on September 08, 2012, 03:35:09 AM
Definitely check what the drug coverage is on your husband's plan. Most group insurance plans have better coverage than we get on Part D and with no donut hole. For ex., when I was working and had their insurance, Valcyte was a non-preferred brand name so it had the highest copay of $65/month. Now on Part D I have to pay $2500 for the first month to go through my donut hole and about $300/month after that. His HR would be able to give him written info or you could call the insurance company with his card number and ask questions.