 |
Member
|
|
Join Date: Jan 2008
Location: Southern California
Posts: 308
|
|
|
Member
Join Date: Jan 2008
Location: Southern California
Posts: 308
|
Victor - does your insurance plan not have a copay maximum for the year? Many do...it does seem just outragous that you spend so much.
My out of pocket maximum for the year is $4,000. Sadly, I think I JUST hit that mark. At this point, all of my copays will be 100% covered. Unfortunately, prescription meds do not count toward the copay maximum.... (Tysabri counted b/c it was an office procedure, but Copaxone is not counted - so I needed to get assistance for that b/c I am going back on it in a few weeks).
Medicare, last I heard from someone, does cover Tysabri. Also, I was told that with medicare you can select to have the coverage go thru another company - so I have a friend with medicare who actually has Kaiser. I believe her tysabri payments are ZERO.
I met someone here in Baltimore and Medicare is covering his HiCy/Revimmune, too!
Now, as for insurance - do you know the State of California has a great thing - (yeah, believe it or not - it's actually decent) - It is catastrophic health insurance plan - or something like that - and basically it is this:
If you do not have insurance or can't get insurance (so if you dropped yours b/c you couldn't pay) - AND you have an illness such as MS - you would qualify for TWO years of health insurance, offered by one of many major carriers out here - and the rate would be about 200-300$ a month. After the two years - that company has to continue insuring you, though it would be at higher rate - but wouldn't be over the top (still under 1k, I'm told). As for the insurance companies - it covers the major ones out here - I'm not sure you get a choice of carriers, but you would get choice of plan (HMO vs PPO, etc). The companies basically provide this for the state - and how it was explained to me is that they rotate through the companies - so whoever is up when you apply, that is who you would get. I WAS TOLD IT IS NOT INCOME BASED! IT IS SOLELY BASED UPON THE FACT THAT YOU HAVE BEEN UNINSURABLE.
It is worth looking into this - for the reason that: 2 yrs at a reduced copay - and then that same major insurer has to cover you - but you will have been able to pick what plan works for you (ie: one that has an annual out of pocket maximum).
Don't quote me on the specifics of that CA plan - but call the NMSS and they will tell you about it. Someone spoke to a group of us once about it. It was great to know that was out there for "people like us".
Victor, you pose a great question! I don't qualify for much assistance b/c I own a home and a car. Which is absurd - because basically the BANK owns my car and my home! And even when I had more income coming in - it went to pay for the home and the car....and mortgage interest is tax deductible - so my income after my deductions has been very low - but NO one wants THAT number!
It's very expensive to live, I tell ya!
~Keri
|