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Old 11-28-2008, 07:04 PM #1
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Default HMO's

I can't afford my old helath insirance plan any longer - if I pay the premiums there's no money left to pay my out-of-pocket expenses (drugs, deductible, etc.) Not to mention the premiums are sky high. Does anyone know how HMO's work when it comes to drugs like Copaxone? Are there maximum drug allowances? Thanks for your help!
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Old 11-28-2008, 08:08 PM #2
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Quote:
Originally Posted by newone View Post
I can't afford my old helath insirance plan any longer - if I pay the premiums there's no money left to pay my out-of-pocket expenses (drugs, deductible, etc.) Not to mention the premiums are sky high. Does anyone know how HMO's work when it comes to drugs like Copaxone? Are there maximum drug allowances? Thanks for your help!
I can tell you who is expensive...Anthem Blue Cross.

Take a look at my post in the Tysabri thread.

I wish you a ton of luck in your search.

-Vic
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Old 11-29-2008, 08:49 AM #3
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Before starting any plans, understand what they cover. I get through my husbands job, go to doctor I like (who is one of doctors approved
I like plan, as most doctors are etc.. Got my Rebif for nothing but when getting a power chair, their approved comppamny said 16,000 (Yikes) and found out they only allow 3500!!!! I couldn't pay the other 12,500! We negotiated price down (Removing wheelchair options - did they bother?) and lo and behold it became much lower price I stated I could pay with my 3500 DME (Durable Medical Equipment.)

If think equipment suppliers ask a charge a lot. Be careful out there!
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Old 11-29-2008, 07:59 PM #4
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Depends on whether or not you are on Medicare, etc - Copaxone is a Tier 4 injectible - with RX insurance plus medicare you have to pay 1/3 the cost - which is a lot - perhaps you can apply for funding through Copaxone's Shared Solutions - they give your info to the Chronic Disease Fund which then evaluates whether or not you qualify - you might even get it free depending on your circumstances -
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Old 11-29-2008, 08:19 PM #5
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My HMO did not charge anything for copaxone. It was considered a treatment, not a med. It all depends on your plan.
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Old 11-29-2008, 08:28 PM #6
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Wow - what's your plan - mine is $860 monthly - if I stay with Copaxone - all the Medicare approved supplementary insurances are 1/3 the monthly cost -
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