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Myasthenia Gravis For support and discussions on Myasthenia Gravis, Congenital Myasthenic Syndromes and LEMS. |
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10-31-2013, 10:09 AM | #41 | ||
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That's good to hear. It would make sense to "grandfather" all the meds in, as there would be a LOT of whacked out people if they suddenly were forced to start experimenting with meds. However, you never know.
I looked up IVIG and the prescription "helper" made it look really difficult to get, as I expected. My dosage would run $6200 every 3 weeks on the plan, which is actually less than it currently does. Whether it will approve it for MG is another question and I will have to wait and see. |
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10-31-2013, 12:36 PM | #42 | ||
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Elder
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Yep you are right, hell has no fury compared to a mom protecting their child.
My son is 38, and he got snookered with a purchase. Believe me, I am all over it with Better business bureau. Got him a lawyer, and if necessary I will fly to California for court on his behalf!!!!! He just got transferred to a new job, so time off isn't possible. I have not been this ticked off in years. I wonder how people who do these things, can sleep at night.........Morals, what's that? I hope your daughter gets to keep on the medication she is on. Try the company who manufactured the drug. Many times in situation like this, the company has programs to get the drug to you at very little cost if any. I did this for two medications that were not covered for myself. I wish you all the best. Ginnie |
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10-31-2013, 02:50 PM | #43 | ||
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If they wish, they can say CASH ONLY. If you spent years in medical school, would you like someone to dictate to you what you can charge, what you can accept, what your practice should be, etc.? If you opened a business of any kind, do you HAVE to accept credit cards? NO. Would you benefit by having more customers if you did? Probably. When businesses accept credit cards, they have to pay a percentage of the sale amount to the credit card company. Doctors accept "coverage" from third parties as a service and convenience to their patients and to increase the number of patients attracted to their practice. Insurance companies do not have to continue to offer the policies that are considered "grandfathered". Having a policy prior to the passage of ObamaCare (PPACA) does not guarantee that it will continue to be offered. It only means that IF the insurance company AND the policyholder make NO changes, it will be grandfathered. A change by either will void the grandfather clause. If the provider (doc) agrees to accept Medicare, YES, he must accept the amount they pay. BUT, he is not required to accept Medicare itself. He/she may simply state that they will not accept Medicare period. |
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10-31-2013, 03:02 PM | #44 | ||
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10-31-2013, 03:07 PM | #45 | ||
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10-31-2013, 03:18 PM | #46 | ||
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40% of some "unknown" amount can be a very HIGH cost to the insured. Just a very short hospital stay could cost thousands and 40% of that can wipe someone out completely. My plan has NO percentages, just flat dollar amounts so I KNOW what I will pay before I have the service, whether it be an office visit, a CT scan, blood work, surgery, hospitalized, etc. My drugs are also covered. I can NOT afford even the 10% on a Platinum plan if I have a HIGH expense. What happens if I get hospitalized and my bill totals $125,000? I don't have the $12,500 for my portion. What if it is a bronze plan? 40% of $125,000? It is more than comparing premiums or conditions covered. It would be impossible for me to become pregnant so why pay for maternity coverage? Substance abuse? Dental? I do not need these items. Health care and health insurance should not be one size fits all. Oh, did I mention that the plans of which you speak may not include your doctors or hospitals? I do not want ANYONE deciding whom I should trust with my life. I want to have MY doctor. |
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10-31-2013, 03:29 PM | #47 | ||
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"Thanks for this!" says: | suev (11-02-2013) |
10-31-2013, 04:07 PM | #48 | ||
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The ACA plans have caps on out of pocket expenses so that people won't get wiped out. I believe the cap for an individual is around $6500 and for a family it's around $12,500.
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10-31-2013, 04:35 PM | #49 | ||
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Senior Member
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Abby |
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10-31-2013, 05:50 PM | #50 | ||
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Junior Member
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I read the article and it said that 'some' plans or insurers may not have a cap until 2015. The plans that I looked at offered by Blue Shield and Anthem have the cap now.
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