insurance

[BRANDI]

I just would like to know for those of you who have kids with cf do you have insurnce through your job and medicid or just insurnce through your job? I am asking becuse i have insurnce on my son and i also had katie beckett but they have denied him this year and i need to know if i should appeal the decission or not. We are from Georgia if that helps any. I am just scared that if he does not have medicaid as secondary we will not be able to afford meds or pay for his appointments. For those that have just insurance are you usually left with an outstanding amount to pay for meds? I know all insurnces are diff. i am just trying to get an estimate.

 

[rcq925]

Brandi,

I have a 2 year old, Hayley, with CF and we only have insurance through my employer. We make too much money (according to all the assitance program) to receive any type of government or secondary insurance. Now all employers, policies are different, but our policy has a $500 deductible which we pay not matter what, after we meet the deductible (which happens very quickly with CF!) then they pay for 80% of prescriptions and $90% of all other things, (i.e., doctor appt's, clinic visits, lab work, hospitalizations, medical equipment, ect) But once Hayley indidually meets her $1,000 out of pocket expenses (including deductible) then they pay everything at 100% for the rest of the year. So at most for her we pay $1,000 out of pocket, which we do every year of course. So personally think we have very good insurance and I would for the local county government in Indiana, so we get good plans due to the sheer number of employees. My worry, as I stated in another post, is that her insurance has a lifetime maximum of $2 million dollars, so I am worried about her going over that! ANyway, hope that helps you some!

 

[julie]

Brandi,

I'd be more than happy to help you out with the denial of medicaid that you got, but I definately need more information as to why they denied you, what state you live in, your income level, your family size.... stuff like that.

 

[BRANDI]

I live in the state of Georgia. I am a single parent of 2 but i do get child support and my son is on his fathers insurance. I bring home between 1400 and 1500 a month plus 720 a month child support. I was just needing to know do you think it would be worth appealing or trying to get him on my insurance through my work as secondary. I do not know if they would pick him up since he has a preexisiting condition.

 

[Alyssa]

If getting him on with your employer insurance is an option, I would look into it -- if he has current coverage the pre-existing clause may not apply due to the HIPAA laws, but if they say they will not cover for pre-existing, find out for how long and get him started. I believe there is a federal maximum of 18 months for pre-existing, then they have to cover for it.

use this link to check out Beth Sufian -- she is an attorney with CF who helps people with insurance and SSI problems

<a target=_blank class=ftalternatingbarlinklarge href="http://esiason.org/newsResourcesRights.html">http://esiason.org/newsResourcesRights.html</a>

 

[trent]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>BRANDI</b></i>

I just would like to know for those of you who have kids with cf do you have insurnce through your job and medicid or just insurnce through your job? I am asking becuse i have insurnce on my son and i also had katie beckett but they have denied him this year and i need to know if i should appeal the decission or not. We are from Georgia if that helps any. I am just scared that if he does not have medicaid as secondary we will not be able to afford meds or pay for his appointments. For those that have just insurance are you usually left with an outstanding amount to pay for meds? I know all insurnces are diff. i am just trying to get an estimate.</end quote></div>

If your having a hard time searching for a cheap insurance try this insurance broker that offers free quotes <a target=_blank class=ftalternatingbarlinklarge href="http://www.insurancepaylite.com">InsurancePayLite</a>, they can surely help you decide which insurance company is best for your insurance needs.

 

[julie]

Brandi, as alyssa mentioned (Hi Alyssa!!!) if your son currently has coverage through your husband the pre-existing clause actually does not apply in the sense that they canNOT deny him for coverage. What they CAN do (based on the literature of their contract with your employer) is make him have a waiting period for any CF related coverage. This is usuall a 90 day to 6month waiting period.

So you make about 1500 a month before taxes??? The programs always count gross income, which is before taxes. Plus 720 a month in child support is roughly 2200.
And are you considered a family of 3?

Can you be specific about why they denied you for medicaid/the Kate beckett Program? I'd love to help but I definatley need more info. Feel free to PM it to me or email me at division902@hotmail.com