I am freaking out. I received a letter from insurance company saying that my RA was a pre-existing condition. I was hospitalized for it last fall when I was insured by them, I was laid off for six months and had to go to drs. twice and pay cash to get prednisone because I could not function. Not only will my insurance not pay for what I assume are mega costly tests they have been running - cat scan, bone scan, tons of xrays, blood tests, urine............and dr. visits, and lets not forget prescriptions but the scariest is - I am not covered for six months. My concerns:
Anyone have a guess at the cost of above tests? I live on a paycheck to paycheck budget and just my deductable alone since I was hospitalized have stacked up to 00+ in medical bills.
What will happen if I put off treatment for six months as doctor said I already have bone erosion in my hips and lower spine?
How much does MTX cost?
How dangerous or effective will another six months of prednisone be as my RA begins to flare up right after I am off prednisone?
I am so stressed, sad, and scared. Please, any advice would be appreciated.
Oh my gosh, Roxy. I wish I could offer some help or information, but I'm really not sure what things cost. And I'm not sure I want to know, as I know the Enbrel I'm on is around 00 a month. As for the tests, I really don't know what they cost. I'm waiting to see what my insurance company says. I have insurance through work, but I wasn't working at the time the RA initially reared it's ugly head. I'm hoping that I don't get a letter like the one you got. If I do, I'm not sure what I'll do, other than just take it a day at a time. My RA is really bad right now, but if insurance doesn't cover me, I'm doomed. There's no way I could pay for any of it. Like you, I live paycheck to paycheck. Actually, I get my check on Friday, and by the end of the day it's all gone. After paying bills, I'm left with literally nothing. It scares me to think what would happen if my insurance didn't cover me.
Sorry I couldn't be of more help, but I will keep you in my thoughts and prayers.
Cris
I don't understand. They are just now getting around to telling you that they won't pay what you were hospitalized for last fall? Was it diagnosed prior to getting that insurance. If not, they can't really argue it was preexisting unless you had just started the insurance and they have some sort of window where you can't file claims... That really sucks! Roxy, I am so sorry to hear of the insurance hassles you are having to deal with. Have you talked to your doctor since finding out about the insurance problems? What does he suggest? I know someone posted about drug companies being able to offer drugs if you qualify, but I have no idea how that works (check past posts). Do you qualify for any public assistance that will cover you in the meantime???? A lot of times, if you are not able to work, you may qualify for medicaid, again, you'd have to call a local agency to see how that works. I know that hospitals and doctors have to treat non-covered people (a certain percent each month). I think it's call the Burton-Hill program. I know a lot of loopholes around here where I live, to qualify for certain programs, but I'm not sure of how things vary state-to-state. I hope you are able to get the help you deserve in your waiting period. Love and gentle hugs, Juliah
Roxy,
Try not too panic. Take a couple of good deep breaths, everyone here will try to help you.
1) talk to whoever handles insurance where you work
2) call the insurance comissioner in your state and find out for sure if they can make you wait 6mo. since you had that insurance when you were diagnosed
3) contact the people who gave you treatment and explain your situation, that they will just have to wait for their money, you can't give them what you don't have
4) MTX is the least expensive of the arthritis drugs that can slow down or stop the progression of the disease
5) contact drug companies to see if you can qualify for their reduced cost or free meds. Some people here know how to do that.
6) prednisone is the cheapest med period. Its been out for eons and everybody makes it and it works.
7) declare bankruptcy, but do so before the new bankruptcy law signed by Bush takes effect in 6 months. It will make it much harder to file, even if your debts are medical. That really sucks!
Thats all the suggestions I can come up with right now, but I know other people will try to help you. Hang in there, kiddo.
Barb
If the test were done in the hospital, talk to billing explain what happen, they may be able to cut your bills down, they do have programs where they absorb the costs of treatment for patients who can't pay their bills. Now if I remember, the insurance company can not refuse to pay for treatment, they knew you had this condition and had paid for it before. if need to there should be a place in your town where you can get a laywer pro bono or for a lower fee then normal. Try Barb's way first call the Insurance commissioner in your state before calling a lawyer though. I am so sorry for all of your problems,Roxy. meme
So, what am I going to do. I am first going to go talk to the rheumy and see what his advice is. Then I am going to come back here and make a list of all of your suggestions and get to work and figuring out how to get treatment. I have been hurting so bad, I may be able to go on temporary disability which may qualify me for state insurance. OK that is the plan. You guys are GREAT
I'm just checking in on you guys and saw your post. I'm usually not around much on the weekends. This seems bad I know...but after 6 months they'll cover you right? Obviously these past test are going to be costly; but once you explain your situation they will set up some sort of payment plan for you. Don't be overly concerned about that. Of all the creditors hospitals and doctors offices are probable the easiest to work with. As far as future treatment goes; most of us here have waited years to be on these stronger treatments such as bioligics. I myself waited 10. You'll indeed need your insurance for those. Humira weekly for me is about 00 a month (I pay co-pay). I can't rememeber right off what MTX cost; but it's probable about to 0 a month. That's not too bad you can probable manage that. I'm the one that posted several sites that show financial assistants programs. You might could look under my name and search past post. I don't have time to do it tonight but I'll check back with ya next week . Roxy; I can only imagine what a shock this is for you right now. Of all the things I'm grateful for the past few years...my insurance comes in a close second to my family; but you'll get throught this...and be stronger for it. We'll help you figure things out. One thing though: filing bankrupsy would not be a good idea. Make that a absolute last resort. I know you're getting ready to get married but we all (Us ladies) need our good credit...or at least pretty good credit to be able to remain independent even in marriage. Unless you just can not manage any other way I myself would not do that. Good Luck my friend. I'll be praying for an easy resolution to this problem for you. Lovie
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