Topic: COBRA runs out in five weeks, looking for alternative insurance

Forum: Employment, Insurance, and Other Financial Issues — Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jun 25, 2010 11:04AM

Posted on: Jun 25, 2010 11:04AM

MaryNY wrote:

My COBRA coverage will end at the end of July.

I'm looking at getting coverage under a low-cost plan, Healthy NY. Premium would be about $300/month. There are some disadvantages such as needing a referral for every consultant visit, only certain doctors covered and my nearby hospital and my breast surgeon not covered as they're over the state line. But at least it's insurance.

Healthy NY is sold by a number of providers and I narrowed the list down to three—Aetna, Blue Cross Blue Shield and Oxford. Then I found that BCBS are currently involved in a dispute with a number of area hospitals which means that until it's resolved their clients have no coverage at those hospitals. So that leaves Aetna and Oxford.

Would like to hear from others who use Healthy NY or your state's equivalent plan.

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jul 25, 2010 04:49PM karen333 wrote:

Mary, do we just have to wait and see?  I didn't give any info on my breast cancer to Healthy NY or to Univera either?  Karen  More uncertanty, we didn't need.

Dx 8/8/2009, 2cm, Stage IIA, Grade 1, 0/1 nodes, ER+, HER2+
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Jul 25, 2010 04:55PM - edited Aug 2, 2010 06:46AM by lovemygarden

Hi MaryNY, it's the employment criteria that disqualifies me. One of the requirements is that the person (or their spouse) must be either employed or have been employed within the previous 12 months. That's not the case for me.

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Jul 25, 2010 05:53PM MaryNY wrote:

lovemygarden: I sent you a PM.

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jul 25, 2010 06:00PM MaryNY wrote:

Karen: yes, I think we'll have to wait and see. I think they couldn't be so heartless as to deny us both coverage for the mammos we are due.

Just thinking back -- I switched health insurance providers at the beginning of March when I was midway through treatment. The new provider didn't deny any of my claims. And they were hefty claims as I had just started rads. So this is really like a change to another provider and I'm hoping it's treated the same way. The switch in March wasn't voluntary on my part. My former employer switched plans so I had to go with the flow.

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jul 25, 2010 08:34PM carol1949 wrote:

Not only did we lose our Cobra, my husband lost his job as the company was closed  and therefore there wasn't even anyone to administer the Cobra had we been able to afford it!  I feel that when we are in a position like this... I, at least am grateful for any medical coverge I can get... so I am not so caught up in where we can go.  Something is better than nothing. 

I wonder if there are any programs in your community that reach out to people.  For instance in my community I qualified for a discount on at least basic medical care for which I am grateful.

Perhaps through a county service or Senior Center?

Dx 4/4/2008, IDC, 6cm+, Stage IIIB, ER+, HER2-
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Jul 29, 2010 10:42AM lago wrote:

Good information here: Pre-Existing Condition Insurance Plan (PCIP)
http://community.breastcancer.org/forum/113/topic/754874?page=1
DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2-
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Aug 10, 2010 05:04PM Medigal wrote:

MaryNY:  I was under the understanding that "if" the insurer had this delay in coverage for up to 12 months they were supposed to inform you about it.  I remember calling a company for my daughter when I saw this and she had a pre-existing disease. However, they told me since she was constantly insured by jobs or COBRA etc. they would not impose that on her so everything was fine for her insurance.  The way I think about it is if you get the pre-existing waiver then why should they even have a right to ask you if you have any pre-existing conditions.  Now if they asked you on your forms to list all your medical conditions and you did not that's another story.  Hope everything works out ok for you.

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Aug 15, 2010 12:23PM MaryNY wrote:

I still have to wait and see how the new insurance works out. I had a visit to my oncologist on Friday so I'm hoping that will be covered. I have an appt on Thursday for mammo and ultrasound but although my PCP gave me a referral to the breast center at the local hospital, I'm still not sure it will be covered. The trouble is that this breast center is not one of their listed providers and it's in CT rather then NY. The center do not pre-validate for insurance purposes. The insurance company told me over the phone that it would be covered but I have nothing in writing.

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-

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