health insurance

[amyjean]

My husband and I just lost our health insurance. My daughter and I are both have Type 1 diabetes. We didn't lose our insurance because my husband quit his job or because we weren't paying the insurance company. We lost our insurance because of a hospital bill back in December that was over $3000. It was her ER visit when we found out she had diabetes. And because we don't pay the doctors or hospital direct the insurance company doesn't have to work with us. We offered to pay $100 a month(thats all we could afford to do) until it was paid off and they said it wasn't good enough. So they cancealed our insurance and sent us to collection. The frustrating thing is the collection company has accepted $100 a month which is what we offered the insurance compant to begin with. So now we are paying $100 a month but now have no insurance. We are paying out of pocket at the pharmacy alone at least $600 a month. And that doesn't include the Symlin I had to go off of because it would cost me an extra $253 a month. I am so upset. I was doing really well on the symlin and now I have gone back to high doses of Huma log. I don't know how much longer we are going to be able to afford the $600 a month at the pharmacy. why are insurance companies so EVIL!!

Sorry I just needed to vent. It would be one thing if it was just me , but my 8 year old is also diabetic. She shouldn't suffer because the insurance company is greedy. Thanks, for listening.

Amy

[JediSkipdogg]

Amy, sorry to hear that the insurance company did that too you. Unfortunately, insurance companies can do that. Have you looked at trying to get on Cobra or something similar. I'm sure someone else will post them, but I know there's a bunch of companies out there that help people in need to lower prescription costs.

Just a small question, did you insurance not cover hospital ER visits? Just wondering how you got a bill so large for initial diagnosis.

Good luck with everything.

[gettingby]

Amy, if it were me, I would call my local health department and see if they can help out or point you in the right direction to get help. Or maybe Social Services?
I know that Blue Cross/Blue Shield has policies that may help you but they sometimes come with heavy premiums.
Sorry that I wasn't much help. Give these suggestions a try and see what you can find out.

[amyjean]

Thanks, for the suggestions. I can't afford COBRA because it would be around $850 a month. I'm not sure why the ER visit wasn't covered more(my insurance only paid $20 of the hospital bill), but I did find out after the fact that my husbands company carries the cheapest plan possible through RMHMO. I called both of our doctors to see if they had any insulin they could give out that the drug Reps bring them , but they both said "no". I am trying to get the paperwork ready to give to our doctors for the Lilly Cares program. I am hoping we get approved. I have not been able to find a program to help out with the Symlin. It has been an unfun experince getting off of it.

[lgvincent]

Can you file a complaint with the state insurance commission? Perhaps they can offer some type of assistance in getting you back into the program you were in, or perhaps another one.

[am1977]

Amy~ I'm so sorry to hear about your insurance problems... I believe the Lily Cares program is a good one... and hopefully they will be able to assist you with the insulin, etc, if not the Symlin.

I have to admit that is something I fear... losing my job and then my health insurance . That would certainly put me in a very difficult position financially.

I definitely hope that you are able to work something out- please keep us posted.

[Stuboy]

I think it's discusting that insurance company's can do that to people in the US. The fact that you simply couldn't survive if you couldn't afford to pay for your prescriptions and get no help is just ridiculous. Maybe you should move to the UK!?

seriously... it's all free here! We moan about the NHS a lot but when it really counts... they are a brilliant service for after-care.

[Cinnabon]

Amy,
Im sorry for all this "uneeded" trouble incurance companies do. Please try this:

http://www.chcpf.state.co.us/HCPF/elig/Q3.asp
http://www.cfmc.org/medicaid/medicaid_general.htm

Let me know if u need any help

[amyjean]

Thanks for all of your suggestions. I guess I need to call my husbands boss and see how maybe I can file a complaint. I've been without insurance before and it sucked but it was never for more than a month or so. It's just double hard now adding my daughter to it. I really do appreciate everybody's thoughts and concerns.

Amy

[jeggeman31]

Okay I am a little confused. Did your insurance pay the bill and then come collecting from you for what was not covered? If that is the case I have NEVER heard of that. I would also file a complaint with your state insurance commission.

[amyjean]

The way our insurance works is we don't pay anythingy (not even a co-pay) at the doctors office/hospital/ER. The insurance company pays their part and then bills us. We never get a bill from the doctor/hospital/ER. So we never have the option to pay a bill out. My husband and I feel this way is really unfair. Like I said before we have really bad insurance.

[jeggeman31]

The way our insurance works is we don't pay anythingy (not even a co-pay) at the doctors office/hospital/ER. The insurance company pays their part and then bills us. We never get a bill from the doctor/hospital/ER. So we never have the option to pay a bill out. My husband and I feel this way is really unfair. Like I said before we have really bad insurance.

Wow I have never heard of such a thing.

[Scooter]

That does sound odd. I've never heard of insurance being cancelled for this reason. Generally, the insurance company pays their part and they are done. The hospital/dr/lab bills you and your liability is to them, not the insurance company. That's an interesting position your insurance company has taken.

[JediSkipdogg]

What insurance company is this? Is this a big name one or some small one?

[amyjean]

Rocky Mountain Health Plans is /was my insurance company. They pretty much own the town I live in. My husband tried to talk to someone at the hospital, but they don't care about us because they already got their money. I did find out that Rocky Mountain Health Plans and St. Mary's is in bed together. They have a pretty sweet deal going on between the two. I find that funny considering St. Mary's is a non for profit hospital. My husband is going to find out who all we can write to/contact to cause a stink.

[JediSkipdogg]

My husband is going to find out who all we can write to/contact to cause a stink.

Media media media...Start with TV and any troubleshooters they have. Then go to newspapers. Everyone hates TV and news because they usually get action taken.

[kidvid]

I was insured by RMHMO for years. I'm glad I am not now, though that's no help to you now.

It seems we're in the same valley - I recognized the "RMHMO" and St. Mary's. Maybe somebody at Community Hospital can help. I know they run Diabetes Education programs, and there is a Diabtetes support group...I think it is on Tuesday nights - they advertise it in the Daily Sentinel. Go to the group and ask if anyone has good info. They have a number in the book for their Diabetes Center as well.

I'd figure out how to fight RMHMO to the bloody end. Can anyone in your husband's company's Human Resource Dept. assist with this issue? I know our HR dept. had contact directly with them and could assist indirectly at times...

Call the Marilac Clinic. I heard recently that their criteria for accepting patients was changed, and you didn't have to be super-low income anymore to receive assistance - just a shot, but it's only a phone call...

Good luck!

Joe

[jrcskb]

I will no belabor the point raised by so many others - insurance companies can be confused for the devil at times.

There may be a program to insure your child through the State. Connecticut has a (HUSKY plan) program to cover children that cannot get private insurance. They base it on the income of the parents - so you may/may not qualify. I am not sure if this is true in Colorado.

It may be too late, but I would also look at the Hospital's bill for services and what the company paid. If the ins. company knows it is to collect from you, it may just pay everything, even unnecessary charges that they would drop. That may be an angle at getting at least a reduction.

[amyjean]

WOW! I knew I liked this forum for a reason. You guys are full of good ideas. I hadn't even thought to call Community Hospital/ their diabetes education/support group. I had heard about it, just never checked into it.

We did look at the Hospital bill and called st. Mary's to dispute it, but like I said they already have their money so they don't care. My husband and I have called so many times and they jusy keep putting us off. One thing we disupetd was them charging us $10 or $12 everytime they checked her bloodsugar. The reason we disputed it was because I used my daughters meter/lancets everytime. I don't see how they can charge me for something when it was our meter and I did the testing not the nurse. Antways, I know I am rambling.

I did try to get my daughter approved for a colorado state program but my husband made a hair too much. I did get the forms turned in to both of our doctors for the Lilly Cares program.

[amyjean]

Also, my husbands company is very small so their isn't a HR department. The owner of my husbands company called to raise a stink, but they still wouldn't budge.

[kidvid]

Do everybody that has to put up with Rocky Mountain Health Plans a favor and write a letter to the editor of the Daily Sentinel. Tell the rest of our area just what kind of "great" health insurance company we have in our community. Describe your plight and maybe save somebody else some pain.

Be brave, good luck.

Joe