NYS Health Insurance Filter: I live in New York state. I am between jobs. I just enrolled in
because I can no longer afford my monthly COBRA payments through my former employer. The good news is that my monthly premium with my new insurance is reduced by 50% from what I was paying for COBRA. The bad news is, I just realized that in all likelihood none of the prescription medications I take regularly are covered by this plan. Please help me figure out what, if any, my options are at this point.
I have bipolar II. I was diagnosed six years ago, have been taking medication for it since, and have been managing just fine.
I just received my enrollment letter from Healthy NY and was filling out the mandatory HIPPA form when I thought I should go back to the website and double-check their pre-existing condition clause. But before I even got that far, I discovered this page on the benefit package
, which somehow I completely missed when I was filling out the application for this program because apparently I am a HUGE FUCKING IDIOT. Here's the relevant part:
Because Healthy NY has a streamlined benefit package, certain services are not covered. Examples of these services include: Mental health services and prescription drugs relating to mental health conditions, including but not limited to treatment and medication for ADHD, depression and anxiety.
So basically I am fucked, right? Pretty much the only reason why I need health insurance is so that I can have prescription coverage for the three medications I take to keep my mental health under control. Now it looks like I won't have that coverage anymore. There's no way I can afford to pay out of pocket for this medication.
I have no idea what to do at this point. I'm really upset and scared and I'm sort of all over the place at the moment, so apologies for incoherence. I am going to call the insurance carrier on Monday morning just to clarify, but it hardly seems worthwhile since it says in plain letters on the Healthy NY website that prescriptions for mental health conditions are not covered, so I doubt that somehow they will magically have something different to tell me. I am still covered by my former employers' health insurance plan till the end of January, so I'm going to call my psychiatrist ASAP and ask him to call in new prescriptions for me before the end of the month.
Slight snowflake detail: while my bipolar II prescriptions have been covered thus far by my insurance coverage, I have been paying out-of-pocket to see my psychiatrist. I don't know if this actually has any bearing on anything I have mentioned thus far, but thought it would be worth mentioning.
After that wall of (con)text, here's my real question: what the hell does someone like me do in this situation?
Even if I pull out of Healthy NY, I cannot afford to remain covered by my former employer, so no matter what I'm SOL when it comes to my prescriptions. I don't qualify for Medicare or for Family Health Plus
(my UI payments put me beyond the maximum income eligibility for those programs). I turn 28 this year, so I'm long past the eligibility to go back on my parents' insurance plan. I don't have a partner who can put me on their insurance plan. I'm busting my ass to find a new job, but until that happens, here I am. Now I'm freaking out.
Is there something else I'm missing somehow? Or do I need to start selling my plasma to pay for my medication?
Needless to say if I go off my meds, I will not be able to function properly, which will make the already disheartening job hunt even more difficult. Not to mention the likelihood of me falling into a major depressive phase, which would be a nightmare. I cannot even begin to explain how scared I am right now. If it does turn out that I am as fucked as I think I am at this point, please be nice. I know I'm a moron for not noticing that my prescriptions wouldn't be covered by Healthy NY when it says right so on the website. I feel so fucking stupid. But as I said, it hardly matters when I am no longer able to afford COBRA, so no matter what I would be asking some version of this question at some point.