When my insurance (COBRA) ends in March, what can I do?

December 13, 2003 10:45 AM

When my insurance (COBRA) ends in March, what can I do? Private insurance is prohibitively expensive, and chances are with my preexisting health problems I may not be able to get insurance at all. Worst part is my monthly prescriptions are extremely expensive-we are talking the price of a car payment here, if not more.
Any suggestions, besides moving to Canada?
posted by konolia to Health & Fitness (14 answers total)

This ask question may be some help, and I would lie to the new insurance company about any preexisting conditions (and i've found that new doctors will do so too, to ensure payment)--you can also order the drugs from canada online.
posted by amberglow at 10:54 AM on December 13, 2003

Response by poster: Well, I can't lie (on moral grounds-I am a Christian) and my only real option for possible insurance (assuming I could afford it) is the company that already covers me for said condition. And it's something that will not go away on its own. But at least I won't die from it.
posted by konolia at 11:03 AM on December 13, 2003

It's not so much lying as it is omitting certain details : >
posted by amberglow at 11:31 AM on December 13, 2003

State high risk pools are programs fed (via state mandate) by the private HMO's operating in that state for those with pre-existing conditions. Depending on age and sex, your monthly cost ranges from slightly less than COBRA to twice the COBRA rate. Not ideal, but it may be the best option for those with high prescription costs. For me, it will be a good short-term solution between the expiration of my COBRA plan and my finishing school.
posted by PrinceValium at 2:38 PM on December 13, 2003

I should add the caveat that I am in Connecticut, and I hear anecdotally that the system works better here than in most other states. I am also a 26 year old male and as such my rates are competitive with COBRA. Still, it's worth a call to your state government to get some literature on the particular program in your state.
posted by PrinceValium at 2:42 PM on December 13, 2003

Many professional/trade organizations offer group insurance to their membership; if you are not a member of one and are eleigible, it might be worth the price of membership. As far as pre-existing conditions go, you are just going to have to tough it out until you are covered, I am afraid, if you cannot join a high-risk pool as mentioned above. (And the suggestion that you should just lie, in addition to being immoral, is insurance fraud and is being looked at more and more harshly with possible criminal penalties) In some situations you can finde physicians who take barter or other nontraditional forms of payment, but this is not common and is more for office visits than for major health problems that insurance is designed to cover. If anyone in your area knows a good insurance agent, they can be a great source of advice for you specific situation.
posted by TedW at 2:53 PM on December 13, 2003

Do you perchance live in New York state? If you do, I can tell you about low cost insurance plans here. Unfortunately I'm logging off in a few seconds and will probably not see your answer earlier than tomorrow. Hopefully someone else will be able to help before then.
posted by lassie at 2:55 PM on December 13, 2003

Just FYI, moving to Canada with pre-existing conditions won't work. I've seen people suggest the Canadian option on other sites and boards. Canada won't cover anyone who isn't a permanent resident or citizen, and it's pretty hard to pull that off. Especially if they know you'll need medical coverage.

But amber is right, you can get your drugs from Canada. We generally use generic versions of name brand drugs, so right off the bat it's cheaper. Take in the exchange rate, and I hear it's a real deal for American buyers.
posted by Salmonberry at 2:59 PM on December 13, 2003

Just in IM with a friend. She takes fluoxetine, which is a generic version of Prozac. She also has private insurance which pays 80% of her prescription drugs, and her total cost per month is $22 Canadian for the drug. She and I are on the same private plan for extended health and dental (covers any extras universal health care might not) and it's $55 a month for the insurance.

I don't know what you take, but maybe that can give you a comparison to work from.
posted by Salmonberry at 3:13 PM on December 13, 2003

also, before your cobra ends, ask your doctor if they can give you a larger prescription refill this time (and next?), so that can cover you for an extra month or so.
posted by amberglow at 3:35 PM on December 13, 2003

Response by poster: The professional/trade organization thing just might give me a glimmer of hope-my hubby may have access to one.

I was kidding about Canada.

Oh, and the refill thing-on one,that just might work-on the other med I am already taking pretty much the maximum dose. Which means I will probably be going halfsies.
posted by konolia at 4:40 PM on December 13, 2003

konolia, I'm going through the same thing myself. If you're not eligible financially for a state assistance program (usually under $12k? yearly or so), many drug companies offer free medications to low-income people. Pfizer's program is "connection to care" and if you can prove your individ. income was under $16k, they will send free meds to your doctor. Of course, the cut-off is pretty tight, but if you were unemployed last year, maybe your tax returns would make you eligible, or maybe whatever co. your drugs are manufactured by has a different cut-off. Best of luck.
posted by mdn at 5:27 PM on December 13, 2003

Some other options: find a provider (physician, nurse-practitioner, physicians-assistant, naturopath perhaps, etc) that runs a "cash only" practice...they are growing in popularity and usually offer straight, one-on-one, no-frills care. Also consider barter - if you have a skill or product that you can exchange with a provider, perhaps you can work something out.
posted by davidmsc at 5:43 PM on December 13, 2003

Some insurance companies will in theory waive waiting periods on pre-existing conditions if you've been covered for a sufficient previous amount of time, and been treated for it. The key to that is not to let a day slide by on coverage.

An acquaintance of mine has said good things about National Health Insurance out of Texas....
posted by namespan at 12:37 AM on December 15, 2003