Hope Me Pay for My Meds!
December 13, 2007 12:10 PM   Subscribe

Why Don't We Have Socialized Medicine Yet? Filter: Help me deal with privatized health care.

I have epilepsy and it takes between $300-$500/mo in medication (depending on the month) to keep me seizure-free. I have gone from having no insurance to full coverage to COBRA, and now I'm back to no insurance. Due to the cost of COBRA, this isn't much of a difference, cost-wise, but once I have to go to the neurologist again... oh boy.

Is it at all possible to buy an individual plan or some such thing, given the dreaded "pre-existing condition"? I live in Rhode Island - does anyone know of any state plans that I could buy into? Can my parents pay to put me on their plan?

My previous insurance was from working for a SoulSuckingMegaCorp. While I have thought of going to Starbucks for the insurance, given my career path (Early Childhood Education), that's not really a smart move. I'm going to be nannying in 2008, so job-based health insurance is out for at least a year. I'm going through a divorce, and don't know anyone with good enough insurance to marry when it's finalized (though the thought has crossed my mind).

Anything, anything at all, even if it's just "Oh hey, if you declare yourself as a monkey, this company will pay for your meds!" would be really, really helpful.
posted by grapefruitmoon to Health & Fitness (19 answers total) 1 user marked this as a favorite
Best answer: Is your income low enough to qualify for state medical aid? Your state, Rhode Island, has a medical assistance program for adults. And, good luck! I know how frustrating major medical expenses can be because we've dealt with the same sorts of problems with my now-adult daughter who is an insulin-dependent diabetic. We were finally able to put her back on our family insurance, but she was on state medical aid for almost a year before that happened.
posted by amyms at 12:26 PM on December 13, 2007 [1 favorite]

You don't mention your school's health program(s), have you looked into that?
posted by rhizome at 12:27 PM on December 13, 2007

Best answer: I'd suggest going over to the Foundation for Health Coverage Education, which may have information about RI that would be helpful to you. I know in my state, which is better than average, we have state programs designed to provide insurance for people in your situation, although that insurance does cost a lot of money (relatively). There are several links worth following, and a number for an uninsured help line. Good luck.
posted by OmieWise at 12:36 PM on December 13, 2007

Response by poster: rhizome: I'm all grown-up and out of school.
posted by grapefruitmoon at 12:53 PM on December 13, 2007

Response by poster: amyms: My income might be low enough once I get the divorce finalized. For now, they still count my ex's income in with mine, which is why I haven't been able to qualify for state aid before. Thanks for the link!
posted by grapefruitmoon at 12:55 PM on December 13, 2007

Best answer: I haven't used them myself, but a patients' organization which I'm a member of recommends
NeedyMeds and NAMI's page on Patient Prescription Drug Assistance Programs. A number of pharmaceutical companies have these programs, and these sites help people connect with them.
posted by worldswalker at 1:13 PM on December 13, 2007 [3 favorites]

When I was a nanny, I agreed to take a small paycut if they would help pay for health insurance for me. They got me an individual policy through Blue Cross and Blue Shield that was actually pretty good. My part cost about $40 a month and they did cover meds for some of my pre-existing conditions. It's worth mentioning to your future employers and see if they'll help you out.
posted by Ugh at 1:14 PM on December 13, 2007

Talk to your doc. They can probably get you set up with some samples-then get on the computer and check out the pharm company's programs to help with meds (the links upthread should help.) Your health care provider will have to fill out some paperwork but other than that the process isn't hard.
posted by konolia at 1:27 PM on December 13, 2007

If your husband has insurance, you should be able to stay on COBRA for 36 months after the divorce.

See: http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html
posted by dpx.mfx at 1:42 PM on December 13, 2007

Why not move to Fall River/other border town? Massachusetts' new health care system seems like it would probably assist you with insurance than Rhode Island.
posted by one_bean at 1:50 PM on December 13, 2007

I don't know exactly what medication you're on, but a number of drug companies give out medication for free to people who need it. You have to qualify by having no insurance and being under a certain income level, and often these programs are hard to find information on. A lot of my doctors haven't known about programs for some of the medications I'm on--I found out by digging, lots of digging. If you can't find information on free programs through your doctors or online, then try calling the drug companies.

Shop around. Price varies widely on some medications, depending on where you buy them. Is Canada cheaper for you? I've found that Costco pharmacies are often cheapest for anything. I don't know if there are any Costcos in RI, but their pharmacies can ship to some states (and you don't have to have a membership to use the pharmacy).

I also second asking your doc for samples. I can often just call my doctor and ask the nurse if samples are available without having to pay for an actual visit.

Good luck--I know how it is.
posted by tejolote at 1:59 PM on December 13, 2007

Response by poster: Ugh: I will definitely keep that in mind! Once I know who is employing me (should find out in the next week... I hope...), this will be much easier to figure out!

konolia: Thanks for the reminder that yes, I should talk to the doctor.

one_bean: Part of the agreement my doctor and I came up with for treating my seizures included not driving. Moving is totally out of the question.

dpx.mfx: Yeah, unfortunately he was getting insurance from me, so that's a no go. :(
posted by grapefruitmoon at 1:59 PM on December 13, 2007

bunnycup, even if she did that it would not solve her immediate problem, since her condition is indeed a prexisting condition. She would have to wait a year for her benefits to kick in . Not to mention that jobs with benefits aren't always growing on trees, and meanwhile a girl's gotta eat. And did you notice that because of her condition she cannot drive?

If she gets meds from the pharm companies that doesn't affect the taxpayers one whit. In my opinion it partially atones for the fact they charge so stinking much for these meds in the first place.

Finally let me point out that a lot of these antiseizure meds cannot be stopped cold turkey without risking her health and triggering seizures. (Many of these meds are the same meds that bipolars take. I have been on some of them.)
posted by konolia at 2:34 PM on December 13, 2007

(Never mind my post-yay, flags work!)
posted by konolia at 2:35 PM on December 13, 2007

tejolote has it right - shop around for your meds, the price distinction can be astonishing. I also have found Costco to be head and shoulders better price-wise than anywhere else.

As far as Starbucks not being a smart move, why not? My parents are insured by virtue of my mother's 20 to 30 hours a week at Starbucks and they pay less now (with premiums notably higher then they were 6 years ago) as a couple of retiree-age that way than I used to as a healthy single male at age 32 back in 2002.

bunnycup is harsh and rude, but not entirely wrong. You may think (as I do) that the state of US health care is embarassing, but the world is not what it should be: it is what it is. You need to get in a situation where you can take advantage of a pool of people with lower costs than you.

You don't say when your COBRA ran out, but if it was less than 62 days ago then you need to buy something else, toot sweet, regardless of cost - even if it doesn't cover any of your immediate needs and is only catastrophic care. Maintaining a continuity of coverage with no lapse of 63 days or more is what keeps you from dealing with the dreaded "pre-existing condition" problems. It's part of HIPAA, look it up.
posted by phearlez at 2:47 PM on December 13, 2007

Response by poster: I don't want to justify myself to every person in this thread, so I am going to say this once:

My goal is to work in Early Childhood doing art education with children 3-5 yrs old. To do this, I need to first get a Master's in ECE in addition to my BA in art. To support myself in the meantime, I am going to do some nannying (as it is much more lucrative than teaching in preschools - which I have done). I recently took off a whole year to work for SoulsuckingMegaCorp solely for the health insurance, during which time I also had my husband's income to fall back on. Now, I am on my own and Starbucks' starting salary is not enough to support myself on. Due to my condition, I can not afford to be both nannying AND serving coffee as lack of sleep triggers my seizures. It would be moronic for me to have a job that meant I couldn't make ends meet in terms of rent and utilities AND didn't get me any closer to what I wanted to be doing just for the one redeeming factor of having health insurance.

So. I'm a year behind in getting where I want to be in my career and taking off another year to serve more coffee is only getting me further behind. I will eventually be in a grad program or employed somewhere where I have insurance. The question I have is specifically: are there ways to make my meds more affordable in the meantime?

Many people have had very helpful suggestions, but "move to Massachusetts," or "get a different job" aren't options right now.
posted by grapefruitmoon at 2:55 PM on December 13, 2007

I am on expensive seizure meds as well (let me guess, lamictal?) and I am going to try to order them from a Canadian pharmacy. I have no idea if it's going to work. I would suggest trying to avoid a longer than two month lapse in your coverage if you can, otherwise insurance will be pointless for about a year.

I wish I knew of a way to get insurance, because I'm sick too often to work full time.

A lot of colleges have health insurance plans, can you look into that as an option?
posted by sondrialiac at 6:28 PM on December 13, 2007

Response by poster: sondrialiac: Yep. Lamictal it is.

As for colleges - I will probably be going to grad school eventually, at which point I'll be able to get coverage either through the school or through my parents' insurance (which will cover me if I'm a full-time student), so that will be a possibility. In the meantime... well... we'll see how it goes.
posted by grapefruitmoon at 6:58 PM on December 13, 2007

I've not checked "the list" but both Walmart and Target have a $5 program for generic medications. I'm guessing though that your particular medications are probably not on that list (as severe as your epilepsy is, you're likely on newer meds and most of these are older ones), but it's worth a moment to take a look... just in case. Google will get you started, but you'll probably have to dig for the lists. I've seen them, although it's been awhile.
posted by magnoliasouth at 8:08 PM on December 13, 2007

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