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positively
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anyone have health insurance through work or self?
      #133078 - 01/19/05 09:23 AM

I have started a part-time job and just informed SSDI. This isn't the first trial work time I've done and I think my disability will end. I really want to work because of the satisfaction it gives, not only for the income. Although I don't want to go broke either.

My question, does anyone here have insurance through work or self? How is the prescription benefit? I am looking at a bill of 1800 a month for my meds if I have to pay out of pocket. right now I have ADAP, but that will probably end soon too, because my income is "too high"

just trying to get an idea how others handle this.

thanks in advance

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Jackie_Blue
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Reged: 10/26/00
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Re: anyone have health insurance through work or self? new
      #133106 - 01/20/05 05:22 AM

The amount paid for prescriptions will vary depending on the plan. My old plan was $20 per prescription. My new plan has tier levels that run from $20 to $45 depending on the medication. Some plans have prescription caps that limit the amount the insurance company will pay...stay away from those. They are typical capped at around $1500 a year....not even a months worth of medication.

Some such as HMO have a co-pay that can vary and others such as PPO where you can pick your own doctor use a percentage method with the patient paying a certain percentage of the doctors bills until meeting a certain amount paid at which time the insurance company pays 100%.

Your best bet is a group health plan. A few of those do not ask health questions and don't penalize you for a pre-existing condition. You're more likely to find a plan like that with a large company that offer better benefits.

Under HIPPA, a company can't slap you with a pre-existing clause if you have had prior insurance within a set time period before switiching and have met other requirements. I'm assuming you now have Medi-care under SSDI. I don't know if that is considered actual insurance for the pre-existing clauses. Do some research on HIPPA (Health Insurance Portability and Accountability Act of 1996) . You may also want to check with Social Security and see what they have to say about it.

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Jackie_Blue
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Reged: 10/26/00
Posts: 2028
Re: anyone have health insurance through work or self? new
      #133107 - 01/20/05 05:22 AM

The amount paid for prescriptions will vary depending on the plan. My old plan was $20 per prescription. My new plan has tier levels that run from $20 to $45 depending on the medication. Some plans have prescription caps that limit the amount the insurance company will pay...stay away from those. They are typical capped at around $1500 a year....not even a months worth of medication.

Some such as HMO have a co-pay that can vary and others such as PPO where you can pick your own doctor use a percentage method with the patient paying a certain percentage of the doctors bills until meeting a certain amount paid at which time the insurance company pays 100%.

Your best bet is a group health plan. A few of those do not ask health questions and don't penalize you for a pre-existing condition. You're more likely to find a plan like that with a large company that offer better benefits.

Under HIPPA, a company can't slap you with a pre-existing clause if you have had prior insurance within a set time period before switiching and have met other requirements. I'm assuming you now have Medi-care under SSDI. I don't know if that is considered actual insurance for the pre-existing clauses. Do some research on HIPPA (Health Insurance Portability and Accountability Act of 1996) . You may also want to check with Social Security and see what they have to say about it.

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Anonymous
Unregistered

Re: anyone have health insurance through work or self? new
      #133353 - 01/21/05 05:30 PM

Yes, I have health insurance through my company and actually I have not had a problem with insurance. But I do stick with large companies that have a no pre-existing condition clauses. I work for a very large company and have had no problems for 3 years.

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