I work for a small company that is making cuts in staff and my head is on the chopping block. My husband is an independent contractor without health insurance, so our family is covered by my company's plan. Our HR department told us that we could be covered by COBRA for 18 months, at a cost of over $600 per month. Coupled with medication costs, there's absolutely no way we can afford that, but I'm worried we won't get coverage because of pre-existing conditions like asthma and diabetes. What can we do to keep our health insurance without going broke? I am most concerned about affording medications if we lose coverage.
Worried,
D.M.
Dear D.M.:
Health care coverage is causing quite a debate as presidential candidates plead their cases. Unfortunately, it's all talk at this point. COBRA requires that participants pay the total amount for the policy, which can be ridiculously expensive because employer group coverage takes into account all employees--both the well and those with health issues (plus an additional administrative fee).
Thankfully, you have options. Let me give you several options. You may be able to combine some of these tactics to obtain the coverage you need. Find out all the information you can and hunt for the best options. Because when it comes to health care coverage in the United States, you are truly on your own.Health Care Plans
1. Divide and conquer through COBRA. If you can't afford coverage for your entire family under COBRA, talk with your HR department about keeping one or more family members on the plan (like the diabetic or asthmatic family member), which should reduce your costs. If you plan on looking for a new position in a company that offers health benefits, COBRA can tide you over.
2. Divide and conquer through state sponsored child plans (AKA SCHIP or State Children's Health Insurance Program). If COBRA still proves to be too expensive, look to your state for any health care coverage plans that are aimed toward children, particularly if one of your children has a pre-existing condition.
3. For healthy family members, it might be in your best interest to find an individual market plan. Choose a plan with a high deductible (based on accessing your needs), which usually have significantly cheaper premiums. At the very least, purchase a catastrophic health insurance plan to keep you protected in case something happens that requires a hospital stay.
4. Talk to several insurance companies and insurance brokers (but don't allow yourself to get talked into anything!). Go to EHealthInsurance.com to shop policy options and find brokers to chat with at NAHU, the National Association of Health Underwriters.
5. Check to see if your husband has a professional organization he can join that offers group health care coverage. As with any other plan, you will want to examine the costs and benefits to see if it's a good option.
6. Talk with your health care provider. Many doctors are sensitive to the needs of their patients. Your physician/PA/NP may be willing to offer you drug samples, reduced costs, etc. Explain your predicament and see what you both can come up with.
7. Find low cost alternatives if your physician is unable to work with you. Visit the HRSA Bureau of Primary Health Care to find clinics offering low-cost care.
Medications
1. Again, talk with your health care provider. My wonderful mother is a Nurse Practitioner who works primarily with indigent, uninsured folks. She explained that there is a brochure available that patients can take, fill out, and mail in to receive assistance with medications. But here's the key--you have to do the foot work. You have to ask your provider and follow through with the pharmaceutical companies yourself. Many providers are swamped and don't remember to inform patients of such options or have the time to make the calls and fill out the paper work.
2. Ask your prescriber to write all necessary prescriptions for you with as many refills as possible in addition to any free samples they can provide. Make sure to request that they check the box that allows for the generic option, if your medications have generic counterparts.
3. This is the only time you'll hear me say it, but shop for your medications at Wal-Mart if Target doesn't offer them. Wal-Mart and Target offer several generic medicines for only $4 a pop. Wal-Mart has an extensive list. Target also offers many of the same prescriptions for $4. But if you can't find it at Target, go to Wal-Hell.
4. Visit RxAssist.org, NeedyMeds.org and PPA (Partnership for Prescription Assistance) to find patient assistance programs that may work for you.
5. Check individual company websites if you can't find what you need at the above websites. For instance, Johnson and Johnson has the Access2Wellness program to help customers find affordable medications.
All of this hunting for adequate care adds up to a lot of work. But thankfully there are options available. Finding the best match for your needs and your budget may require the combination of several approaches.
Here's to your health,
Consciously Frugal
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