Can folks like us get health insurance?

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Maggot Brain
Posts: 3
Joined: Fri Sep 03, 2004 12:57 pm

Can folks like us get health insurance?

Post by Maggot Brain »

Or do we become bankrupt and homeless in the event of a sudden hospitalisation/employment-redundancy double-whammy? :shock:

This is something I've only really considered now...a few years after leaving 'school' and getting a proper job. Maybe the job covers this, but maybe not, and I'm sure not for ever (if it ever came to that :? ). Yeah it sounds really pessimistic, but 'just incase'....that's what insurance is for anyways! Even for supposed non-riskers! I'm assuming the premiums would be a tad higher.

If anyone has any information on brokers of choice/costs I'd be fantastically grateful! :D


Thanks, Marc
nycpetit
Posts: 262
Joined: Fri Apr 23, 2004 11:00 pm
Location: Miami Beach

Where are you

Post by nycpetit »

Where are you located? If it's not in the US, then i probably can't help much. Here in the US if you've not been covered when you were first diagnosed, then it's going to be tough to get affordable insurance until you are either, A) preparing for and approved for a kidney transplant with the date set, or B) on dialysis and diagnosed with ESRD.

I was covered by student insurance, and have never had a lapse in my coverage, however, when I started to call insurance companies to buy insurance myself as opposed to through an employer, it was way too expensive, like as much as 5k a month!!

I had to get another job, and work the three months before that plan would kick in (usually a 90 day grace period for employee benefits to kick in). The insurance was the largest stressor for me. The operation and illness was literally a piece of cake in comparison with finding a way to pay for the whole thing. It's easier (but in a sick way) if you are on dialysis first, as meds and Medicare can kick in right away. But if you are like me, ill, but not yet on dialysis, testing donors and trying to set a transplant date, it's considered "elective surgery" and means that all costs up to the date are on you. (With your own insurance coverage of course, but one of my plans had a 600 dollar a year cap on medications which I went through in one month).

You'll have to let us know where you are located to help you more. In short, it's not easy, but it can be done.
Bruce
Posts: 65
Joined: Thu Jul 29, 2004 1:21 am
Location: Long Island, New York

can folks like us get health insurance?

Post by Bruce »

I don't know what country you're in, but in the US dialysis patients can be covered by Medicare, even if under age 62. The social worker in your dialysis clinic should be able to halp you.
Hal
Posts: 617
Joined: Wed Apr 21, 2004 9:56 am
Location: Liverpool, UK

Post by Hal »

Hi,

If you let us know what country you are in and what kind of kidney condition you have, how serious it is, etc ... then I'm sure someone can give more help.

Hal
Pam
Posts: 866
Joined: Sat Apr 24, 2004 8:13 pm
Location: Springfield, Illinois, USA

Post by Pam »

Here in the U.S. if you have a transplant, Medicare will only pay for the first three months after transplantation...it used to be three YEARS. :roll: I have always had insurance, but my mom and dad had trouble paying for my meds when I was young-I worked for awhile for our state and got a pretty good insurance plan-I am so thankful that it pays a big chunk of my medical bills! Even with it, though, I have trouble keeping up-I usually set up a payment plan to pay the minimum amount allowable and usually have more than a few that I am paying at the same time! :wink: . If you are paying SOMETHING, they cannot call the bill collectors.
You would think that if they (Medicare) paid for dialysis, they would certainly help somewhat with transplants-after all, it is a treatment as much as dialysis is! :roll: :?
-Pam
32 yr cadaver transplant recipient, now on peritoneal dialysis with the help of Audrey, my Homechoice machine... as of 4/3/09
Romans 8:28
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Maggot Brain
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Joined: Fri Sep 03, 2004 12:57 pm

Post by Maggot Brain »

Thanks for the replies! Yeah sorry I didn't really give any details at all about my state...actually when I think about it, my question is a bit complicated so I appologise in advance.

I had a (live, related) transplant 11 years ago now, but however succesfull that may sound there's always this dark cloud looming overhead...like, is it gonna rain soon or what? At the moment though I feel fit and healthy, so I'm pretty lucky. I'm actually British (English), but living in France for a few years of work. After maybe a year of being here I finally managed to get onto the French health system so for now I am covered...or at least 75% of the way (haven't sorted out the 'top up' insurance)...although I do nip back 'home' every 3 months for the usual bloods so I'm never far from the good ole' ( :lol: ) NHS. So that's my current state. As yet though I have no private health insurance.

I didn't expect to have some replies from over in the States (because of the url) but it's great nonetheless - not only am I starting to think about health insurance, but I have the more pressing issue of what my next job will be...or rather, where. What I decide to do in the next year or so greatly effects what sort of answer I'm looking for.

The most likely scenario is go back to London. This option is my primary concern, in which case I will have to check what the social security does exactly provide for, but no doubt will have to get a private health insurance. I have no idea if this is affordable in the UK, for post-tx, or indeed whether it is common practise for renal patients in the UK to take up private insurance. If it just meant the difference between a private room with TV/cable/private nurse :P , or stuck in a corridor somewhere with only rats as company then it wouldn't really be that important...even corridors can be nice, so long as I'm not out of pocket 8) . But if it's the difference between getting a regular paycheck for however long it took to mend, or
having to raffle off any remaining organs so I can have a roof over my head when I get out...then it's worth pursuing. Any suggestions from the UK perspective much welcome :)

The other possible relocation would be somewhere else in Europe, but I'll tackle that as and when I decide because of how totally screwed and unpredictable the 'EU effect' can be at the moment...I kind of suspect I'd be prollonging the arguement until I finally decide where to settle down proper.

So my final option is work in the States for a few years...again this would most likely be a temporary concept. Although I'd really hate to play a part in the 'brain drain' (not that I got a brain, but I work in science anyhow and I believe that's what describes the notion of defectors), I have seen some nice jobs over in NYC...my brothers working over there at the moment and I'm mighty jealous :D So yeah, from what you say it would be extremely expensive to get med insurance in the States considering I'm not a citizen? It seems also that the premiums vary considerably depending on your current state of health? I would have to look at what options the host company/institution would offer obviously, but maybe it's just not feasable to get sorted given the 'pre-existing' condition....is post-tx considered a condition? I guess a pre-existing permanent prescription and the need for regular blood tests would kinda give the game away :x I think (maybe I'm wrong) for Medicare you need to be in the US for a number of years before you qualify, so I don't think that would help.

I guess that's my concern in a nutshell. Really I'm more interested in my questions regarding UK cover, but because of the good possibility of getting a job in the US I am still very interested in what possibilities there are for foreigners with pre-existing conditions getting temporary cover. However, I'd hate to think I would be the first ever renal patient to get temporary employment over there. Hmmm, ok, now that was more like a 'nutshell' than the waffle I just spilled before :D


["hate to think" and anal grammar edit]
Bruce
Posts: 65
Joined: Thu Jul 29, 2004 1:21 am
Location: Long Island, New York

can folks like us get health insurance?

Post by Bruce »

Marc:

Maybe this will help. It's from the Medicare part of the social security administration's website: http://www.socialsecurity.gov


If You Have Kidney Failure
There are special rules for people with permanent kidney failure. Under these rules, you are eligible for hospital insurance at any age if you receive maintenance dialysis or a kidney transplant and:

you are insured or are getting monthly benefits under Social Security or the railroad retirement system; or
you have worked long enough in government to be insured for Medicare.
In addition, your spouse or child may be eligible, based on your work record, if she or he receives continuing dialysis for permanent kidney failure or had a kidney transplant, even if no one else in the family is getting Medicare.

Hope it helps. Bruce
Maggot Brain
Posts: 3
Joined: Fri Sep 03, 2004 12:57 pm

Post by Maggot Brain »

Thanks a lot for the info Bruce (and everyone else!). I am going to try and contact the Medicare folks directly and see what they say...
Hal
Posts: 617
Joined: Wed Apr 21, 2004 9:56 am
Location: Liverpool, UK

Post by Hal »

Hi Marc,

UK wise, I was told there was little advantage of private health insurance for renal issues because there are very few places that can treat renal patients privately. Maybe its different in the south, I'm not sure.

Also whether you would get insurance in the first place is a completely different matter. I don't think it would cover a pre-existing medical condition and would also presumably cost an absolute fortune if you could get it.

Good Luck,

Hal.
JMan
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Joined: Fri Apr 23, 2004 10:21 am
Location: Lives in a slightly weird bit of Shropshire called Telford!

Post by JMan »

Just reading back a little (on some old threads) I agree with Hal Re the insurance.

However, many of the NHS renal doctors/physicians also to private work and clinics. So chances are if you decide to have stuff done privately (whether via insurance or not) you will be treated by the same docs, just in different surroundings. Also private hospitals in the UK may not have the full and as wide a range of 'backup' facilities and staff should any problem occur further down the line or during a procedure.

Just my 2p:)
"Dialysis! What is this? The dark ages!"
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amanda in CA
Posts: 1806
Joined: Fri Apr 23, 2004 5:14 pm
Location: Georgia, USA

private health insurance

Post by amanda in CA »

If you are a British citizen, why would you need to have a private insurance to pay for the meds etc. if you move back to the UK since the NHS will pick up the costs? I can't imagine any of the UK insurance companies covering a pre-existing medical condition including a transplant, such things are generally excluded.

I am living in the US and all my healthcare costs (with the exception of deductibles, co-pays etc) are picked up by my husband's insurance which is provided by his employer. I am not sure if this is the case in the whole of the US or just in CA but insurance companies here if they are providing group coverage eg. to an employer they have to accept people pre-existing medical conditions. I have a lifetime maximum on my plan since it is what is called a PPO plan (gives you a wider accessibility to doctors and hospitals) but there are also HMO policies which operate in a slightly different way, are cheaper and don't have lifetime maximums.

Medicare isn't an option if you have never paid into the American social security system. We checked it out when I started dialysis, my transplant having given up. I will be eligible under my husband's contributions (I think) but not for 10 years.

I thought that there was a reciprocal system with all EU countries for healthcare or is that limited to acute stuff?

I hope that you find my input useful. Amanda
JMan
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Location: Lives in a slightly weird bit of Shropshire called Telford!

Post by JMan »

Its limited to acuteish stuff for traveling.. And I think longer term healthcare is reciprocal, eg the country claims it back from yours. I believe maintainance haemodialysis is perhaps the exception.

Which is why you see posts for 'travel health insurance' from UKers.. I looked into working/living elsewhere in the EU and because I don't yet have enough NI (national insurance/tax points) its not as simple as plain relocation.
For living purposes, one is effectively stuck in the UK unless you have a full time job in the country of choice, british citizen or no. UNLESS you have already lived/worked enough in the UK to allow those points to be transferred (as far as I can understand the system anyway) Its not as 'free europe' plug n play as it seems.. As a british and european citizen in the UK currently on state support. I cannot just go and live say, in france or germany. I can visit on holiday (tho the Local Primary care trusts are trying to restrict that also as far as hemo is concerned) or to visit relatives.

The main reason people choose private healthcare in the UK is either, they are rich enough anyway. They have had BAD experiences with the NHS. They are not eligable for NHS care. Or (probably more common) they are sick of waiting for ROUTINE elective procedures/surgery.
"Dialysis! What is this? The dark ages!"
L. 'Bones' McCoy, ST"
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oldborris
Posts: 266
Joined: Fri Apr 23, 2004 1:01 pm
Location: Fulham, London, U.K.

Post by oldborris »

Before my retirement private health care was part of my job package and, after retirement I continued with it privately for a few years, but discovered it was a waste of money. As a renal patient almost anything that happens to me ensures a bed right away in the renal ward. I am limited to my local hospital 'cos that's where my neph works but even if I wanted the private ward for the sake of the privacy, better nursing, better food, and own t.v. etc. it was never available when I was hospitalised. So what was paying all that dosh for?
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