Insurance Coverage

Tiffado

New member
I am reading a lot of people seem to have problems with Insurance companies. What kind of problems are they? Who are the Insurance Companies?
 

Tiffado

New member
I am reading a lot of people seem to have problems with Insurance companies. What kind of problems are they? Who are the Insurance Companies?
 

Tiffado

New member
I am reading a lot of people seem to have problems with Insurance companies. What kind of problems are they? Who are the Insurance Companies?
 

Tiffado

New member
I am reading a lot of people seem to have problems with Insurance companies. What kind of problems are they? Who are the Insurance Companies?
 

Tiffado

New member
I am reading a lot of people seem to have problems with Insurance companies. What kind of problems are they? Who are the Insurance Companies?
<br />
 

Alyssa

New member
That's almost too broad of a question for us to answer :)

Anyone can have a problem now and then with almost any company. The biggest things I think most people have problems with are:
genetic testing
expensive drugs like pulmozyme
home IV's

often times they tend to finally agree to pay on things if you keep pushing them and jump through all the pre-authorization hoops etc... the CF docs are used to having to fill out the forms and cooperate with the pharmacy and insurance companies to get what they have ordered.

if you are scoping out your health insurance company and/or evaluating a new policy, you want to check out things like:
co-payment and co-insurance amounts on prescription meds (you will not be able to afford a prescription policy that has you paying 20% of the cost) - pulmozyme runs in the neighborhood of $1700 per month - Tobi (should your child ever need it) runs about $3300 per month

check out coverage on durable medical equipment - the vest machines run between $10-13,000. Compressors are only around $100.
 

Alyssa

New member
That's almost too broad of a question for us to answer :)

Anyone can have a problem now and then with almost any company. The biggest things I think most people have problems with are:
genetic testing
expensive drugs like pulmozyme
home IV's

often times they tend to finally agree to pay on things if you keep pushing them and jump through all the pre-authorization hoops etc... the CF docs are used to having to fill out the forms and cooperate with the pharmacy and insurance companies to get what they have ordered.

if you are scoping out your health insurance company and/or evaluating a new policy, you want to check out things like:
co-payment and co-insurance amounts on prescription meds (you will not be able to afford a prescription policy that has you paying 20% of the cost) - pulmozyme runs in the neighborhood of $1700 per month - Tobi (should your child ever need it) runs about $3300 per month

check out coverage on durable medical equipment - the vest machines run between $10-13,000. Compressors are only around $100.
 

Alyssa

New member
That's almost too broad of a question for us to answer :)

Anyone can have a problem now and then with almost any company. The biggest things I think most people have problems with are:
genetic testing
expensive drugs like pulmozyme
home IV's

often times they tend to finally agree to pay on things if you keep pushing them and jump through all the pre-authorization hoops etc... the CF docs are used to having to fill out the forms and cooperate with the pharmacy and insurance companies to get what they have ordered.

if you are scoping out your health insurance company and/or evaluating a new policy, you want to check out things like:
co-payment and co-insurance amounts on prescription meds (you will not be able to afford a prescription policy that has you paying 20% of the cost) - pulmozyme runs in the neighborhood of $1700 per month - Tobi (should your child ever need it) runs about $3300 per month

check out coverage on durable medical equipment - the vest machines run between $10-13,000. Compressors are only around $100.
 

Alyssa

New member
That's almost too broad of a question for us to answer :)

Anyone can have a problem now and then with almost any company. The biggest things I think most people have problems with are:
genetic testing
expensive drugs like pulmozyme
home IV's

often times they tend to finally agree to pay on things if you keep pushing them and jump through all the pre-authorization hoops etc... the CF docs are used to having to fill out the forms and cooperate with the pharmacy and insurance companies to get what they have ordered.

if you are scoping out your health insurance company and/or evaluating a new policy, you want to check out things like:
co-payment and co-insurance amounts on prescription meds (you will not be able to afford a prescription policy that has you paying 20% of the cost) - pulmozyme runs in the neighborhood of $1700 per month - Tobi (should your child ever need it) runs about $3300 per month

check out coverage on durable medical equipment - the vest machines run between $10-13,000. Compressors are only around $100.
 

Alyssa

New member
That's almost too broad of a question for us to answer :)
<br />
<br />Anyone can have a problem now and then with almost any company. The biggest things I think most people have problems with are:
<br />genetic testing
<br />expensive drugs like pulmozyme
<br />home IV's
<br />
<br />often times they tend to finally agree to pay on things if you keep pushing them and jump through all the pre-authorization hoops etc... the CF docs are used to having to fill out the forms and cooperate with the pharmacy and insurance companies to get what they have ordered.
<br />
<br />if you are scoping out your health insurance company and/or evaluating a new policy, you want to check out things like:
<br />co-payment and co-insurance amounts on prescription meds (you will not be able to afford a prescription policy that has you paying 20% of the cost) - pulmozyme runs in the neighborhood of $1700 per month - Tobi (should your child ever need it) runs about $3300 per month
<br />
<br />check out coverage on durable medical equipment - the vest machines run between $10-13,000. Compressors are only around $100.
<br />
<br />
 

Tiffado

New member
Yes...I guess it is a broad question. I just keep hearing that CF is financially draining and I was wondering how so? I figured (probably niave) that insurance would pay for most things....

I know it depends on insurance plans-but I just wondered what we are headed for.
 

Tiffado

New member
Yes...I guess it is a broad question. I just keep hearing that CF is financially draining and I was wondering how so? I figured (probably niave) that insurance would pay for most things....

I know it depends on insurance plans-but I just wondered what we are headed for.
 

Tiffado

New member
Yes...I guess it is a broad question. I just keep hearing that CF is financially draining and I was wondering how so? I figured (probably niave) that insurance would pay for most things....

I know it depends on insurance plans-but I just wondered what we are headed for.
 

Tiffado

New member
Yes...I guess it is a broad question. I just keep hearing that CF is financially draining and I was wondering how so? I figured (probably niave) that insurance would pay for most things....

I know it depends on insurance plans-but I just wondered what we are headed for.
 

Tiffado

New member
Yes...I guess it is a broad question. I just keep hearing that CF is financially draining and I was wondering how so? I figured (probably niave) that insurance would pay for most things....
<br />
<br />I know it depends on insurance plans-but I just wondered what we are headed for.
 

Alyssa

New member
sometimes it's just all the little things that add up - many people are on numerous medications...even with good coverage the copays can add up to quite a bit every month.

it can also be the hospital stays, some people go in every few months - each time a portion doesn't get paid by the insurance company - say $500-$1000 maybe? Add to that the adult with CF who misses time from work while at the hospital.

we count ourselves among the fortunate so far... always had good coverage, few medications (well, ok the pulmozyme is expensive, but we have excellent copays) and no hospital stays.
 

Alyssa

New member
sometimes it's just all the little things that add up - many people are on numerous medications...even with good coverage the copays can add up to quite a bit every month.

it can also be the hospital stays, some people go in every few months - each time a portion doesn't get paid by the insurance company - say $500-$1000 maybe? Add to that the adult with CF who misses time from work while at the hospital.

we count ourselves among the fortunate so far... always had good coverage, few medications (well, ok the pulmozyme is expensive, but we have excellent copays) and no hospital stays.
 

Alyssa

New member
sometimes it's just all the little things that add up - many people are on numerous medications...even with good coverage the copays can add up to quite a bit every month.

it can also be the hospital stays, some people go in every few months - each time a portion doesn't get paid by the insurance company - say $500-$1000 maybe? Add to that the adult with CF who misses time from work while at the hospital.

we count ourselves among the fortunate so far... always had good coverage, few medications (well, ok the pulmozyme is expensive, but we have excellent copays) and no hospital stays.
 

Alyssa

New member
sometimes it's just all the little things that add up - many people are on numerous medications...even with good coverage the copays can add up to quite a bit every month.

it can also be the hospital stays, some people go in every few months - each time a portion doesn't get paid by the insurance company - say $500-$1000 maybe? Add to that the adult with CF who misses time from work while at the hospital.

we count ourselves among the fortunate so far... always had good coverage, few medications (well, ok the pulmozyme is expensive, but we have excellent copays) and no hospital stays.
 

Alyssa

New member
sometimes it's just all the little things that add up - many people are on numerous medications...even with good coverage the copays can add up to quite a bit every month.
<br />
<br />it can also be the hospital stays, some people go in every few months - each time a portion doesn't get paid by the insurance company - say $500-$1000 maybe? Add to that the adult with CF who misses time from work while at the hospital.
<br />
<br />we count ourselves among the fortunate so far... always had good coverage, few medications (well, ok the pulmozyme is expensive, but we have excellent copays) and no hospital stays.
 
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