My insurance coverage has changed-* a little update-Friday afternoon*

A

AnD

New member
My insurance coverage has changed-

Thanks, that's what my dh said, too <img src="i/expressions/face-icon-small-wink.gif" border="0"> (in response to me saying I had a stress headache). It's going away now <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

I am hoping that my social worker will know about the appeal, since I have no clue. Things have not been too terribly sunnyside up lately- I guess I got spoiled with all the smooth sailing!

Oh well, there is a reason for everything...I will just have to trust and be <i>patient</i>...not my forte'- lol. I wish I would hurry up (hehe) and get the hang of it- all this lesson stuff is hard!
 
A

AnD

New member
My insurance coverage has changed-

Thanks, that's what my dh said, too <img src="i/expressions/face-icon-small-wink.gif" border="0"> (in response to me saying I had a stress headache). It's going away now <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

I am hoping that my social worker will know about the appeal, since I have no clue. Things have not been too terribly sunnyside up lately- I guess I got spoiled with all the smooth sailing!

Oh well, there is a reason for everything...I will just have to trust and be <i>patient</i>...not my forte'- lol. I wish I would hurry up (hehe) and get the hang of it- all this lesson stuff is hard!
 
A

AnD

New member
My insurance coverage has changed-

Thanks, that's what my dh said, too <img src="i/expressions/face-icon-small-wink.gif" border="0"> (in response to me saying I had a stress headache). It's going away now <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

I am hoping that my social worker will know about the appeal, since I have no clue. Things have not been too terribly sunnyside up lately- I guess I got spoiled with all the smooth sailing!

Oh well, there is a reason for everything...I will just have to trust and be <i>patient</i>...not my forte'- lol. I wish I would hurry up (hehe) and get the hang of it- all this lesson stuff is hard!
 
A

AnD

New member
My insurance coverage has changed-

Thanks, that's what my dh said, too <img src="i/expressions/face-icon-small-wink.gif" border="0"> (in response to me saying I had a stress headache). It's going away now <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

I am hoping that my social worker will know about the appeal, since I have no clue. Things have not been too terribly sunnyside up lately- I guess I got spoiled with all the smooth sailing!

Oh well, there is a reason for everything...I will just have to trust and be <i>patient</i>...not my forte'- lol. I wish I would hurry up (hehe) and get the hang of it- all this lesson stuff is hard!
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
A

AnD

New member
My insurance coverage has changed-

Bummer, Jennifer. I certainly will. *sigh*

Oh, thanks for reminding me- I forgot to check my Viokase...

Not covered either...there were only around 6 enzymes that were covered- and this is the only one that actually makes my tummy feel <i>better</i>...
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
R

Ratatosk

Administrator
Staff member
My insurance coverage has changed-

deep breath.... I will say that up until last year DS was covered under the tobi foundation and DH and I make fairly good money. This past year we didn't qualified. Other thing is that maybe there's an appeal process thru your insurance company. When we couldn't get DS' synagis shots covered because they were too expensive all it took was a letter from our attorney who indicated costs of not having the shots far outweighed the cost of the shots themselves -- hospitalization, lung damage, stress to us as parents dealing with a child with a life shortening illness.. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
C

cdale613

New member
My insurance coverage has changed-

What state do you live in? As of 2006, several states had adult CF assistance programs.

CA, MI, and NY have adult CF assistance programs that do not use financial eligibility criteria. The NY plan is the most complicated of these, requiring enrollees to carry private insurance, and contribute 7% of income toward CF related medical expenses. The CA and MI plans are more straightforward. CA has minimal cost sharing, but higher income enrollees have to pay an enrollment fee. MI has cost sharing for enrollees with income over 250% of the federal poverty limit (FPL).

OH has a program that evaluates financial eligibility on a case-by-case basis. The program does require cost sharing based on ability to pay.

PA and FL have programs that have financial eligibility criteria of <300% FPL. The FL program has no cost sharing; the PA plan does have some, based on a sliding fee scale.

TX financial eligibility requirement of income/ assets <200% FPL, no cost sharing.

Hope this is helps... sorry to hear about the changes.

Chris

27 m w/CF
 
C

cdale613

New member
My insurance coverage has changed-

What state do you live in? As of 2006, several states had adult CF assistance programs.

CA, MI, and NY have adult CF assistance programs that do not use financial eligibility criteria. The NY plan is the most complicated of these, requiring enrollees to carry private insurance, and contribute 7% of income toward CF related medical expenses. The CA and MI plans are more straightforward. CA has minimal cost sharing, but higher income enrollees have to pay an enrollment fee. MI has cost sharing for enrollees with income over 250% of the federal poverty limit (FPL).

OH has a program that evaluates financial eligibility on a case-by-case basis. The program does require cost sharing based on ability to pay.

PA and FL have programs that have financial eligibility criteria of <300% FPL. The FL program has no cost sharing; the PA plan does have some, based on a sliding fee scale.

TX financial eligibility requirement of income/ assets <200% FPL, no cost sharing.

Hope this is helps... sorry to hear about the changes.

Chris

27 m w/CF
 
C

cdale613

New member
My insurance coverage has changed-

What state do you live in? As of 2006, several states had adult CF assistance programs.

CA, MI, and NY have adult CF assistance programs that do not use financial eligibility criteria. The NY plan is the most complicated of these, requiring enrollees to carry private insurance, and contribute 7% of income toward CF related medical expenses. The CA and MI plans are more straightforward. CA has minimal cost sharing, but higher income enrollees have to pay an enrollment fee. MI has cost sharing for enrollees with income over 250% of the federal poverty limit (FPL).

OH has a program that evaluates financial eligibility on a case-by-case basis. The program does require cost sharing based on ability to pay.

PA and FL have programs that have financial eligibility criteria of <300% FPL. The FL program has no cost sharing; the PA plan does have some, based on a sliding fee scale.

TX financial eligibility requirement of income/ assets <200% FPL, no cost sharing.

Hope this is helps... sorry to hear about the changes.

Chris

27 m w/CF
 
C

cdale613

New member
My insurance coverage has changed-

What state do you live in? As of 2006, several states had adult CF assistance programs.

CA, MI, and NY have adult CF assistance programs that do not use financial eligibility criteria. The NY plan is the most complicated of these, requiring enrollees to carry private insurance, and contribute 7% of income toward CF related medical expenses. The CA and MI plans are more straightforward. CA has minimal cost sharing, but higher income enrollees have to pay an enrollment fee. MI has cost sharing for enrollees with income over 250% of the federal poverty limit (FPL).

OH has a program that evaluates financial eligibility on a case-by-case basis. The program does require cost sharing based on ability to pay.

PA and FL have programs that have financial eligibility criteria of <300% FPL. The FL program has no cost sharing; the PA plan does have some, based on a sliding fee scale.

TX financial eligibility requirement of income/ assets <200% FPL, no cost sharing.

Hope this is helps... sorry to hear about the changes.

Chris

27 m w/CF
 
You must log in or register to reply here.
Top