Navigating health insurance

[froggymama]

My husband was in school for 3 years, so we qualified for state help - services that covered most of my daughter's medications. We also have an individual policy for her with Blue Cross. But brandname drugs are not covered in her policy. In the past, we had to have Prevacid compounded and no one would cover it. We had our doctor write a letter saying it was needed, etc, and then Blue Cross said, "We'll cover it, but you have 100% copay."

Is this legal? I'm afraid this will be how it is with all of her medications. I'd love some advice. If our insurance won't cover anything and we now won't qualify for medicare and CCS, what in the world do we do? Thank you in advance. Elise Free

 

[froggymama]

My husband was in school for 3 years, so we qualified for state help - services that covered most of my daughter's medications. We also have an individual policy for her with Blue Cross. But brandname drugs are not covered in her policy. In the past, we had to have Prevacid compounded and no one would cover it. We had our doctor write a letter saying it was needed, etc, and then Blue Cross said, "We'll cover it, but you have 100% copay."

Is this legal? I'm afraid this will be how it is with all of her medications. I'd love some advice. If our insurance won't cover anything and we now won't qualify for medicare and CCS, what in the world do we do? Thank you in advance. Elise Free

 

[froggymama]

My husband was in school for 3 years, so we qualified for state help - services that covered most of my daughter's medications. We also have an individual policy for her with Blue Cross. But brandname drugs are not covered in her policy. In the past, we had to have Prevacid compounded and no one would cover it. We had our doctor write a letter saying it was needed, etc, and then Blue Cross said, "We'll cover it, but you have 100% copay."

Is this legal? I'm afraid this will be how it is with all of her medications. I'd love some advice. If our insurance won't cover anything and we now won't qualify for medicare and CCS, what in the world do we do? Thank you in advance. Elise Free

 

[froggymama]

My husband was in school for 3 years, so we qualified for state help - services that covered most of my daughter's medications. We also have an individual policy for her with Blue Cross. But brandname drugs are not covered in her policy. In the past, we had to have Prevacid compounded and no one would cover it. We had our doctor write a letter saying it was needed, etc, and then Blue Cross said, "We'll cover it, but you have 100% copay."

Is this legal? I'm afraid this will be how it is with all of her medications. I'd love some advice. If our insurance won't cover anything and we now won't qualify for medicare and CCS, what in the world do we do? Thank you in advance. Elise Free

 

[froggymama]

My husband was in school for 3 years, so we qualified for state help - services that covered most of my daughter's medications. We also have an individual policy for her with Blue Cross. But brandname drugs are not covered in her policy. In the past, we had to have Prevacid compounded and no one would cover it. We had our doctor write a letter saying it was needed, etc, and then Blue Cross said, "We'll cover it, but you have 100% copay."
<br />
<br />Is this legal? I'm afraid this will be how it is with all of her medications. I'd love some advice. If our insurance won't cover anything and we now won't qualify for medicare and CCS, what in the world do we do? Thank you in advance. Elise Free

 

[MaryamsMommy]

Hi I dont know if I can help or not, but your daughter may still be able to qualify for medical under institutionaly deeming,reguardless of income. You may want to ask about that. And Is CCS not suppose to pick up copays? Just wondering the only thing we were ever able to get from CCS was the vest. My daughter has a great health plan with only 5 dollar copays for all meds. And now that her father is working full time will he be able to get coverage through work?


Karen
Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Hi I dont know if I can help or not, but your daughter may still be able to qualify for medical under institutionaly deeming,reguardless of income. You may want to ask about that. And Is CCS not suppose to pick up copays? Just wondering the only thing we were ever able to get from CCS was the vest. My daughter has a great health plan with only 5 dollar copays for all meds. And now that her father is working full time will he be able to get coverage through work?


Karen
Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Hi I dont know if I can help or not, but your daughter may still be able to qualify for medical under institutionaly deeming,reguardless of income. You may want to ask about that. And Is CCS not suppose to pick up copays? Just wondering the only thing we were ever able to get from CCS was the vest. My daughter has a great health plan with only 5 dollar copays for all meds. And now that her father is working full time will he be able to get coverage through work?


Karen
Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Hi I dont know if I can help or not, but your daughter may still be able to qualify for medical under institutionaly deeming,reguardless of income. You may want to ask about that. And Is CCS not suppose to pick up copays? Just wondering the only thing we were ever able to get from CCS was the vest. My daughter has a great health plan with only 5 dollar copays for all meds. And now that her father is working full time will he be able to get coverage through work?


Karen
Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Hi I dont know if I can help or not, but your daughter may still be able to qualify for medical under institutionaly deeming,reguardless of income. You may want to ask about that. And Is CCS not suppose to pick up copays? Just wondering the only thing we were ever able to get from CCS was the vest. My daughter has a great health plan with only 5 dollar copays for all meds. And now that her father is working full time will he be able to get coverage through work?
<br />
<br />
<br />Karen
<br />Mommy to Maryam 9 with CF

 

[froggymama]

Karen,

Hi, thank you. I'll ask. Our nurse care manager with CCS is not the kindest of souls, so I wanted to have our social worker or someone who knows the system well to call her. CCS has never picked up our co-pays. I believe they will only cover a medication if that med is 'denied' by your insurance. And nope, my husband's new job is per diem, so health insurance isn't offered. Maybe someday, but not in the near future. Thanks again. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[froggymama]

Karen,

Hi, thank you. I'll ask. Our nurse care manager with CCS is not the kindest of souls, so I wanted to have our social worker or someone who knows the system well to call her. CCS has never picked up our co-pays. I believe they will only cover a medication if that med is 'denied' by your insurance. And nope, my husband's new job is per diem, so health insurance isn't offered. Maybe someday, but not in the near future. Thanks again. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[froggymama]

Karen,

Hi, thank you. I'll ask. Our nurse care manager with CCS is not the kindest of souls, so I wanted to have our social worker or someone who knows the system well to call her. CCS has never picked up our co-pays. I believe they will only cover a medication if that med is 'denied' by your insurance. And nope, my husband's new job is per diem, so health insurance isn't offered. Maybe someday, but not in the near future. Thanks again. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[froggymama]

Karen,

Hi, thank you. I'll ask. Our nurse care manager with CCS is not the kindest of souls, so I wanted to have our social worker or someone who knows the system well to call her. CCS has never picked up our co-pays. I believe they will only cover a medication if that med is 'denied' by your insurance. And nope, my husband's new job is per diem, so health insurance isn't offered. Maybe someday, but not in the near future. Thanks again. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[froggymama]

Karen,
<br />
<br />Hi, thank you. I'll ask. Our nurse care manager with CCS is not the kindest of souls, so I wanted to have our social worker or someone who knows the system well to call her. CCS has never picked up our co-pays. I believe they will only cover a medication if that med is 'denied' by your insurance. And nope, my husband's new job is per diem, so health insurance isn't offered. Maybe someday, but not in the near future. Thanks again. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[MaryamsMommy]

Oh yeah one more thing. About the prevacid. Get it in the solutaba mix it in 10 ccs of water and give it to her. We did that for years for my daughter. But through the g-tube.
Good luck, I hope u figure something out soon. Because what the cost of meds would be for you,ur husband may as not work.


Karen Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Oh yeah one more thing. About the prevacid. Get it in the solutaba mix it in 10 ccs of water and give it to her. We did that for years for my daughter. But through the g-tube.
Good luck, I hope u figure something out soon. Because what the cost of meds would be for you,ur husband may as not work.


Karen Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Oh yeah one more thing. About the prevacid. Get it in the solutaba mix it in 10 ccs of water and give it to her. We did that for years for my daughter. But through the g-tube.
Good luck, I hope u figure something out soon. Because what the cost of meds would be for you,ur husband may as not work.


Karen Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Oh yeah one more thing. About the prevacid. Get it in the solutaba mix it in 10 ccs of water and give it to her. We did that for years for my daughter. But through the g-tube.
Good luck, I hope u figure something out soon. Because what the cost of meds would be for you,ur husband may as not work.


Karen Mommy to Maryam 9 with CF

 

[MaryamsMommy]

Oh yeah one more thing. About the prevacid. Get it in the solutaba mix it in 10 ccs of water and give it to her. We did that for years for my daughter. But through the g-tube.
<br />Good luck, I hope u figure something out soon. Because what the cost of meds would be for you,ur husband may as not work.
<br />
<br />
<br />Karen Mommy to Maryam 9 with CF