- advertisement -

extreme changes in copays

Discussion in 'Parents of Children with Type 1' started by goochgirl, Mar 10, 2012.

  1. Jake'sMama

    Jake'sMama Approved members

    Joined:
    Dec 28, 2008
    Messages:
    580
    sounds about like us... lots of money out of pocket. Again, happy to have insurance but we can't do this forever. It has slowly been creeping up each year. Every plan varies but we understand that we have a "bottom of the barrel" insurance through my husband's work. We have no choice.

    Some companies offer discounts due to financial hardship. It never hurts to call and ask.
     
  2. 2type1s

    2type1s Approved members

    Joined:
    Nov 23, 2008
    Messages:
    1,438
    Ours went from 0 for insulin and strips to $30 co-pay for each, so that's $120 per girl. Extra bottle of lantus, $30, thyroid meds $5, and best of all...$90 for 2 glucagon kits for each girl ($360) to refill those that expired over a year ago" one for school, and one to carry with us for each girl.
    That was $510 just in meds in January. Don't even get me started on DME!
    We have had the same insurance for years and the copays and deductibles are insane now for MORE money out of mikes check. don't get me wrong, I
    M grateful for insurance, just not the thousand I pay in deductibles and copays come january and February!
     
  3. MommaKat

    MommaKat Approved members

    Joined:
    Sep 2, 2011
    Messages:
    646
    Not every state - CO has nothing other than CoverColorado, which is stop gap insurance if you've been underwritten at a higher premium for pre existing conditions. SCHIP and medicaid do not cover everything, and what they don't cover is 100% out of pocket. If you have other insurance, you cannot qualify for either of these programs in our state. When I read about other states, it makes me want to move...
     
  4. Lee

    Lee Approved members

    Joined:
    Oct 5, 2006
    Messages:
    9,633
    Have you checked these folks out? I used to work with a state coalition on healthcare and CO was actually thought to take care of kids with Chronic Illnesses pretty decently.

    http://www.cchap.org/nl22/
     
  5. MommaKat

    MommaKat Approved members

    Joined:
    Sep 2, 2011
    Messages:
    646
    Thanks for the link - I've been in touch. They aren't directly involved in providing resources, but instead work with county agencies in making sure all eligible children are screened for CHIP and Medicaid, as well as trying to enroll new providers in CO's ACCOUNTABLE CARE COLLABORATIVE (ACC), which is a restructuring of Medicaid services under the state's latest reform act. I've also been in touch with HCP (Health Care Program for Children with Special Needs), but type 1 diabetes is not a covered condition. It's really targeted towards children with significant medical needs, such as in home care, respite care, etc. They are an incredible organization, and I'm familiar with their stellar reputation between prior work with them through Children's and a number of friends whose children with significant chronic needs benefit from their services.

    T1D, along with some other conditions that don't limit activities of daily living when well managed, seem to have fallen into the abyss with reform. When dd was first diagnosed, we were able to receive 250 strips without question, 300 with a prior auth. After a new company took over for PAR review (no longer ACS) the strip allotment was decreased to 100 per month and pen needles also to 100 per month. Ours was the first in a long string of pump denials in February, when the state hadn't seen a denial for a pump when submitted with a letter of medical necessity. After months of research and trying to work with the DME supervisor for Medicaid, we are certain that no additional support exists for families of CWD. We now use the Freestyle Promise program to purchase the balance of our strips out of pocket - at least it affords us $15 off each box. Lisa P can share her experience of what's happening with CoverColorado, but I still think the state plans to phase out that program in 2014. :(
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice