Re: Re: Re: Insurance and diabetes

[Guest guest]

Thanks, Sandy...I've already checked with the human resources department

of my hospital and alas, there's no carry-over for retirees. Cobra

(which is expensive) is good for 3 months only, after that I'm on my

own. Oregon has something called the Oregon Risk Pool for high-risk

people but diabetics are even excluded from that. Flatly.

If I'd worked for the fed, I'd be in better shape, insurance-wise.smile.

told me about a group called NASE, group insurance for small

businesses which includes retirees and I checked them out but

unfortunately, top age for application is 65. And I'm 67.

Phooey.

Vicki

Re: Re: Insurance and diabetes

>

> Vicki wrote:

>>I've often mentioned that I keep working because my medical insurance

>>is

>>so good...well, now I'm seriously considering retirement Even though

>>I'm

>>healthier than most non-diabetics, being a diabetic puts me in a high

>>risk category and therefore I'm apparently uninsurable.

>

> Vicki -

> If I remember correctly, you work for a large hospital/medical system.

> I would speak with the Hospital Administration folks in charge of

> Retirement Plans and Benefits:

>

> 1) What health insurance/plan (if any) are you eligible for as a

> retiree

> from their system?

> 2) In retirement, can you maintain your current level and source of

> health

> insurance? If yes, how? i.e., Do they continue to pay any part of that

> insurance/health plan as a retirement benefit? Can you maintain the

> plan if

> you pay all or part of the monthly premiums/cost?

> 3) As a retiree from their plan, would you be eligible under COBRA to

> keep

> the same plan and pay all of the premiums/cost yourself?

>

> Only very large groups can take on diabetics (especially T1's), and

> even

> then, usually with a waiting period (of 6 months to a year) for

> " pre-existing conditions " . . . during which time you pay full

> premiums but

> are not covered for care related to that " pre-existing condition. " It

> gives

> the provider a period to stash $ from your premiums before they have

> to

> start paying on you for certain circumstances. Some groups disallow

> pre-existing conditions entirely which is dangerous for diabetics

> since so

> many peripheral health issues can be attributed to " diabetes " by an

> insurance plan that wants to avoid payment expense. That said, and the

> health insurance system being what it is (a risk vs. $-making system),

> there are probably a variety of open/public health plans that would

> accept

> a diabetic for exorbitant rates and narrow coverage with lots of

> exclusions.

>

> I would think that a large hospital/medical employer certainly has

> some

> retirement health care/coverage benefit, even if only partial or if

> you

> have to pay most/all premiums yourself.

>

> My husband and I are retired but our health plan coverage is part of

> his

> Federal Government retirement plan. We still have choices of various

> plans

> available (during an " open season " each year) and pay about $200/month

> premiums as well as co-pays defined (and increased each year) by the

> chosen

> plan.

>

> For a couple years in the early 80's my ex and I had independent

> health

> insurance (family coverage; me as diabetic T1) . . . Premiums were

> $100/month (even then) and my diabetes was excluded entirely for the

> first

> year.

>

> Sandy

> T1 - 1979

>

>

>

[Guest guest]

Thanks, Sandy...I've already checked with the human resources department

of my hospital and alas, there's no carry-over for retirees. Cobra

(which is expensive) is good for 3 months only, after that I'm on my

own. Oregon has something called the Oregon Risk Pool for high-risk

people but diabetics are even excluded from that. Flatly.

If I'd worked for the fed, I'd be in better shape, insurance-wise.smile.

told me about a group called NASE, group insurance for small

businesses which includes retirees and I checked them out but

unfortunately, top age for application is 65. And I'm 67.

Phooey.

Vicki

Re: Re: Insurance and diabetes

>

> Vicki wrote:

>>I've often mentioned that I keep working because my medical insurance

>>is

>>so good...well, now I'm seriously considering retirement Even though

>>I'm

>>healthier than most non-diabetics, being a diabetic puts me in a high

>>risk category and therefore I'm apparently uninsurable.

>

> Vicki -

> If I remember correctly, you work for a large hospital/medical system.

> I would speak with the Hospital Administration folks in charge of

> Retirement Plans and Benefits:

>

> 1) What health insurance/plan (if any) are you eligible for as a

> retiree

> from their system?

> 2) In retirement, can you maintain your current level and source of

> health

> insurance? If yes, how? i.e., Do they continue to pay any part of that

> insurance/health plan as a retirement benefit? Can you maintain the

> plan if

> you pay all or part of the monthly premiums/cost?

> 3) As a retiree from their plan, would you be eligible under COBRA to

> keep

> the same plan and pay all of the premiums/cost yourself?

>

> Only very large groups can take on diabetics (especially T1's), and

> even

> then, usually with a waiting period (of 6 months to a year) for

> " pre-existing conditions " . . . during which time you pay full

> premiums but

> are not covered for care related to that " pre-existing condition. " It

> gives

> the provider a period to stash $ from your premiums before they have

> to

> start paying on you for certain circumstances. Some groups disallow

> pre-existing conditions entirely which is dangerous for diabetics

> since so

> many peripheral health issues can be attributed to " diabetes " by an

> insurance plan that wants to avoid payment expense. That said, and the

> health insurance system being what it is (a risk vs. $-making system),

> there are probably a variety of open/public health plans that would

> accept

> a diabetic for exorbitant rates and narrow coverage with lots of

> exclusions.

>

> I would think that a large hospital/medical employer certainly has

> some

> retirement health care/coverage benefit, even if only partial or if

> you

> have to pay most/all premiums yourself.

>

> My husband and I are retired but our health plan coverage is part of

> his

> Federal Government retirement plan. We still have choices of various

> plans

> available (during an " open season " each year) and pay about $200/month

> premiums as well as co-pays defined (and increased each year) by the

> chosen

> plan.

>

> For a couple years in the early 80's my ex and I had independent

> health

> insurance (family coverage; me as diabetic T1) . . . Premiums were

> $100/month (even then) and my diabetes was excluded entirely for the

> first

> year.

>

> Sandy

> T1 - 1979

>

>

>

[Guest guest]

Vicki, why don't you check out AARP? My sister and her husband have

that as a supplementary insurance to Medicare. He is a diabetic, and

she is, too, although she won't acknowledge it. Besides helping with

doctor bills, it also helps with medications, although they still have

to pay some of the cost. Medicare covers testing strips, but I don't

know if they'll cover as many as you use. I think this has been

discussed here before, but I don't know what conclusion was reached.

My state employees and teacher Blue Cross Blue Shield became my

supplementary insurance when I went on Medicare last August. It covers

medications, and I have a $10 co-pay for generics, $25 for brand names,

and $40 for ones not on their formulary, and also the Enbrel I use for

RA, which costs about $1200-1400 a month.

But so far it has wound up not paying for much when it comes to doctor

bills. Medicare pays 80% of what the approved amount, then my

supplementary has me pay a $15 co-pay for each visit, plus 20% of the

remainder. This is after I pay $350 in deductible. After that, they

might wind up paying 59 cents toward an office visit.

But it's free. Did I mention that? Sometimes you get what you pay for,

LOL. But at least I don't have to pay $200-500 per month for it. I cost

them plenty for medications, so I won't complain.

Sue

On Wednesday, February 16, 2005, at 02:24 PM, whimsy2 wrote:

>

> Thanks, Sandy...I've already checked with the human resources

> department

> of my hospital and alas, there's no carry-over for retirees. Cobra

> (which is expensive) is good for 3 months only, after that I'm on my

> own. Oregon has something called the Oregon Risk Pool for high-risk

> people but diabetics are even excluded from that. Flatly.

[Guest guest]

Vicki, why don't you check out AARP? My sister and her husband have

that as a supplementary insurance to Medicare. He is a diabetic, and

she is, too, although she won't acknowledge it. Besides helping with

doctor bills, it also helps with medications, although they still have

to pay some of the cost. Medicare covers testing strips, but I don't

know if they'll cover as many as you use. I think this has been

discussed here before, but I don't know what conclusion was reached.

My state employees and teacher Blue Cross Blue Shield became my

supplementary insurance when I went on Medicare last August. It covers

medications, and I have a $10 co-pay for generics, $25 for brand names,

and $40 for ones not on their formulary, and also the Enbrel I use for

RA, which costs about $1200-1400 a month.

But so far it has wound up not paying for much when it comes to doctor

bills. Medicare pays 80% of what the approved amount, then my

supplementary has me pay a $15 co-pay for each visit, plus 20% of the

remainder. This is after I pay $350 in deductible. After that, they

might wind up paying 59 cents toward an office visit.

But it's free. Did I mention that? Sometimes you get what you pay for,

LOL. But at least I don't have to pay $200-500 per month for it. I cost

them plenty for medications, so I won't complain.

Sue

On Wednesday, February 16, 2005, at 02:24 PM, whimsy2 wrote:

>

> Thanks, Sandy...I've already checked with the human resources

> department

> of my hospital and alas, there's no carry-over for retirees. Cobra

> (which is expensive) is good for 3 months only, after that I'm on my

> own. Oregon has something called the Oregon Risk Pool for high-risk

> people but diabetics are even excluded from that. Flatly.

[Guest guest]

Laws may be different in OR than in CA; but here an HMO has to accept

you and cannot exclude your condition.

Pacific Care operates Secure Horizons, the senior Medicare HMO. The

problem there is they do not cover name brand medications and insulin is

considered a name brand med. The rate is $54 a month, plus you need to

have both Part A & B on your Medicare. Mail order generics are $18 for

a three month supply. Strips are covered too. Perhaps in 2006 when the

Medicare drug program goes into effect, SH might cover name brands, or,

at the least, insulin.

By federal law COBRA is available for 18 months after termination of

employment. I have Medicare and COBRA thru my husband. Medicare does

become the primary when the secondary is COBRA. My COBRA will run out

in June and I already have a stash of insulin. Before I make any

decisions as to my secondary insurance, I obviously need answers to a

lot of questions.

Helen

[Guest guest]

Laws may be different in OR than in CA; but here an HMO has to accept

you and cannot exclude your condition.

Pacific Care operates Secure Horizons, the senior Medicare HMO. The

problem there is they do not cover name brand medications and insulin is

considered a name brand med. The rate is $54 a month, plus you need to

have both Part A & B on your Medicare. Mail order generics are $18 for

a three month supply. Strips are covered too. Perhaps in 2006 when the

Medicare drug program goes into effect, SH might cover name brands, or,

at the least, insulin.

By federal law COBRA is available for 18 months after termination of

employment. I have Medicare and COBRA thru my husband. Medicare does

become the primary when the secondary is COBRA. My COBRA will run out

in June and I already have a stash of insulin. Before I make any

decisions as to my secondary insurance, I obviously need answers to a

lot of questions.

Helen

[Guest guest]

> Yikes. I never would have expected that out of a hospital/medical system.

> So much for taking care of their own, eh?

I used to work in a hospital in NYC. Urban children tend to get asthma

because of all the pollution. And the hospital incinerated all its waste, so

you could see black smoke coming out of the chimney.

At a hospital cafeteria in Bennington, Vt, I couldn't find anything to eat

that wasn't breaded and fried.

Let's face it. Hospitals are just like any other business.

Gretchen

[Guest guest]

In these days of cost-cutting, nothing surprises me. I shoulda been born

20 years earlier...then I could've probably had insurance that continued

after I retired. Apparently there are very few corporations that now

offer that.

Vicki

Re: Re: Insurance and diabetes

>

> Vicki wrote:

>>Thanks, Sandy...I've already checked with the human resources

>>department

>>of my hospital and alas, there's no carry-over for retirees.

>

> Yikes. I never would have expected that out of a hospital/medical

> system.

> So much for taking care of their own, eh? I notice someone suggested

> AARP

> and that may have some possibilities when combined with Medicare.

> Good luck -

> Sandy

>

[Guest guest]

> 20 years earlier...then I could've probably had insurance that continued

> after I retired. Apparently there are very few corporations that now

> offer that.

And there are also a lot of corporations that offered that, and people stuck

with them for years for just that reason, and then when the people were

close to retirement, the corporations stopped the benefits for retirees.

I got a major medical policy when I was 40 and healthy, so it was cheap, and

it was guaranteed that they could never cancel it. Then Vermont changed its

insurance rules, the company stopped doing business in the state, and they

canceled the policy.

You can't trust anyone.

Gretchen

[Guest guest]

For sure Gretchen. State governments work against the employees too. I retired

with the

full retirement available for my class but others at first had a choice of not

paying

into the system (not being told it would cut their retirement in half) and then

no

choice but that formula. And then they kept cutting benefits and after I retired

they

still cut something every year and before Arnold S. became officially governor,

he cut a

medical benefit I had been getting for being rural out of Sacramento.

ml

Gretchen wrote:

>

> > 20 years earlier...then I could've probably had insurance that continued

> > after I retired. Apparently there are very few corporations that now

> > offer that.

>

> And there are also a lot of corporations that offered that, and people stuck

> with them for years for just that reason, and then when the people were

> close to retirement, the corporations stopped the benefits for retirees.

>

> I got a major medical policy when I was 40 and healthy, so it was cheap, and

> it was guaranteed that they could never cancel it. Then Vermont changed its

> insurance rules, the company stopped doing business in the state, and they

> canceled the policy.

>

> You can't trust anyone.

>

> Gretchen

>

[Guest guest]

For sure Gretchen. State governments work against the employees too. I retired

with the

full retirement available for my class but others at first had a choice of not

paying

into the system (not being told it would cut their retirement in half) and then

no

choice but that formula. And then they kept cutting benefits and after I retired

they

still cut something every year and before Arnold S. became officially governor,

he cut a

medical benefit I had been getting for being rural out of Sacramento.

ml

Gretchen wrote:

>

> > 20 years earlier...then I could've probably had insurance that continued

> > after I retired. Apparently there are very few corporations that now

> > offer that.

>

> And there are also a lot of corporations that offered that, and people stuck

> with them for years for just that reason, and then when the people were

> close to retirement, the corporations stopped the benefits for retirees.

>

> I got a major medical policy when I was 40 and healthy, so it was cheap, and

> it was guaranteed that they could never cancel it. Then Vermont changed its

> insurance rules, the company stopped doing business in the state, and they

> canceled the policy.

>

> You can't trust anyone.

>

> Gretchen

>

[Guest guest]

Yes, retiree insurance is a thing of the past.

My dad was one of the fortunate. He retired (at 62) from NW Bell Telephone

30 years ago & he had full, company paid good insurance, including 100% for

prescriptions for both he & mom. Unfortunately that all went away when he

passed-away 2 years ago.

I retired at 63 1/2 last year & am paying $900/month (COBRA for 2 people)

for " pretty-good " insurance which keeps getting more expensive out-of-pocket

all the time!

, T2, etc..............

>>>>>>>>>>>>>>>>>>>>>>

In these days of cost-cutting, nothing surprises me. I shoulda been born

20 years earlier...then I could've probably had insurance that continued

after I retired. Apparently there are very few corporations that now

offer that.

Vicki

[Guest guest]

After that, you're on your own to get private insurance, go without or maybe

Medicare if you're that age.

I don't know what the interaction is between COBRA & Medicare since I didn't

have to deal with that.

, T2, etc...........

>>>>>>>>>>>>>>>>>>>>..

Oops, I meant to say 18 months. But what happens after that...

[Guest guest]

My understanding was that COBRA was good only for 3 months after

termination of employment.. Am I wrong?

Vicki

Re: Re: Re: Insurance and diabetes

>

>

> Yes, retiree insurance is a thing of the past.

> My dad was one of the fortunate. He retired (at 62) from NW Bell

> Telephone

> 30 years ago & he had full, company paid good insurance, including

> 100% for

> prescriptions for both he & mom. Unfortunately that all went away when

> he

> passed-away 2 years ago.

> I retired at 63 1/2 last year & am paying $900/month (COBRA for 2

> people)

> for " pretty-good " insurance which keeps getting more expensive

> out-of-pocket

> all the time!

> , T2, etc..............

>

>>>>>>>>>>>>>>>>>>>>>>>

>

> In these days of cost-cutting, nothing surprises me. I shoulda been

> born

> 20 years earlier...then I could've probably had insurance that

> continued

> after I retired. Apparently there are very few corporations that now

> offer that.

> Vicki

[Guest guest]

18 months

Re: Re: Re: Insurance and diabetes

My understanding was that COBRA was good only for 3 months after

termination of employment.. Am I wrong?

Vicki

[Guest guest]

I worked for Blue Shield in Calif for 3 years. Our cobra lasted 18 months. I

believe this is a state law. It might even be a federal law also. But I know

for sure Blue Shield carried a member for 18 months on cobra

jan Haney

My understanding was that COBRA was good only for 3 months after

termination of employment.. Am I wrong?

Vicki

[Guest guest]

Oops, I meant to say 18 months. But what happens after that...

Re: Re: Re: Insurance and diabetes

>

>

>>

>>

>> Yes, retiree insurance is a thing of the past.

>> My dad was one of the fortunate. He retired (at 62) from NW Bell

>> Telephone

>> 30 years ago & he had full, company paid good insurance, including

>> 100% for

>> prescriptions for both he & mom. Unfortunately that all went away

>> when

>> he

>> passed-away 2 years ago.

>> I retired at 63 1/2 last year & am paying $900/month (COBRA for 2

>> people)

>> for " pretty-good " insurance which keeps getting more expensive

>> out-of-pocket

>> all the time!

>> , T2, etc..............

>>

>>>>>>>>>>>>>>>>>>>>>>>>

>>

>> In these days of cost-cutting, nothing surprises me. I shoulda been

>> born

>> 20 years earlier...then I could've probably had insurance that

>> continued

>> after I retired. Apparently there are very few corporations that

>> now

>> offer that.

>> Vicki

[Guest guest]

You are out of luck - no insurance, or your state's high risk pool - expensive,

high deductibles, low caps.

Re: Re: Re: Insurance and diabetes

Oops, I meant to say 18 months. But what happens after that...

[Guest guest]

>Blue Shield carried a member for 18 months on cobra<

Same with Oxford in NY state.

Dianne

__________________________________________________

[Guest guest]

18 months by federal law.

After that you start to look into medicare plus insurances. Whether or

not your diabetes is excluded is up to state law. However, you will

have medicare, you presumably will have enough coverage under the new

drug program to cover your insulin. Your co-pays should be less than

the cost of COBRA, as you do not have many conditions.

I know you are math impaired, but you need to sit down with pencil and

paper and start writing numbers.

Are you going to lose insurance immediately? One thing to consider is

if you stay at work, will they allow you to stay in the group if you pay

for your insurance yourself? While you are working, the cost would not

be such a killer. On retirement income only, it might be another story.

Secure Horizons is available in OR, - http://tinyurl.com/42x9e

I suggest going to the site and see what they offer and for how much.

Another suggestion, if you decide to go with them, stockpile enough

insulin to get you thru to the beginning of next year and the medicare

prescription program.

The medicare site itself will give you more information about

supplemental policies.

Good luck,

Helen

[Guest guest]

Thanks, Helen.

My plan is to work for 3 more years unless my hearing gives out first,

in which case I'll have to retire earlier I'm just trying to line up

all my duckies to get an idea what my financial situation will be.

From what I've learned, my insurance through work ends when I stop

working. Then I get COBRA for 18 months. Then ... that's what I'm

worried out, after COBRA runs out. I don't think I'll be poor enough to

qualify for the low-income stuff, ...but I don't think I'll be rich

enough to pay through the nose without a great deal of pain.

It's apparently going to take up a LOT of my discretionary income.

I do think it's ironic that I can't get insurance because of diabetes,

even though I have no diabetic complications...but I'm being sideswiped

by hearing loss which can't be corrected or slowed down (it's a high

frequency hearing loss, which isn't correctable with hearing aids,

apparently).

Vicki

Re: Re: Re: Insurance and diabetes

>

> 18 months by federal law.

>

> After that you start to look into medicare plus insurances. Whether

> or

> not your diabetes is excluded is up to state law. However, you will

> have medicare, you presumably will have enough coverage under the new

> drug program to cover your insulin. Your co-pays should be less than

> the cost of COBRA, as you do not have many conditions.

>

> I know you are math impaired, but you need to sit down with pencil and

> paper and start writing numbers.

>

> Are you going to lose insurance immediately? One thing to consider is

> if you stay at work, will they allow you to stay in the group if you

> pay

> for your insurance yourself? While you are working, the cost would

> not

> be such a killer. On retirement income only, it might be another

> story.

>

> Secure Horizons is available in OR, - http://tinyurl.com/42x9e

>

> I suggest going to the site and see what they offer and for how much.

> Another suggestion, if you decide to go with them, stockpile enough

> insulin to get you thru to the beginning of next year and the medicare

> prescription program.

>

> The medicare site itself will give you more information about

> supplemental policies.

>

> Good luck,

>

> Helen

>

[Guest guest]

I checked it out. I can't even get into the state's high risk pool -

they exclude diabetics. Even well controlled ones.

Re: Re: Re: Insurance and diabetes

>

>

> Oops, I meant to say 18 months. But what happens after that...

>

[Guest guest]

I believe that is not correct Vicki. It is a federal program & is it a

mandated 18 months long as far as I know. It is better to use it if you

cannot get other ins right away because then you do not lose your

" coverage of insurability " & the new ins must accept you even with

diabetes as long as there is no break between cobra & the new ins.

cappie

Greater Boston Area

T-2 10/02 1/05 A1c: 5.4 = 115 mean glu

50-100 carb diet, walking, Metformin

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

2/05:145 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

Vicki,

You will have medicare no matter what your financial situation is. The

premiums for it are quite low comparitively speaking.

Without any other insurance, your out of pocket expenses will be for

prescription meds and for docotrs who don't accept medicare if you choose to go

to

them.

Some amount of diabetes supplies are covered under medicare. You might not

be able to get as many strips as you get now, but my understanding is that with

a doctor's note, you can get more than the typical three per day.

If you're hospitalized, I believe there's a $750 one time per year co-pay

with medicare (far cheaper than separate insurance).

My mother is 73 and has no other insurance but medicare. She recently has

been prescribed an asthma drug and lipitor, but over the course of the last 8

years since starting medicare, even with a couple of hospitalizations for

various things, she's ahead of the game insurance wise. She only goes to

doctors

who accept medicare and pays her co-pay which is very reasonable.

Since except for the diabetes, you're reasonably healthy, perhaps the extra

insurance isn't worth the cost?

Stacey

[Guest guest]

At 12:19 AM 2/18/05, whimsy2 wrote:

>I do think it's ironic that I can't get insurance because of diabetes,

>even though I have no diabetic complications...

Unfortunately insurance companies never seem to take individuals and

individual needs into consideration.

...............

Okay, I've just sat here for a minute or two and have managed to avoid

the temptation to climb up on a soapbox.

>but I'm being sideswiped

>by hearing loss which can't be corrected or slowed down (it's a high

>frequency hearing loss, which isn't correctable with hearing aids,

>apparently).

Vicki, what are some of the symptoms of high frequency hearing loss? I'm

wondering because I think my hearing may not be all that it was. Seems like

when I visit some friends and we end up watching the news or something on

TV I'm always asking them to turn it up a notch. I feel so OLD sometimes

with all of this ka-rap happening.

-=sky=-

Type 2 dx'd 9/04. Last A1C: 5.8

Low Carb, Metaformin XR (1500mg).

Other Meds: Hydrochlorothiazide,

Lipitor, Cozaar, Synthroid, Toprol,

Lexapro. Supplements: B50, CoQ10,

Omega 3, L-Arginine, biotin, folic acid,

and others.