Health Insurance

[Guest guest]

Delaine,

Sorry you've been working so much. I hope your B & B is sold soon.

I started the AB treatment 5 weeks ago. Enbrel helps with the inflammation,

but is not stopping new joint involvement.

I've also changed my diet, elimintating sugar, dairy, meat and caffeine.

I'm hoping it helps. If nothing else I'll loose the 30 pounds I'd like to

loose

a

>

> I haven't posted for awhile...our manager quit at our bed & breakfast

> and

> I've had to work everyday.

>

> a, how long have you been on the antibiotic treatment. Weren't you

> on enbrel? Did the enbrel stop working?

>

> Teri, have you tried changing your diet at all? As I recall, no

> medications

> have worked for you. As long as I eat correctly, (no dairy, sugar,

> etc.), the

> arava & methotrexate & vioxx50 have me feeling rather well. However, if

>

> I eat anything that isn't good for me, my joints hurt all night long.

>

> I met a woman in the grocery store yesterday that has had RA for 7

> years. We have the same RA doctor. We talked about our illnesses

> and she told me that she has to stay away from dairy products, sugar,

> refined flour, and all processed foods like I do. Anyway, Teri, I've

> been

> thinking about you and wondering if you had tried it. It's tough not to

>

> be able to eat anything that I want to eat...but, if I stay to this

> strict diet

> that I've put on myself, my joints don't hurt so much.

>

> Also, remember when I was so excited when we got our new health

> insurance.

> Well, humana isn't so wonderful, after all. They are really messing

> with me. I

> got a letter from them stating that insurance works when a " pool " of

> people pay

> their premiums and their premiums support the sick people. A review of

> our

> insurance shows that our group is not paying enough money to support me.

>

> Basically, it shows me again that insurance is a rip off. They want

> everyone to

> pay premiums and then don't want to pay out anything. They refused to

> let

> me have enbrel and wouldn't allow vioxx50. Then, today, when I went to

> get my prilosec refilled, the physician said that they weren't going to

> pay for

> it anymore.

>

> They have given me a couple of months to send in some forms and are

> threatening to stop our insurance on November 30, 2000.

>

> Our insurance agent suggested humana as most insurance companies won't

> cover pre-existing conditions OR they have you pay the premiums for two

> years before they'll cover it.

>

> Does anyone know of ANY insurance company that really pays out when

> a person is sick?

>

> Having RA is really rough...as soon as an insurance company finds out

> that

> you have it, they want to get rid of you as soon as possible.

>

> Sorry that I don't post so much anymore. Hopefully in a few weeks, the

> B & B

> will be sold and I'll have more time. Without a manager, I'm working

> everyday

> again...Jim and I don't remember what day of the week that it is because

> we work

> everyday with no days off.

>

> I have had RA for over 2 years now. I'm much, much better off than I

> was

> last year this time. However, the disease has really slowed me down.

> Good

> thing that we're selling the 23 room guesthouse as I can't keep up with

> the

> pace that I was keeping 5 years ago.

>

> Delaine

>

>

>

>

> Our websites: http://rheumatoid.arthritis.freehosting.net/

> http://www.rasupport.webprovider.com/

> Change subscription options:

>

[Guest guest]

Dear a:

Hi, my name is . I usually don't post too much. However, I had to

write to you to tell what I thought. The diet you put yourself on sure does

seem to be very interesting. I think it is wonderful that you can stick to

it. I am interested in doing the same diet. I don't know if I can stick to

it, but I am going to try. The way you are doing it has sure given me some

ideas.

If you can offer me any suggestions please do. I have RA for 5-7 years, I

don't know exactly when it started since I have other bone illnesses too plus

fibromyalgia, asthma, and a kidney transplant for 15 years. I can't take any

of the Arthritis medicines because they would affect my transplanted kidney.

I use homeopathy, herbs, ultram, and sometimes some percocet when I really

need it. I take frequent epsom salt baths, and use Boswellin cream and

pills. I take a lot of vitamins and pray a lot. LOL.

If you can off any advice I would be interested. Hope you are feeling good

and hope that the AB's are helping you.

Sincerely, Colletti

Anjillah@...

[Guest guest]

All I suggest is get away from HMO and go

ppo!

[Guest guest]

Jill,

Check out the database section under Whose insurance paid what. Maybe

you can get a feel for what company consistently pays.

Marci (Mom to )

Oklahoma

> Attention all parents!

> My husband and I have to change our health insurance because our

> premiums will be jumping $200 a month as of July. Who has had the

> most success with their insurance, especially as pertains to the

DOC

> band and/or physical therapy? We are currently on Blue Shield, it

is

> an HMO, and we need to make a decision fairly soon. Help!!!

> Jill Ramos, Tommy and Gavin, age 6mos.

[Guest guest]

My husband's Blue Cross insurance covered my CMT without a problem. When we had

Aetna they needed 3 months before they would cover CMT.

Not much to go by - sorry.

[Guest guest]

Shula!

Terrific to hear from you! I can't believe your son has graduated from

college - it seems like he was just completing high school and had the

job at the bookstore! I am so happy for him and your family!

I haven't had to reapply for insurance, but your son might want to look

into Blue Cross (the Prudent Buyer Plan is the one I have - took me

right away - no questions asked and i can see any doc of my choice +

prescriptions covered.) IF for some reason your son is denied, you might

want to look into Calif.'s Major Risk Insurance Pool - it is also

underwritten by Blue Cross. I will pull out the info if I can find it -

the last I heard there IS a waiting list for it - 3 to 6 months or so)

If Ariel (that's his name, if I remember?) does apply for MMRIP, he will

need to show those denial forms from Kaiser.

Let me know how it goes.

Again, great to hear from you! ~ Gretchen

[Guest guest]

Thanks Gretchen and

Gretchen, I can't believe you remembered my son's name and that he was working

in a bookstore!!! He's moving to Portland, OR in a couple of weeks... simply

taking time off from being a " professional student " and is contemplating going

to law school.

We will certainly check into the Blue Cross option and I will keep you posted

regarding the outcome of the Kaiser reconsideration procedure.

, while browsing the posts I read that Adam had an accident. How is he

doing?

It's good to be back on board.

Shula

[Guest guest]

Hi to all!

I don't remember what the original question was regarding Health insurance

coverage, but most of the time coverage is due to whether it is an

individual policy with the insurance company or whether it is a

group/employer based policy with the insurance company. There is a drastic

difference between the two types of policies. Individual plans have to go

through regular underwriting where group plans do not. On the individual

side of insurance, the insurance company can rate up, rider out conditions

or decline individuals.

State insurance laws apply to group plans where if someone qualifies for the

insurance coverage and accept it the first time it is offered to them on the

date of qualification the insurance company has to take the employee/family

with no riders or exceptions no matter what the condition. If the employee

waits to take coverage then they have to wait for another open-enrollment

period or go through regular underwriting and then the insurance company can

put riders on conditions.

I know in our state, I have to stay on a group type policy in order for

coverage of my CMT because otherwise I would be a flat decline with any of

the individual plan companies that I work with.

Jane

[Guest guest]

I promised to keep you posetd, Gretchen,

We finally received Kaiser's response to the Reconsideration Form we

submitted a couple of months ago and once again they rejected

individual membership based on same excuses they issued originally:

CMT and underweight.

We still have to explore Blue Cross (as you suggested) and hopefully

Ariel will go back to school SOON so he can once again be covered by

my husband's group insurance.

On a different subject... my husband is being fitted today with

shoes/braces (the brace is an integral part of the shoe) that have

Velcro straps instead of laces (tying is becoming increasingly

difficult). We are hopeful that the shoe/brace combination will

work. Is anyone else using such shoes? Are they comfortable?

Functional?

Shula

[Guest guest]

Rob, are you absolutely sure your company does not provide you with health

insurance? My personal experience in collecting long term disability from

my former company is that my health insurance benefits continue even though

I'll never be returning to work. I've been on LTD for 2 1/2 years, and my

former company requires a medical update annually. My company also required

me to file for social security benefits, which I was awarded almost

immediately. My company LTD benefit was then reduced by the amount of social

security I receive. Even if your company doesn't mandate your application

to SS, you should apply because of the medicare benefits you will

eventually be entitled to.

(You're entitled to Medicare in 2 years) I don't think that they can

legally stop your health benefits - if they offer it to retirees, they

should offer it to their former disabled employees. I would definitely

check with an attorney as to your rights.

K.

[Guest guest]

Hi Rob,

If you have been covered by employer provided insurance and they no longer are

providing it you can look into a HIPPA policy and I believe that you cannot be

turned down. I forgot what the letters stand for, but it is for pre-existing

conditions and the premiums are high. (Probably in the $500-$750 range.) Many

states also have programs for genetically handicapped persons, but I found those

premiums even higher than HIPPA policies and found them to be offered by the

same insurance companies. I currently have no health insurance and am waiting

for Medicare to kick in. I am hoping that my medical expenses will be less than

the premiums...and they probably will be only a fraction of the premium...but it

is a gamble.

Good luck to you in finding something afforadable and if you are successful,

please share it.

Ruth

[Guest guest]

Hello everyone,

I have been a lurker for about 2 months.

I will be getting group insurance for my own company, and I will be

starting treatment for newly diagnosed RA. After doing some

research and getting lots of wonderful information from all of you,

I would like my doctor to go the aggressive route with my

treatment...straight to TNF-blockers/biologics such as Enbrel,

Humira, or Remicade, if possible.

I would like to hear about your experiences with various health

insurance companies and their coverage in order to more easily make

my decision. Here are my questions...for those of you who wanted to

go or did go the biologics route:

1. What state are you in?

2. What insurance company do you have, if any?

3. What did your insurer cover or decline?

4. Tell me anything else you can about the experience with your

insurer.

Thank you, in advance for your input. If I hear from enough of you,

it really may help me choose the best insurance plan. So,

please...lurkers respond too!!! I need you!!!

Thanks,

Christie

f/30, So. California

[Guest guest]

Hi Christie,

My second doc that I went to (my first doc didn't even realize I had

RA!) wanted me on aggressive treatment right away. I live in NJ and

have Aetna and had no trouble getting on Enbrel right away, and am

now on Humira. I do not pay a co-pay, it comes out of " Major

Medical " . I get Humira through Aetna Specialty Pharmacy and there

have been no problems. So, I would say if you have a choice, Aetna

is a good company for these types of meds.

>

> Hello everyone,

>

> I have been a lurker for about 2 months.

>

> I will be getting group insurance for my own company, and I will be

> starting treatment for newly diagnosed RA. After doing some

> research and getting lots of wonderful information from all of you,

> I would like my doctor to go the aggressive route with my

> treatment...straight to TNF-blockers/biologics such as Enbrel,

> Humira, or Remicade, if possible.

>

> I would like to hear about your experiences with various health

> insurance companies and their coverage in order to more easily make

> my decision. Here are my questions...for those of you who wanted

to

> go or did go the biologics route:

>

> 1. What state are you in?

> 2. What insurance company do you have, if any?

> 3. What did your insurer cover or decline?

> 4. Tell me anything else you can about the experience with your

> insurer.

>

> Thank you, in advance for your input. If I hear from enough of

you,

> it really may help me choose the best insurance plan. So,

> please...lurkers respond too!!! I need you!!!

>

> Thanks,

> Christie

> f/30, So. California

>