Med Student Insurance, RX amount

[karate134]

Hey all,

First off, I'm excited to be joining you guys starting this fall. I'm wet behind the ears: I need a little help.

ATSU doesn't have a health plan. All I see is individual plans or something like the plan from SOMA. However, they cover Rx up to 500-1000 dollars for a year from what I see.

I have a pre-existing condition, and the meds I need actually would eat up the max allowed for scripts in a single month on any plan I've seen.

Unfortunately, I can't join my parents plan as I'm 27 (28 this summer).

Is there anyone out there with a similar circumstance or someone that is knowledgeable in this area?

Thanks!

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[Helen Wheels]

I would check out http://www.pparx.org/

This links to programs for various brand Rx meds that the drug manufacturers run. Usually, if you have any kind of drug coverage (even if it's crappy) they won't approve you but since you'd have no income as a med student you might still qualify for some. I would definitely check out the meds you are taking and see if you qualify by starting here. It's a start.

Best of luck!

 

[Prncssbuttercup]

If you are currently insured, and have been for 12 months, MOST insurance companies will waive the pre-existing condition clause. Do a search online for plans, I found a BCBS plan for $250/mo for both my husband and I with 15$ copays for generic/formulary Rxs... the out-of-pockets are a bit high, but I am using it as temporary until school starts...

Best of luck!

 

[Helen Wheels]

If you are currently insured, and have been for 12 months, MOST insurance companies will waive the pre-existing condition clause.

Also, I am pretty sure that under Obamacare pre-existing condition exclusions are not allowed for adults beginning in 2012.

 

[MedStudentWanna]

If you are currently insured, and have been for 12 months, MOST insurance companies will waive the pre-existing condition clause. Do a search online for plans, I found a BCBS plan for $250/mo for both my husband and I with 15$ copays for generic/formulary Rxs... the out-of-pockets are a bit high, but I am using it as temporary until school starts...

Best of luck!

Depending on what the pre-existing condition is, it's likely to be much higher for the OP. The insurance companies will offer him coverage, but at an insane amount.

 

[MedStudentWanna]

That starts in 2014, not 2012.

 

[Prncssbuttercup]

It is really really hard to say... I have pre-existing conditions, & my premium didn't change. They also waived the clause because continuous coverage. Either way, there are options, and most places will do the underwriting & get back to you with an amount for an up charge to see the difference... I think it is best for the OP to still check into options through as many companies as possible

 

[karate134]

Ok. I do see many plans that will 'accept' pre existing conditions with continous coverage. Does anyone know about the prescription limits. From what I see, most have about 250-1000 dollars per year max. Thats basically nothing....

 

[Prncssbuttercup]

I will look at mine, I didn't think it had one, but I'll check. I'll get back to you on it

 

[painmd87]

As far as I know, full-time students are ineligible for state health plans (Medicaid) but it may be worth looking into your specific case.

Also, look into the manufacturer of the drug's assistance programs. Many offer reduced fees for those who cannot afford their medications, even with insurance.

In my experience, most group plans cover pre-existing conditions with continuous coverage, but the individual market may vary. Make sure you weigh the increased cost of an individual plan vs. the amount you'll spend over the group plan you may be eligible for through the school and its affiliates.

 

[karate134]

Thanks for your help. I really haven't seen a forum more helpful and productive than SDN. There's a huge sense of "we're in this together".

I will definitely check out everyone's information that you posted and see what I can come up with. Starting med school can be intimidating as it is: this just makes it more so.

 

[Prncssbuttercup]

Ok, I finally received my insurance info from BCBS. I have an "anthem" plan, it is a "clear protection" plan, with a 3300$/person deductible (I didn't want to pay for the 1000$ deductible). So, I looked at the prescription coverage and it says there is a 7500$ deductible for tier 2 and tier 3 drugs, after that is met, it is a $40 copay. There was no maximum coverage, and the Rx and regular deductible are different. I don't know what drugs are on what lists... PM me if you have any specific questions

http://www.anthem.com/wps/portal/ah...73.htm&state=va&label=Prescription Drug Tiers