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Young Adults and Health Insurance

Feb 12, 2009

What Will They Do After Leaving The Nest?

Editor's note: We recently received the following heartbreaking letter. The article that follows was first published in May, 2006. Little has changed.

"I think someone should address the issue of young adults with diabetes that are going out on their own, leaving home, when they are no longer on their parents' insurance, can't get insurance themselves, can't get help through the state if they don't have a child. I should know. I am 22 years old with over $100,000 dollars in debt, all of which is medical.  I have poorly controlled diabetes due to years of not being able to afford bottles of insulin that cost a $100 dollars apiece. I need at least three a month and I was on my own paying bills and I couldn't get help. I had to sacrifice and most of the time I gave up my medications. I was in and out of the hospital in DKA every three months.  I feel like giving u. I have so much debt and a life time ahead of living with diabetes.. I'm married now with a child and I wonder what I have done to my husband who was pretty much debt free before and now can't get a loan for anything. How can I provide for my daughter when I can't take care of myself? I want to make sure people know how hard it is for an 18 year old out on their. I don't want anyone to end up like me over $100,000 in medical debt living in a basement, depressed, and out of luck."

-Ladonna, 2/11/09

For most young adults, May is a month of looking forward. The month of May heralds summer vacation, and for those graduating from high school or college, it offers a diploma with a stamp of independence.

But Nicole Daley, a 23-year-old type 1 in New York City, warily eyes this impending milestone. She’ll be graduating from the Fashion Institute of Technology this month, and eight months later she will lose dependent status under her parent’s employer-sponsored plan—a deadline that has set her scrambling for health insurance. The clock is ticking: If she fails to secure coverage before her current plan expires, future carriers will view her diabetes as a pre-existing condition, and she’ll be forced to foot the bill for her diabetes care for at least a year, maybe indefinitely.

Most jobs available to recent graduates like Daley are low wage or temporary—the type that usually offer limited or no health benefits. She is working part time for a small marketing company, but the company can’t take her on full time. As a result, she is considering leaving her job to find something full time or leaving New York City altogether, where the cost of living, combined with her medical expenses—more than $1,000 a month, she estimates—is too much to bear.

Welcome to the real world, or, more precisely, the reality facing young adults with diabetes in America today.

Welcome to Adulthood

Amid the flurry of life changes that accompanies young adulthood—changes in schools, housing, jobs and relationships—teens and twenty-somethings with diabetes face a real risk of losing the health insurance they need to cover their treatment. In a healthcare system without universal coverage, where access to health insurance is determined principally by employment and family status, the transitory nature of young adulthood makes individuals in that age group especially vulnerable. According to the Kaiser Family Foundation, approximately one-third of all uninsured Americans are between the ages of 19 and 24—a number twice that of 30- to 64-year-olds. In addition, according to Gallup’s annual survey on health and health care, conducted in November 2005, one in five 18- to 29-year-olds is uninsured.

The health insurance industry’s tough love begins at ages 18 and 19, birthdays seen by most private and public programs as the critical divide when teenagers are reclassified as “adults.” A 2004 study by the Commonwealth Fund found that nearly 60 percent of employers who offer health coverage do not insure children over age 18 or 19 if they do not attend college.

This fact gives high school graduates reason to worry. According to an analysis by Penn State researchers, of all young adults graduating from high school, three out of 10 were uninsured for some time in the first year following graduation.

For families with high school graduates immediately matriculating into college, the health insurance burden may be momentarily lifted, since many plans extend dependent status for teenagers until age 25 or as long as they are full-time students, but they still face weighty considerations. For starters, some policies have a minimum credit hour requirement in order to qualify as a “full-time” student. And other life changes can affect status. For instance, if a student should get married, most policies will terminate him or her from the parents’ coverage.

What’s more, the coverage that was once provided to teenagers living at home may not be the same once they leave for college. This holds true in particular for plans through many health management organizations (HMOs), which may only provide emergency coverage out of the local area. “Out of network” doctor visits or prescription medications—even those written by college health clinicians—are usually not covered even if, under the plan, school clinicians are allowed to provide routine and emergency care.

Nicole Daley, who is covered by Kaiser Permanente, a California HMO, as well as by her limited school plan, has found it more cost effective to fly across the country to see a network doctor for routine checkups and blood tests. Even adequate coverage has come with some frustrations. Two years ago Daley was hospitalized for a diabetes-related kidney infection. It took a whole year for the bill to get paid, as her school and parents’ insurance plans wrangled over who should cover the cost.

On Their Own

Once out of school, young adults join the millions of diabetics for whom health insurance is a matter of not just physical, but financial, survival. They won’t find much solace, however, in this shared reality: Most diabetes policy experts agree that, in America today, no government-sponsored health protection provides coverage that is at once available, affordable and adequate for diabetes care. Finding private coverage that meets those essential criteria is equally challenging. For young adults, their options depend highly on the state in which they live and on their age and income level.

Greg Venker, a 23-year-old law student with type 1 living in St. Louis, pays $450 month for COBRA—a federal law that allows young adults who lose coverage under their parents’ employer-sponsored plan (for employers with more than 20 employees) to purchase temporary extended healthcare coverage for up to 36 months. In all but 12 states, state continuation or “mini-COBRA” coverage exists for individuals with small (fewer than 20 employees) group plans. Although COBRA offers a temporary reprieve, most young adults find it cost prohibitive because the employer no longer contributes their share of the plan.

Facing mounting student loans, Venker may be forced to drop COBRA and pay out of pocket for his diabetes care. His application for a Blue Cross policy was recently rejected, and he knows that if he goes uninsured, his chances of picking up coverage again are slim. “Every other part of me is healthy—my heart, kidneys, liver,” he says, echoing a frustration felt by millions of otherwise healthy young adults. “I just happen to be diabetic.”

Other recent graduates left with nowhere to go may purchase coverage through state-run programs known as “high risk pools,” available in 32 states. Only around 175,000 Americans are enrolled in high-risk pools across the country. Although pre-existing condition exclusions exist, an ADA-Georgetown survey released in February 2005 found that among diabetics of all ages, affordability, adequacy and bureaucratic red tape, not eligibility, were the main reasons for such low participation.

For example, a 23-year-old female in Missouri, under that state’s high-risk pool, might have to pay a monthly premium of $563 (at a $200 deductible). Selecting the highest deductible—$5,000—would, of course, lower that premium, to around $252 per month—but for a recent graduate, $5000 is a lot to shell out.

In many states, young adults who are losing dependent coverage under their parents’ employer-based group plan can enroll in an individual plan under the same insurer, an option known as “conversion coverage.” State law, however, doesn’t require that the conversion policy look anything like the comprehensive benefits afforded under their parents’ group plan, and in most states, the insurer can set the price of the individual policy, making conversion coverage typically more expensive than COBRA, with fewer benefits.

Charged More Because of Diabetes

Without a job that offers comprehensive health benefits, young adults face the grim task of finding an insurance company that will sell them an individual plan, as Greg Venker found. Even if they do, they’ll likely be charged more because of their diabetes. State regulation of the market varies greatly, and only a handful of states—New Jersey, New York, Massachusetts, Vermont and Maine—require insurance companies to sell coverage with comprehensive benefits to all residents at the same price, regardless of health status (in Michigan and Pennsylvania, only Blue Cross is required to do so).

In their 2005 survey of people with diabetes and their health insurance, Georgetown University and the ADA found that when it comes to insurance in the individual market, there is huge tradeoff between affordability and eligibility. If you can even get insurance, it will probably come at a hefty price. And for group health plans, where eligibility isn’t an issue, affordability comes at the expense of adequacy. For example, an employer-sponsored policy may cover hospital care and diagnostic services but not physician office visits or prescription drugs. Another might cover physician office visits but not prescription drugs and vision care.

The ADA has successfully fought for laws in 47 states, including the District of Columbia, that mandate that insurers offer adequate diabetes services and supply coverage. (Alabama, Idaho, Ohio and North Dakota don’t require such coverage.) Even so, the laws apply only to individual health plans and small- to mid-sized employer plans, since health insurance coverage provided by large employers and the federal government is not subject to state insurance requirements.

This leaves young adults working for large employers or the federal government at the whim of their employer for their diabetes coverage. A study conducted in 2005 by the Government Accountability Office, which found the diabetes education and medical nutrition therapy offered in some of the country’s largest private and federal employer health plans to be inadequate, makes that an uncomfortable position.

Ask Questions About What Is Covered In the Plan

Boyer recommends that young adults who are choosing plans provided through their employer “take an inventory of their current medical needs and ask detailed questions about what is and is not covered in the plan, to determine whether it is right for [their] needs. Just because something is sold in a pharmacy,” he says, “doesn’t mean it’s covered under a pharmacy plan—like test strips, which are considered durable medical equipment. Ask, what are my co-pays and deductibles associated with insulin? With test strips? Eye exams? And chose a comprehensive health plan, even if it costs several dollars more a month.”

Some safety nets exist for young adults with low incomes who may find themselves caught without any insurance. Government programs like Medicaid tend to be available only to disabled or pregnant diabetics, teenage mothers or parents of diabetics under age 21. For others, free or low-cost community health centers may offer clinical care. And while they probably won’t cover medication needs, most hospitals will provide financial assistance to people who cannot afford visits to a doctor, and some offer “free” or “compassionate” care to individuals who cannot afford their physician visits.

Many pharmaceutical companies also offer financial assistance programs to help pay for oral medications and insulin, and some include pumps and pump supplies when they cannot be paid for out of pocket. The qualifications for these programs vary widely, however, depending on age and healthcare status. They are meant to meet transient, not long-term, coverage needs, and as such, may require reapplication every few months.

TogetherRX Access, sponsored by some of the largest pharmaceutical companies, provides some diabetes medications and blood glucose meters and strips to low-income diabetics at a 25 to 40 percent savings. To qualify, young adults must have no existing public or private prescription drug coverage and an income of less than $30,000.

Young adults losing their health insurance coverage after graduation this spring will likely undergo a period of being uninsured: two-thirds of them do. It’s an unfortunate rite of passage into adulthood, leading to feelings of frightening vulnerability that will likely characterize health insurance transition periods for the rest of their lives as diabetics.

“It can be very scary when you don’t have health insurance and are paying full freight, as the consequences of it not working well can be incredibly devastating,” says Karen Pollitz, project director at the Georgetown University Health Policy Institute and co-author of the Georgetown-ADA report on health insurance for people with diabetes. “To the extent that young adults [can find] health insurance that won’t turn them down, that’s a first step. Next they need to find adequate and affordable coverage. Parents might have thought they were ‘done,’ but if they can’t keep helping, their kids may get into trouble.”


Mom and Dad’s Work Plans

About half of all fulltime students between the ages of 19 and 23 receive health insurance through their parents’ employer-sponsored plans, while another quarter have other sources of coverage, such as plans offered by their colleges or universities.

Students who want to continue the protections they have under their parents’ plans should not enroll in any other type of health insurance plan upon entering school, or they run the risk of preempting that coverage, warns Tom Boyer, a healthcare policy consultant and advocate who has drafted legislation supporting diabetes care.

“If you’re using [a school plan] as secondary coverage, you should be OK,” says Boyer. “But once a student moves off his or her parents’ plan, there’s no going back.” For the legal protections and tax benefits it affords, Boyer advises young adults to continue classifying themselves as dependents—“staying under their parents’ wing, as easy or difficult as that may be”—as long as they can.

Also, many university plans do not include comprehensive diabetes care, says Holly Whelan, public policy manager at the American Diabetes Association. She advises students enrolling in school to know how they’ll get their prescriptions and supplies, as some school plans include supplies, but with a limit, often up to only a couple of thousand dollars,—which is quickly spent by most diabetics, —after which students would be stuck paying out of pocket for the rest of the year. Also, the majority of school health clinicians are not specialized in providing diabetes care, and referrals to an outside doctor can be very costly.


Coverage Through COBRA

If young adults opt for COBRA coverage, the U.S. Department of Labor advises parents to notify their employer in writing within 60 days that their covered child is no longer a dependent. Their employer-sponsored healthcare plan should then advise the child of his or her right to extend healthcare benefits under COBRA (the Consolidated Omnibus Reconciliation Act). The child will then have 60 days from the date the notice was sent to elect COBRA coverage.

For young adults who exhaust COBRA, another federal protection, HIPAA (the Health Insurance Portability and Accountability Act), picks up where COBRA leaves off. If COBRA is not an option for a young adult, or if he or she lives in a state that doesn’t offer continuation coverage, the child may go directly from losing the parent’s plan to HIPAA, which guarantees the right to buy non-group coverage without pre-existing condition exclusions.

However, there’s no limit on what insurers can charge or guidelines for what they must cover under HIPAA, often resulting in premiums even more costly than those offered under COBRA.


Health Insurance Resources Online

The Georgetown University Health Policy Institute has a regularly updated consumer guide for getting and keeping health insurance for each state:

www.healthinsuranceinfo.net

The American Diabetes Association offers health insurance information for people with diabetes:

www.diabetes.org/advocacy-and-legalresources/healthcare/insurance.jsp


Categories: Blood Glucose, Diabetes, Diabetes, Health Insurance, Insulin, Losing weight, Type 1 Issues



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Comments

Posted by Anonymous on 7 February 2008

The Gov. and medical/pharma. Industry really along with the corrupt insurance industry doesn't care a bit! JUST SEND THE MONEY is all that matters to all of them. We have Diabetes because of the CHEMICALS the Gov. and FDA allow us to absorbe as guiny pigs. Hey, "give us your money" and hope you make it OK. SeeYa is their answer.........Its all about the money!Don't worry about if you need you legs or arms, who needs to see anyway, Just keep sending the money, as the Insurance companies rape and pilfer you. You remain ill and the Exec's get million dollar incentives......GOD WILL SORT THEM OUT because they are denying GODS CHILDREN. TRUST THAT!

Posted by Anonymous on 19 May 2008

ditto to that one. It's like they don't care that certain people can't help the fact that they have a disease....all they care about is that they get their money and continue to make millions of dollars. (ditto for the oil companies on that matter). But it's like no one cares anymore....

Posted by Locke8382 on 14 October 2008

Back when I was under my parents insurance, I was taking care of my diabeties but now I am struggling. I have to limit the amount of blood tests and insulin I use because I just can't afford it. I thought insurance was supposed to help a person with an uncurable disease. Why is it such a hopeless maze of jargon a common person cannot even understand. How do these people sleep at night?? I'm killing my body because I cannot pay for medication that should be available to me. God save us all.

Posted by Anonymous on 12 February 2009

What will they do after leaving the nest? Work until they drop..... Forget dream jobs - you have to find a FT grunt job that offers health insurance benefits and pray you don't get sick during the pre-ex period... because you won't have any coverage for a year. No one with Type 1 insulin dependent diabetes can go "treatment free" for even one day - and the pre-x exclusions apply if you cannot go 30 - 90 days or six months treatment free. I speak from experience.... I have had type 1 for 39 years, and had to get a fulltime job that I hated and work it for over 20 years. My current job doesn't offer benefits. I have gone back to school to get a teachers credential so I can change careers, and then teach until I am 65 and eligible for Medicare (which only covers 50% of drug charges... and no test strips), in order to have insurance benefits after my husband,older than I and who currently provides insurance benefits for the family, retires. How can the richest country in the world NOT provide universal health care to ALL of its citizens?

Posted by bernus on 15 February 2009

Although American scientists, doctors, and businessmen have produced the most advanced medical technology in the world, American health care is in a state of crisis. Technologically, we are surrounded by medical marvels: New “clot buster” drugs enable patients to survive heart attacks that once would have been fatal; new forms of “keyhole surgery” enable patients with appendicitis to be treated and discharged within twenty-four hours, whereas previously they would have spent a week in the hospital; advances in cancer treatment enabled bicyclist Lance Armstrong to beat a testicular cancer, which, had he lived fifty years ago, would have killed him; and so on.

From an economic perspective, however, such medical treatments are increasingly out of reach to many Americans. Health care costs, as reported by the New York Times, are rising twice as fast as inflation.1 And health insurance, as reported by USA Today, “is becoming increasingly unaffordable for many employers and working people.”2 A decreasing percentage of employers are offering health insurance benefits to their workers, and many of those who are offering benefits are requiring their employees to pay a greater percentage of the costs.

This discord is affecting doctors as well. The American Medical Association warns physicians that, due to the lack of affordable health insurance, “more patients will delay treatment and . . . doctors will likely see more uncompensated care.”5 Hence, each year doctors are working harder and harder but making less and less money, resulting in a “critical level” of stress and burnout. According to a recent survey of doctors, “30 to 40 percent of practicing physicians would not choose to enter the medical profession if they were deciding on a career again, and an even higher percentage would not encourage their children to pursue a medical career.”

For more (and I mean, more) go here:
http://bit.ly/1lI85S
It's enlightening.

Posted by Anonymous on 17 February 2009

As far as health insurance goes, it doesn't matter if your a student or older and in the employment world.
The company my spouse works for changed their health insurance, because it was cheaper for the company. Therefore, it cost me over $300.00 for diabetes supplies. I ended up doing mail order. It's cheaper but still expensive, if you know what I mean. I made my three month supply of insulin last eight months. I don't eat much and at times I starve myself so I don't have to use insulin. Like several of you, I don't test as much as I should. I also reuse needles, even though you shouldn't. It seems that no one cares and I feel very alone. I told the health insurance company that if I die, it will be their fault and also the company that my spouse works for. As long as the big wigs get their bonuses, they could care less about their employees and families. Unfortunately, if something does happen to me, that will leave a widowed spouse and two kids without a parent. But as I said, the company doesn't care. All they want is their bonus. I also failed to mention that this company was recently bailed out by the government.

Posted by Anonymous on 17 February 2009

This is an extremely important, not to mention horrifying, issue - I'm glad to see that Diabetes Health has brought this to more public attention.

If you are a young adult woman in NYC - please consider joining our new support group at Beth Israel Medical Center. Contact diabetesnyc@gmail.com for more information. We can't promise you coverage of course, but we can promise a safe space for information sharing and mutual support.

Posted by Anonymous on 18 February 2009

I completely understand the frustration and cynicism of people with diabetes in respect to sub-optimal healthcare coverage for their chronic and often debilitating disease. As a diabetes registered nurse/clinician and certified diabetes educator (CDE), I have spent greater than 38 years of my 43 years in nursing devoted to those patients I serve with diabetes. Additionally, I have been married for over four decades to someone who has had type 1 diabetes for 59 years, so I know first hand the exclusions and healthcare reimbursement issues faced by those with this disease. Many years ago I was astonished when I went to our pharmacy to learn that insurance will pay for insulin, but NOT insulin syringes. I was wondering just exactly how do people with diabetes use insulin to sustain their lives, but have no insurance coverage for syringes to deliver their life saving medication. Insurance constraints for people with diabetes extend far beyond healthcare. When we purchased our first home, we were not entitled to mortgage insurance, and had it not been for my husband's parents, who took out a modest life insurance policy when he was in his teens, he was even denied life insurance by a number of insurers. When we finally found one who would be willing to take on the "risk" of a pre-existing condition, the cost of the premiums were beyond our reach. Living life with little "insurance security", that most people appreciate, is very disconcerting. Unfortunatley, little has changed in the insurance industry with their bias of chronic disease. Just recently when my husband, who now relies on an insulin pump delivery system, became Medicare eligible, he had to first prove, through a series of mandated bloodwork, that he even had type 1 diabetes. He found this incredibly insulting and quite frustrating, as when one blood result might have shown he had the slightest trait toward producing a markedly scant amout of his own insulin, he had to return to the lab on two more occasions to have additional, more sophisticated bloodwork, at Medicare's expense, I might add, to FINALLY prove his type 1 diabetes condition. All the while, he was growing dangerously close to running out of pump supplies and insulin, with the pump company sending him via overnight FedEx delivery, charged, of course, to Medicare, several days' supplies to get him through until Medicare would finally agree he had type 1 diabetes and would require coverage for his supplies and insulin. I could go on and on with insurance-related issues that people with diabetes face. As immediate Past-President of our statewide diabetes educator organization, I, along with my remarkable colleagues, have worked feverishly at the local, state and federal levels to improving access to diabetes care and education, including coverage for testing supplies, medications and delivery systems to optimize the lives of those with diabetes. Our hope is these insurance companies will one day have mandated oversight as to who they are denying insurance coverage to and why. Until then, we will continue our quest to support those people who live each day with the uncertainty of insurance constraints.

Posted by dorisjdickson on 18 February 2009

As former employee benefits specialist and type 1 diabetic of more than 32 years, this is the most comprehensive and accurate article on the subject I have ever read. Thank you for reposting it.

I currently pay $445 for a BC/BS Mass PPO with very good coverage and “reasonable” copays. However, COBRA ends shortly and I will, again, be faced with the same challenges and choices I have made since I left college in 1984 – Russian roulette or debt and going without to pay medical insurance and supplies.

I have previously exercised the HIPAA continuation option under United HealthCare (UHC). The benefits did not change dramatically. However, after starting with a similar premium structure to the original group plan, UHC raised the premium every 6 months by about 20%. It became entirely unaffordable very quickly.

This time, I am required by the State of Massachusetts to buy health insurance whether I can afford it or not. I am currently unemployed but my previous income is too high to qualify for any assistance under the Commonwealth Care standards which require my income be less than $31,212 per year.

That may be not be a bad thing. A woman who lives with me has Commonwealth Care; no local doctors are participating. She has to travel 20-30 minutes, several towns away, to a physician who does participate. However, she does not drive. Imagine that – low income with no car.

BC/BS, Tufts, Harvard Pilgrim, Neighborhood Health, Fallon, and Health New England sponsor the plans available for purchase through Commonwealth Choice. The premiums are hardly “affordable” as marketed by the Romney Administration enacted into law a few years ago.

Prescription coverage is one of the most vital portions of a diabetic’s health care plan, since insulin and frequent glucose monitoring help keep diabetics from using the hospital admissions and emergency room coverage. Yet, most of the “good quality” plans have prescription deductibles and 50/50 coinsurance, thereafter. Who can afford a huge premium, deductible and 50/50 coinsurance on diabetes supplies?

The only BS/BS plan that covers prescriptions without a deductible (and 50/50 coinsurance) is their HMO Blue Premium plan at $597 per month (rated by age and zip code)! Even at that level, prescription copays are $10, $25 and $45. Several insulin and test strips products are in the third-tier ($45). The lower BC/BS priced plan ($467 per month) only uses the “basic” formulary. I do not have access to the formulary to determine which medications are included in this plan. The Tufts plans even limit choices of doctors and hospitals at the $484 per month premium level (their “best” plan) – equally as scary as limiting my prescription access.

I am seriously contemplating choosing the conversion policy when offered to me. Since continuation policies are normally offered month-by-month (so they can easily raise premiums), that also means I will not be committed for a long period.

Whichever choice I make it is going to be expensive. The premiums alone are an entire unemployment check! Add in three or four types of insulin, syringes, 15 test strips per day, thyroid, blood pressure, allergy medication, office visits, and lab tests. I am fortunate. I have never been treated to a trip to the emergency room or admitted to the hospital for any diabetes related complications. Hmm … guess that means I have kept costs down for the insurers too. How ‘bout they return the favor?

Doris J. Dickson

Posted by gandalf888 on 22 February 2009

"Health Insurance" is a joke. Those who have diabetes are often left to fend for ourselves. I am 62 years old, and have not only dealt with type 1 diabetes for 52 years, but I have dealt with having my money drained by constant medeical costs, even with insurance. The insurance companies look for ANY way to get out of paying. If I just had diabetes to fight, it might be tolerable, but I have always had to fight the insurance companies for coverage, and I now live in terror that I will not be able to continue to work full time and lose what coverage I have. I'm not eligible for Medicare for three more years, and we found out the hard way that insurance companies won't touch you at all if you are within one year of Medicare coverage. I wouldn't make it a year without coverage - I have no savings, no retirement, and may well lose my home this year, due mainly to decades of trying to pay for the medical treatment we need (my husband is type 2 and we both have had coronary bypass and he has had a series of strokes). Our doctors are really good about giving us samples when they can; otherwise even with coverage, paying for prescriptions leaves us juggling with paying for the meds or paying the heating bill. I am not whining or feelng sorry for myself - I just know that there are so many poeople in the same situation. Dealing with the complications of long-term diabetes is enougg; having to constantly worry about whether or not we can get the health care we need is intolerable.

Posted by Anonymous on 23 July 2009

I have an eight year old son with type 1 insulin dependent diabetes. No one on my wife or my family has diabetes. I am scared as hell that he will not be covered when he is an adult and have a hard time getting insurance. Right now he is on our insurance that takes care of most everything so we have his blood sugar under control. Something needs to be done. Diabetes is not a death sentence if managed properly with insulin, diet, and excersize. Wake up insurance companies and pick up these young adults.

Posted by Anonymous on 17 September 2009

September 17, 2000. My husband and I have 4 sons, one of who is a type one diabetic since age 8, now 22. His father was a teacher in Illinois. We paid $125 mo. for a family of 5. He retired 2 years ago. My son is in College and has been since he was 19. Since retirement we were given the Teachers Retirement Insurance Program. What a kick in the butt that was. Now we pay 900 mo. for health insurance, and went from O for RX prescriptions copays to copays amounting to $450 dollars a month. All because he retired. Now I get a letter from the Retirment teacher insurance fund stating now that kevin is going on 23 years of age and still a student new regulations have changed. Are you ready for this shocker. Kevin now is considered an adult/student and because he is still in school he will be charge an additional $500 dollars per month for his insurance premium, which was $225 month. They now want us to pay $750.00 per month just to insure him. They know they have us by the tail, and we have no choice but to pay this. This is highway robbery to the fullest. Can anyone out there advise me to where we can go to get insurance for him. I only have 4 weeks to find someone reliable and affordable. Thank you.

Posted by Anonymous on 9 May 2011

I have a pt who has been a Type l diabetic since age 3, he is in his 30's now and his sugars can run from 500 to 38 in a single day
every day, he said Medicare/Medicaid will not pay for Actos,he said he was on this before and it worked but now he cannot get it. Does anyone know why they do not pay for it? Does anyone know how he can get it?
Thanks for suggestions.


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