posted
I'll try to make this as brief as possible.
I began dating a wonderful man and we have been engaged THREE YEARS. This was in part due to finances (I lost my job due to Lyme and he's still working on his degree and working) and then we kept hoping I would get better. This is my second year of treatment and haven't really noticed much change.
However, I HAVE been insured under my father by MDIPA and by some incredible miracle my LLMD refered to as I'm "flying under their radar" they have been covering every test and odd, excessive, repeated, etc. prescription he has thrown my way. No questions asked. Somehow I've been listed on their system as disabled (probably from Panic Disorder I've had since 14) and my father works for the federal government with a very good union.
My fiance has been working the same job for nearly two-years now at UPS. He got insurance: Aetna PPO. We were very excited, thinking finally we could get married. So, we finally started planning.
But then a few things happened that made me wonder if his insurance would be as good as what I currently have. Little things that wouldn't have bothered me if I'd been well but big enough to a sick person who needs her Abx and expensive Fentanyl patches to keep the electric feeling from making her want to take a toaster into the bath with her.
So, my father looked into HIS and he can carry me another 3-years but at a price of over $200 a month, something we can't really afford as my mother is also very ill with her own problems. We also fear that by doing this it will alert them to my insane Rxs and give us trouble.
I went through the panic and hysterical stage, now I'm more collected and hoping for advice.
What would YOU do in this situation?
Do YOU have or have had Aetna PPO and how do/did they treat you (my LLMD actually said since it's a PPO and UPS a big company with a Union that they should give me LESS problems than MDIPA if I weren't somehow, again, flying under their radar).
We really want to get married. It's been an awful three-years for my health, him cutting ties with his family, him working tirelessly at work, going to school, taking care of me, helping out my parents since mom went downhill. We just want one good thing but we're scared to screw it up and I'm left begging for meds, etc.
We don't know how much longer my mom will live. Everything is nearly planned and finished for our set date and our only other idea is a Committment Ceremony, which isn't all that ideal to us but would be better than nothing, I suppose.
I think it's horrible we have to choose between love and insurance. Posts: 23 | From Virginia | Registered: Jan 2008
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
Yikes, that is a really hard decision!
I would try to find out everything you possibly can about the insurance you could potentially be getting from your fiance.
Maybe do a google search about insurance and Aetna to see if there are any horror stories. Like look for people talking about it on websites.
Or look for websites where people rate their health insurance.
Or, if your finace has a REALLY good friend at work he can confide in that is married, he could ask them how the coverage has been for them.
I think I would make my decision based on that?
Can you call Aetna and say, "I'm considering purchasing your insurance, and I'm wondering if you would cover (X drug) for (Y diagnosis)? I dunno, worth a shot.
Or the other thing you can do, if you qualify financially, is apply for state Medicaid, and then your insurance will be independent of him.
But then when you get married, if he makes too much money, you might not get it then. I guess you just have to ask your county's office, "if i have medicaid and I get married and my husband makes X, would it get taken away from me then? Because I am getting married soon and I want to know if this is worth getting or if it will just get taken away."
If you are too sick to work you might qualify for the Medicaid.
Hope some of those ideas help....
Posts: 4590 | From Midwest | Registered: Jun 2008
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
I'm sorry this is weighing on you so heavily.
It is NOT a good position to be in.... I agree with you. And...
I wouldn't dream of suggesting what you should do in this situation, as far as chosing one option over another.
I will, however, point out that next week dad's insurance might start giving you headaches. But then again it may never do that.
And I've not hear much fantastic giddy-up about Atena either... so...
Darned if you do... and darned if you don't.
MY opinions are not like many others.... so remember that when you read the following.
But if I were in this situation ... and knowing that a piece of paper does not love make....
I think I would have a beautiful commitment ceremony... and do the loving with your hearts rather than the "deal breaker" piece of paper.
If it were me... I think that would be fun.
And.. when the time is right....
I would have a nice wedding.... with no pressure being put on me by insurance issues.
I am NOT Dear Abby, I am not a marriage counsler.....
And I live by the seat of my pants with my heart guiding the way.
Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
posted
Hi,
I am sorry that you are burdened with a decision like that.
I can only pass along that I pay over $300/month for my insurance and it pays very little of anything.
It is a Highmark plan, but my point is that you could possibly end up with hundreds of dollars of expenses per month if you have a policy that doesn't cover alot.
Mine does not pay for Dr visits, only pays a portion of labwork and a small portion of meds.
If I only had to pay $200/mo for a plan that covered everything, I'd be ecstatic.
If you apply for a different plan, you will have to disclose your pre-existing conditions for sure.
Sometimes a new plan will not cover pre-existing conditions for a year.
Just wanted to give you that info to consider.
Hope you find what is best for you.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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bettyg
Unregistered
posted
maid,
i feel for you and agree with tincup and dekrator ... about making sure WHAT INSURANCE COVERS & NOT COVERING LIKE PRE-EXISTING CONDITIONS!! ********************************************************
that was the 1st thing i thought of reading your plight above. you can NOT be without insurance as we end up going to ER many times too with all our lyme problems occurring at ODD times.
best wishes, and may god guide you to make the correct decision for YOU.
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