Insured RN Suffering from Incurable Disease

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Specializes in Critical care, tele, Medical-Surgical.

RN Suffering from Incurable Disease Fails to Keep Up With Medical Expenses Even Though She's Insured

Pays $14,000 a year out of pocket

"After being an emergency room nurse for 17 years, I became too ill to work," said Jan Stephens, an RN from Anaheim, Calif. "It all started out manageable enough. In 1992, I enrolled in a Blue Cross policy with a monthly premium of $282, a $500 annual deductible, and a $250 prescription drug deductible.

"Then in 1995, I was diagnosed with an incurable bladder disease called interstitial cystitis and several other coexisting illnesses. I was disabled due to the excruciating pain and, like so many other people who become sick and can't work, I had to live on a fixed income. Problem was, my insurance costs kept going up. Now, my monthly insurance premiums are $639, with an annual deductible of $1,500, and I pay up to $500 per month out of pocket for prescription drugs.

"As just one example, the copayment for Elmiron, the only medicine specifically for treating interstitial cystitis, zoomed from $25 a month in 1999 for 200 capsules to $250 a month now for 180 capsules. Blue Cross will not cover the syringes, needles, urinary catheter, Lidocaine, or sodium bicarbonate that I need to administer the cocktail of medicines I use.

"I truly do not know how much longer I will be able to keep my home that I've lived in for the last 30 years. In saying all that I've said, I do realize that there are many people who are much worse off. While I am not terminally ill, my quality of life suffers immensely due to my illnesses and the financial strain that has resulted."

She tells her story here. Since she made this video here costs have increased.:

It is my opinion that no one has replied to your post because you scare them. Americans are great for rallying around the flag, but when you fall - you fall alone. You represent the damage being done in this country and for that you will be ostracized.

I'm deeply sorry to hear what you are going through.

Specializes in Acute post op ortho.

http://www.pparx.org/

http://www.rxassist.org/

http://www.needymeds.org/

http://www.patientassistance.com/

http://www.ic-network.com/drugassistance/

http://www.rxassist.org/pap-info/company_detail.cfm?CmpId=141

https://www.rxhope.com/PAP/info/PAPList.aspx?drugid=4495&fieldType=drugid

I've had BCBS for nearly 20 years, our premiums went up last year by about 18.00 a month for the first time in 5 years.

My son was diagnosed with what most would consider a catastrophic illness in 2005 & the service we received was above & beyond anything I've ever imagined.

His meds alone were $5,500.00 a month, of that we paid a $50.00 co-pay.

Our premiums remain steady to this day.

We cover a family of 4.....327.72 a month.

The coverage is average, the service is excellent.

An insurance policy is a contract, just like any other business agreement, you need to read & understand it before you sign the paperwork.

I can't speak to anyone's experience but my own.

Specializes in Critical care, tele, Medical-Surgical.
http://www.pparx.org/

http://www.rxassist.org/

http://www.needymeds.org/

http://www.patientassistance.com/

http://www.ic-network.com/drugassistance/

http://www.rxassist.org/pap-info/company_detail.cfm?CmpId=141

https://www.rxhope.com/PAP/info/PAPList.aspx?drugid=4495&fieldType=drugid

I've had BCBS for nearly 20 years, our premiums went up last year by about 18.00 a month for the first time in 5 years.

My son was diagnosed with what most would consider a catastrophic illness in 2005 & the service we received was above & beyond anything I've ever imagined.

His meds alone were $5,500.00 a month, of that we paid a $50.00 co-pay.

Our premiums remain steady to this day.

We cover a family of 4.....327.72 a month.

The coverage is average, the service is excellent.

An insurance policy is a contract, just like any other business agreement, you need to read & understand it before you sign the paperwork.

I can't speak to anyone's experience but my own.

I am glad your son received the care he needed without bankrupting your family.

It is good you have insurance that works well for your family.

I hope your family remains secure.

I hope the same for all families.

PS: Janet Stephens tried all the available ways to get assistance with her increasing premiums and medication costs. She actually met Montel Williams and the bus you see on TV.

She has written hundreds of letters a year, hired an attorney, contacted the Department of Managed Care, and tried all the organizations in your links.

So far she hasn't received any assistance.

Specializes in Acute post op ortho.
I am glad your son received the care he needed without bankrupting your family.

It is good you have insurance that works well for your family.

I hope your family remains secure.

I hope the same for all families.

PS: Janet Stephens tried all the available ways to get assistance with her increasing premiums and medication costs. She actually met Montel Williams and the bus you see on TV.

She has written hundreds of letters a year, hired an attorney, contacted the Department of Managed Care, and tried all the organizations in your links.

So far she hasn't received any assistance.

I worked in a clinic where one of my duties was to fill out the paperwork for patient assistance programs. I never saw anyone who qualified get turned down. We had a few that were borderline, but a call from the doctor usually resulted in success.

If she didn't receive assistance, there is a reason she doesn't qualify.

I worked in a clinic where one of my duties was to fill out the paperwork for patient assistance programs. I never saw anyone who qualified get turned down. We had a few that were borderline, but a call from the doctor usually resulted in success.

If she didn't receive assistance, there is a reason she doesn't qualify.

a possessor of rose colored glasses? i would bet that this would very from location to location

Specializes in Acute post op ortho.
a possessor of rose colored glasses? i would bet that this would very from location to location

How is this rose colored glasses?

The assistance is there.

The patient qualifies, we send in the paperwork, he's accepted.

The patient doesn't qualify, he's denied.

A few that were borderline, got help with a little push.

Those are the facts.

Was the paperwork a monthly pain to fill out, eh, some worse than others.

We work in an impoverished area, we do so by choice. I've NEVER seen anyone turned down for true medical care, regardless of their ability to pay.

How is this rose colored glasses?

The assistance is there.

The patient qualifies, we send in the paperwork, he's accepted.

The patient doesn't qualify, he's denied.

A few that were borderline, got help with a little push.

Those are the facts.

Was the paperwork a monthly pain to fill out, eh, some worse than others.

We work in an impoverished area, we do so by choice. I've NEVER seen anyone turned down for true medical care, regardless of their ability to pay.

Why not just skip the bureaucracy altogether (if what you say contains any facts at all) when all you say a person needs is a "little push" after months of submittals and jumping through hoops?

You also stated this was in an impoverished area...what if it were low-middle class and a two income family earning say $40k??? Would they qualify even if they didn't have enough money to cover monthly bills never mind affording self-pay insurance? I'd bet the answer is probably not.

You stated " The patient qualifies, we send in the paperwork, he's accepted. The patient doesn't qualify, he's denied." What do they do and where do they go when they're denied and sick?

Specializes in Gerontology, nursing education.
How is this rose colored glasses?

The assistance is there.

The patient qualifies, we send in the paperwork, he's accepted.

The patient doesn't qualify, he's denied.

A few that were borderline, got help with a little push.

Those are the facts.

Was the paperwork a monthly pain to fill out, eh, some worse than others.

We work in an impoverished area, we do so by choice. I've NEVER seen anyone turned down for true medical care, regardless of their ability to pay.

This sounds like an excellent system. Why can't that be done everywhere?

BTW, who pays for true medical care when patients are unable to pay? And who decides what exactly is "true" medical care?

Yeah, I had to purchase my meds from Canada becuase one of them were generic there. I was very choosy and somewhat leary about it but if the Canadians are ok with the generic, I was too. Maybe that would help someone. It's not like I went to Mexico! CanadaRx was the company. Never a problem.

An insurance policy is a contract, just like any other business agreement, you need to read & understand it before you sign the paperwork.

I agree.

So much of the fault is placed on the 'evil' insurance company when a VERY large portion of it lies with the employer for choosing the plan and/or passing on the costs to their employees.

Also, people who are receiving disability usually also qualify for Medicare/Medicaid. I think there is far more to the posted story than is told.

Specializes in Acute post op ortho.

Why doesn't the government give every family and homeless person a house? There are lots of people that have 2 homes, they can't live in both of them at once! Take the greed out of the housing-industrial complex! Why doesn't the government give food to it's citizens rather than let those greedy food companies make money off of it? People need food to live! It would greatly diminish their quality of life if they didn't get enough! Why can't we do that too?

Why don't we do those things too? Having private, for-profit food manufacturers or home and property sales is just as bad as having private, for-profit health care, isn't it? You simply cannot live without food and shelter, so these things shouldn't be for profit or private should they?

How far down this "socialized" rabbit hole do we need to go?

Does government need to take over these businesses too, out of its obligation to protect and take care of its citizens? There's a lot of risque stuff on television and the internet nowadays.... should the government also censor some of this in order to "protect and take care of its citizens"?

Tell me where the line between government responsibility ends and individual responsibility begins.

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