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#51 |
Senior Member
Posts: 158
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![]() Let me break my answers into sections, it makes it easier.
1. My first concern is the status of your employment. As being a contract employee, unfortunately, your employer cannot offer insurance benefits. This is considered a type of independent contractorship. Under this provision, an entity pays a person or business a fee for a person to perform certain duties. A business does this so they can stay out of the catch-all umbrella of fees for worker's compensation, insurance benefits, employee benefits (vacation, paid time off, etc.), 401k, unemployment, etc. If you believe the company is satisfied with your work, then you may try to negotiate a contract for work which will entitle you to benefits. Has this business made any mention of insurance benefits? The reason I ask is because of the information I provided. You would have to take certain measures to protect yourself if they tried to make this arrangement while you are still, essentially, an independent contractor. 2. Waiting periods are usually dictated by the insurance company. There is an open enrollment period, in most cases, which is typically for one month in the fall or early winter (usually October). During this time, employees can switch plans, modify benefits, add/delete benefits, etc. If an open enrollment is not mandatory from the insurance, then the employer will let an employee be added at any time. 3. If open enrollment is not a factor, then there is a form that the employer will have you fill out, called an add/delete form, which they would then have to fax or mail to the insurance company. Once recived, the information is keyed into their system (usually within two weeks) and you would then be added to the plan. You would then receive a package with your cards and benefit guide. You need to ask the business if they have an insurance with a open enrollment period or an insurance which any employee can be added at any time. I hope this helps out. It was lengthy, but I find details help explain an answer better than just throwing terms out there. After you find out the information from the business, let me know and perhaps I can help you from there. Also, ask if they have a "large group plan". If they do, then the insurance company cannot disqualify anyone for preexisting conditions. Best of luck. -Christy |
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#52 |
Junior Member
Posts: 25
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![]() Hi csdmommy, thanks for the speedy reply! I was able to get the contracting agency to re-activate my insurance immediately right away today. It is limited benefits and covered less than 20% of the cost of my prescription, let alone reimbursement for doc visits. I guess I should be lucky they covered anything at all.
Today- I told my actual manager at the company I work for that I require outstanding health insurance- which they have. I cannot say that she was all too surprised. This company is actually very interested in making me a permanent employee. They will soon find out that if they wish to keep me as an employee- they will need to provide benefits asap so that I can meet my "basic needs". Its a rather interesting situation there at work, but I will say that I am rapidly learning that they need which gives me leverage. Are you familiar with the BC/BS or BC/BS Horizon PPO thingys coverage in this area? I am probably way off LOL... I know little about this, just repeating what I think they have. Thank you again, I appreciate it! |
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#53 |
Junior Member
Posts: 25
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![]() PS I hope I do not sound spoiled, I am VERY jaded about the healthcare system in this country...
I honestly know that I am truly fortunate and grateful to be alive and have any type of insurance in the first place- even if it dosen't cover everything. Thanks again! ![]() ![]() ![]() |
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#54 |
Senior Member
Posts: 158
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![]() Hey, icequeen! Which state are you in? That will help me out when I am working on the BCBS Horizon PPO information for you.
Good for you.........having leverage on them to get benefits. When I was in med school, I worked part-time jobs (before I met my husband) and could never get benefits through them (employers). I was still eligible under my father's insurance (I was under 24 and a full-time student), but did not want him to take on that expense. With my medical problems, though, I had to keep coverage under him. Good for you! -Christy |
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#55 |
Junior Member
Posts: 25
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![]() Hi csdmommy, I am in California, thanks for checking it out, you rock!
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#56 |
Senior Member
Posts: 158
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![]() I will get all of the detailed information I can for you. It might take me a few days.
-Christy |
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#57 |
Member
Posts: 50
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![]() Hi, thanks for this great post. I've learned so much here. I have United Healthcare through work, and The good Lord was able to help me get into a sub program just 2 days ago. After less than a week of praying for it. Although God is strengthening my faith because I asked him to, I am still so pessimistic, Everything in the past few weeks seemed to good to be true, from finding out about Suboxone, to actually getting on it, and having my insurance cover everything. and I keep expecting the bubble to burst anytime.
I checked and was so surprised that my insurance covered the medication under my plan. I only have to pay $30 a month for pills. Otherwise it was cheaper to stay addicted almost. I broke down and cried when I saw that. But I keep reading nightmare stories of insurances only covering it for a short period of time, or denying coverage. My own paranoid feelings that they'll be some clause I missed, and that they won't cover it for some reason... and that when I go to get my 1st full month's supply on Monday, they're gonna say it's $2000. As I said, my faith has a long way to go. Forgive me Lord. It's just after years of thinking it was hopeless, in the last week my whole life has been handed back to me, After reading about Sub, to calling around, making appointments at the wrong places, and actually getting a call saying to come in right away by a Christian doctor who is in Network. Sorry about the rant, but with all the stigma in the news with insurance companies right now. I've just gotta say that God, using United Healthcare and Suboxone saved my life. |
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#58 |
Senior Member
Posts: 128
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![]() I just got my first reimbursement check from Aetna for my $150 appointment. It was a whole $18!!! I will be calling them tomarrow and see what the deal is. Maybe they can suggest another sub Dr?? Oh well its better than nothing and my scripts are only costing me $30 so I guess I am fortunate in that aspect.
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#59 |
Senior Member
Posts: 158
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![]() OK, I'm back!! Any more ?'s for me? Fire away!! I missed you guys.......
-C. P.S. I am still sober!! |
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#60 | ||
Senior Member
Posts: 1,069
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![]() Quote:
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#61 |
Senior Member
Posts: 432
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![]() csdmommy,
Would it be possible to read all the posts in the thread "Insurance will pay Drs just won't accept it" and add your comments. Any advice that you can offer on how to bill in NY would be appreciated. Thanks. |
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#62 |
Member
Posts: 37
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![]() Hey csdmommy,
Are you still around and available to answer ins questions? Thx, KJ |
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#63 |
Junior Member
Posts: 2
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Just saw today that if you qualify the company that makes suboxone will cover your mess for 1 year.
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#64 | |
Junior Member
Posts: 1
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![]() Quote:
So I'm completely new to ALL of this. I told my parents just a few hours ago that I have an addiction problem to Herion. It took a lot for me to tell them, but after doing so they are very much on my side only because I WANT to get help! I live in New Hampshire an I have Medicare for insurance through the state. I've looked into a few drs that prescribe soboxone. I just need some help as to I've never been in this boat before.. I had a miscarriage about a year ago an got into using every day after that. From the moment I woke up till when I fell asleep. I want to beat this addiction an I know it's possible for me with the sobo an support of my family. Any information would be GREATLY appreciated!!! Thank you |
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#65 |
Senior Member
Posts: 714
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![]() Here's a question from an overly paranoid person.
I need to go to rehab. Applied for insurance on Marketplace. Chose a top, top widely accepted insurance company--zero deductible-and inpatient substance abuse is "fully covered" at "no charge". I already paid for the first month. I know the rehab I want to go to accepts this insurance company. I called. Are there any waiting periods? Or should I be able to go to rehab on Jan 1st when my coverage begins? I didn't read anything about a "waiting period", but, just wondering. Also, are pre-existing conditions-such as substance abuse-prohibited from being excluded under the ACA? I think they are, but just figured I'd ask, anyway. Thank you for providing help for us.
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MicheleJ Last edited by MicheleJ; 12-18-2014 at 01:00 AM.. |
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#66 |
Administrator
Posts: 25,466
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![]() Hi Nalaaaxo and Michele, csdmommy hasn't been around in a few years, so I think, unless someone else knows, you might have to call your insurance carriers to get those answers.
Nancy
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Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. NEVER take any online advice over that of a qualified healthcare provider. Any information contained on AddictionSurvivors.org should only serve to inspire further investigation with credible, verifiable references sources such as your physician or therapist. |
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#67 |
Senior Member
Posts: 714
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![]() Thanks, Nancy.
Frankly, I'm not going to call & even open up that whole can of worms with the insurance company. If someone here had advice- that's one thing. I don't need my insurance plan canceling me because of any questions I may ask!! I also know I didn't read anything about any of that- so I'm just going to put it out of my mind!!
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MicheleJ |
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#68 |
Senior Member
Posts: 140
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![]() Hi csdmommy. I totally agree with everything you said. Sometimes it is meased up that it has got to be that way. Do whats best and easiest for you and mostimportabtly so what is right. Good luck on everything. Thanks! Matt
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#69 |
Senior Member
Posts: 140
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![]() Hi MicheleJ. I would definately call my insurance company and ask them as im sure they would have all the answers you need. In my opinion it would be covwred but i am in no way any type of professional in that category. I will be prayong for you as you go on your journey. Thanks!! Matt!
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