Multiple Sclerosis: Coverage Waiting Periods
- Tuesday, August 11, 2009, 10:17
- Multiple Sclerosis
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- Dick:
- On the phone with us from Oklahoma is Terry.
- Terry:
- I am currently on FMLA, and I’ve been approved for Social Security disability, and I’m getting ready to make that transition. But in order to keep my health insurance, I have to take on COBRA premiums, which are just outrageous, and I’m not going to be able to do that. I’ve been told by Social Security that I have to be on disability for two years before I qualify for Medicare. What are we to do in that two-year period when we’re going to lose our insurance, to remain on treatment – I’ve been on Avonex now almost six months?
- Dr. Frohman:
- I have innumerable examples in my practice of people who have become chronically, permanently disabled because of their multiple sclerosis where my case manager has been able to accelerate this process and get them their Medicare and in some cases Medicare and Medicaid coverage very rapidly. That being said, I would strongly urge this gentleman to do whatever it takes to maintain COBRA coverage. It is very expensive, but you really can’t go beyond 60 to 90 days without COBRA. Obviously, people who are losing and changing jobs may lose other insurance.
The other question is whether this gentleman would be a candidate for something like a health high-risk pool. I would probably get the help of a case manager.
- Terry:
- I’ve been told that because I’m disabled I can get an extension all the way up to 24 months. So, if I could afford the COBRA I could keep it for the two years. But the problem is, I can’t afford the insurance. I love the insurance. It’s been great. I’ve never had an issue with the Avonex. They paid 100 percent.. Never had a question about it. But this two-year period before I can even determine how to deal with the 20 percent issue, that’s the problem.
- Dr. Frohman:
- Contact ActiveSource through Avonex. Have your physician fill out the ASAP form. Many physicians should have these. Contact ActiveSource and talk to their Medicare account staff, because even though you aren’t on Medicare yet, if you’re actually transitioning and losing this insurance, then all of a sudden you become a brand new candidate in terms of potential assistance. Now, that may not cover everything, but you need to explore this, and I’d explore it immediately.
- Dick:
- That’s an excellent idea, and if you didn’t jot down that 800 number before for MSActiveSource, I’ll give it to you one more time. 1-800-456-2255. That may be the source for the help you need.
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