Insurance loss

Hello everyone,

I'm going on disability and will not be able to get Medicare Insurance for 24 months. I cannot afford $550.00 a month for my current Cobra Insurance payment so I must cancel it. My wife and I make too much income for any NY State Ins. Plans. (over the limit by $400.00) So, I'm at a loss as to what to do for insurance coverage. It would cost $800.00 a month to add me to my wife's plan, which is not and option. I am devasted about this and feel I will have to stop my Pump use and other meds. I see know other way. Anybody please help with any info you have on getting insurance coverage. Yhank you all.


Matt -
You have several options.

  1. Contact all the manufacturers of what you use - i.e. Pump manufacturer for supplies, insulin manufacturer etc. Explain the situation - they may be able to help you out to some extent.
  2. You say that your wife and you make too much by $400/month to qualify for the New York State plans. It might be worthwhile taking a pay cut if that will help you. You would at least have insurance. Worse case scenario you can always enroll in the Republican Universal Health Care Plan - also known as making the Emergency Room your home away from home but that really should only be the very last resort. ERs are overworked and understaffed these days and you also expose yourself to many many more potential infections from the germs.
  3. Call your Doctor and Endocrinologist right away. Explain the situation to them. They may have contacts that can help you with supplies. You may have to come off your pump and go back to insulin and needles for a while however.
  4. Check with every pharmacy in your area to find out the medication prices. Examples: Price Chopper (which I believe you have up your way as well) gives away (with a scrip) lancets, meformin and other diabetes medications. WalMart has a very inexpensive generic medication program as well. Wegman’s may also have one if they have pharmacies in their stores. With some of these discount programs you can get up to a 90 day supply of meds for $10 to $12 dollars. You may have to change to the store brand meter (which at Price Chopper I think is also free) and their strips/lancets but hey - if it’s free that will help you. And I know the insulin at Wal-Mart was 66 percent cheaper than the brand names and their is made be Novo-Nordisk so it is the same stuff but with the Wal-Mart name on it.
  5. Now more than ever it is imperative that you take extra good care of yourself. That means checking your feet daily and keeping your blood glucose levels under control. No cheating at all.
  6. When insurance options pop up be sure to read very carefully the terms so you know what you are getting in to. Example - many of the companies that offer insurance policies from Texas actually are selling you a ONE year term policy or coverage. When the year is up - they will automatically renew you BUT since you were covered for Diabetes previously it is now considered a 'pre-existing condition" that your new policy does not cover. In effect they did NOT renew you because your policy expired - they issued you a brand new policy. And that is still perfectly legal.
  7. Does your hospital or area have any sort of Diabetes Support Group? Are you a member? Remember that often times diabetics end up with extra strips at the end of the month. They either throw them out or donate them to a charity. You could find out and maybe some people have extra boxes of strips they can give you.Remember you might be told to test 4 times a day but only test 3 times a day. You’ll use up the box but eventually have a full box you won’t use. It’s worth checking this out.
  8. Check with your local hospital. They may have a program for uninsured and under-insured people. For several years I did not have any health insurance and I was able to utlize a program like that. Remember that most Doctors and Specialists affiliated with the hospital will not necessarily be part of that program but most will work out either a payment plan or give you a much lower negotiated rate for service. And that’s the last part - you have to be vocal about the situation. Talk to your doctors and other service providers. Finally see what you can cut back on. I can understand that high speed internet is a necessity these days and for finding out information about Diabetes it is essential but if you have cable tv then maybe you can cut back on your services to what is called the low end basic. (I used to be head of the Cable Committee in my town) That would run you less than $15/month. Yes - it may be a tight two years as you look at other ways to save money so that you can cover what is not covered but it really does beat the alternative of complications.
    OK - I’ll get off the soapbox now. I wish you the best of luck and hope it all works out.

well, peter covered a lot more than i could.

there IS…check them out too.

i don’t know what aarp helps with, but my guess is they could not hurt. give them a call.

talk to a lawyer. it makes no sense that you need to be on disability yet won’t be covered by public insurance somehow.

Are you eligible for the subsidized COBRA that is part of the stimulus package? If you are, that can cut the cost of your insurance down to something reasonable. One of my co-workers who was let go was paying just over $200 a month for her continuation of coverage. This is the exact circumstance I live in great fear of. We just had another round of lay-offs. There have been 3 since the downturn. I’m pretty sure that the bleeding hasn’t stopped. Couldn’t have universal health care because that might actually help the middle class. What’s happening to you is just wrong in a society that claims to be as civilized as we’d like to think.

SF Pete - you are right - I totally forgot about that. There is (or was) a federal subsidy for COBRA that covers (I think) 9 months at 65% of your premium. Additionally some States also have a subsidy program that can either cover the balance or, if you wait until your federal subsidy runs out will cover a larger percentage of your premium until your COBRA expires which is what a friend of my mother’s just did. She exhausted the federal subsidy and is now on the state subsidy program. Both of them bring her insurance premium down substantially. Once COBRA expires the insurer is required to give you a certificate of portability so that you can prove you had insurance in the 60 days preceding. This is VERY important until 2014. The catch in the Health Care Reform Bill is - if you never had insurance and were considered uninsurable you now can not be denied coverage for a pre-existing condition. However if you had insurance and let it lapse for more than 60 days you CAN be denied for a pre-existing condition. This goes away in 2014 if the existing bill is not modified too much by Congress. When you went onto the COBRA plan you were supposed to be notified by your insurance company. If you phone them and they say they did not receive the form back in time then you can phone the US Department of Labor - let them know what transpired and they will let you apply online for an appeal. If the appeal is approved (and most are) you will then be covered for the entire period of eligibility for the subsidy. If that is less time than what is available on your COBRA claim your insurance company will be instructed to issue you a check for the difference and your actual monthly premium will go down substantially.for the balance of the claim or eligibility period. I know - it’s complicated but well worth it. If you qualify and get a check be sure to just bank it. You WILL need the money at a later date or use it to pay your premiums…

Thank you. For years I’ve had to deal with my parents; Medicare and Medex plans plus the Medicare Part D prescription plan for my mother that went into effect a few years ago. This is in addition to living with my diabetes and living with a) no insurance at all b) insurance where I was self-employed (go through a Chamber of Commerce - they have great group rates and you cannot be turned down) c) where I worked for a company and had insurance as part of my employment d) where I paid part of my insurance and the company paid the rest e) where I lived overseas and had universal health care/public option and d)being unemployed and on COBRA, etc. Add to that the fact I am fortunate enough to live in Massachusetts where we do have a health care mandate/requirement and I almost feel as if I could set up a business as a patient advocate for insurances, etc… I am more than happy to share whatever I can.

Thank you so much Peter. It was just amazing to me that you took the time to write so many options and your thoughts. I feel truly blessed that so many people like you care to help.


I am on Cobra Insurance since being laid off from work in July. It costs me $550.00 a month. I just can’t afford to continue it.
Thank you for your reply.


Matt - unfortunately I think that you have to have been laid off by June 2010 in order to get the subsidy. (It was part of the compromise to get enough Blue Dog democrats and republicans to extend the funding for unemployment.) However that doesn’t mean that the Democrats won’t try to get it through again with the next funding for unemployment. If so it would probably be retroactive so you should stay on top of it by monitoring the NYS Dept of Labor/Unemployment and US Dept of Labor websites. Unfortunately it will be up to you to find this out as the press doesn’t give it tons of coverage (most people did not know about the subsidies) and the Unemployment Dept employees are so overworked that they often forget to tell clients everything that is available to them in terms of benefits, etc. But you should go down to the unemployment office (in person) and see if they know anything about a NY State funded subsidy for health insurance for the unemployed on COBRA and if they don’t then contact the NY State Insurance Dept…Finally - are you currently or were you formerly a member of any fraternal organizatons - a fraternity in college or Rotary/Masons, etc? If so you should see if they have any programs to help a member in your situation. You never know…and when the time comes you can always “pay it forward.” Keep a positive attitude and keep looking - as a diabetic you have to add up the cost of your meds and supplies on a monthly basis and compare that to a premium. Another thing to look at is since it will be two years before you can get on Medicare you might consider setting up your own business of sorts. Make it a real business - maybe some sort of service and then join your local or the state chamber of commerce. First see if they have a group health plan and who is the broker. Then call the broker to see if there is only one plan or if there are others. They can (and usually will) send you the information on any plans they offer through that specific chamber of commerce. (Most chambers are just happy to have member so you could in theory join a chamber in OshKosh WI) Find out what the premiums are. You may find out that you can afford something through them. Of course you’ll have to pay the chamber membership fee but that’s only once a year. Group policies apply to a “class of people” so I am really surprised that an organization such as American Diabetes Association or any of other non-profits have not set up a membership fee-based program where health insurance would be one of the benefits. Personally I spent the last couple of years on a CDHP (Consumer Directed Health Program through Blue Cross Blue Shield) - low premiums; 20 percent copays for doctors and meds and a hgih ($1400 yearly deductible with a maximum out of pocket yearly expense of $5000. With my meds running close to $550 a month this turned out to be the best way to go. Have you given any consideration to talking with your wife about that $400 pay cut so you qualify for the state program? That still sounds like the money you save on insurance will more than make up for what you lose in salary. Think about it.

Wow, Peter. You are an amazing source of info. Thanks so much for sharing!

Hello Matt,

I’m so sorry to hear about this situation. No one should have to face this.

Can you try to order as much supplies as possible before canceling your insurance?

Also, as others mentioned, it may be a good idea to offer a slight pay cut to your wife’s employer and see if you can qualify for the NY State Ins plan.

There are some old discussions that might have useful tips: click here and here

For non-prescription items (test strips etc), there is a Supply Exchange program HERE

Also, TuDiabetes has a list of patient assistance programs HERE

Kristin - great resources. I’ve bookmarked them for the future as Matt’s problem does pop up on this and other place periodically.
Matt -
One more thing - you cannot afford to skip your A1c tests. There’s been a lot of buzz amongst diabetics about the A1c NOW! kits from Bayer which give you an A1c at home in 5 minutes. Problem is that the kit (which does contain 2 tests) runs $30 or about $15 a test if you don’t lose the 2nd test before you need it in 3 months. However there is another company that has an at-home test kit that is sold under a variety of names - both theirs and as a generic house brand. The Wal-Mart version of that is the cheapest I’ve found to date sold as the Reli-On A1c Test. It’s easy to use - you just be careful to follow the directions exactly. Put a drop on the form - mail it in and you can receive your results via email in about a week. At $10 it is 1/3 the cost of the Bayer version and it is equally accurate. I compared it against my hospital’s lab over a period of 1 year (actually 5 tests) and it was spot on! Just for what it’s worth.

Thanks Kristin. We did discuss pay cut with my wife’s employer. They said it was not possible because they would have to cut her hours and they need her full time. They would not just cut her pay rate.

Thanks for replying.

Sell the boat