July Update

Holding Out For Hopkins

I spent the month of July on the phone to sum it up. Trying to figure out any which way to solve the insurance debacle and trying to contact Hopkins to arrange admission and find out if there was any option for financial assistance.  

I applied for an extension on my Mom's health insurance plan (which I aged out of on June 30th) back in the Spring. At first I was denied, we appealed and I was denied again. Even though I was determined to have a medical disability, they determined I was not handicapped and that's the only reason they would allow an extension of coverage.

The admissions coordinator at Hopkins informed me that there is NO way to get medical assistance if you are an out of state resident. Medical assistance was only available to in-state residents. I started seeking any other options as to how I could out of state health insurance coverage.

To sum up the roller coaster of up's and down's here is a quick recap: 

At my appointment on June 24th at John Hopkins (after 6 months of waiting), the team of doctors I met with told me that not having insurance wouldn't prevent me from getting the treatment I need, it would just mean admitting me in a round-a-bout way through the ER to get into their inpatient program. They instructed me to contact the admission's coordinator to arrange admission in this way. Sounded promising.... 

Upon calling the admission coordinator the next day, and learning she was out of the office for a week! I was up against a deadline of trying to figure out if I needed to cancel the Horizon insurance so it wouldn't prevent me from being able to get admitted through the ER in another state as a self-pay. Being persistent I kept calling other people at Hopkins. I finally got through to someone on June 29th and found out there was a 3-4 week wait list to get into the program. So keeping the insurance for a month didn't seem to be detrimental. Felt like a bit of the weight lifted from my shoulders...but there was still a lot to work out. 

First week of July I finally spoke to the admission's coordinator who informed me that the only way to be admitted as a self-pay patient with no insurance was to pay the full amount up front which would be over $40,000. I asked about financial assistance and was told it is only available to Maryland residents, not out of state residents. Even being admitted through the ER as a self-pay, I would have to have the payment to get into the program. Now Hopkins was out of the question....

I realized I needed out-of-state insurance in order to get into this program. I took the admission's coordinator word over what the doctor's said at my appointment because she is the who deals with the insurance, not the doctors. The doctors treat patients, not spend their day setting up insurance coverage. I called the doctor's admin assistant and explained there was NO WAY for me to have $40k up front and this was not what we were told by the doctors at my appointment. Now, I was told that it isn't an all or nothing up front. If I don't have the $40k (which, um who would....and IF I did I wouldn't be without insurance!!!) I would need to work with admission's coordinator to negotiate what I could pay up front and then arrange a payment plan. Seemed a little more promising than $40k up front...

In the meantime, while I left more countless messages trying to reach the admission's coordinator, I looked into paying for an individual health insurance plan that had out of state coverage, and wanted to slam my head into the wall a few times. It felt like this was going to kill me before I could get there to get the treatment I needed! After countless hours, I found out individual insurance plans with out of state benefits pretty much don't exist. Individual health insurance plans cover basic basic coverage in the state you live in (with huge deductibles that cover nothing until you hit the deductible!) In the course of researching individual health plans looking for out of state coverage I came across a NJ law for Dependent Under 31 coverage. You are able to extend coverage through a parent's health insurance if they meet certain requirements. It seemed like I met all of these...Things started looking up this seemed like a good option.

A few days later after, can you guess...more phone calls and headaches, we found out my Mom's employer is self-insured excluding us from the Dependent Under 31 law. Not so promising....

I found out I was eligible for Cobra. I wasn't aware that a dependent could get Cobra, I knew my Mom could get Cobra because she was the employee. It was outrageous! But I realized this was the best option because it would give me the out-of-state coverage I needed to get admitted into the program -- without trying to go in as a self-pay and have to worry about getting admitted through the ER and hoping I didn't get sent home to Jersey! 

I sent in the application and payment for Cobra mid-July and it took 7-10 business days to process blah blah. Hopkins couldn't verify the insurance coverage until it was in effect -- even though it was the exact same coverage I had before. I pulled up an outline of my plan and spouted off what my coverage was and how much of my deductible was met and they still needed to hear it from the insurance not from me. (sigh)

Cobra finally went into effect the first week of August. So now all that was left was the Hopkins admission's coordinator had to verify the insurance, and have it reviewed by the admin staff and approved. Then, once a spot opened up I would be admitted. I was getting closer.... Now can you see why I said it felt like a rollercoaster??