WHAT INSURANCE COMPANIES COVER TPN/HOME IV ???

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WHAT INSURANCE COMPANIES COVER TPN/HOME IV ???

Postby ESAKKO » Aug 09, 2007 12:48 am

I HAD SEVERE HYPEREMESIS WITH MY FIRST AND ONLY PREGNANCY SO FAR. I COULDN'T EVEN SWALLOW MY OWN SALIVA. MY INSURANCE WAS TRING TO ENCOURAGE ME TO GET AN ABORTION BECAUSE OF THE HIGH COSTS FOR THEM. MY ISURANCE WAS THROUGH A PAST EMPLOYER WHICH I HAD QUIT AND RECEIVED COBRA. I HAD AETNA HMO AND NOW MY INSURANCE IS DUE TO EXPIRE. WHAT INSURANCE COMPANIES WILL COVER TPN CAUSE I AM CURRENTLY UNEMLOYED AND MY HUSBAND IS SELF EMPLOYED AND MAKES TO MUCH FOR ME TO GET APPROVED FOR INSURANCE THROUGH THE GOVERNMENT. I CAN'T FIND ANY INSURANCE THAT WILL COVER ME IN CASE MY FUTURE PREGNANCIES WILL BE JUST AS BAD. PLEASE HELP!!!
EILEEN
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Insurance

Postby ptfrog19 » Aug 09, 2007 8:45 am

In Maryland, I have Carefirst (Division of Blue Cross and Blue Shield). The actual plan I have is called BlueChoice. They covered 100% of EVERYTHING. Hospital stays, TPN, IV Therapy, Home Health Nurse visits...everything associated with all the problems I had was 100% covered, no deductibles, no copays, no money out of my pocket. It saved my life not having to worry about where I was going to get the money to pay any of that stuff especially since I couldnt work. The same policy even covered the Zofran, granted for that I did have a $20 payment towards each prescription, but compared to $500 for 12 pills, Id gladly pay the $20. I didnt have any problems with them whatsoever filling the prescriptions as much as I needed. I HIGHLY HIGHLY recommend them, although not sure if they are in your area or not.
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Postby JennyK » Aug 09, 2007 10:21 am

Insurance policies vary from state to state. Perhaps you could call your state insurance commissioner and see if they can give you help finding companies to apply to. It's usually big bucks to buy a policy that is not through an employer group. You also may be denied based on your history. Good luck.
Jenny
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Will, August '06
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Postby Trubiedoos » Aug 09, 2007 1:14 pm

In CA it's covered 100% by Pacificare HMO and Pacificare POS.
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Postby aaronsmommy » Aug 12, 2007 9:21 pm

I can't imagine that you would be able to purchase an individual policy that covers pregnancy. They reject people for all kinds of stupid reasons, and a history of hg would actually be a pretty reasonable one for them to reject you for.

Is there any way your husband could get a employer sponsored plan - with himself as the employer? He may have to have a group to get an employer plan (which would mean covering an employee or two, does he have employees? Could you be an employee and then get him qualified as a group?

I would guess that all companies cover home health, but it would depend on the actual policy. You will need to make sure that it is listed as a covered benefit, and pay attention to any limits of # of visits, time periods, or any exclusions. Also pay attention to any copays/coinsurance, as coinsurance for home health and hospital visits will add up fast, and also what the annual maximum out of pocket expenses for you are (and what gets included in this).

Any chance you live in CA? They have some great state sponsored insurance here for middle income people who don't qualify for Medicaid.
Aimee

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individual plans that cover tpn

Postby carrielynch8 » Oct 03, 2007 5:53 pm

I live in MD and I have an individual PPO plan through Carefirst BlueCross BlueShield and after meeting my deductible of $1000, the TPN/home care was completely covered. From the cost of all of the drugs and hospital visits I went way of the $1000 deductible within a few weeks. During one of my many stays, the social worker at the hospital was actually the one who told me about TPN and called my insurance company to help me get set up. I would maybe ask the social worker from the hospital you plan on delivering at. They deal with cancer patients that need TPN and might know off the top of their head which company would cover it. Good luck!
Carrie in Baltimore, MD
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Postby mrsbigdog » Oct 03, 2007 6:11 pm

First point...you might want to check into this. If your husband is self-employed is it possible to add you as an employee? You could lower his pay in order to show paying yourself at least minimum wage. Aetna, United and Blue Cross all offer small business health plans that cover companies with as few as two employees I believe. When I checked into them the price wasn't cheap but it was better than paying out of pocket. Maybe that could be an option for you to check.

In 2005 I went through three different group insurance policies while pregnant.

Blue Cross/Blue Shield of Maryland PPO plan. We had a $1,500 deductible and then we were responsible for 20% of the home health bills. They did cover everything on the home health bills after our portion and the 20%. This was through my employer.

When my job was terminated we added the family to the policy at my dh's employer, Aetna PPO. This plan had a $1,500 deductible and again the 20% but picked up on the day BCBS stopped. They covered all of the home health bills after our deductible and 20%. Once I was weaned off my PICC they covered my Zofran (28 pills at a time). I had to pay a $20 copay for the Zofran every two weeks but that was it.

Near the end of my pregnancy dh's employer's policy year rolled over. We were given the choice to stay with Aetna PPO or change to Aetna HMO. Staying with the PPO would have meant paying another $1,500 deductible for the some of the extra ultrasounds and hospital costs. I spent about four hours on the phone with the HMO people verifying that they would continue to pay for my Zofran ODT and was assured that they would since it was on the approved list. I called several times and spoke with several people. As a result we switched to the HMO so we would only have to pay the $500 co-pay for the hospital bill at delivery. The first time I went to get my Zofran refilled would only give me 14 pills and said that was the absolute total they would cover, the rest would be out of pocket. My dr and I both argued with them about it but they refused to budge unless we woud retry all of the possible meds they listed in a letter. We had already tried several with no luck and knew I didn't react well to others on the list. I was only a few weeks from delivery so we cut my dosage and induced early.

Dh's newest employer has Aetna PPO which covers home health at 100% with no co-pay or deductible.

Every policy that is written is different whether it is for an individual or company so there is no way of knowing if something will be covered by a certain company because even policies from the same company will have different coverage. The best is to read all of the fine print in any policy you are offered in order to determine if it has the coverage you need.

Good luck...Donna
3x HG survivor: Theresa - 11/88, Katie - 1/95, Emily - 1/06
(one HG baby in each of the last three decades! - yes, just call me crazy)

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