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  • ranlon555
    My son is waiting foir a call to get an MRI. He doesn't have a diagnosis yet. I noticed someone said something about having a $5000 co-pay and they couldn't afford meds because of it. We were going to try to get some insurance for him in November during open-enrollment, not that we can probably afford it but he has no insurance right now because he's not working. So, is it super expensive? I was under the impression that you could get insurance premiums based on your income. Of course he has no income. But if he gets insurance, is it going to cost a fortune for the meds or does insurance cover a substantial part of the meds?  Do some not get insurance and just try to get assistance? Maybe these are dumb questions but lately I'm kind of overwhelmed about everything and I feel like I am climbing a mountain and mentally I'm not doing so great at all this. Thanks.
  • Wendell_
    Hi ranlon555,

    We have been lucky on the insurance front. It can definetly get expensive. The MRI's, hospital stays, and treatment can definitelyadd up. I went to an event thrown by the MS Society and they said it amounts to about $8,000 a year. Have you looked into the Affordable Care Act? 

    https://www.cnn.com/2018/09/07/politics/obamacare-premiums-2019/index.html
     
  • MS_Navigators
    Hello ranlon555,

    I am glad you and your son are looking into insurance coverage during open enrollment. You can click here for some basic information about the Health Insurance Marketplace.

    Most states use the Marketplace run by the federal government, and some states run their own marketplaces. If your state’s marketplace is run by the federal government, open enrollment period will start on November 1st and will end on December 15th. Coverage for any plans purchased during this enrollment period will being January 1, 2019. Applications can be done by phone (call 1-800-318-2596), with a paper application or in person with an assister. Since the process of picking a plan and understanding what cost help you may be eligible for can be overwhelming, we recommend finding local help so that you can get more personalized support. You can find local help at this link. They should also screen your son for Medicaideligiblity. 

    You may also want  to review the questions and resources in our Health Insurance Application Checklist which provides guidance for choosing a plan and includes resources for help with costs. Page 5 of that document provides the resources for help with both medication costs and MRI costs. 

    If you have any additional questions, please give us a call at 1.800.344.4867 (M-F 7am-5pm MST).

    Best,
    MS Navigator Stephanie 
  • punkym
    ranlon555 you can get a free MRI through a program with the MSAA. Your doc needs to write an order for it. The MRI is only for the brain and can be done once a year or two. Also try The Assistance Fund to help with insurance premiums and meds. Check with drug manufacturers for any cost assistance programs that may be available. I though that I had coverage when I got my Dx in 2009 but then was stuck with paying for all the blood tests. I couldn’t get coverage until 2012 when I applied for the now defunct PCIP. Wishing you much luck with getting coverage for your son.🤞Its about time that we have a universal single payer healthcare system in the US. It’s criminal that we don’t.
  • nats007

    My exprience is kinda simalir to your son's, but the diffrence was that I was a full time College Student with a part-time job. I walked into the ER with no insurance, no diagnosis, and was blind within less than two weeks. If your son is expriencing symtoms that are signs of ms, and the MRI shows lesions, he's doctor is going to order a spinal tap test to finalize his diagnosis. When he's in the hospital make sure to request to speak to a Social Worker. The Social Worker would be helpful to file a claim for Disability and other benifits. I learned it is better and faster to higher an attorney, because the Department of Children and Fmaily and Scoial Security Administration aren't the most organized and they are the most overworked department.

    Once your son is approved for Disability, all the bills that the hospital had sent to your billing address, send them to your local Scosial Security Deparment and they will handdle all your son's expenses. Another thing, if your son attends to none priviate hospitals and clincs, the prices of your son's medications can be reduced to about 80% than buying them in local phramacy stores. Mind you, this is not having any insurance. Also, if your son does end up with ms, and needs medication for MS, and still doesn't have insurance for any reason it could be, the majority of these medications are free or resonable prices. 

    I've learned to not stress about cost vs one's well being. Try to relax and not worry about so much about bills, prices, or how things going to be paid, because in the end it will always be ridiculously expensive no matter what and there's no way of controling this problem at the moment. I've stayed in a hospitl for 28 days with no insurance and the city paid for it because there's always a fund for criitical sick paients. So, don't worry about it. I hope his doctor finds what's wrong with your son soon and hopefully something can be done to make him well again.