Do I still get kicked off my parent’s insurance even though I have Crohn’s Disease?

[scottusn06]

Hi,

I’m currently 24, and I’m still in college because I changed my degree like.. 5 times, so I won’t be able to graduate and hopefully quickly find a full time job with benefits until after I turn 26.

Right now I’m working a part-time job with no benefits, and I’m pretty sure I will keep working a part-time job until I graduate, especially since I am going to school full time to graduate faster.

I told my dad that I’m scared about getting kicked off his health insurance when I turn 26, and that I’ll lose my medication I HAVE to get every 6 weeks, or else I’ll get horribly sick. Then he said I won’t because I’ve been living half of my life with Crohn’s disease, so I need to have health insurance.

Is what he said true?

 

[ema20]

@scottusn06 No, the 26 year old cutoff isn't diagnosis related at all.

https://healthcareinsider.com/turning-26-health-insurance-guide-61126

 

[scottusn06]

@ema20 Thank you for helping I appreciate the link as well.

 

[fishmansf]

@scottusn06 Some employers do allow for dependents to be validated as disabled to stay on the plan after 26. Mine does. It’s worth him calling his benefits office to ask.

 

[oommenphilip]

@fishmansf This is the answer. Certain policies or employers allow adult disabled dependents. If they do, there is usually a form that your doctor fills out certifying what the issue is and why it would meet the criteria. It gets submitted to the employer or the insurance company and coverage can sometimes be extended. A lot of companies do not offer it though.

 

[fishmansf]

@oommenphilip You must be in the business too

 

[oommenphilip]

@fishmansf Not where I ever envisioned but a safe spot in this crazy fucking country.

 

[fishmansf]

@oommenphilip I switched from the employer side to the GA side and I like it so much better.

 

[neil1]

@fishmansf Crohn's disease is not considered that type of disability. Usually it has to be a disability that makes you still dependent on your parents.

 

[edprof]

@scottusn06 I had severe health problems while in college on Mom's health insurance. IF I was fully, 100% disabled before coverage ended, I was grandfathered under her policy as long as I was 100% disabled.
But it's not easy for a 20-something to be found fully disabled. It often has to be something like institutionalized w treatment resistant schizophrenia.
Look into Affordable Care Act programs.

 

[schultzkathryn]

@scottusn06 What state do you live in?

Look up your states Medicaid pdl.

Find the drug you're taking.

It will say if covered, or if a pa is required.

Pdl is preferred drug list. Changes every 4 months

PA is prior authorization.

Here is Colorado pdl.

https://hcpf.colorado.gov/medicaid-pharmacy-benefits

 

[jrichard68]

@schultzkathryn If you are going to have a gap in insurance you can also speak your current doctor about having a valid prescription extended for you. You will probably have to shop around as you will be paying out of pocket, but at least you will have your needed medication until you get on a new insurance plan.

 

[solaymend]

@jrichard68 The medication for an inflammatory bowel disease usually cost $3-6,000 every 4-8 weeks. OP is worried about not being able to afford the medication without insurance if they are dropped from parents plan.

 

[jrichard68]

@solaymend Understood. But OP should still speak with her doctor now about what is happening. There are some options from the drug manufacturers. Some of these drugs used to treat these diseases have programs to help pay for their meds and close the gap if this is a temporary loss of insurance.

 

[dreamsandcats]

@jrichard68 The medication is usually given every 6 weeks by IV infusion. It’s a type of chemotherapy. My son is on it and it’s about $8000 for the infusion (and given in the hospital or a chemotherapy center, so additional expenses there). But, there are other treatments that are weekly home injections that he might be able to get (although he might be on infusions because that is all that works, as in my son’s case) Crohn’s can absolutely be debilitating, some of the other comments on here do not seem to understand that.

 

[jrichard68]

@dreamsandcats Still think it is worth speaking with the doctor and seeing what options are out there. Crohn's is a nasty condition. My heart goes out to anyone that has it.

 

[erin30ga]

@scottusn06 You won't be able to stay on his insurance but you will be able to get health insurance.

Hopefully you live in a state that has expanded Medicaid - you should probably research that now so you can start planning.

Some colleges offer health insurance which is generally a very good price since the pool using it are generally don't need much medical care which is how premiums are determined - i.e. based on pool of pool with that insurance/health plan

 

[hemahe]

@erin30ga But also look into the plan closely. I work in a medical facility near a college and college kids are always trying to come use their insurance with us but it’s an HMO that basically requires they use it on campus only for coverage

 

[smiddy420]

@scottusn06 If you are still in college after 26, buy the college insurance (it is only for full-time students) as it will be cheaper than the marketplace.

Also, write or call the manufacturer of your meds and ask them if their a low income rate. Explain the situation. You might be surprised as you might get it for cost.

Also, their are jobs that give insurance for less than full time. An example is school districts. I work 4 hours a day in school food service. It is not hard work, and I get insurance and a retirement plan.

 

[kamille]

@smiddy420 Marketplace is income based pricing. If the OP is working a retail job while taking classes odds are they will be paying like $30 or so a month for marketplace coverage. University insurnace is usually pretty limited and is often more for people who live in one state but go to school in another where their parents insurance plan isn't accepted. Most insurance plans avaliable to small and medium sized companies and almost all insurance plans available to individuals have localized networks