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    • #13836
      Kathleen Sheffer

      Getting proper insurance coverage seems to be a constant challenge for patients with pulmonary hypertension, at least in the United States. Growing up, my mom handled most of the “battles” with insurance companies. I have enjoyed good coverage through my dad’s insurance, with secondary insurance though social security. Now that I am turning 26 in April (and self-employed), I will have to buy my own plan (or get a “real job”). I’m quite intimidated and procrastinating on researching plans.

      So, I thought I’d start the conversation here. Have you had positive or negative experiences gaining access to health insurance? Does your current plan suit your needs? What, if anything, is it lacking?

      Over the years, I have learned some tips from physicians about language to use to get the medications I need when the insurance company doesn’t want to cover it. Specifically, my mom has memorized the phrases, “medically indicated,” and “potentially life-threatening,” which usually gets things moving.

      What questions do you have about handling insurance companies? What strategies have you learned to expedite the process of gaining coverage?

      Do you have dual insurance? I do right now, which has taken care of my copays, saving me lots of money (thank goodness)! If I were to get a job paying more than a certain amount per year, though, I would lose my coverage through social security. I’d be okay with that, as long as the company offers a good healthcare plan. Have you struggled with this trade-off? Right now, I am in good health, but I worry that I could decline again and not be able to work like I am now. Have you ever gone off and back on social security? How difficult was that?

      Please post your questions in the comments and I will do my best to research answers to them!

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