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Insurance Assist

The high cost of insurance coverage is an area of great concern. Many insurance plans have high deductibles and high out of pocket maximums, which have to be met before  the cost of services are covered.  If you find that you are in this situation and are having difficulty paying the deductibles, there are a number of resources available that provide assistance.

There are a number of programs available to help people with Turner Syndrome to afford the medical care and drugs they need. Many people don’t realize that they qualify for these assistance programs.

If you or a loved one has trouble paying for your health care, the Turner Syndrome Foundation recommends that you contact your local health care provider to identify a social worker who can assist you in your community.

  1. Contact American Hope Resources.
  2. Contact your State Department of Insurance and ask about consumer assistance programs and patient advocacy groups. There are national organizations such as the Healthwell Foundation, which offer patient assistance.
  3. Ask your physician if he/she is familiar with any organizations or charities in your area which offer assistance.
  4. Bio pharmaceutical companies provide free or discounted medications. The drug company may have a prescription co-pay plan to reduce monthly out-of- pocket expenses. Growth Hormone Reimbursement Assistance Programs
  5. Many insurance companies offer a three month supply of medications at a reduced rate, if you order by mail.
  6. Ask your physician if any of the drug reps servicing the office can obtain medications for you at a reduced rate.
  7. Each state has its own medicaid program. Many states offer insurance through a medicaid HMO and eligibility is based upon income. Check with the medicaid office in your state to see if you qualify. Access insurance coverage through the Health Insurance Marketplace.
  8. If you are age 26 or younger you have the option of remaining on your parent’s health insurance.

Health Coverage Plans:
United Healthcare Community Plan – Member services: 1-800-941-4647 or www.uhccommunityplan.com
Amerigroup – Member services: 1-800-600-4441 or www.amerigroupcorp.com
Children’s Health Insurance Plan (CHIP) Member services: 1-877-Kids-Now (1-877-573-7669) or 1-800-701-0170 or www.insurekidsnow.gov

Dental Coverage Plans:
DentaQuest (Dental Vendor for Healthfirst) – Member services: 1-800-436-5298 or www.dentaquest.com
Healthplex (Dental Vendor for Amerigroup) – Member services: 1-888-468-2183 or www.healthplex.com

Patient Assistance:
Patient Assistance Network – Patients or their advocates can call: 1-866-316-7623 or www.panfoundation.org
Catastrophic Illness Fund (NJ Residents) www.nj.gov/humanservices/cicrf/home/index.html

Centers for Medicare and Medicaid
Health Insurance Marketplace CMS.gov

State Health Insurance Counselors (SHIP) 1-877-839-2675 https://www.shiptacenter.org
Provides health care coverage to uninsured children in families with incomes that are too high to qualify for Medicaid.
Phone: 1-877-KIDS-NOW (1-877-543-766) Web site: www.insurekidsnow.gov

Medicare Rights Flyer – https://www.shiptacenter.org/media/1287/programsthathelpwithmedicarecosts.pdf​

Medicare
Provides health care coverage for people with long-term disabilities.
Phone: 1-800-MEDICARE  Web site: www.medicare.gov

Social Security Disability Insurance (SSDI)
Provides income to people who are no longer able to work because of a disability; benefits are based on a person’s work history (and low-income Americans age 65 and older) to help meet basic needs for food, shelter and clothing. Individuals who receive SSI are often eligible for Medicaid  People who receive SSDI are eligible for Medicare after 2 years.
Phone: 1-800-772-1213 Web site: www.ssa.gov/disability  www.ssa.gov/pubs/11000.html

Is my test, item or service covered? https://www.medicare.gov/coverage/your-medicare-coverage.html?q=mri

Hearing Aid Assistance:
http://sertoma.org/ways-to-help/hearing-aid-resources/

Your Rights: Gina Law – Washington, Wed., May 21 2008 — Then President George W. Bush signed into law the Genetic Information Nondiscrimination Act (GINA) that will protect Americans against discrimination based on their genetic information when it comes to health insurance and employment. The bill had passed the Senate unanimously and the House by a vote of 414 to 1. The long-awaited measure, which has been debated in Congress for 13 years, will pave the way for people to take full advantage of the promise of personalized medicine without fear of discrimination.
The US Dept of Health and Human Services “GINA” The Genetic Information Nondiscrimination Act of 2008″ pdf for Researchers and Healthcare Professionals


The “A Lifetime of Advocacy” booklet referenced above can be a helpful guide as you begin this process.

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©2017 Turner Syndrome Foundation

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