Insurance Agent Forum

I live in California and I am 23 year old male. I do not currently have health insurance, just CMSP. I do not drink or smoke, and I do not think I have a preexisting medical condition. I was recently diagnosed with HSV-1 and it went dormant and its back again 2-3 months later. The doctor at the clinic said I may have to take Valtrex once daily for the rest of my life. I'm looking for health insurance that will cover or mostly cover the cost of the Valtrex because it is quite expensive. I am a student, so I need the least expensive plan that will cover my needs. Please help, and thank you.

[JustinUpright]

Originally Posted by Nickfu06

I live in California and I am 23 year old male. I do not currently have health insurance, just CMSP. I do not drink or smoke, and I do not think I have a preexisting medical condition. I was recently diagnosed with HSV-1 and it went dormant and its back again 2-3 months later. The doctor at the clinic said I may have to take Valtrex once daily for the rest of my life. I'm looking for health insurance that will cover or mostly cover the cost of the Valtrex because it is quite expensive. I am a student, so I need the least expensive plan that will cover my needs. Please help, and thank you.

Well sorry to tell you that you do have a pre existing condition: [COLOR=Red]I was recently diagnosed with HSV-1[/COLOR][COLOR=Black]. Unfortunatly you will not be covered for that for at least 12 months and possible could be an exclusionary rider for the HSV-1 and may never be covered. Best case scenario is you will have to pay for it for the first 12 months.[/COLOR]

I was diagnosed with HSV-1 while I was covered by CMSP does that help my situation? Can I lie and say that I do not have a preexisting condition? Then start collecting after 12 months?

[YouGotMyMoney]

Remember California like Michigan is a non rider state.

They can not exclude conditions.

[VolAgent]

Originally Posted by Nickfu06

I was diagnosed with HSV-1 while I was covered by CMSP does that help my situation? Can I lie and say that I do not have a preexisting condition? Then start collecting after 12 months?

I can't speak for California, but you are aware that in many states intentionally lying on an insurance application is fraud?

But I'm just curious, since Valtrex easily costs several hundred dollars a month, how much should you give the insurance company in return to cover that cost, plus any other health issues that may arrise?

Sorry I got a bit freaked out that I wouldn't be able to attain coverage for my condition. I wouldn't intentionally lie on my insurance app.

I understand that valtrex costs several hundered dollars per month. I make around 12,000 per year. I can not afford to purchase valtrex on my own. Should I suffer with my flareups? HSV-1 is highly contagious during a flareup, so should others suffer the possibility of contracting the virus because I cant afford to purchase the proper medication?

[souldeux]

Originally Posted by Nickfu06

Sorry I got a bit freaked out that I wouldn't be able to attain coverage for my condition. I wouldn't intentionally lie on my insurance app.

I understand that valtrex costs several hundered dollars per month. I make around 12,000 per year. I can not afford to purchase valtrex on my own. Should I suffer with my flareups? HSV-1 is highly contagious during a flareup, so should others suffer the possibility of contracting the virus because I cant afford to purchase the proper medication?

Try the following resources:

MyRxAdvocate

Benicard

PPaRx

Rx Hope

I have a couple of clients using one or more of those programs, but none of them are using it with Valtrex so I'm at a loss to how well that'd work. Sorry if it's not kosher to post a referral link for Benicard, but the only link I have bookmarked to that place is from Somarco.

I have no clue how CMSP works, but here's an eligibility manual to see if you can get back on it.

[JustinUpright]

If you had coverage and haven't been with out coverage for very long then you may be able to get a hippa plan I don't know about Cali but I would think since you make so little the state may have a plan for you like here it is called tencare

[VolAgent]

I do feel for you, I cannot imagine having to live with such a condition. And I applaud you for not wishing to spread the disease to others.

Numerous options available, it all depends on what you are willing to do.

1. See if there is a free clinic or clinic for the needy that can help you out. Perhaps even your college has such a clinic.

2. Contact the drug manufacturer, see if they have a program for people like yourself. Many have started programs to help people without coverage.

3. Get a job at a company that offers group health coverage without a pre-existing condition exclusion.

4. Be responsible. Avoid situations that could allow you to spread the disease during flare-ups.

5. Find out if there is a drug study for HSV-1 in your area, and if so volunteer for it.

Originally Posted by Nickfu06

Sorry I got a bit freaked out that I wouldn't be able to attain coverage for my condition. I wouldn't intentionally lie on my insurance app.

I understand that valtrex costs several hundered dollars per month. I make around 12,000 per year. I can not afford to purchase valtrex on my own. Should I suffer with my flareups? HSV-1 is highly contagious during a flareup, so should others suffer the possibility of contracting the virus because I cant afford to purchase the proper medication?

Thank you for the links about patient assistance that looks too good to be true, and thank you for listing out some options for me.

[somarco]

Patient Charity

Dave Fluker is our resident CA expert on GI plans. He might have some ideas.