Well this is news to me. I did not know I could purchase Insurance with no drug coverage. I still am not sure what category I fall under. I am single, 55years old, but am raising a 12 year old autistic granddaughter who has Mass Health. My adjusted gross income for 2006 was 36,781.00. My company offers a cafeteria plan but is still about $350.00 after taxes. What do I qualify for? Which scale do I fall under? I was told months ago by the Connector that I had to buy my companies plan. I could not afford it. Then I talked to a co worker that was able to buy a plan on her own wiht drug coverage for $105.00 dollars a month. It just seems to me that this law is changing by the month. I would love to be able to afford insurance. I will not buy a plan with drug coverage. I don’t and won’t take drugs. Some might ask What if you aquire a disease that you will need to take drugs for. My answer is I won’t unless its Diabetes and even then I would do every thing in my power to control it without pharmaceuticals. I should not hav e to apy for other peoples medicaiton needs. The deaths in this country due to medication screw ups kill more people than all the diseases they are taking medicaitons for. We saw how congress voted to lower the cost of drugs by importing from Canada. They voted against it. After looking at the criminal behavior of the FDA, and the Pharmaceutcials, the over prescribing of doctors, I would not believe any drug does what it was licensed to do. Oh lets not forget the off label prescribing. When Pharmaceuticals were allowed to advertise drugs the cost jumped 30%. This is reflected in the cost of Insurance. If the Commonwealth even tries to force people to buy insurance for drug coverage then it’s time for a revolt. This will be the final straw. Does anyone know if anyone has challenged this law in court yet?

Peggy,

I have contacted over 20 lawyers at least but they are all afraid of Beacon Hill. The only way is to somehow get a lawyer from out of Massachusetts.We need to get a class action suit and sue the State for breaking it’s own laws. There is a law that Massachusetts has that no company can sell a product that can’t be used for it’s intended purpose. Like insurance policies that the State itself is selling! And taxation without representation by getting the DOR after our money. We need a citizens revolt! This is so convoluted, this is their agenda; have so many laws and penalties they won’t know which way is up. The media will not report any of this because they are bought by the insurance companies too. The Insurance companies are running our State and ruining it at the same time.

Norma,
This is not just happening at the State level. This is all over the country. Medicine is becoming a religion. All you see on TV now are drug ads, or some new virus, or bateria lurking just around the corner to kill us all. In the same breath they will admit that these superbugs are being caused by the overuse of antibiotics. They have even linked superbug strains of ear infections to the prevnar vaccine. The anser of course is not to stop using the vaccine, just make stonger antibiotics, and more vaccines. They are creating the diseases, and then trying to force us to buy insurance so we can keep going to the doctors to get more drugs. Its all profit driven. Everyones making money, and we are dying, and going bankrupt. Welcome to the New World Order Norma. esasesresistant strains ienven linked I just read an article about MRSA. j.

MR. Bullen,
I agree with you. I am more apt to think that the Pharmaceuticals lobby is somehow involved in this. If you have an insurance plan with no drug coverage you would be more inclined not take the drug rather than buy it out of pocket. This is an interesting thought. If someone was Dx with high cholestrol, and did not have drug coverage they might forgo buying the drug and do nothing to treat the cholestrol, or they may decide to try diet and exercise to bring it down. This would be tragic for the pharmaceuticals profits. Of course the argument would be used that without the med the high cholestrol could lead to a stroke. This is exactly why this law is a slippery slope. This is why I don’t trust State for Federal Government to manage health care. We have already heard of towns banning the use of transfats in resturants. How dare Cities tell people what they can cook with, or eat. Of course they do nothing about the quality of the air we breath, or the chemicals in our food, and the floride in our water. Next they will pass a law saying that if you don’t take all the medications recommended you could lose your job, or Health Insurance because why should Insurance companys have to cover you if you don’t follow the medical standards of care. They have lowered the numbers for high blood pressure, and also cholestrol in order to sell more drugs. They never tell the consumer how toxic the statin drugs are to the liver, or the results of a 30 year study done by the NIH that found the best way to control HBO was with very cheep diaretics. The NIH have the best studies because they are funded by the tax payer, and not Big Pharma. It was the NIH that found that the HRT drugs were causing breast cancer and heart disease. The exact opposite of what the Pharmaceutcal industry was telling us. We should be able to purchase Insurance for surgery, and emergency care. The corruption in the Medical industry needs to be dealt with before they mandate citizens to buy Insurance. While I have your ear what about the fact that MD’s are billing the insuracne companies to see patients every ten minutes. What kind of health care is that. What are the insurance companies doing about their consumers getting the health care they are paying for? You don’t have to answer because I already know the answer. The cost is just being passed on to the consumer.

Norma,
We need to get a class action suit and sue the State for breaking it’s own laws. There is a law that Massachusetts has that no company can sell a product that can’t be used for it’s intended purpose. Like insurance policies that the State itself is selling!
Norma what about the portion of our state tax that goes to subsidized the uninsusred, and now we have to pay higher premium policies like drug coverage for drugs we don’t take so other people can take them and pay nothing. Then there is losing your State deduction, and then paying another penalty on top of that. Don’t forget that they claim that the penalties are going to get even stiffer as time goes by. They just keep adding to this law without any of our legislators saying a dam thing. Norma can you email me off this board? rpggyr@aol.

To say the goal of health reform is simply to insure as many people as possible is selling the reform short. The ultimate goal of health reform is to insure more people so that they have access to health care. Health insurance that leaves people underinsured because of gaps in coverage and high out-of-pocket costs for care do not bring us closer to meeting the goals of reform.

Insurance without drug coverage is exactly that – underinsurance. Prescription drugs are not a luxury. They are central to basic health care – just like coverage for doctor’s visits and hospital care. Prescription drugs help prevent and combat disease. People without access to needed medications (either because they don’t have drug coverage or because they have unaffordable deductibles or other out-of-pocket costs for drugs) suffer worse health and higher long-term health costs. It’s ironic that no one would think to question coverage of doctors visits and hospital services. Yet, without drug coverage, people are at risk of not being able to comply with their doctor’s orders and of being unable to afford the medications that will help prevent higher cost hospitalizations.

Certainly the cost of health coverage and the cost of all health care services (not just drugs) is a concern. However, trimming coverage doesn’t make health care more affordable for consumers.

Lisa, the issue is whether or not to mandate drug coverage not whether to make it available. Choice is always good, especially when there are over 400 generic drugs avaliable for less than $10 at one giant retailer alone. Over 100,000 people have chosen no-drug policies in the marketplace today. Should we no longer give themm this choice and require them to pay more for coverage than they have so far been willing to pay?

A few reactions:

1. There are certain basic health care services that we don’t let people choose to exclude from their insurance. People cannot choose to exclude doctor or hospital services – why drugs? There are some that are cheaply available. Many conditions, however, can only be treated by prohibitely expensive brand name drugs. It would be wonderful if we could all forsee our future health care needs. Unfortunately, we can’t.

3. The MCC standards play a crucial role in health reform. MA is requiring people to buy insurance if creditable coverage is affordable them. People should not be required to purchase insurance that does not cover their basic health care needs because those (and only those) plans are affordable to them.

I guess I have a hard time seeing how a young, relatively healthy person will think that it makes sense to be forced to buy comprehensive drug coverage that includes all brand-name drugs when so many reasonable over-the counter and generic alternatives exist in the event that drugs are needed outside the hospital (where they in fact would be covered). Especially when the choice to purchase or not could so easily be offered.

Health care reform is a whole lot more than just medical insurance, going to see doctors, and taking prescription medications. Real reform would be allowing a person to choose what kind of care they want. More and more people are turning to aternative forms of healthcare. This article in the Journal of the American Medical Association (JAMA) is the best article I have ever seen written in the published literature documenting the tragedy of the traditional medical paradigm.
The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health and she desribes how the US health care system may contribute to poor health.

ALL THESE ARE DEATHS PER YEAR:
12,000 — unnecessary surgery
7,000 — medication errors in hospitals
20,000 — other errors in hospitals
80,000 — infections in hospitals
106,000 — non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!!
What does the word iatrogenic mean? This term is defined as induced in a patient by a physician’s activity, manner, or therapy. Used especially of a complication of treatment.
Dr. Starfield offers several warnings in interpreting these numbers:
First, most of the data are derived from studies in hospitalized patients.
Second, these estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
Third, the estimates of death due to error are lower than those in the IOM report.
If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).
Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings,with:
116 million extra physician visits
77 million extra prescriptions
17 million emergency department visits
8 million hospitalizations
3 million long-term admissions
199,000 additional deaths
$77 billion in extra costs
The high cost of the health care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care.
However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.
This is what our lawmakers are sending us into bankruptcy for.

[...] WBUR’s Commonhealth Blog has an interesting back-and-forth on the issue of requiring prescription drug coverage as part of “MCC” — the minimum creditable coverage standards that specify what complies with the individual mandate. See it here [...]

Lisa Kaplan Howe and HCFA couldn’t be more incorrect about drug coverage. There is a large percentage of the population that doesn’t believe in medications. There are people that solve medical issues through chiropractic care, naturopathy, or other herbal methods. So those people will be paying more into the system for a benefit that they will NEVER UTILIZE.

You take the average policy difference of $100 per month per family and that adds up to huge profits for BCBSMA, Tufts and Harvard Pilgrim. Those companies are the only ones who are benefiting from these plans. The Commonwealth Care people are still getting something for nothing. The health population that doesn’t utilize the medical system is gettting nothing for a huge payment each month.

Eliminate guarantee issue and allow rate ups for smoking and other life choice decisions and then you’ll see more users in the marketplace.

I agree wiht you an everything you say but I take issue with this statement. (Eliminate guarantee issue and allow rate ups for smoking and other life choice decisions and then you’ll see more users in the marketplace)
This is the last thing you want. Now begins a very slippery slope when our governemnt can tell us waht kind of lifestyle we can live. You mentioned in your post about people who don;t believe in in medications. What makes you think these self appointed Gods won’t try to mandate you have to take a drug for any given medical condition or else. A perfect example of this this forced vaccination mandates for our children. This is already happening. They are adding every new vaccine that Big Pharma licences to the childhood schedule. The Heb B vaccien was never tested tested on infants yet it was mandated on their first day of life. Or forced psychiatric drugging, base on no scince other than a subjective opinion. This is already happening. I’ll keep going Forced flu vaccines in order to be able to keep your job. This is already happening. State and Federal government does not belong in our beds, our refrigerators, or our medicine cabnets. Medicine has become a greedy machine goobling up more and more money and leaving death and destruction in its wake. The FDA is going after our vitmins, herbs and even our organic foods. They have basically stated that any food that can is claimed to cure or prevent any illness is considerd a drug. That means oranges, and lemons are drugs because they can prevent and cure scurvy. The FDA Threatens To Raid Cherry Orchards. As Americans struggle to eat a healthier diet, the FDA has taken draconian steps to suppress information about foods that reduce disease risk.
http://www.lef.org/magazine/mag2006/mar2006_awsi_01.htm

These people have gone mad with power and we have got to stop this insanity.

“especially with the availability of very low-cost generic drugs?”

The phrase “very low cost” is a value judgment but does not reflect that the reality for a majority or near majority of households.

Add up a few of these generic drugs and even 3-5 can easily hit $100 or more a month.

An albuterol inhlare (basic for asthma) is $20. Fluoxetine (Prozac) 10 & 20 mg are $22 but the 40 mg are $74. Robaxin generic (muscle relaxant) is $28 for 60 tablets or 20 days of doses. (And it causes severe drowsiness while the other generic muscle relaxants cause drowsiness, nausea and gastric distress or are addictive. The only drug of this class that does not have those side effects is only available in a brand at $309 for 60 tablets for 20 days.)

400 generic drugs at Walmart are a JOKE as a selection for treatment. First Walmart counts different doses of the same drug as a different drug thus upping its total count. Second, there are over 10,000 prescription drugs approved by the FDA . (And Bruce, I know people in their early 30swho have suddenly been diagnosed with Diabetes when they have had no risk factors.)

Then there are the drugs for which there are NO generics. One is Advair, a critical asthma drug, and cost $172 – 285 depending upon the dosage. Insulin is another with Humulin for 30 doses at $96.

Peggy:

You wrote: “My company offers a cafeteria plan but is still about $350.00 after taxes. What do I qualify for? Which scale do I fall under? I was told months ago by the Connector that I had to buy my companies plan. I could not afford it. Then I talked to a co worker that was able to buy a plan on her own wiht drug coverage for $105.00 dollars a month”

It is correct that you will not qualify for Commonwealth Care with the subsidized premium. If your employer did not offer coverage you would have qualified for the subsidized system with a premium of about $105. (Your income with 2 people puts you at268.67% Federal Poverty Level.)
You are looking at about $350 with a $2000 deductible and no prescription coverage for a Commonwealth Choice Plan. (And if you get a diagnosis of breast cancer, you can BET you will take the drugs.) No payments of less than $100 will apply towards the deductible. I suspect that your co-worker is a LOT younger and probably in his/her 20’s as that sounds like a Young Adult Plan (limited coverage.)

Now given, your income, you will be exempt from the mandate as the income/premium schedule states that a premium which is more than that $105 or so is not deemed affordable for you. Go here to look up the premiums for you area, age and occupation:

http://www.mahealthconnector.org/portal/site/connector/

Go here to read the premium/income schedule:

http://www.mass.gov/portal/gog_cache.jsp?q=cache:xxOWjXVkPNcJ:www.mahealthconnector.org/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/About%252520Us/Publications%252520and%252520Reports/Current/Connector%252520board%252520meeting%252520June%25252026%25252C%2525202007/Afford%252520and%252520Premium%252520Scheds%252520%252528062607%252529.doc+affordability+schedule&access=p&output=xml_no_dtd&ie=UTF-8&client=mgov&site=HICx&proxystylesheet=mgov&oe=UTF-8

Oh – and Norma and Peggy, get off this nutty idea of a “class action” lawsuit unless the two of you or others are prepared to put up $500,000 – 1,000,000 in a retainer. Nolawyer with enough sense to come out of the rain would touch that turkey without a huge fee up front as it is a loser of a case and there are no damages to recover. (And I know –I am a retired lawyer who did US Constitutional litigation.)

To add to AnnS’s sadly enlightening post:

*Be prepared to very very angry and outraged*

The CERTIFICATE OF EXEMPTION TY07 APPLICATION -http://www.mahealthconnector.org/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/FindInsurance/Individual/Affordability%2520Calculator/Certificate%2520of%2520Exemption%2520Application -

I have just spoken with a rather sympathetic rep who told me that, yes, just as it says at the top of page #1, there is NO exemption possible for CommCare – if someone who is in the CommCare income level can’t afford it, that’s just too bad – they’ll just have to find some other insurance that meets the guidelines or pay the penalties – she told me that this application is only for Comm Choice level incomes.

Even then, the reasons for exemption are very dire indeed (see page 6).

- You are homeless, or more than 30 days behind in rent or
mortgage payments, or have received a current eviction or
foreclosure notice.
- You have a shut-off notice from your utility company (gas,
electric, oil, water, or telephone), or one of your utilities has
been shut off, or one or more of your utility companies is
refusing to deliver services because you cannot pay.
- You have a large increase in expenses in the past six months due
to domestic violence.
- You have a large increase in expenses in the past six months due
to death of your spouse, family member, or partner with primary
responsibility for child care.
- You have a large increase in expenses in the past six months due
to the sudden responsibility for providing full care for an aging
parent or other family member, including a major long illness of
your child that requires a working parent to hire a full-time
person to care for your child.
- You have a large increase in expenses in the past six months due
to a fire, flood, natural disaster, or other unexpected natural or
human-caused event causing large damage to you or, your
home, or your property or personal possessions.
- You have had non-cosmetic medical and/or dental out-of-pocket
expenses (not including premium payments) totaling more than
7.5% of your household’s adjusted gross income that were not
subject to payment by a third party.
- You can establish that the expense of purchasing health
insurance that meets minimum credible coverage would have
caused you to experience serious deprivation of food, shelter,
clothing or other necessities.
- Your family size is so large that reliance on TABLE 1 to
estimate what monthly premium you can afford would result in
significant inequity.

And, also, please note the intrusive nature of the questions!

So, when they tell someone that they may apply for an exemption, they need to tell also that not everyone can file.

Also, she told me that it takes 2-3 months to for exemption determination, so while you’re waiting to find out if you’re approved or not, you could still be racking up months of “non-compliance” if it is denied.

Ann,
You are wrong on two points My coworker is 47 years old. and No, If I get breast Cancer I will not take the drugs. There are many safer alternatives that have been suppresed. I was also wrong about the plan my company offers. Its $532.00 before taxes, and 491.16 after. No one at the connector told be I qualified for the exemption. I wonder how many people they are telling this to and who are being forced to buy plans that they can’t afford. I was even told by someone to file for commonwealth care. I was on the phone all day yesterday. I counted 11 people that I talked to. They kept giving me another phone number. The thing I can’t figure out is why isn’t everyone paying something. No one is addressing the cost of health care, and the kind of health care we are getting. I just heard on TV the dollar is now equal to Canada’s. Matt Lauer interviewed that millionaire Buffet last night. He did a survey with his employees. He only paid 16% tax and his lowest paid employee paid 33%. This law will fail when whats left of working middle class ends up on welfare. Then who will foot the bill. The wealthy?

Now I am really confused. Do I just wait till I do my taxes and check of a box on the form that there is no plan that is affordable for me? Is this different than applying for the exemption, or is it the hardship? You I think I’ll call the IRS maybe I’ll get a straight answer from them.

By the way I called the CLU yesterday. The woman said they were getting a lot of calls about this law. She said they read it before it was passed and thought it was a good law. I asked her who they thought it was good for? Then I asked her the question was not whether it was a good law, was it unconstitutional. She did not answer me. Then I went on to read about a lawsuit they filed for a girl who after working hours applied suntan lotion in her office and found out they had cameras in the office so she was being filmed. They lost the
case. Now let me get this straight. A women decides to apply suntan lotion at her office in a public area after work hours and finds she was being filmed and they sue on her behalf, but they think this law is a good one?

This discusion about mandatory drug coverage is rather silly. Each subscriber can opt in or opt out of drug coverage on an annual basis at the anniversary of the policy. This has worked well forever and should continue to be the policy going forward.

RJ, No. The policy going forward would be that in order to comply with the health reform law’s individual mandate and avoid a financial penalty a subscriber must buy drug coverage.

Understood Mr. Bullen. I meant to emphasize that the silliness is to mandate drug coverage which increases costs for those people who don’t now opt for drug coverage. I believe it was you that aptly explained that the added cost to the overall premium is the cost of the drug coverage itself. So why mandate anyone to buy this benefit when one can voluntarily do so once a year based on individual circumstances and affordability. Aren’t more people apt to purchase insurance the more affordable it is? I am suggesting this part of the law should be revisited and rescinded.

RJ

Rx coverage is not mandated by law, it’s a requirement foisted upon all adult residents of the Commonwealth by an unelected board that has decided what’s best for everyone.

That’s the real absurdity of this whole discussion.

The unelected Connector Board has mandated drug coverage when — despite mandating plenty of other special interest benefits — the legislature never got around to mandating drug coverage.

Go figure.

Bruce, I am responding to your original post and particularly to your comment that: “I guess I have a hard time seeing how a young, relatively healthy person will think that it makes sense to be forced to buy comprehensive drug coverage that includes all brand-name drugs when so many reasonable over-the counter and generic alternatives exist in the event that drugs are needed outside the hospital (where they in fact would be covered). Especially when the choice to purchase or not could so easily be offered.”

Why are you and others singling out drugs here? (Is this a business issue: Does Harvard Pilgrim have a lot of members who don’t have drug coverage? Is this a choice that you give to your own employees? Did you think that not covering drugs was sound public policy when you were the Medicaid director? At least for younger Medicaid members?)

I suspect you don’t offer plans without drugs to your employees at HPHC because because you know that drugs are an absolutely essential means of treating many conditions and diseases (many of which have no generics or over-the-counter alternatives). And you know that not taking drugs for many of these conditions will result in avoidable hospitalizations and other forms of more expensive care (not to mention suffering and financial hardship for people who don’t have drug coverage and need to take expensive medications). And you also realize that insurance just doesn’t work if we let people individually pick and choose the services that they want to buy coverage for. It’s no surprise that young healthy people might indeed prefer to buy no insurance: insurance is a crummy deal if you’re young and healthy. No one really wants to buy insurance that they think they aren’t going to use. But let’s take that line of reasoning to an extreme (and this responds to Tim’s postings about just letting people pick and choose their benefits once a year, presumably based on what health problems they have this year that they didn’t have last year.) Wouldn’t it be nice (except to the cost of insurance for people who need to use it, and to social solidarity) if we could all customize the benefits we want to include in our own health insurance: Since I’m getting up in years and risk, I prefer comprehensive coverage and I’m lucky that I have it available through my employer at a premium I can afford. But my much younger sister might prefer to buy insurance with no coverage for anything to do with the prostate or Peyronie’s disease or vasectomies (only used by men), no coverage for childbirth or assisted reproductive technology (she already has her kids), nothing for cystic fibrosis,cerebral palsy,hemophilia, NICU care or any of dozens of condition or types of care that she knows that she or her lucky kids won’t need. While we’re giving her “choice”, she might exclude hysterectomies (already had hers, whether she really needed it or not–thanks to those who helped pay for this and no thanks to her insurer for not being more involved in helping her figure out whether this was necessary or not–now that could have saved some money). Maybe she’d take a chance on no coverage for lung cancer and diabetes, since her risk of those conditions is really low right now. She’s been a vegetarian since she was 11 and an avid exerciser, so she might exclude heart disease too. She might even decide not to have drug coverage, because she doesn’t take any drugs right now, or, if she had to have a drug benefit, she’d sure like to exclude coverage for oral contraceptives, and all drugs used mainly by children, much younger women and men (including Viagra). She’d might like to have drug coverage for mental health conditions, since we have a family history of depression, although she doesn’t need them right now. But who knows what the next year might bring.

And of course, that is exactly the point: who does know what the next year might bring? Or the next week or day? A rational choice of health coverage today can look awfully bad tomorrow if you have a terrible accident on the way to work or you are diagnosed with a serious medical problem at a “routine” medical visit. Health insurance is a social compact, and the requirement that as many people as can afford it get insurance is a means of trying to expand and strengthen that compact in Massachusetts. So, let’s stop demonizing a rational requirement that health policies include an essential benefit like drugs. HPHC, other health plans and everyone else involved in trying to implement this law should stop focusing on this problem and redouble your efforts on figuring out how we’re going to control the rising cost of health insurance by finding and eliminating waste, overuse, misuse and underuse, and dealing with monopoly provider systems. If we’re worried about the cost of drug coverage, let’s come together as a state and find some way to regulate drug prices, which are a major reason why drug coverage is so expensive, and a cost control technique that most other countries figured out was necessary decades ago to deal with the monopolies granted to drug companies by the patent system.

Peter, The issue isn’t about the value of drug coverage but about the best approach to take in the effort to expand insurance coverage. It is a well known fact that many younger, healthier people will not buy comprehensive coverage. In the case of drugs, there are affordable over-the-counter and generic alternatives, if drugs are needed. Would it not make sense initially to offer a range of policies and work together over time to make comprehensive coverage more attractive to this group?

Beth (and Peggy)

“I have just spoken with a rather sympathetic rep who told me that, yes, just as it says at the top of page #1, there is NO exemption possible for CommCare – if someone who is in the CommCare income level can’t afford it, that’s just too bad ”

That is incorrect. The long list of the hardship reasons DO APPLY to Commonwealth Care. That includes the things like homelessness etc.

The income/premium cost rules apply to:

(1) Those above 300% FPL who have to buy a Commonwealth Choice Plan; AND

(3) those like Peggy who whose employer offer coverage but the cost of the coverage exceeds the premium considered affordable for their income. If the employer offers coverage, no matter how little the employee makes, they are NOT eligible for Commonwealth Care. As to whether the person then has to pay for the employer’s plan, you go to the income/premium schedule and look up the income versus their share of the premium for the employer’s plan.

Peggy – go to the link that Beth posted (or ou can go to the main web page which I think I posted.) One way or anoother, those links will get you to the application for an exemption.

You need to have proof of your income plus something from your employer listing what your share of the premmium would be for the employer’s plan.

You can file now for the exemption or wait until tax time and fill out the form with the tas return. You do need to start accumulating the documents about income, the emploer’s plan and the cost.

That coworker who claims that she is only paying $105 or whatever still does not compute. The typical cost of a Commonwealth Choice planfor someone who is 47 should be between the average $175 for a 35-39 year old and the $350 for over 50-64. Now, if she is not eligible for your meployer’s plan for some reason such as length of employment, type of job, full time vs part time, or some other reason, then she would qualify for Commonwealth Care where the premium for 250-300% FPL for one person is about $105. (And then there is the question of whether she signed up for Commonwealth Care and didn’t tell them that the employer offerred coverage…….)

Dear AnnS,

The text of the first paragraph of page on the exemption application clearly states:

“To be considered for a Tax Year 2007 Certificate of Exemption,
you must demonstrate that you cannot afford a Connector health
insurance product because you experienced at least one
qualifying financial hardship event. Commonwealth Care is not a
Connector health insurance product so if you are eligible for
Commonwealth Care, you cannot apply for a Certificate of
Exemption. The Connector may revoke a Certificate if it
determines at a later date that any of the information
contained in this Application is inaccurate.”
…
So, this is clearly not for CommCare.

Can you tell us where are the hardship rules/application for CommCare?
…
Also of note (from HCFA – http://blog.hcfama.org/?p=1215) – “A panel of 28 hearing officers who are independent lawyers have been set-up to consider the appeals.”

Perhaps someone can tell us what this task alone will cost the State?

Lisa” Speak for yourself.

While I have no crystal ball, I am 51 years old, and the last script I used was for Tylenol #3, back in 1977m when I had a wisdom tooth extracted. My 82 year old mother’s only recent prescriptions
were for nulitely, in preparation for colonoscopies. Given my track record (and that of my family’s, I don’t need YOU to tell me if I need drug coverage. Ther real reason you are mandating drug coverage is to make scripts cheaper for the chronically ill, at the expense of those of us who are healthy!

Tom,

Lisa, the connector board, HCFA, etc all know better than you what you need.