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TOPIC: Help me with insurance!

Help me with insurance! 6 months 1 week ago #68628

  • Lman
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Hello.
I need help with insurance policies in different countries around the world. I'll have my bachelor's degree in 2 years with good grades and I'm looking to apply to a better university but as you know with itp it can get tricky. I'd prefer to be able to attain the residence of my destination country (through several years of working and studying).
I have already checked and emailed many universities around the world and asked about their insurance policies and accommodations for people with pre-existing conditions, but I still lack much information.
My main concern are these:
  1. I might not be able to ship more than 10 week supply of Romiplostim (20 vials of 250mcg, 2 each week). so, here two issues arise: first of all I need to be allowed to carry them inside the airplane and inside the country. I can have my doctor's note on my condition and my dosage. will it be ok? o they won't think I'm smuggling it?
    and second issue here is that I'll run out of drugs in 10 weeks. That means 10 weeks is all the time I have to be visited by a doctor, he conducts tests he needs to confirm my itp (not another bone marrow test? :| They're painful) and views my previous medical records. But as I know I must first be referred to a GP and the n a hematologist which can take months. that's REDICULOUS for someone with itp! Is there any way I can circumvent this process (through mailing to the university or any department about my emergency situation?).
  2. Second and most important: As you know Nplate is costly and I won't be able to pay more than $2000 each year on it (I'm currently receiving it for free) So that the destination country must provide public health for its foreign students and public health must have special care for people with chronic disease.
    For example, As I know in Italy they have free treatment for people with rare or chronic diseases (itp is both). In the US there's such a thing called "out of pocket maximum" which limited all medical bills to $2000 a year or even less which is affordable to me. But at this time I'd prefer a European university for my Master's degree because they are generally cheaper and I have more chances to get a scholarship.
    Also, several countries like the Netherlands offered some form of private insurance to the students (by AON) which had full coverage for medical costs! But generally, private health insurance won't pay for such huge bills as far as I know. As far as I know, I have no chance in Australia nor Canada because they have very weak coverage for the prescribed drugs, So I'm thinking about Europe
  3. 3rd and still important: As all of you know, we have refused many treatments, especially splenectomy or maybe immunosuppressive drugs. My concern is that is it possible that the doctor in the destination country says "You must undergo splenectomy" or "You must take Imuran?". I need to have freedom of choice and I'll choose Nplate or Revolade. You know why. So one important thing is freedom of choice (especially in public insurance service)
The more response I get, the more information I have about which universities (in which countries) I cand send my application, and I can avoid what I'm most afraid of: Remaining untreated in a foreign country!
Thanks.

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Help me with insurance! 6 months 1 week ago #68630

  • MelA
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Might insurance change in the next 2 years before you get your degree?
Have you looked into insurance where you live to see if it will apply in other countries?

We moved to Japan shortly after I was diagnosed and on 60mg of pred - I didn't even know if I'd have a hematologist once there. However I was referred to a super hematologist & I did like his hospital even though I never had to be admitted just went there to see him. We moved there, then to Hong Kong, through my husband's employer so never really changed medical insurance - we paid the bills and sent in for the insurance to pay us back. In Hong Kong I used private doctors/dentists.

Never was I told I 'had" to have a splenectomy - but the hematologist [wasn't crazy about this one] in Hong Kong would panic if my count went down & would want me have my spleen removed but I always refused - these were the days before all this new type of treatment, back then it was prednisone or splenectomy.
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD
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Help me with insurance! 6 months 1 week ago #68637

  • Lman
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MeIA thanks for your response.
I don't think my insurance is going to be changed in the next 2 years. It does not apply in other countries, I still can get drugs and ship them to the destination but as you know Nplate has strict storage rules and shipment won't be easy and I don't know any person/system that I can trust to ship them to my destination.
Japan was also an option for me, but I have not yet inquired about Japan (nor any other Asian country). Their language is so hard and accessing their insurance plan won't be easy. Do you know if their public health insurance supports itp? and all other concerns I mentioned (waiting period, time it takes to be visited by a hematologist and etc).

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Help me with insurance! 6 months 1 week ago #68641

  • ImPatient
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I'm wondering about the same, except I'm looking to work, taking Eltrombopag and I'd really like to move back to the U.S. someday.

MelA's response sounds encouraging.

I highly doubt anyone would expect you to have splenectomy, but it's probably different from country to country what meds which insurances pay for. I would make a few phone calls and ask them directly once you know where you would prefer to go. Are you sure you can't keep your current insurance as a student? I was able to keep my German insurance in other EU countries (to study and travel, not to work). The paperwork was a bit of a hassle, but the coverage was better in most cases.

I can tell you from personal experience the Netherlands aren't the easiest place to adjust to. Their health system may be okay in theory, but I got sent away from hospitals when actually I needed emergency surgery. I also walked around with an infected tooth for over a month until I found a dentist willing to treat me (after countless unnecessary cleanings). It's not to say don't go there, there's a chance I would if I got a good enough job offer. Just inform yourself and consider what's important to you.

I switched doctors in Germany a few times recently. There was no waiting period because I said it's urgent (if it's not then yes it can be a few weeks or months).
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Help me with insurance! 6 months 1 week ago #68643

  • Lman
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Thanks, ImPatient.
Unfortunately, I don't think there's any way I can pay for my drugs in Europe and have them reimbursed in my country, but just to make sure I will ask.
I assume you're German? I was also interested in Germany. It was stated that people can opt-in public healthcare systems and costs for those people with chronic diseases are limited to 1% of the gross annual income of that person. Is it the case? As far as I know, German universities are also free, and It looks attractive.
I don't have a GP system in my country and I thank it. It would be ridiculous if you're already diagnosed with diseases and need to wait months to visit a GP, then months to visit a specialist and then get your treatment!! Isn't there any way that you can circumvent this process? For example, explain your condition to somewhere (maybe university?) and they arrange a specialist visit as soon as possible?
That was also the case with Belgium and Norway. They said you'll probably need to wait 6 months to be visited by a specialist! What Da ...
The reason I'm worried that a doctor might say "You need to take the cheaper medication" is my previous hematologist, who diagnosed me. I think he has violated his oath by pushing me to splenectomy or Imuran. One day maybe I visited him again and told him that I didn't like the way he treated me and my itp (But I'd prefer to be in Remission that day). And given that I'm a foreigner in the destination country, I'm afraid that the doctor or the insurance company discriminates against me.
It worths noting that as far as I understood, most European countries with GDP per capita more than $30000 per year, have a nice coverage for people with chronic disease (except for Sweden).
www.hope.be/wp-content/uploads/2015/11/99_2015_HOPE-REPORT_Out-of-pocket-payments-in-healthcare-systems-in-the-European-Union.pdf
I also need to mention that I have a brother living in France. He has a handful of close friends in Toulouse. Maybe France is also a good option. I told him to investigate French public insurance, but he procrastinates and has not done much yet. Any information about France is also welcome!

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Help me with insurance! 6 months 1 week ago #68648

  • ImPatient
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Hi Lman,
I think it's good MelA decided on where to go first. If you know where to go you also have a bit less to research and you don't want to end up some place that is "safe" but doesn't fit your personality, your career plans etc. Sounds like France might be a good option for you as you'd have your brother's support and it's a lovely place with lots of options.
Yes I have German and U.S. citizenship. It only takes months in Germany, if it's not an emergency. You're taking NPlate because you would have problems if you stopped right? So it is considered quite urgent. You tell them on the phone how low your lowest count was, what symptoms you had and that you need an appointment now. A lot of places will take you the same day or within a few, if they get the impression it'd be bad to wait. You talk to a gp briefly, pick up your referral, hematologist next. If worse comes to worse you go to an er.
I wouldn't know how much coverage you would get. I never heard that chronic illnesses aren't fully covered. That is, what's necessary.
Some unis are free, it depends on what you want to study. I did most of my studies in NL and the US because it wasn't possible the way I wanted in Germany.
I can relate to you feeling pushed into treatments by a previous doctor. I had similar experiences for which I got a couple other doctors' opinions and then made my decision. Somebody not hearing you is certainly the last thing you need when you're not well.
I think what I will do before I move again is save up a few thousand for emergencies, so I have some peace of mind regardless of what insurance I will have.
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Help me with insurance! 6 months 1 week ago #68649

  • Lman
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Thanks, ImPatient.
I agree that it's good to narrow your choices. This is what I'm doing! Several countries that don't have sufficient healthcare for itp will be ruled out. Several other factors can have an effect on my choice. Tuition fees, cost of living in a foreign country and etc.
Generally, Europe has cheaper universities than the US. I'd prefer to earn my master's in Europe so that I won't be so far from my family. But maybe I migrated after my masters again. At this point, I want to assume the country I'm going for a master's is where I'm going to live the rest of my life.
3 or 4 countries is more than enough for me. France, Germany, Denmark, the UK, and Austria have low tuition fees and good healthcare. I think I'm going to send my application to 5-10 universities so that I can maximize my chance to get admitted (or even have a scholarship if possible).
The reason I was thinking about NL was that when I contacted Radboud university, they stated that they have special accommodations for people with pre-existing countries. Their universities might not be as cheap as those countries I named above but is still affordable and a financially-well supported healthcare.
I'm getting my bachelor's in computer engineering. I was studying civil engineering when I collided with itp. Maybe itp changed my mind to shift from civil engineering to computer engineering (indeed I double majored, but I'm going to have computer engineering for my masters). I think job opportunities and also universities for computer science are more than enough.
I think I need to follow what you said. Have a few thousand for the worst scenarios (which I hope don't happen). Also a bag of steroids. Maybe I could combine 10-15 mg of pred and one Nplate shot each week so that I could double the time I can have Nplate from my reserves.
Since I have two more years to finish my studies, I'm going to check this topic regularly to decide which country (and which university) I can go to.
Any more information about this topic is warmly welcomed!

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Help me with insurance! 6 months 1 week ago #68650

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What you write about that Radboud Uni sounds like a great deal. Maybe taking cheap flights or Flixbusses and visiting a few places is a good idea. Though from just visiting I wouldn't have known some things. For the Netherlands, there are websites like iamxpat or you can use meetup to meet new people, though I only found them useful in bigger cities.
Did your current doctor suggest anything about your medication when moving?
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Help me with insurance! 6 months 1 week ago #68651

  • Lman
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I haven't talked to him. But I think he is a fan of splenectomy :)
He might be right, I'm young, I don't have time to be sick, I have had GI bleeding twice and now I wanna go somewhere remote.
www.ashclinicalnews.org/spotlight/rituximab-or-splenectomy-in-steroid-resistant-itp-patients/
I still have 2 more years. Enough time for good things :)
In my statement about Radboud, I think most universities have accommodation for people with ailments. Maybe Radboud's admission officer answered me patiently (unlike many others). Also, Milan polytechnic stated that they have a special office for people with the disease. Italy is also cheap and has free medical care for people with rare or chronic diseases.My last choice would be Italy.
And I think It would be a nice idea if I could visit those universities. Now, traveling is dangerous because of COVID19. Maybe I tried it later or at least told my brother to investigate those universities for exact details. At the right time.

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Help me with insurance! 6 months 1 week ago #68652

  • MelA
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I loved Japan - but then I wasn't a student but a wife/mother (still am ;) ) so I look at things differently. From what I gathered hospitals have doctors and the doctors have their offices in the hospital, there is also a pharmacy. I'd ride my bike to the hospital, stand in a line to get a folder with my records in it, then go upstairs where the offices were and sit and wait until I was called. Being an expat I was treated differently - which I didn't like but it was nice - I had an appointment time, other came and had to sit and wait to be called I guess in the order they arrived. After my visit with the hematologist I'd go downstairs with my prescription for prednisone and sit & wait for it to be filled & I'd pay for it then. Think I paid for the office visit when I picked up my chart, can't remember. I really did like that hematologist!

As to the public health there I really can't tell you - the medical office my husband/sons went to was across from the Tokyo Tower - good doctors. Sorry I can't help you with the public health insurance.

We traveled to Egypt, Italy, Mainland China, Macau, Singapore, UK, Thailand and more and I barely thought about my count until we moved to Hong Kong and that hematologist would panic & suggest splenectomy - but then prednisone was keeping it at what I would call a decent level most of the time.

Just remember, a splenectomy isn't a cure - that is why I never got mine out, could not be guaranteed it would cure me. Even my brother-in-law, a thoracic surgeon, said I needed it out - still have it. But - that is me, you are you - I did what I felt was best for me and you need to do what is best for you!!
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD
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Help me with insurance! 6 months 1 week ago #68654

  • ImPatient
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Lman I was wondering how dangerous traveling here really is. I recently took a cab more often instead of a cheap (and almost equally convenient) train. Are some illnesses worse in people with ITP? Or is it only when they take meds that suppress the immune system? Looking back at the choices I made when I moved, I wish I had observed more how I felt there immediately, not so much how beautiful a place is and what it has to offer.
I don't know much about splenectomy, but from what I read here, the risk that it won't have any benefit is too high for me personally, as long as other treatments work.
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Help me with insurance! 6 months 1 week ago #68655

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In the UK you have to be referred by a GP but it's very quick for an appointment with a haematologist. I recently asked to be referred to a different hospital and got an appointment with a haematologist the next week. I told her I have had Nplate before and she said that in that case I would get that again when needed. Students generally have free health care although there is a prescription charge of 8 pounds or so per prescription.
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Help me with insurance! 6 months 1 week ago #68657

  • Lman
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Thanks for your responses!
I should say I agree that surgery should be postponed until there's a suitable treatment (thank God I already have one). The main reason I'm also investigating is that I'm looking for a country with suitable healthcare so that I don't need any surgery!
But (Maybe unnecessary now) my story is a bit different from you. Most of you have contacted Itp in your 30's or even later (mrsb, Hal, probably MeIA). At that age, you have "settled" down in your life. Have finished your education, had your job and probably spouse. As you know when it comes to the quality of life it can be subtle. Fortunately, Nplate is ok and I'm doing well, But I was just worried if there would be some cases that itp would stop me to follow my ambitious goals! The only young case I knew was Neeve from eastern Europe who eventually (after 2 relapses) undergone a successful splenectomy.
But at the time I'm pretty sure that I don't need surgery and I'll try my best to avoid, as it might fail and also within couple next year me (and you) might recover or we already have treatments that have mostly vanished itp from our day to day life.
Again, thanks for your kind replies!
By the way ImPatient, I asked the Bavarian ministry of health about their coverage but unfortunately, they responded to me in German (why!?). I have already used google translate to translate it in English and got the most of the meanings (which as I had anticipated was that I can have public healthcare and they cover my condition and I can't have private insurance adequate coverage) but would you please take a look to this letter and tell me if there's anything important that I have missed? I don't know why when I click to your name it says "you are not authorized to view this page" (Sandy?), so I post it here:

Krankenversicherungsschutz in Deutschland
Sehr geehrter Herr Smith,
zu dem dargestellten Sachverhalt kann Ihnen das Staatsministerium für Gesundheit und Pflege leider keine rechtsverbindliche Auskunft geben. Konkrete Entscheidungen kann nur die zuständige Krankenkasse treffen. Als Selbstverwaltungsträger ist sie dafür eigenverantwortlich zuständig und insoweit auch zur Beratung und Auskunft verpflichtet (§§ 14, 15 SGB I).
In allgemeiner Form kann aber mitgeteilt werden, dass wenn Sie während Ihres Aufenthalts in Deutschland der Versicherungspflicht unterliegen und Sie so Mitglied einer gesetzlichen Krankenkasse werden, dieser Versiche-rungsschutz auch die notwendige Arzneimittelversorgung entsprechend der bundesrechtlichen Vorgaben umfasst, ohne dass hier eine Vorerkrankung einen Ausschluss zum Zugang zur Krankenkasse oder deren Leistungen darstellen würde. Diese vorangehenden Aussagen gelten aber nicht für Unternehmen der privaten Versicherungswirtschaft.
- 2 -
Zur Klärung Ihrer Fragen empfehlen wir Ihnen deshalb, sich direkt mit einer gesetzlichen Krankenkasse in Verbindung zu setzen. Dabei können Sie frei wählen, an welche gesetzliche Krankenkasse Sie sich wenden. Eine Über-sicht über die gesetzlichen Krankenkassen finden Sie im Rahmen des In-ternetauftritts des Spitzenverbandes Bund der Krankenkassen ( www.gkv-spitzenverband.de/krankenkassenliste.pdf ).
Zu Fragen mit Auslandsbezug informiert allgemein auch die Deutsche Ver-bindungsstelle Krankenversicherung – Ausland (DVKA) im GKV-Spitzenverband ( www.dvka.de ).
Ich hoffe, dass wir Ihnen mit diesen Hinweisen weiterhelfen konnten.
Mit freundlichen Grüßen
gez. Dr. Steinmann
Ltd. Ministerialrat

JJ-Thanks. I had already contacted King's college and they also said so. Also, it could take up to 3 months to have coverage. It think 3 months is the lease amount I need to wait in most countries (even US)

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Help me with insurance! 6 months 1 week ago #68658

  • ImPatient
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Hey Lman- They say they can't give you concrete advice, but that by law you'd have to be insured, therefore you can pick an insurance from the list ( that krankenkassenliste pdf link) and contact them directly. They also said that a preexisting condition doesn't exclude you from receiving necessary treatments. Just keep writing English, most Germans speak it, though some don't speak it well.
I'm almost 40 and didn't settle. I lived in a place in the U.S. where it's quite common not to do that. I'd say it's different depending on where you go, and it's also changing as a lot of people need to change jobs and have more than one or two careers in their lives (and don't depend on having a family). I can't tell you whether ITP interferes with it though, as I'm new to it. I imagine it has a lot to do with each person's specific case of ITP and what they are trying to do.
Also, in the U.S. I never had a 3 month lease, mine were always a year then monthly, except my last one was month to month immediately.
I'm inspired by your effort, I should contact a few more places too. I need at least a new job here and move to a bigger city.
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Help me with insurance! 6 months 1 day ago #68697

  • Lman
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Regarding my question:
In some countries and some insurances, it's stated that "medications administered in a hospital" are covered, but "prescription drugs provided in non-hospital settings" are not covered.
I wonder that is it possible that I'm referred to a hematologist, he prescribes Nplate to me and I have it weekly in a hospital?
As I recall, many people receive their Nplate in the hospital each week. I think most (although she lives in the UK) and a guy named "Jose" on Instagram (I failed to find his id). He lived in the US. Also an I follow an Australian mother who's child has itp, and she used to receive Nplate in the hospital each week.
That is, is Nplate considered an in-hospital drug or not? Of course, if one is able to administer it at home it's a lot more convenient (As I do so now) but given that many insurances support drugs prescribed in hospitals, I wonder if this rule applied to Nplate or not?
Most Canadian insurances support drugs used in hospitals. Canada is also suitable for me because I have an uncle living in Toronto and surprisingly the field he works in is computer science, the same as me.
For example, here is a link to the Alberta healthcare plan:
www.alberta.ca/ahcip-what-is-covered.aspx
Thanks.

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Help me with insurance! 6 months 1 day ago #68700

  • MelA
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Are you sure you would even be able to get Nplate in Canada - that would be the big question.
Are you sure you could get in to see a hematologist as quick as you would like?

I recall a mother who was here a couple years ago - it was going to take months [can't recall the exact time, but I believe it was over 6 months] for her young child to see a pediatric hematologist, and they are Canadian citizens.
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD
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Help me with insurance! 6 months 23 hours ago #68702

  • CindyL
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When I was first diagnosed, it didn't take me long to get in to see a hema. I'm pretty sure Nplate is available here by now. It wasn't when I was treating. Each Province has its own health insurance guidelines. Steven and I are losing his insurance so we'll have to go on the Provincial coverage which means we'll be paying 20% for our medications.
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Help me with insurance! 5 months 4 weeks ago #68721

  • Lman
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MeiA
No, I'm not sure! This is why I'm asking. It's natural for anybody to try to maximize his options. But now, most part of my concern is whether insurances in the destination country (practically, the public insurance) support Nplate and testings and visits so that it would be affordable to a person with an average salary.
But about the time it takes to be visited by a specialist, I have heard about what you said from other people and I believe it's really ridiculous to wait such a long time with an already diagnosed disease :|
But in general, If there's adequate support for the costs, the initial waiting period for up to 3 months won't be a big concern (but not 6!).
CindyL-
As you mentioned Nplate is available, probably you were already insured when you entered the itp world? My concern is that insurances (typically in Canada) don't support such a thing as pre-existing conditions adequately. Even if I have to pay up to $5000 per year for itp is ok, but I think that would be a lot more in Canada if you come in with an already diagnosed itp?
Typically, I expect student insurances to be much better in some EU countries and the US. But that was not the case in Canada, at least when talking about pre-existing conditions.

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Help me with insurance! 5 months 4 weeks ago #68723

  • CindyL
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Lman, yes I was covered. I didn't have to worry about paying for any of my treatments. Even when I did my Rituxan, I didn't have to pay for it. Good thing or I wouldn't have gotten it. My hema used it for his cancer patients and got special permission to use it on his ITP patients. I actually mentioned it to him after reading about it on this site.
I don't know anything about folks coming into Canada with pre-existing conditions. We just had an election in October and one of the promises made by the party leaders was looking into universal health care for all. Maybe by the time you're ready to move, we'll have better coverage.
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Help me with insurance! 5 months 4 weeks ago #68730

  • ImPatient
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Hi Lman,
in Germany NPlate is covered, when you take it home. In fact I think many doctors prefer if you do that. I like Cindy's comment that maybe more countries are looking into providing better health care. I want to believe that, and I've seen small improvements. Though I've also experienced healthcare that's fine in theory and useless in practice. I would definitely always ask what other peoples' experiences have been.
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Help me with insurance! 5 months 4 weeks ago #68735

  • Lman
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I know, but my concern was the fact that some insurers had stated that out of hospital treatment would not be supported so one might think to be able to receive Nplate in a hospital or clinic. Although this is awkward and time-wasting, I think this trick works in some countries because I know some people have their Nplate shot in hospitals.
Do you know anything about the US? I know under a rule passed a couple of years ago, insurances cannot refuse to cover someone with pre-existing conditions or charging them more because of their pre-existing condition.
en.wikipedia.org/wiki/Pre-existing_condition
But how is that now? As I know with student insurance in the US, there's something called maximum out of a pocket policy that would not allow an insured person to pay above a specific amount on his annual healthcare matters. Having that amount exceeded, the insurance company would pay the rest. That's the case with many other European countries like Switzerland.
Is this out of pocket maximum also applicable to the national healthcare system in the US?
And my second concern:
www.sfchronicle.com/business/amp/Worker-student-visa-renewals-add-questions-about-15061144.php?__twitter_impression=true
Suppose I was admitted to a university in the US. Would what is said in the link above prevent me from having a working visa, in order to be able to stay in the US?
And also third concern :) (too many concerns)
You told me that you have experienced being pushed to treatment by a doctor (say, pred or splenectomy). In any insurance company, is it possible that the doctor prescribes a cheaper way of treating a patient's disease? Say, The doctor you're visiting says you MUST have a splenectomy. What are you able to do to avoid that? This scenario. has happened to me but I was able to avoid this by simply changing my Hema, But I'm afraid in another country I might not be able to have such a privilege.

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Help me with insurance! 5 months 4 weeks ago #68737

  • ImPatient
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Hey LMan, I wish I knew more about insurances in the US, too. Maybe somebody else here knows about how this rule for preexisting conditions really works.
If you're a student, I _think_ you can do a certain amount of hours of student work, work-study or whatever it's called, but I don't think there's an easy way to get a work visa. But since you're in computer science, maybe if you have some special skills that most people don't have you can convince some company to sponsor you. There are forums with people who can help you more with this legal/visa stuff. I was on one for Germans trying to get dual citizenship and even some lawyers were so nice to give free individual advice on there. There must be something like that that applies more to your situation. Maybe you can also take part in the Greencard Lottery.
In Germany nobody can make you have a specific treatment. You just look for a different doctor, if you don't want it. It's possible you have to take cheaper meds if they have almost the same effect, but not something totally different like splenectomy vs NPlate. And yes insurances usually cover you taking it at home here, but I'd always verify everything with the insurance you end up taking.
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Help me with insurance! 5 months 3 weeks ago #68786

  • Hal9000
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Lman wrote: ...
I still can get drugs and ship them to the destination but as you know Nplate has strict storage rules and shipment won't be easy and I don't know any person/system that I can trust to ship them to my destination.
...

Lman, haven't followed this thread. Maybe you've already figured this out.

Can't FedEx ship things like Nplate? As I recall, years ago FedEx started out shipping donor organs for transplant over long distances. I think what would be required to ship Nplate would be to ship it overnight and then put it in a thermos like container with enough ice in it to keep it at the required temperature range for that overnight trip.

On a side note. I have a BS in Electrical Engineering (specialty: Electronics) and a MS in Computer Science And Engineering (specialty: Artificial Intelligence). I would think that you will soon need to identify your area of specialty. Have you thought about 'Bio-informatics'? With CRISPR technology now coming into age, and your understanding of ITP, computer science with genetics/DNA research might be a lot of fun. Might be a lot of breakthroughs in the coming years. Sometimes an area of specialty can dictate where you live geographically.
en.wikipedia.org/wiki/Bioinformatics
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Help me with insurance! 5 months 3 weeks ago #68789

  • Lman
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Hi Hal.
That might be an option. I'll try to figure it out, but I would not choose it as a permanent solution, because my current insurance does not provide service for me if I'm out of the country. But this can be done once or twice I guess so that I have enough time to wait for a new insurance plan to start its coverage. Also, I was thinking that instead of getting my drug in 10 weeks batch, maybe I could tell them I wanna go abroad and you have a chance of not needing to provide me this anymore if you give me 30 so that I can move easier? Lol.

About your field that is CS, I should say I had already suspected that your field must be related to computer science because you were building your own model of itp and it's types :)
I'll probably be going to have my master's in AI. I took two courses from Coursera (for the Stanford University). One was called machine learning and the second one deep learning (consisted of 5 courses) both taught by Andrew Ng.
I have already thought about entering the bioinformatics and I'm considering it as an option, one of the main reasons might be due to topics I read about itp and medical world. I also saw a couple of animations on the Ted-ed website which described synthesis biology and also CRISPR. They both look to be on the edge of science and they seem to be attractive. But one of my concerns is that do I have enough knowledge of the medical world (or is it possible to acquire them is not a long time) to enter bio-informatics?
I'll need to choose a topic for my Bachelor's thesis next year. Until then I must also consider which field I'm going to pursue my masters because having a related topic in the Bsc project to what you're going to study at master is a big grace.
By the way Hal, you said "Sometimes an area of specialty can dictate where you live geographically". what do you mean by that?
As you know, my biggest fear at the time is itp, and the consequences it might have on my life, especially in my education :(
Right now, I'm looking for a country with an adequate educational opportunity, also with affordable healthcare (you know what that means when you have itp) and living costs for a student not be exceeding 1000$ a month.
I should also say my current GPA is 3.8/4 so I'm also hope that I'm able to have a scholarship.
As I found my chance at Canada is low, although Canada is ideal for me because I have an uncle in Toronto who is also in CS, but as I understood Canadian healthcare isn't sufficient for someone to move while having itp. Interestingly, recently someone from Alberta mailed me back and stated they have coverage for NPLATE/REVOLADE. I'm currently working on that. But if I failed to go to Canada, I'll probably apply to a European country. US is also ideal given that I have a chance for permanent residency.
These are the two links I was given by Alberta:
Alberta1 Alberta2
But what I'm currently afraid of, is that would they approve Nplate for me (mostly for free) or force me immunosuppressants or splenectomy?

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Help me with insurance! 5 months 3 weeks ago #68817

  • ImPatient
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I found a site where you can look up what meds are generally covered in the Netherlands it's medicijnkosten nl and you click on zoeken (I had to look up something for myself, as I have a job offer there, but I think I'll stay in Germany till I feel a bit more stable with all this). I still would call the insurances directly though, because it says NPlate and Revolade may be covered, but it also says only the cheapest options for meds are covered. I know I said I wasn't too happy in NL. But there are good things about it too. A good thing is, studies are usually very hands-on and give a lot of insight about how the current job situations would be.
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Help me with insurance! 5 months 2 weeks ago #68824

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Thanks, ImPatients. It's also good to hear you're applying for more jobs and you're coming out of itp initial shock.
I checked the website you mentioned. I searched for the Nplate name and also checked the fully reimbursed option and it showed me the drug information and its original price.
But it also said 9% of the prescribed drug fees must be paid by the patient?
And as you said "only cheapest option", you see how tricky it can get :(
But as far as I talked to Radboud university and the Delft university their private insurer had adequate coverage for Nplate. I don't recall their fees now.
The best option is to apply to a university in which it has adequate coverage for chronic/rare diseases.
About NL I've found these:
ec.europa.eu/info/sites/info/files/file_import/joint-report_nl_en_2.pdf
which says:
"The AWBZ
covered not only care for the elderly, but in
principle all chronic care, especially concerning
large expenses where insurance on a private
market would not be feasible."

And Also www.hope.be/wp-content/uploads/2015/11/99_2015_HOPE-REPORT_Out-of-pocket-payments-in-healthcare-systems-in-the-European-Union.pdf in which it says (on page 42 on the NL section):
"Patients with a chronic illness or disability receive
financial compensation." and "There are two rates of coinsurance,
which correspond respectively to 12.5% and 8.5% of the fee for the healthcare service". But unfortunately, I didn't find any specific explanation on the amount of that ceiling, or the extent of that compensation.
I think at this time I should try my best to have some form of scholarship. I think helping a diligent boy with a special disease would be a task most professors and campus employees would like to do :)
As you said, I should focus on playing better than other participants in the match, to maximize my chance and (from an evolutionary point of view) my survival chance.

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Help me with insurance! 5 months 1 week ago #68893

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Lman,
I took Machine Learning too, and Neural Networks. I don't think Deep Learning neural networks had been invented yet when I got my masters, LOL. Don't know about the degree requirements for Bioinformatics. Just assumed it was all CS. Might be worth the time to talk to your adviser, or, seek out a fellow student with that as a goal. For my master's thesis I modified the Lempel–Ziv (compression) algorithm so that it would learn/recognize sequences of data faster than the standard algorithm. I came up with the idea and my graduate thesis adviser agreed to it and that it was novel. LOL, my writing skills radically improved on writing that thesis.

On area of specialty. I would be tempted to identify which companies, who you would like to be employed by, as a goal. Then work backwards from there. Find out which courses would be preferred for those they hire and which Universities they normally hire from. For example, AI specialty should give you one list of potential employers and Bioinformatics should give you a completely different list. And similarly, those employers will likely be in completely different geographic locations.

As for expenses and ITP. Not sure about how they do things in Europe but an internship for a few months at a prospective employer can be very beneficial. Fill the pocket book and get a better idea of where and who you want to work for. LOL, I remember one Phd student/candidate that I met. As I recall, he had interned at IBM after master's degree. Working at IBM completely changed his goals. Decided he preferred the academic setting and to become a professor.

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Help me with insurance! 5 months 1 week ago #68899

  • ImPatient
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Lman can take an internship as part of the studies in Europe. I agree, not only does it give you better insight, you might get hired by them later on too. That's how one of my American classmates in the Netherlands got to stay there after our last studies. I felt really stupid that I had previously turned down that exact same internship cuz I felt too old and experienced, it seemed like a great job once it's paid at least.

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Help me with insurance! 3 months 3 weeks ago #69175

  • Lman
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Hey, Impatient. Yes you are right. As for now, my brother studies in Toulouse in France already had one internship at the Airbus and now having his second internship at another aviation company. I think I should only focus on the US and a couple of European countries. If I succeded to have a master's position in the US, with good funds, I'll choose that. Otherwise, I'll go to Europe, maybe France, where I have some acquaintance. I have currently forgot this issue and I'm doing my best to enrich my resume!.

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