I’m sure this is very situationally dependent, but I am trying to think ahead to what my daughter will do post-graduation this spring.
As way of background, so does not have many extraordinary medical needs EXCEPT that she is on an antidepressant so will need regular med checks to continue with that prescription.
She went to school OOS, so established a PCP on campus and that has worked well. It is most likely that she will be OOS again (in a different state) post-graduation. The twist is that it will probably be a shorter term internship, then she will be on the move again.
Is there a good way to handle or plan for this situation?
What will her “permanent address” be? When one of my kids graduated from grad school, his permanent address was here, and that’s where his insurance was. He was traveling constantly with a music group for a whole year. BUT he made it his business to be here for routine medical visits (he saw an eye doctor twice a year…never missed).
Not sure how that works with ACA. This was in 2009 for my kid.
This has been one huge PIA for my daughter because we moved states when she graduated HS so she had to re-establish a family doctor when we moved. Then she opted to co-op and was often in different parts of the country, and now she’s in a rotational ELDP program.
She tries to plan ahead with her physicals for when she’s home and they’ll refill and prescribe meds over the phone for the next 12 months and do telehealth visits. She uses a mail order pharmacy where she can get 6 months at a time.
Local HR folks have been helpful in steering her to the right medical providers, walk in clinics, and dentists when she hasn’t been able to get home.
Once she stays somewhere longer than a year, she’ll have to get established with new providers. Thank goodness she’s healthy!
She will still be able to be on our insurance (no ACA insurance) and her permanent address has continued to be in our state, but I don’t think a lot of PCPs will cross state lines to do virtual interviews. Because of the nature of her internship, she wouldn’t be able to come home for the med checks, plus she went from a pediatrician here to a PCP there, so she doesn’t have an established provider.
Yes, that’s exactly the situation! I’ll have her look into 6 month prescriptions the next time she sees her doctor at school. That could at least give her some breathing room!
One of my kids started grad school recently OOS (but not too far) and also aged out of my insurance. She is also on medication and is able to see her doctors remotely- but they are licensed in both states. They move around a lot at this age and it can be a little tricky.
I agree if the internships are not too long it may not be an issue.
There are a lot of telemed docs now that are licensed across multiple states. See if her PCP also does telemed - many do if they already have a relationship established.
When my daughter was study abroad for a year - her PCP gave her 6-9 month prescriptions (for different scripts) so she only had to get home once to get her refills - which she did during winter break. Definitely ask to see how long of a prescription your PCP can get filled for you.
Does your insurance cover her in different states? If so, then going home every three months (or you could get the meds and ship them) makes sense, if the doc will prescribe without a visit. Or she could go on Medicaid and find a PCP where the internship is. Or perhaps there is an extension of your policy to cover the state she is in-?
My kid graduated and went on Medicaid at first, between things, which was lucky because they had an accident that would have cost $400k. They have chronic health issues so we made sure she was covered, thank heavens.
I am amazed at how many young people don’t have insurance.
ShawD graduated a BSN/MSN program and went to work doing primary care, so I think had another provider from her practice.
ShawSon was an entrepreneur for a year after graduation and was on our insurance. Not sure he had or saw a PCP during that period. Then, he went to grad school and his PCP was the walk-in clinic at the school, I think. He co-founded his second company while in grad school and the company purchased good insurance. When he finished school, he signed up at One Medical and his PCP is there. This has been very satisfactory. Good provider. Easy to get appointments. Telehealth. I imagine that will continue. He has some health challenges so having an accommodating provider makes a difference.
My insurance only allows a 90 day supply, but the prescription is for a year. I just renew it every 90 days (at the pharmacy or mail order). If she uses Walgreens or CVS, she can pick up the prescription at any pharmacy nationwide.
My kid did a study abroad. The RX company did an override of the 90 day limit and sent him a 5 month supply before he left here. We contacted them and provided the necessary documentation of the dates, etc.
But for in this country? Just use a pharmacy with locations both at home and near enough to the college. Our kid used CVS in Target…and therefore could go to any CVS for refills…which is what she did.
She spoke to her PCP at school and her PCP will see her remotely for med checks for 6 months, so she should be ok through this internship. I guess we will figure out the next step as it draws nearer!
One Medical is concierge-lite primary care (I think $200/yr or $9/month for Amazon Prime members). It started out as a tech company and had a fully developed telehealth capability and 24/7 telehealth. But, if you are traveling or outside of business hours, you can call telehealth and your provider will get a full report when they start work. One Medical will not have specialists or surgeons but will refer their patients. One Medical does not have hospitals. So, in Boston, One Medical has a referral arrangement with Mass General Brigham, which is the largest hospital/provider network in New England. But it just does primary care – so you go there for a PCP.
Kaiser provides one-stop shop primary care/specialists/hospital/insurance if I am not mistaken. My impression is that the organization (I think it is comprised of three related organizations – the health plan, the providers and the hospitals) is very well managed, but I have no direct experience.
I don’t know Sutter (other than having driven past some of their buildings) but it appears to be provide primary care, specialists and hospitals. Unlike Kaiser, it takes outside insurance. I don’t know if it also provides its own insurance plan if requested.
Sutter and Kaiser are in many ways similar, but their main difference is in how they work with insurance. Kaiser is coupled to Kaiser insurance plans where it is extremely obvious whether a provider or facility is in-network or not (unlike many other insurance plans where you have to look up each one, and do so each year in case they move in or out of network). Sutter tries to be in-network with typical employer and Medicare Advantage insurance plans; in areas where they are have large market share, their (relatively high) costs are a big influence in the costs of insurance plans.