Getting Medical Insurance When You Have Pre-Existing Conditions

Home Lifestyle Insurance Health Getting Medical Insurance When You Have Pre-Existing Conditions

The Problem

My husband and I are having a difficult time as I presently do not have any health insurance. The reason being is that my husband's work does not provide insurance, so we went for private insurance which of course is more expensive. Well, my husband and daughter are covered now, thankfully, but I was denied because of several factors. Since that time I have had emergency surgery which we are going to get some help with, but we still have a sizeable amount to pay. I cannot work because of health challenges. So we are living on one income. We recently applied to another carrier and I was denied again. Is there anything I can do to get some kind of insurance? I am getting very concerned, as this debt is swallowing any and all money that we should have otherwise. We are striving to live frugally already, but I would appreciate any and all help on finances and health insurance of course.
Lynda in CA

Try for Catastrophic Plan

She should try for catastrophic health insurance. I know that at least Blue Cross Blue Shield of Illinois has a good plan. While it doens't cover doctor visits or anything, it does help with hospital bills and other major expenses and the premiums are very cheap (I think I paid $20 a month).
Jen B.

Exclusion Periods?

Have her check with the carrier she has for her husband and child on how long she is excluded for. Most insurances have to cover her if they are covering the rest of the family after a certain time period, usually 1 year.
Sandy

Most States Have a Plan

In Washington State, there is a state insurance fund for people who are unable to obtain private coverage. I am not sure of all the details, but know that most states do have such a fund. The coverage is not as extensive as a private carrier, but it would provide her with some catastrophic type coverage and give her an option until she is able to find private coverage. This fund is separate from the Medicaid (or welfare health) program so she should qualify for it. I would suggest that she contact the Insurance Commissioner's Office in her area.
Steve F.

Editor's note: readers from a number of different states had similar advice.

Find a "Group"

I too, live in CA and up until 10 months ago I was the group insurance administrator for a company of 300 employees. If the writer of the question (or the victim of insurance companies as I see it) was covered for 6 consecutive months PRIOR to searching for medical insurance, she cannot, by law, be declined by any insurance company for any reason, including pre-existing conditions. I suspect, however, by her post that she had gone some period of time without coverage. Given that, her best bet is to become affiliated with some kind of group that offers its members medical insurance. For instance, my husband is a real estate appraiser. as such, he belongs to FREA (Foundation of Real Estate Appraisers) which offers group insurance for all of its members. Real estate agents have similar organizations they can belong to. Many, many professions have related clubs and organizations which offer health insurance. If she cannot find one related to either her or her husband's occupation, then I suggest she start up a small business---maybe Mary Kay, Avon, Tupperware, anything that will allow her to apply to organizations for small business owners. most of those offer group health plans. As long as she tries to obtain health insurance through a group plan, it is unlikely she will be denied. Most group plans are set up so that members, upon initial enrollment, cannot be denied.
Jackie M.

Pre-Existing Clauses

We too had a similar problem with the insurance companies because of our daughters health. You should talk with the insurance commission in your area. Also, if your illness is something that will be with you for the rest of your life, you could ask for a preexisting illness clause. This means that the insurance company will not cover any bill related to this illness but will cover the other expenses.
V.

Check Local Hospitals

I work for a county hospital. We have a program which is based on people's income. Its to help those that fall between the bracket of to low or to high to qualify. Its usually called some variant on 'medically indigent'. for instance ours is the Colorado indigent care program (cicp for short). Call around to your local hospitals. See if anyone offers it. Its usually the local county hospital.

Also if you have any doubts about quality of care, let me reassure you. I would never want to go anywhere else than my own county hospital. We have a level one trauma center, and the care is excellent. So call around, this is a federally funded program, all over the country, and there are others.
Tammee

Try an Appeal

I was in a similar situation, and a Farmer's insurance agent told me that each state has laws that goven health coverage, and if you're denied for any reason, especially poor health, you can appeal. You need to ask the company applied with, or call your State's attorney general's office (usually located with numbers to your State senators, whom you can also call for help and answers). This appeal should get you some coverage, as I believe there may be a federal law saying you can't be denied because you are in poor health, overweight, etc.
Jani

Health Benefits Counselor Could Help

You may want to contact your local county agencies to see if they have a Family Health Benefits Counselor. I used to be one for the Public Health department in a County in Wisconsin. Different states may have them not all counties have a Family health benefits counselor. They provide information, referral counseling and advocacy for families in order to obtain health care financing through public and federal programs. You may want to see if your state has a risk insurance plan. Wisconsin has H.I.R.S.P. Insurance. They will accept persons who have been denied insurance for reasons of pre-existing conditions or if you are a high risk patient. Also, your medical centers should have a patient assistance program to help with the cost of your medical bills. They can either take a percentage as payment in full or sometime write off the entire bill if you are intigent. I have helped many folks who have enormous medical bills as a Family health benefits counselor it takes patience but being persistant with agencies and asking for help is the key.
Kevin D.

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