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Steps to Pre-Existing Condition Health Insurance
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.
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