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UC pre-existing condition and getting health insurance

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Ulcerative Colitis
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Posted 10/29/2009 11:22 AM (GMT 0)
Well, I am just getting out of a flare and my husband found out yesterday he is being laid off. So much for cutting the stress out of my life. My job doesn't have any benefits and COBRA is SO expensive, so how do I get insurance with a pre-existing condition? I am praying for health reform, but until then??? Honesty, this is the biggest stress I have. My husband is a consultant, so I know he'll get consulting work, but most likely he won't get health insurance.

Thanks!
Posted 10/29/2009 1:17 PM (GMT 0)
Do pay for your COBRA! Yes, it's expensive but the insurance is there if you need it and it continues your coverage.

I think it's extremely important for anyone with a chronic disease to get a job where the employer offers group coverage. You cannot be denied insurance over pre-existing conditions and the coverage is comprehensive and affordable. Since you and your husband both work one of you should seek employment with a city, county, schools, college, or university. Those are some of the employers who offer group insurance. Bigger companies do too.

Sue
Posted 10/29/2009 1:56 PM (GMT 0)
Disneynut, you'll find that a fair number of companies won't insure you at all. The ones who do will likely only offer limited coverage at a very high price. Sue is absolutely right, COBRA is going to be your best - and likely cheapest - option. Then pray for healthcare reform, because every option I've heard about has forbidden insurers to invoke the pre-existing condition refusal.

It's sad that we sometimes have to let our career and life decisions be directed by our need to have good insurance coverage, but that's how things are now. I worked for local government, and will have good insurance for the rest of my life because of that.

Whatever you do, try to avoid going without insurance. I'm sure you'll find the COBRA sounds much less expensive if you figure out how much your medications would cost you every month.
Posted 10/29/2009 3:02 PM (GMT 0)
I would get the Cobra coverage. See COBRA Health Insurance Continuation Premium Subsidy (www.irs.gov/newsroom/article/0,,id=204505,00.html) which allows eligible workers who have lost their jobs to pay 35 percent of the premium to their former employers for nine months.

I had left my previous job that had group coverage and stayed on Cobra for 18 months. I have now transitioned to my state's high risk pool insurance. Sadly, after only one month on it I have had close to $10,000 worth of medical claims submitted.

This site (www.healthinsuranceinfo.net) has been very useful for me in my attempt to transition through the insurance maze.

- tap
Posted 10/29/2009 4:36 PM (GMT 0)
I dont know how much COBRA costs or what state you're from but it was impossible for myself to get insurance with UC as a pre exisiting condition here in California. I tried for about 6 months with every company I could find and would get turned down. Luckily I found that California has a MRMIP (major risk medical insurance program) that takes about 6 months to get in and you're guaranteed insurance through a few companies of your choice.

I pay around 300$ a month for Kaiser now but more than make up for it with just the Asacol. I suggest try to dig around and find out if your state offers something comparable. Good luck, it sucks to be without insurance with this pos disease..
Posted 10/29/2009 4:43 PM (GMT 0)
I would definitely get COBRA. If you allow your insurance to lapse, it gets even harder to get insurance. With a preexisting condition, you need a plan with prescriptions covered, a lot of the plans don't cover or you have to pay more for them. You also have to pay higher premiums for having the condition. The deductibles are very high, so high, you may never hit them - you are pretty much paying out of pocket, plus you are also paying for prescriptions and monthly premiums. I have had a lapse for a while and now it will be next to impossible for me to get coverage unless I get it through a group plan. If I do get insurace through a job, I could end up waiting up to 6 months for them to cover my preepxisting condition depending on their policy. Some companies will cover it right away.

I am currently unemployed with a lapse, I have looked for plans and have been denied. A while ago, I was told I might qualify for one HMO plan that would cost $700 a month+. I doubt I would qualify for that plan now. I go to the doctor and pay out of pocket. I probably spend 1,000 on doctors a year. I get my medication through patient assistant plans for low income people. Fortunately I am not married so my income is not lumped with my significant others. If it were, I would not qualify. I have been lucky because I have been relatively nonsymptomatic but if something happened, I would be in a lot of trouble. I want to get insurance but it's too expensive. If I get a low cost plan, I probably will not be elligible for the patient assistance programs anymore because I am not "uninsured". The medication I use is too expensive to buy without insurance. I was also lucky because I got a colonoscopy for free through a clinical trial for UC. I got $150 for having the colonoscopy. tongue

Posted 10/29/2009 5:06 PM (GMT 0)
Go with the Cobra for yourself. Mine is dirt cheap right now with the Cobra subsidy. We were put in the exact same situation last year in Dec. I kept the insurance through Cobra, and my wife and little one got a private insurance since they have no problems. Then hopefully by the time it is used up, we will be able to get insurance without the pre-existing terms....
Posted 10/29/2009 7:24 PM (GMT 0)
Thank you, thank you everyone. Tap that is great news...I had not heard of that. Dr-A, how exactly do you set that up? I read a little bit of the article and ran upstairs to tell my husband. We were so relieved. It seems he might be getting some contract work, but we won't get insurance so this will help until I get a new job.

The thing that stinks is that I'm an instructional assistant for a school district and we do not get health insurance. Even the cafeteria workers get health insurance! And I work with special needs kids so my job is really hard for very little money and no benefits. Anyway, the 9 months will give me time to maybe find another job in the school district that has benefits.

Thank you all so much. This has taken a lot of stress off of us!
Posted 10/29/2009 9:33 PM (GMT 0)
http://www.dol.gov/ebsa/cobra.html

So, if you just keep yours it would pretty much be 35% of whatever your cost was for 9 months. Then, unless things change you would have to pick up the extra 9 months of coverage for the full 18 months. At that point you would be eligible to go to the private insurance without a pre-existing condition limit.

What Tap said actually, lol.. just read that.
Posted 10/29/2009 11:48 PM (GMT 0)

Dr-A said...
At that point you would be eligible to go to the private insurance without a pre-existing condition limit.


That's not accurate for here in Minnesota. Insurers are not required to provide private insurance.

From the Minnesota entry at www.healthinsuranceinfo.net: "In general, companies that sell individual health insurance in Minnesota are free to turn you down because of your health status and other factors."

Great care needs to be taken when transitioning to individual health insurance. Some states don't even offer high risk pool insurance. I'm guessing that the uninsured people in those states use the ER a lot when ill.
Posted 10/30/2009 12:03 AM (GMT 0)
Too bad you don't live in Arizona. The same thing happened to me over a year ago and I immediately got "AHCCCS." Here in Arizona if you have low income, or no income you can get it. It's completely free and covers all medical about 100%. Amazing huh? Well, that's probably why Arizona has so many budget problems.

Post Edited (desdwel) : 10/29/2009 6:09:04 PM (GMT-6)

Posted 10/30/2009 12:14 AM (GMT 0)

desdwel said...
Too bad you don't live in Arizona. The same thing happened to me over a year ago and I immediately got "AHCCCS." Here in Arizona if you have low income, or no income you can get it. It's completely free and covers all medical about 100%. Amazing huh? Well, that's probably why Arizona has so many budget problems.

We will all soon have that insurance. Of course the US already has budget problems.... And this will not help. But hey, at least we cannot be denied coverage anymore.

Sorry kids, daddy is spending away your future.
Posted 10/30/2009 3:53 AM (GMT 0)
My husband just lost his job today and I'm wondering about insurance.  We will have coverage for about 8mths and then COBRA, but what will happen then.  Will we have trouble finding insurance to cover our family since my daughter has UC?  Is it the same when it's a child?

 

Posted 10/30/2009 11:26 AM (GMT 0)
I'm sorry your husband lost his job, too. I think it might be hard to get insurance for your daughter. I was told that I should try to get the "healthy" family members their own policy and try to get mine another way. This was a few years ago when we needed private insurance.

Lookingforthecure---my husband is a consultant, too. His company just got rid of his division and now he is deciding whether to do it on his own. I would have to get a job with benefits, though. Luckily I have 9 months before I have to really think about that now...thank you Recovery Act!

We used to live in California where they had a high risk plan. Now we are in Indiana and the only plan I could find would be more than COBRA for all of us.
Posted 10/30/2009 3:54 PM (GMT 0)
Something you will be VERY interested in:


http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-Immediately-102909.pdf

2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL) — Creates a
temporary insurance program until the Exchange is available for individuals who have been uninsured for several
months or have been denied a policy because of pre-existing conditions.


As soon as the health insurance "reform" bill is passed, you can get on the government plan if you are denied because of an existing condition.

So pre existing conditions will cease to be a problem in a few weeks.
Posted 10/30/2009 4:51 PM (GMT 0)
Well, it will likely be more than a few weeks. Probably a few months at the least. First this bill has to pass the full house. Then the Senate passes their bill, which will likely be significantly more conservative. Then they have to reconcile the two and have the final bill (which may or may not still include much reform at that point) pass both houses and be signed by the President. Then they have to get the programs up and running.

On the plus side for us, and staying out of the politics because that's not the purpose of this board, all of the proposals I've seen so far have included the aspect of doing away with not insuring pre-existing conditions.
Posted 10/30/2009 6:57 PM (GMT 0)
Judy, reading your post reminded me of School House Rock..."yes, I'm only a bill sitting here on Capitol Hill." Ah, what memories.
Posted 10/30/2009 7:59 PM (GMT 0)
Disneynut, I live in IN too. Are you talking about the state's high-risk pool policy? I've always wondered about that.
Posted 10/30/2009 8:22 PM (GMT 0)
If the House bill passed, you could stay on COBRA until the insurance exchange is up and running.
The pre-existing condition prohibition would not take effect until 2013, but the look-back would be shortened to 30 days until then.

All subject to continued negotiation.

The COBRA subsidy expires at the end of the year, but will likely be extended because so many are still out of work.
Posted 10/30/2009 9:16 PM (GMT 0)
Scrap Girl--I looked into it and it looked VERY expensive. We don't qualify for any of the other low income programs..and hopefully my husband will find a job soon so we won't qualify.

What part of the state do you live in? We live in Carmel.
Posted 10/30/2009 10:27 PM (GMT 0)
Reading this post reminds me of why I stay working for the large company that I do that has fantastic heatlh benefits. Do I give up other things I am searching for in a career to stay here for the insurance, absolutely, but I cannot do without insurance. I'd love to open my own business one day, but don't see that in my future anytime in the near future.
Posted 10/31/2009 1:55 AM (GMT 0)
Disneynut, I live in Ft. Wayne now but lived in Carmel and Fishers for a while after I graduated from college. Nice area. Granted, it's not California. Anyways, I don't know how long you've been here but welcome!
Posted 10/31/2009 4:10 AM (GMT 0)
I think a lot of people would stop working fulltime if health benefits were universally available. I am looking forward to that day. I see it as a lot more happy people who are not so tied to a job they hate. I have been wokring for myself for years and I have to admit, my life has become somewhat a dream, well, aside from the UC. If I didn't have the health insurance problem, I wouldn't be so concerned about getting a job. I would be happier and more able to follow my dreams. It would enable more americans to start businesses and not leave the burden of healthcare on the business owners. I am excited that it is being considered. I would have no problem paying more taxes if it's going towards universal healthcare, I do however think we currently pay way too much for what we are getting. We give so much as Americans and we have such a low quality of life compared to other countries. It's kind of pathetic.

Also, if you work a job solely for the benefits, you might as well work as a cop or go to the army. At least then you do your 20 years and you get the benefits. turn

Posted 11/1/2009 2:32 AM (GMT 0)
We pay so much because we also have to pay a share of what is spent for those who doesn't pay anything. At least if everyone had insurance, care would cost what it should (eventually).

There are SO many people who take jobs, or stay in particular jobs, for the health benefits. It would definitely change things if that didn't matter!!
Posted 11/1/2009 2:45 AM (GMT 0)
I too would not be able to afford Cobra if it were not for the subsidy. Health care should be a right, not a luxury.
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