HELP!!! I need Health Insurance

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Optymystic
Regular Member


Date Joined Apr 2007
Total Posts : 218
   Posted 2/13/2008 7:17 AM (GMT -7)   
Hi everyone. I've read here before that you can get coverage as long as there is no gap between coverages.  My insurance from my husband's (soon to be ex) job runs out at the end of March. I cannot afford COBRA and none of my jobs offer a group plan. 
Blue Cross told me I am uninsurable on an individual policy because of the Crohn's, and now I am freaking out.
 
Does anyone out there know how I can get insurance without having to go work at Starbucks or Home Depot.  Nothing against those places, in fact I love them, but I don't want to work nights and weekends and I know that's what would have to happen.
 
Please tell me as many ideas as you have. Don't be shy, as I am getting desperate.
 
Is there perhaps any government help available?
Has anyone heard of "Good Health Plan" out of Nevada?  They offered to cover me, but turned out to be a scam I think.
 
Thanks guys.
Age 41 female.
dx'd in April 2007 - feeling better now
4000mg Pentasa and 75mg 6-MP
Primal Defense probiotic by Garden of Life


MaryS
Veteran Member


Date Joined Jan 2003
Total Posts : 1668
   Posted 2/13/2008 8:03 AM (GMT -7)   
Then the Ads here in Michigan on TV from Blue Cross saying that they can "insure everyone no matter what" is a crock! Granted, it would not be a cheap adventure just like COBRA isn't.

You almost can't afford NOT to do COBRA for a bit until you find other Insurance. Once Insurance lapses more than 63 days then it is even harder to get insured unless it is through an Employer. Pentasa alone is a hefty sum out-of-pocket.

Can't say I can help any. I would check to see what your State might have available in Group/Pool Insurance. Some States offer it and others don't.

Finding that a lot of the individual Insurances offered out there are more Health Savings/Spending accounts. Would probably be Ok for healthier people, but not sure how helpful it would be for someone with a chronic illness.

Good Luck in your search! I hope you find something!

yogaprof
Veteran Member


Date Joined Apr 2006
Total Posts : 1665
   Posted 2/13/2008 8:06 AM (GMT -7)   
is lifewise available where you live? it is pretty reasonably priced.
48 y/o woman.  Diagnosed 4/06 after colonscopy, SBFT, CT-scan all showed crohns. 3 months later, after pred and remicade, all tests showed no crohns. December '06 had adhesions cut through a laparoscopy. Now taking Glycolax, Ultra Fiber Plus, Florastor, and DHEA. Have become gluten-free diet per naturopath's tests.


bektold
Regular Member


Date Joined Jul 2007
Total Posts : 456
   Posted 2/13/2008 8:34 AM (GMT -7)   
Definitely check with your state.  My infusion nurse told me that Texas (where I live) has a special state insurance plan for those with health problems that make it hard to get other insurance.  Her son is on it.  They don't advertise it, but it's there for those who know to ask.  She said it runs about $350 a month for him.  Expensive, but cheaper than the alternative. 

sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 2/13/2008 8:37 AM (GMT -7)   
In Oregon and Washington there are state insurance pools for people who are rejected by one of the major healthcare companies and are not eligible for medicare or medicaid. I am in OR and it's called OMIP -- Oregon Medical Insurance Pool.

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 2/13/2008 12:10 PM (GMT -7)   
As long as your ex is still employed there are ways to stay on his insurance. This is not legal advice and I have not taken family law anyway... you should probably talk to a lawyer or a legal help hotline about this.

Are you having a contested or non-contested divorce? Basically, the court can order as part of alimony that your former husband maintain you on his insurance policy. His employer and insurance provider would have to comply. The same goes for children that need insurance, even if he is the non-custodial parent. If you have a non-contested divorce you are obviously still going to be dealing with a court. Just get in the terms of your agreement that he must keep you as a dependent on his employer's policy. If you want, you could still offer to pay the premium. This is a very common issue in divorces and any good divorce attorney (or clinic student) should be able to help you with this.
26 Year old married female.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  Currently on Pentasa 4 pills/4x day, hysociamine prn, nexium, and ortho evra.  Good times!!!
 
 


lil-momma
Regular Member


Date Joined Feb 2008
Total Posts : 132
   Posted 2/13/2008 12:50 PM (GMT -7)   
Check all your options ASAP.  You definitely can not have a lapse in coverage.  You will encounter one heck of a time to find coverage if at all.  Check with state funded programs.  Sometimes there are things available based on your income.  We are having similar issues.  Our insurance has been trying to cancel us since my daughter was diagnosed and they believe they have found their loop hole.  Sorry, I don't have exact answers for you.  Best of luck! 

Mother to 15 yr old daughter diagnosed w/CD 9/07.  Had col & endo in 9/07, small bowel follow through 11/07, surgery for abcesses 11/07.  Curently taking multi-vit, iron for anemia, bentyl prn, prilosec 20mg-x2, pentasa  500mg-x5, entocort-x3, 6 mp 50mg-x3.....still not doing well.


stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 2/13/2008 1:19 PM (GMT -7)   

I hope you find your coverage, and remember all states are different so call every agency you can think of.  Blue Cross may not advertise the fine print in their gaurantee............which usually throws in a quesitonaire that reads, "Have you ever been to the physician's in the last 90 years?" redface

I wish you the best.
Kitt


 
Kitt, Moderator: Anxiety ~ Panic  ~ Crohn's
*~* http://www.healingwell.com/donate *~*
It is health that is real wealth and not pieces of gold and silver.~Mahatma Gandhi~
 


yogaprof
Veteran Member


Date Joined Apr 2006
Total Posts : 1665
   Posted 2/13/2008 2:05 PM (GMT -7)   
and how have you been?
one more thought, you don't have to be at one of the big chains for insurance. check out the school system or any colleges in the area. there are lots of jobs at the college where I teach and the benefits are fabulous.
take care, girl! yp
48 y/o woman.  Diagnosed 4/06 after colonscopy, SBFT, CT-scan all showed crohns. 3 months later, after pred and remicade, all tests showed no crohns. December '06 had adhesions cut through a laparoscopy. Now taking Glycolax, Ultra Fiber Plus, Florastor, and DHEA. Have become gluten-free diet per naturopath's tests.


Candy02783
New Member


Date Joined Feb 2008
Total Posts : 9
   Posted 2/13/2008 2:11 PM (GMT -7)   
hello, I am having the same problem and It seems like most states have a high risk pool wher eu can get insurance. Call ur states Dept of Insurance.

Bane
Veteran Member


Date Joined May 2007
Total Posts : 589
   Posted 2/13/2008 2:13 PM (GMT -7)   
well, its not insurance, but one thing to look at is trying to get into a clinical trial for your meds.
19, Male, diagnosed over Christmas Break of my Junior year in High School. BEST CHRISTMAS EVAR LOL

(not really)


jenngrl81
Regular Member


Date Joined Oct 2007
Total Posts : 208
   Posted 2/13/2008 4:54 PM (GMT -7)   
It is a law that you cannot be rejected for group health insurance if there is no lapse in coverage when you start your new policy. I'm not sure the name of the form you have to fill out but you need a "non-interruption, continuous coverage letter" from your previous (current) group carrier to give to the new insurance company. They can't deny you coverage for your Crohn's, just don't lapse in coverage before you start your new plan. Don't let them give you the runaround...
Pentasa 500mg/8x daily down to 6x 1/08; Entocort 3mg/3x daily down to 2x 1/08; Percocet/Ultram for pain; Protonix 40mg
Neurontin, 900mg 3x/day
Probiotic
Ferrous Sulfate 325mg/daily for anemia
Azathioprine 150mg
Currently on a Low-residue diet as of 11/26

I'm so tired, when will this get better?


climbs
New Member


Date Joined Sep 2007
Total Posts : 18
   Posted 2/13/2008 5:08 PM (GMT -7)   
Back right after college I has using the charity care clinic at a hospital near my home. The care there was excellent. In fact, I was diagnosed there and recently selected that same doctor under my new insurance plan.

petittarte
Veteran Member


Date Joined Apr 2006
Total Posts : 686
   Posted 2/13/2008 6:02 PM (GMT -7)   
Jenny26- Unfortunately that is not true. Every state has different rules and regulations for insurance. In some states you can be denied coverage or coverage of certain things or be charged really high rates based on your age, sex and health. The rules regarding a lapse in coverage are different for every state also.
Jodi

Remicade and 6MP


vadreamer1
Regular Member


Date Joined Aug 2006
Total Posts : 196
   Posted 2/13/2008 7:20 PM (GMT -7)   
Have you thought about obtaining employment with either State, City or County governments? They generally include health insurance as a benefit.

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 2/13/2008 7:24 PM (GMT -7)   
Jodi - you may be right but I am fairly certain that Jenny was referring to group coverage that one would get at a large employer or by being married to someone employed by a large company. Although each state can have its on restrictions, the federal COBRA law protects people with certificates of coverage who are moving to other GROUP plans. Group being the key word. You are still up the creek if you are self employed or work for a company that employs less than 50 people (I am guessing on the exact number.) But if your employer offers group insurance as a conditional benefit of employment you generally can not be denied for a pre-existing condition so long as you have been insured up to that date (or had only lapsed during the period in which one could have elected COBRA).
26 Year old married female.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  Currently on Pentasa 4 pills/4x day, hysociamine prn, nexium, and ortho evra.  Good times!!!
 
 


MaryS
Veteran Member


Date Joined Jan 2003
Total Posts : 1668
   Posted 2/13/2008 8:41 PM (GMT -7)   

You might want to check out the following link regarding the HIPAA Law enacted by Congress in 1996 regarding 63 day lapse in Insurance and pre-existing conditions.

http://www.insure.com/articles/healthinsurance/HIPAA.html


Optymystic
Regular Member


Date Joined Apr 2007
Total Posts : 218
   Posted 2/14/2008 9:09 PM (GMT -7)   
Thank you everyone! I am looking into all the ideas you have posted so far, and I will let you know what I find out. The HIPAA info. has been helpful, too. I have been too depressed to look for work for the past couple of months, but thanks to prozac, I am now feeling like I can "get back on the horse" and find a job, or maybe even some state sponsered coverage. I really appreciate you guys.
Age 41 female.
dx'd in April 2007 - feeling better now
4000mg Pentasa and 75mg 6-MP
Primal Defense probiotic by Garden of Life


missteekay
New Member


Date Joined Feb 2008
Total Posts : 3
   Posted 2/26/2008 4:18 AM (GMT -7)   
i went on the internet and found what i believe is that HIPPA that MaryS mentioned. it is kinda expensive, and i had to carry the insuranc 6 months befor it would cover anything to do with my cd. but thank God i got it, because 7 months later, i started remicaid infusions, and another 6 months later, i had surgery. befor that my dr. helped me get pentasa free through the pharmacutical company. i cant afford the insurance through HIPPA much longer, so i have taken a job working nights, and weekends so i can get their insurance. sometimes you just have to do things you really dont want to. having cd does change your life.

Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 2/26/2008 2:32 PM (GMT -7)   
Ok, here are 2 options - pay for the COBRA on your credit card and make your soon to be ex pay for 1/2 of it until you get coverage as part of the divorce agreement OR since you are not currently employed, get your heiney down to the medicaid office ASAP!!!! There's no reason you can't get medicaid if you don't have a job. I know you are caught between a rock and a hard place, but you absolutely CANNOT have a lapse in coverage. It will make it so extremely difficult to get coverage later.

Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 2/26/2008 4:00 PM (GMT -7)   
I know you said you don't want to do the Starbucks thing because of nights and weekends. But, just so you know, my daughter works there and you can give them your "availability". So, if all else fails, you could give them some guidelines as far as when you could work. She is a college student and they are very good about scheduling to her specifications. Just so you have all of your options. Also, I believe you get coverage at 20 hours a week, which isn't bad.
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


map lady
Regular Member


Date Joined Feb 2008
Total Posts : 154
   Posted 2/26/2008 4:20 PM (GMT -7)   

Thanks for the HIPAA link, it was really useful!  I had wondered how the "pre-existing condition" stuff worked and had worried that I would never be able to get insurance again from any employer if I ever had to change jobs.  It doesn't sound too fun to deal with but at least I know how the rules go for that :-)

Now that I know what the deal is with switching insurance coverage if you change employers, does anyone know anything about the health insurance benefits for Starbucks or Home Depot?  I have seen them mentioned many times here so they must be pretty decent.  I was curious as to approximately how much the insurance costs per month and what the out-of-pocket expenses are like, (i.e. $150 a month, $100 prescription cap, $50k yearly benefit cap or whatever) I would be a great mental comfort to have financial estimates of my health expenses ahead of time for if I ever lose my day job or become able to only work part-time.

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