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New Member

Date Joined Jun 2008
Total Posts : 14
   Posted 9/10/2008 3:05 PM (GMT -6)   
   I was wondering if anyone knows of any insurance company that will cover someone with Lupus? I'm sure I'm asking for a miracle but figured it couldn't hurt.

Good luck to everyone and may God Bless you everyday.....

I'm currently taking atenolol, verapamil, ovcon (no cycle since 2000), prednisone, neurontin, cytoxan, folbic, diludad, loratab, demerol,(depending on severity of pain), promethazine, singulair, lasix, amitriptyline, baby aspirin, patanol --- I think that's it...

I have SLE, SVT, MVP, Sjogrens, Fibromyalgia, Neuropathy, migraines, Pleurisy, asthma, endometrosis, Reynauds -- think that's it as well....

Veteran Member

Date Joined Jan 2005
Total Posts : 8616
   Posted 9/10/2008 9:31 PM (GMT -6)   
Hi rere,

are you w/o insurance and trying to begin coverage?

or are WITH an insurance provider and trying to change?

I can't answer your question . . . but it does make a big difference if you are trying to switch or start.

It also makes a difference if it through an employer/group or if you are trying to get individual insurance.

More info would a knowledgeable person answer your question.


In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator

Veteran Member

Date Joined Apr 2006
Total Posts : 1344
   Posted 9/12/2008 10:10 AM (GMT -6)   
I don't know for sure but my guess is that no insurance company would cover someone diagnosed with lupus on an individual plan.  Group plans would take you.
If you are 65 medicare will cover you.  Otherwise, most states have insurance pools that will cover you but they are very expensive.  In Illinois it was $1200 per month per person with big deductibles when I looked a few years ago.
You might find an insurance company that would cover you but excludes lupus. 
This is an example of how screwed up our healthcare system is and how easy it is to fall between the cracks.  50 million have done so in recent years.  I almost did after working for 3 companies that went out of business.  When COBRA expired I had a difficult time but ultimately found insurance.  about a year later I was hit with MCTD and had enormous bills after 3 months in hospitals and countless tests and procedures.  I was so lucky.
Today I am on medicare and don't have to worry but I know so many younger people who have been caught and cannot get or afford individual insurance.
Mixed connective tissue disease (systemic lupus, scleroderma, polymyositis), Raynauds phenomena, Hypertension, Barrett's esophagus.
Meds: prednisone 5mg, 50mg imuran, Lotrel 40/5mg, maxide 37.5/25mg, folic acid, potassium, aciphex 20mg, multi vitamins.
Maintain your optimism and you can beat the odds.
"Although the world is full of suffering, it is also full of the overcoming of it."  Helen Keller

Regular Member

Date Joined Aug 2007
Total Posts : 206
   Posted 9/13/2008 12:13 AM (GMT -6)   
Do you work full-time? I was told when I started my job that if I didn't take the insurance when they first offered it to me and then decided later that I wanted it, I would have to go through a physical to see if I qualified at that time. When I switched from a life insurance policy at one company to another because it was a better plan, they found out I was in the process of maybe being diagnosed with something. So, I had to fight to get my insurance through them and my agent ended up searching for a similar plan through a company that would accept me. Pretty much I can never chance insurance companies again, unless I switch jobs. If you are independently trying to find insurance, I wish you luck-however, some states may offer plans for low-income (if you qualify) or disabled people at a reduced rate. That's always something to look in to.
"Challenges make you discover things about yourself you never really knew."
SLE and Class II Lupus Nephritis

Regular Member

Date Joined Oct 2005
Total Posts : 315
   Posted 9/14/2008 11:32 AM (GMT -6)   
I agree with what the others have stated. If it's individual insurance, then most likely, no...they will not cover anything lupus related that you've been treated for within the last 6 to 12 months (depending on insurance company) for a period of usually 6 to 12 months.
In January I lost my job because my company was going out of business for good. They did call back a handful of people to tie up loose ends before liquidating & closing for good, so I did have COBRA available through May, which depleted my savings account. In New Jersey, there is a law, that if one keeps continuous health coverage in one way or another, even if you buy individual coverage after a while...if you were covered the whole time, they cannot use pre-existing conditions to exclude you for those coverages. So I was in a bind..and ended up buying a cheap individual plan after my COBRA was done. However, it's not a comprehensive plan and I have caps of only $500 per year on both any diagnostic tests and prescriptions. And in just a little over 2 months, met my cap on both. I can still get doctor visits for a co-pay, but cannot get any tests done and cant get my scripts either b/c they will no longer pay. All the other plans were way too expensive. The next cheapest one was a high co-pay HMO but that was almost $550 per month, which I just couldnt afford. My state does have clinics based on sliding scales, but they no longer accept single people without children into that plan so I don't qualify for that either. It's really awful they way the health system is in this country. And with charity care, it's ridiculous the income amount that qualifies one for it. No one can live on that amount. Even on unemployment, I make too much to qualify for other assistance. But you still might want to check into your own States' programs to see if you might qualify for something. As for my prescriptions, I will be without some for several weeks (and dread that) but I applied for prescription assistance through Pfizer already and yesterday got my acceptance letter. So per their criteria, I was approved (due to me including an application and letter of hardship)....was approved to receive any of their meds for free. So that was a BIG load off my back!  But I still have to wait til end of Sept. to see my Rheum about some of the meds he gives me. I already get generic Plaquenil, which is only about $45/month for 3 months worth, so that is okay. But my migraine meds cost over $200/month regularly so I will ask him to sign my application for Glaxo to get my Imitrex. So there are programs out there that can help with certain things, though i've not found anything that helps with testing.
You might also try to negotiate with doctors, labs, etc.. to see if they would accept payment equal to what they would get paid from insurers. Some of them might bite, you never know...
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