You can get insurance

Here’s a very helpful article from CNN: Information on how to get insurance when you suffer from a pre-existing condition. CHDers hate those three words: they are the reason (or the excuse) that insurance is not available to us or only available at sky-high prices.

Insurance companies operate on a pretty simple theory: All the members pay into a fund, and that fund is used to cover costs when a member gets sick. That’s a pretty simplistic explanation, but that’s how they work. The goal of the company is to stay solvent by always having money in the fund, which (hopefully) is well managed through investments and generating a profit.

To prevent sudden disasters from emptying the fund, insurance companies make the safe bet. Good drivers pay less. Healthy people pay less. Healthy people striving to stay healthy could pay even less than that. The homeowner in a “safe” part of the country will pay less than someone living where tornados or hurricanes are prevelant. You can’t predict an auto accident or a weather disaster, but you can predict that folks who were already sick are going to need medical care more often. So Phil will likely be turned down when he applies for insurance, because he has HLHS.

If you are lucky enough to have a job and then unlucky enough to lose it, you have the right to buy COBRA insurance. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, but a lot of people think of the hooded snake: At the prices that you have to pay for it, COBRA can kill you quick. But if you need it, something is better than nothing, and the Stimulus Package will pay a portion of the costs.

Each state has a high risk insurance pool that you can investigate, and you should check out your states ratings when it comes to health. Who knows? You might find that relocation will improve your ability to find health coverage. Yes, it is an extreme option, but sometimes we’ll take any port in a storm.

Probably the best thing to have is a group insurance plan – As one of a crowd, your pre-existing conditions are still covered because the costs are spread out. The smaller the group, however, the less likely you are to qualify for a group plan because the costs begin to out weigh the income generated.

There are some states where you can literally be “a group of one” – self employed, yet able to purchase a group health insurance plan! If that is great, you’re going to think the next point is wonderful: most of the “group of one” states also have “must issue” laws. If your group – even if it is just you – meets the requirements, you have to be offered health insurance!

Some states say that you literally have to have a group – two or more people. Hire a relative. Or hire someone else with a pre-existing condition and solve both of your insurance problems. You can check your state requirements here.  Actually, you can check a lot of things through that link by clicking the list in the blue box.

I am not in favor of obtaining something through dishonesty, but if your state allows very small groups – and occasionally individuals – to obtain health insurance, I think you should look into it.


Tags: , , , , ,

3 Responses to “You can get insurance”

  1. Denise Says:

    Hi Steve, I wanted to say thank you for this information. We’ve always been blessed to have good insurance but it has been a concern to me lately.
    I have been follwing your blog for a few months but only just started blogging myself (for my 16 year old daughter, Emily, who has HLHS) You have given us so much encouragement!
    God Bless and thanks, Denise

  2. Linda D. Says:

    I’ve been enjoying your blog. I have a 3 1/2 year old girl with ToF. She was on ECMO for a week after surgery at age 2 months but is now doing well.

    I have to make one statement about your comment that the stimulus package will help make COBRA payments. This is not true in all cases. My husband passed away unexpectedly at the age of 52 in March (heart attack, no CHD), and I need to do COBRA. I just found out that the stimulus will NOT pay 65% of my COBRA premium because it is due to a death, not a lay off. Just wanted to put that out there.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s