CFS: No Job. Need Long Term Health Insurrance. Any Advice Please.

Discussion in 'Fibromyalgia Main Forum' started by bakeman, Aug 15, 2008.

  1. bakeman

    bakeman New Member

    hi guys. i need some advice on health insurance. i have been getting short term (1yr policy for the last 5 years and reordering it each year). i did this because i was thinking i would be able to work shortly but after 7 years of this i'm thinking i need long term insurance incase something really bad happens. if i continue on the short term policy, if a health crisis happens, once my one year policy is done, i will not be covered after that for anything that is considered preexisting. with my luck, i would get somthing horrile in the 12 months of my one year policy and be screwed. i am going to call blue cross or blue sheild in a day or two. i'm not sure how they handle cfs?

    please, does anybody have any advice for me?

    thanks, bake
  2. Forebearance

    Forebearance Member

    Hi bake,

    I participate in the plan for high-risk people in my state. No one else would insure me. So my premiums go to support all the people with heart disease, AIDS, etc. who cannot get health coverage.

    My deductible is $10,000, in order to make the premiums reasonable. So I have never come anywhere near to going over my deductible. This means that I pay for all my doctor visits, prescriptions, lab tests, etc. out of pocket. But at least I get to pay the rates that the insurance company (BC/BS) has negotiated.

    You could say that my health insurance is just for major disasters, which is something I feel I cannot be without.


    CANSADO Member

    Hi Bakeman,

    NAHU dot org has state-by-state info re the different programs. A quick scan showed that only about seven states (MA, ME, MI(BCBS only), OR, NJ, NY, VT and maybe WA) do not allow individual health plans to discriminate by health. Another part of the site shows by-state info re high risk health pools, etc. Of course, you should also look for a health insurance web site run by your state to confirm anything found on NAHU site. Good luck.
  4. Malcolm82

    Malcolm82 New Member

    I live in New York, so it may be different in your state.

    In the area where I live in Western New York it is just about impossible to get actual health insurance coverage without being in a participating group, like an employer would be in, unless you meet certain maximum income levels or you are retirement age. My disability income is too high to qualify for the low income plans and I am quite a ways away from retirement age.

    I worked for a week and a half checking this out.

    What I have done is this: I found out that my county's Chamber of Commerce offers several different high quality health coverage plans to their business members. To be a member you have to have a business certificate filed with your county clerk's office, and then apply for membership. In my county there is a registration fee for sole proprietors of $100/year to become a member and maintain membership.

    I have been thinking about doing some kind of home based business at some point when I get a little better, but in the meantime I realized I could get my business registered now, which qualifies me for membership in the chamber of commerce, thereby allowing me access to their health coverage group. As a matter of fact, my wife just took me to the county clerk's office this afternoon to register my business name, and the whole procedure took about 20 minutes and $35.00.

    The regulations in your area may be different, and your county's chamber of commerce may not offer health coverage. You should be able to find out if you visit their website. Just do a Google search for your state and county's chamber of commerce's website.

    This turned out to be about my only option.

    Each state usually has a website dealing with insurance that will tell you what kind of coverage you can get in your area. If your state is like New York, you may find that individual coverage outside a group may be available in some areas but not all areas of your state.

    Just another option you might want to think about.

    Good Luck!!
    [This Message was Edited on 08/18/2008]
    [This Message was Edited on 08/18/2008]
  5. PVLady

    PVLady New Member

    I guess I don't know what short term insurance is. Does that mean you have no coverage for pre-existing?

    You are correct about one thing, most health carriers will turn you down for coverage with any medical problem. They don't want to buy a claim.

    I know it does not seem right, but they are very difficult.

    I was on Cobra and transferred to a plan through HIPPA when the Cobra ran out. With the HIPPA law, when you are on Cobra and it runs out, they must write your coverage,no matter what the medical problems.

    I pay $810 a month to Blue Cross for a PPO insurance plan. I do have good prescription coverage and they paid very good on my gallbladder surgery, doctor visits, etc.

    Not inexpensive but not much I can do.

    Malcolm - does that medical plan through the chamber have a guarantee of policy issuance? There are many group plans around but many still underwrite to accept you. If it is guaranteed issue that might be something to go for.
    [This Message was Edited on 08/19/2008]
  6. steach

    steach Member

    I, too, need medical coverage but can not afford it through Cobra.

    In June, I started my own tutoring business and had to go to a zoning board meeting for approval, etc. I did get my "home occupation" business license. I live in WV.

    If I am understanding this correctly, I can contact the county chamber of commerce and obtain some sort of insurance? Is it medical, life, etc.?

    Could you offer any more information? I would take a wild guess that some counties don't even have a clue that optional insurance even exists!

  7. Malcolm82

    Malcolm82 New Member

    you haven't let your current major medical coverage lapse for more than 60 days, as per the regulations in the Insurance Portability Act. The act states that as long as your new insurance coverage goes into effect within 60 days of when your previous coverage terminates, you cannot be turned down based on pre-existing conditions. If your major medical has lapsed for over 60 days, then you can be excluded for pre-existing conditions. This act is the law in New York, but I don't know if it is in every state.

    I might add that I have spent days trying to figure this out. My brain fog doesn't help but I was determined because this is too important. Maybe what I have found will save somebody a lot of time and trouble.

    In my situation, my termination notice from my job states that my health insurance coverage with them will expire August 31. After that I have a 30 day grace period before my coverage lapses completely. This has given me plenty of time to do what is required to get on the chamber's insurance.

    The chamber's insurance in provided by Blue Cross/Blue Shield or Preferred Care, so it is high quality coverage. You have a wide choice of different plans so you can choose the one that suits your situation best, and the rates are the lower group rates. The policy I believe I'm going to sign up for is around $488/month. You have to pay the premiums quarterly, though, which would be $1466.91 in my case, so you you have to get that lump sum up front to pay it. If I went with COBRA it would cost me $751/month.

    In my county, many businesses, especially sole proprietors, have their health insurance through the chamber because it is about the only affordable high quality coverage that is available.

    As I stated previously, I'm not sure if all chambers in the US offer this benefit. If you can search for and find your county's chamber website, this kind of coverage is usually mentioned under a "member benefits" tab, and should at least give you a phone number. I called the number given and told the person that coordinates these benefits that I was thinking about starting a small home based business and I was investigating health insurance options. She mailed me all the policy coverage details and the quarterly rates that their members are elligable for.

    I just mailed my membership application today. When it is approved, I will apply for the insurance, so I'm not quite there yet. I will try to update everyone when I get through it.

    To answer the question on if they offer other types of insurance, dental coverage is the only other type listed. Again, this may be different in your county.[This Message was Edited on 08/19/2008]
  8. steach

    steach Member

    Malcom, thanks for the wonderful information! I did get a business license in June so that I can tutor from home. I contacted the local Chamber of Commerce yesterday and was told that insurance HAD been offered until the legislature ruled that it was discriminatory; he did not go into details, but, said that two plans had been available.

    Apparently, there is a new bill before the legislature now and the COC hopes to be able to offer insurance in the near future- the cost wasn't disclosed to me due to selecting the carriers, plans, etc.

    To become a member of my local COC, the cost is $265 per year.

    Until this new legislation is passed, I, too, have no insurance. And, even when it becomes available, there is no guarantee that it will be affordable. I also don't know if the insurance is for the business owner and/or the family members, as well.

  9. Malcolm82

    Malcolm82 New Member

    I'm sorry that is the case in your county.

    Hopefully it will be affordable when they do offer it again.

    In my county the COC insurance programs do cover the individual business owner and family members if needed.

    Wish I had some other options to share with you, but I don't right now.

    Good Luck!
  10. Malcolm82

    Malcolm82 New Member

    I did apply for and now have health insurance coverage through the Chamber of Commerce effective 9/1/08. It will remain in effect as long as I give the Chamber a copy of my Federal Income Tax Schedule C when I do my taxes each year, showing that my business is still in operation.