Health Insurance after Cobra

Discussion in 'Fibromyalgia Main Forum' started by Sparky1, Jan 5, 2003.

  1. Sparky1

    Sparky1 New Member

    New to the message boards. Stopped working September 2001 due to CFIDS/FMS and my Cobra insurance benefits are finished in two months.... Have not been approved for SSD yet (and therefore extention to 29 months of Cobra or Medicaire) ..wondering if anyone has ideas of where to get PPO health insurance in the state of PAin the meantime ...
  2. Mikie

    Mikie Moderator

    With CFS/FMS you are uninsurable unless you can get a guaranteed-issue plan, either through a working spouse's plan or through a state-mandated plan. The state-mandated plans are very expensive. You need to be looking now; don't wait until the COBRA runs out or you may have no options at all.

    Love, Mikie
  3. pam_d

    pam_d New Member

    I urge you to find yourself a GOOD insurance broker, who will sift through everything for you and come up with the best solution, and be prepared that private insurance costs---a LOT! My husband is self-employed now, after years with an employer, & I don't work. We needed insurance after our 18 mos. of Cobra. We both have health issues (I'm FM, cervical disc disease, and he's a type 2 diabetic) but were able to get individual plans with Blue Cross PPO----and we are paying a small fortune for it (they call it getting "rated up"), I might add, but we are covered. It helped that we live in the Kansas City area, but on the Kansas side---where the state is very progressive & pro-consumer when it comes to health insurance. Had we been on the Missouri side, my husband and I would probably have been uninsurable except by the state plan, which is not good. I actually pay more, and it's my cervical disc disease that was "rated up" even higher than Type 2 diabetes! One thing I learned is, policies vary greatly from state to state; do not assume Blue Cross, or Aetna, or anything else is the same from one state to another---IT IS NOT!! Find a good insurance broker who will do the research for you, and just be prepared for the cost of private health insurance when you want pre-existing conditions waived----but it is possible--depending on your state regs---to get a PPO!

    Good luck to you!

  4. northwoodssue

    northwoodssue New Member

    Hi Sparky:
    I got denied for regular insurance after my job and insurance ran out. I was referred to the state insurance plan that has to be given to anyone regardless of diagnosis , that has been turned down. The insurance co. that turns you down has to give you information and paperwork to apply for the state insurance. I did all this and got the state insurance, cause that wa s the only one I could get. It started out pretty cheap, but they raised it over 100% in 2 years. It didn't pay for office, visits, medications, etc. only paid for hospitalization with a big deductible, but was better than nothing!!!!
    We now have med insurance thru my husbands job, thank heaven.
    hope this helps. I live in Minnesota, but I don't think every state has this plan available?
    good luck
  5. teach6

    teach6 New Member

    It's different in different states. I have a friend in TN whose COBRA just ran out. She had it from her divorce. Due to chronic illnesses she is now uninsurable. However TN has been losing so much money on their state plan that they will only cover those who are low income, which leaves her out. Her ex is a doctor, so her alimony counts as too much money. It's really a crime that people get stuck like this, through no fault of their own. Good luck.

  6. Kay2

    Kay2 New Member

    have just ran out of my cobra, last month. I was always the one to carry insurance, for my hubby and I. He has Blue cross, Blue shield (LIVE in Tn.) I couldn't afford it haing cfs& fibro, plus I smoke. Wanted to charge me 800.00 and something. I was so stressed. Well I heard of CARE ENTREE, ON the radio one day, and I checked it out and it is something that I think will work for me. Better then nothing.You can get it, AND NOTHING IS pre excisting. I t has optical dental, perscription etc. Just look up CARE Entree a it will tell you about it. It is very sad that we have to go through all this worring. Good luck to all. Hugs, Linda
  7. dlizard

    dlizard New Member

    I've got 13 months left on cobra and know I'm not insurable,.,, its scary and unfotunately WHY we NEED universal healthcare! Good luck!
  8. pam_d

    pam_d New Member

    I urge you to find a good insurance broker---yes, you might be told that in your state you are only eligible for the state insurance plan, or that your state doesn't even HAVE a plan......but until you go to a professional who's expert at sifting through the options, you will not know. Health insurance regs vary dramatically from state to state, as do insurance company policies. An insurance broker does not charge you anything (like a travel agent), but has a world of knowledge. I tip my hat to Rich Fuchs, my broker, who spent hours, literally, with my husband & I finding the best option for us, given our pre-existing conditions, and ineligibility for a group plan. He was a real pro, and we have a PPO that's as good as our old employer-guaranteed group plan, with the exception of the dental plan; that isn't as good. And we pay huge premiums. But not as much as the less-desirable state plan....

    Good luck!

  9. Bratnut

    Bratnut New Member


    I got mine through Nat'l Association of the Self-employed. From what I could tell, there requirements are pretty lenient, but it's essential to have continuous coverage so that they can't deny pre-existing conditions. All insurance companies look at that. Anyhow, the N.A.S.E plan isn't great, but it's cheaper than private as it groups self-employeed folks into one group and charges a group rate. If you think "I'm not self employed" that's the part you need to look into for leniency. It wasn't tough to get considered self-employed.

    Hope it helps.