I need health insurance! Help!

Discussion in 'Fibromyalgia Main Forum' started by atrinigyal29, Jul 10, 2003.

  1. atrinigyal29

    atrinigyal29 New Member

    I have no health insurance and no company wants to cover me because of the fibromyalgia. I had group insurance with my previous job but had to leave because I wasn't well enough to work. The insurance covered me for 18 months after I left the job, but that was up in June. I have tried many different insurance companies and no one wants to take on someone with a chronic condition. I see my doctor every week for IV nutrients and really can't afford to go although the treatments help. Can anyone help me?
  2. atrinigyal29

    atrinigyal29 New Member

    Unfortunately, my insurance company (Aetna) said no to the guaranteed issue policy. I will look into State insurance. Thanks for the help! :)
  3. Achy-shaky

    Achy-shaky New Member

    Atrinigyal - are you on state disability? I'm wondering because I'm in the same boat however because I'm getting the maximum in state disability I don't qualify for SSI or MediCal. They said to call back with my disability runs out which I just don't understand what they think you are supposed to do in the mean time for health coverage. I had to stop paying my COBRA because I just couldn't afford 250/mo. I filed for SSD but know that will take at least another year unless they approve my last appeal. So I'm in this limbo. The only thing I've found so far is getting help with prescriptions thru a website called needymeds dot com. I'm lucky in one respect because my FM came from an on the job injury so I have workers comp to cover those costs but if I have anything else happen, I'm SOL.

    I have a friend who does not have FM but has chronic back problems and she was able to get coverage thru a company called Unicare so maybe you have a chance with them.

    Please let me know if you find any way to get insurance.

  4. Mikie

    Mikie Moderator

    If you are not too late to get the state mandated insurance, you will find it very expensive. If you can be self-employed for the rest of this year and file a Schedule C P&L form with your taxes, you can be a group of one, if your state allows that, and get guaranteed issue business insurance. About the only other way is to go to work and get ins. as a benefit or be a dependent on a spouse's plan.

    Care Entree is a non-insurance plan which is sold over the internet and is an MLM. I don't sell it and don't recommend it, but you can check for yourself. It is a well-rated company. You pay about $69 a month whether for a single person or a family. When you see the doc, you pay basically what the doc would receive from an HMO or PPO plus an average co-pay. Same at the hospital. It's better than having nothing at all but could be expensive in the case of catastrophic illness, but again, you would be better off than with nothing. My insurance company paid $1,900 for a $10,000 surgery and that is what I would have had to pay on Care Entree plus my $100 co-pay.

    Love, Mikie
  5. cicada

    cicada New Member

    I haven't had any luck, either, in finding an individual health insurance policy because of a pre-existing condition, chronic fatigue syndrome. I have been on coverage through COBRA following a divorce a little over a year ago; this coverages continues until May 2005.

    I am not eligible to apply for Social Security Disability because the last year I worked was in 1981, and I didn't get a diagnosis until 1990.

    Late in 2002 I joined the National Writers Union (an affiliate of the AFL-CIO) when I found out that I could get coverage through this organization. When I discovered that the policy was not as good and the package more expensive (health insurance was bundled with dental, vision, and life, which I don't need), I opted to stay on the COBRA coverage. I'm glad I did, because the carrier of the NWU group coverage declined to renew the contract at the end of June, and NWU leaders said they had for the last few years used up a lot of resources trying to secure health insurance coverage for members and decided that their time could be better spent advocating for federal universal coverage.

    NWU members have been sharing information on other possible sources of health insurance which I'd like to share with others on this message board:

    National Association of Socially Responsible Organizations (NASRO).
    the Small Business Service Bureau: www.sbsb.com
    Insurance information by state can be found at the Artists' Health Insurance =
    Resource Center at
    At the latter site I read a grim article from Consumer's Report about the difficulty of getting individual coverage (nearly impossible even if the only pre-existing you list is allergies), and some companies prey upon people desperate for coverage. The number of companies who have been taken to court for fraud by state insurance commissions has risen sharply during these last few years of economic downturn.

    I intend to post more information later. Have run out of energy. Any information you could share I would appreciate. Thanks.

    [This Message was Edited on 07/25/2003]
  6. atrinigyal29

    atrinigyal29 New Member

    Thank you all for the information. I will look into them.
  7. BethM

    BethM New Member

    type into your search window, free and low cost medical care, or try typing in, "cost containment research institute" (use the quote marks). You should get links to a government site that will tell you about free and low cost medical care and prescription drugs. You can order the booklets if you want. There is a URL, but I can't give it here.

    I ordered the two booklets for use as reference at work (I am a school nurse). The prescription booklet will be useful for me and my students where I live and work, but not the low cost medical care, as there are no resources close enough.

    I am very fortunate to have good health coverage through work, although there seems to be fewer and fewer drugs covered in the formulary. It is frustrating that the insurance companies have such a vast amount of control over us!

    Hope this helps!

  8. BethM

    BethM New Member

    but didn't President Clinton pass some sort of bill that eliminated the restrictions of "pre-existing conditions" in terms of health insurance coverage??? (I'm often confused, anyone know about this?)

  9. Dara

    Dara New Member

    a group policy that they could not exclude any pre-existing conditions. Also, when you lose coverage at the end of the 18 month COBRA don't they have to offer you a Portability Insurance Policy?

    Also, if you have filed for SSD and are determined disabled back to the first 60 days of when your COBRA started, then you ae entitled to an additional eleven months.

    Also, if a person is 55 or older and they lose their insurance due to a divorce, death of a spouse, etc., my insurance books says you can keep a policy with them until you reach age 65 if you have no other health insurance.

  10. ckball

    ckball New Member

    I am not familiar with the law of CoBRA and SSDI. I was just approved for SSDI and my CObra runs out in Oct 2003, my DI goes to May 2002 when I was let go from my job for not being able to perform due to chronic illness. Anyone else have any other info. I am sure BC/BS will dump me in OCT because I have had a bad year physically and have hospitaized 2 times and many tests. I am paying $380 a month now under my past employment plan so I cannot imagine what a indivdual plan will be. Thanks for the great info
  11. cicada

    cicada New Member

    Options in health insurance coverage vary so much from state to state, that perhaps you should take a look at your state's insurance commission's website (if one exists) or call or write for information. Perhaps other state government agencies could provide information - your local Human Services office? A kindly insurance agent in your area?

    Some states require that insurance companies offer coverage to people with pre-existing conditions. These people, who have not been able to obtain indvidual policies on their own, go into a high-risk pool. In Ohio, where I live, each insurance company has to open up a small percentage of "slots" to people in this pool. The companies are allowed to charge these customers two and half times what others are charged. I was told to expect to pay $600 - 800 a month for coverage. I have to assume that that cost will be higher when in 2005 my COBRA coverage runs out. (My COBRA coverage started out at $350 a month. When I was later given a chance to choose a policy with a higher deductible, I did that and am now paying about $200 a month - and avoiding seeing the doctor because I don't want to pay for fifty-dollar office visits out of my own pocket!).

    I see that you live in Florida. In the article on individual policies in Consumer Reports that I mentioned in the earlier posting, Florida was mentioned as a state with a high-risk pool. Unfortunately, as the article went on to say, Florida's high-risk pool had been closed (and everyone put on a waiting list) for the LAST TEN YEARS. I believe, however, that the article was written a few years ago. You'll have to look into what the situation is at present.

    You may discover that Florida is not the best place to live for health care.

    I heard on public radio not very long ago that in Asheville, North Carolina, medical care workers and activists have set up a successful, free or low-cost clinic for low-income residents. Don't know the details.

    If you are well enough to take a college course or two, you would be eligible for student health insurance offered by the institution. I have not investigated this option. I have wondered if a person taking online courses, offered by so many institutions now, could sign up for health insurance.

    I have some other ideas and information and will get back to you.

  12. Mikie

    Mikie Moderator

    I have removed the URL's from your post. We are not allowed to post URL's here. You can click on the board rules at the top of the page for more info on the rules.

    Love, Mikie
  13. Mikie

    Mikie Moderator

    After COBRA runs out, you are eligible for the state-mandated, guarantee-issue plan. Anyone wanting to apply for it should not wait until the COBRA runs out but should apply 60-90 days in advance. State-mandated plans are very, very expensive. BC/BS has a state-mandated plan in FL.

    Many are confused by HIPPA. They assume that if they have been covered by a guarantee-issue plan through an employer, they can automatically transfer to an individual plan with pre-existing conditions. Not true. Insurance companies have the right to exclude individuals for pre-existing conditions, rate them up and charge a premium, or agree to insure them but not to cover anything related to the pre-existing condition.

    I am a self-employed group of one, so I qualify in FL for small group guarantee-issue insurance. I am 59 years old and my monthly premium for my HMO is $550 a month and in another year, it will jump to $750. I either need to make a ton of money as a self-employed person or go to work for an employer which has health care benefits.

    The only way to get guarantee-issue insurance is to be self-employed (some states require two employees for a group), have health care benefits through your job or a spouse's job, or have the state-mandated issue.

    That is why I mentioned Care Entree. It isn't as good as insurance, but it's better than nothing. I would suggest that anyone going this route put what you would be paying in insurance premiums in a savings account to use in case of a big bill.

    Love, Mikie
  14. cicada

    cicada New Member

    Here are two organizations that provide information on health care:

    Families USA:
    The Henry J. Kaiser Foundation:
    A company that helps people sort out health insurance problems is Healthcare Advocates, Inc., in Philadelphia. The website address listed in a magazine article is www.healthcareadvocates.com. I have not checked the website to see if this organization is still in business. You would be charged a fee for their services.

    Would you be able, I wonder, to buy a short-term policy (like travel insurance) to give yourself some time to sort this out?
  15. Mikie

    Mikie Moderator

    This is the second time I have had to remove URL's from your posts and the second warning. There will be no more warnings. Failure to obey the rules of the board are grounds for banning.

  16. cicada

    cicada New Member

    Sorry. I've never posted on messageboards before. Don't worry. I'm gone.
  17. Dara

    Dara New Member

    and it also sounds like some of us are interpreting things differently. First of all, HIPPA is not health insurance, it is a privacy issue among insurance companies and the medical community.

    Also, when the SSD determined that you were disabled they would have given the date that your disability started. For example; you stopped working on 11/1, your COBRA started on 12/1, your disability payments began in 5/1, but the SSD determined that you were disabled as of 11/1 when you stopped working. The Federal law that governs COBRA states that if you were determined to be disabled within the first sixty days of receiving COBRA, you are entitled to the additional eleven months of COBRA after your initial eighteen months expires.

    Didn't your insurance carrier offer Portability Plans? I have Blue Cross and they had several portability plans that I could have gotten if I had not been able to get the additional eleven month extension. I was told I could choose from any of their plans, except for one, that had to go through underwriting because I was looking for insurance that also had prescription coverage.

    If you are on Social Security Disability you should be eligible for Medicare after two years of receiving benefits. I know there's lots of websites covering the COBRA rules and laws.

  18. Mikie

    Mikie Moderator

    It deals with privacy, but it also deals with portability. Some people do have a choice to convert their policies after COBRA runs out, but not everyone.

    The truth is that insurance companies make their money by controlling risk. They really only want healthy individuals. If they are forced to accept risk, they will increase premiums to offset the potential liability.

    Love, Mikie
  19. atrinigyal29

    atrinigyal29 New Member

    So the people who truly need the coverage don't get it. That's just awful.
  20. searchin4me

    searchin4me New Member

    I am also without health insurance coverage at this time. Up until February, I qualified for state insurance. Our state standards changed, and most of the adults in our state got cut. I now face approximately $400 a month in medication alone, and that is after I cut out some meds that I really probably should be taking, but just simply can't afford. Then on top of that, I have to pay for any doctors visits. I have also checked into private health insurance, only to find that A.) I couldn't be covered because of preexisting conditions, or B.) I could get coverage for an ourtrageous amount of money, but any preexistion condition would not be covered under the policy until it had not been treated for 12-18 months.....like THAT is going to happen. So what is a person to do??? It is just crazy!