Need Health Insurance! HELP!

Discussion in 'Fibromyalgia Main Forum' started by lissamaye, Aug 17, 2003.

  1. lissamaye

    lissamaye New Member

    Hey guys,

    Haven't posted or been on in ages, but I need help once again.

    I'm trying to find good strong health insurance. I'm going to be in graduate school in a few weeks so I need to find coverage.

    Right now I don't think I have any of my dx's on record (I've been striving for that since I knew prexisting issues were going to surface soon).

    So basically I need to know what independent or group(I'm not sure how I'd get that without working) insurance is good for CFS/lyme, adrenals, etc.

    I think I can probably get independent insurance, but it'll cost a fortune and they'll likely not renew me after my year contract.

    Right now my only option is Blue Cross (through school, but it's not group).

    Anyway, sorry to ramble this is not my cup of tea at all so I tend to get anxious about it. I just want an insurance co who's not going to hassle me (but I'm figuring that's like looking for the holy grail).

  2. catgal

    catgal New Member

    Hi Melissa~~After I had to resign my full time job with good pay and great benefits due to my progressive illnesses back in 1993, I went to work part-time [24 hours a week] for considerably less money and NO benefits--no health insurance.

    I was 44 at the time (am 54 now) and had a medical history of FM/CFS and other chronic ailments. I tried & tried & tried to get medical insurance. However, each time I was denied because I was labeled "uninsurable" due to having "pre-existing *incurable, *chronic medical conditions. And, of course, one person trying to get medical insurance for just themselves is expensive.

    As I got older, I developed new "incurable, chronic medical conditions" such as osteoarthritis, psoriatic arthritis, rheumatoid arthritis....and the real kicker *advanced degenerative disc disease* which was extremely painful and required a $1500 MRI, x-rays, Specialists, and costly meds. And the doctors all told me that what I had was progressive, only going to get worse, and that it was imperative that I get some health insurance.

    I was desperate. I was in so much pain. And, my medical expenses were running me $600 a month--and that was just for the monthly doctor's appointment and meds. I tried everything to get insurance, but was consistently denied due to "pre-existing, *incurable, *chronic medical conditions".

    I was told by all the insurance companies that the only way I could get insurance was by "mandated insurance" which means that the company you work for has group insurance, and the insurance company has to accept you--or by having a husband whose company had group insurance which also insured spouses & families--and the insurance company would have to accept me. And that was the only two ways I would be able to get insurance. And even then--all insurance companies have a waiting period of at least 1 year or more before pre-existing medical conditions are covered.

    Then, six years ago I reunited with an old flame; he moved to be with me and took a job teaching at a public school where they had outstanding health insurance--but we weren't married, and due to reasons & circumstances I wasn't going to marry him just to get health insurance.

    I plowed a very hard row over the years just to pay for the monthly medical expenses which made my lifestyle extremely impoverished.

    Then, like a Miracle, in April of this year--my man's insurance company added a new addendum to their policy that said if you could prove common law marriage by filling out a bunch of forms, producing documents that showed you had lived together for at least 5 years, had witnesses sign testimonies that the two of you were cohabitating as husband and wife, and had all the paperwork notorized--then your mate could be added to your insurance as a common law spouse. BUT, in order to avoid the "pre-existing medical condition" clause which would make me wait up to a year and ahalf before they would pay for any pre-existing medical condition--we had to have these tons of paperwork dated and filed in their office within 15 days--after that the pre-existing medical clause went into effect.

    It was almost an impossible task, but we did it. So, now since April of this year, I have had full health insurance that covers everything except the usual deductables. And that is the only way I've been able to get health insurance.

    So, if you can get on Blue Cross which is a fairly decent insurance company--do it and stick with it because once you are on it--they can't kick you off because of "incurable chronic medical conditions" unless you fail to pay your premiums on time. That way, you can start to get all your medical needs taken care of at a considerably reduced cost to you--especially if you needs tests or are ever hospitalized.

    I know it may probably be expensive for you, but perhaps you could ask your family to pitch in and pay the premiums in lieu of birthday and Christmas presents. Or maybe they would pay half the cost or work something out.

    AND, if I were you--even if I got married down the line--I would still keep that insurance even if your husband has company insurance he can put you on because if anything ever happened to your marriage--you would lose the insurance coverage he had on you--and you'd wind up in the same shape I was in (and am). Because if my man and I ever split--he will drop me off his insurance, and I will be right back where I was--"uninsurable". Unless you can always work for a company that has insurance, and then you would still fall under the pre-existing illness clause.

    This has been my experience. Perhaps others will be along with different or better information. But whatever you do--get you some health insurance while you can. Since April when I was put on my man's insurance, I have been able to have all the tests run, be in the hospital when I needed to be, and my medications have been covered. I've saved around $6,000 in medical expenses just since April.

    Congratulations on going back to Graduate School. I did, and it was the best investment I ever made in myself. Best Wishes to you. Carol....

  3. Mikie

    Mikie Moderator

    If you have ever seen a doc who has used a code for fatigue, FMS, CFIDS, or anything remotely associated with our illnesses, it may cause the underwriters to rate you up, exclude treatment for any of these conditions, or deny coverage. Even if not, a pre-existing condition is one for which a prudent person would have sought treatment. This means that if you see a doc and he asks how long you have been sick, you will have to lie to him.

    We are pretty much uninsurable and the only way to get coverage is through a spouse's coverage or through an employer. If the state you live in allows groups of one, you can get insurance if you can show a Schedule C tax form which shows a profit for the year.

    There is a product called Care Entree sold online. It is not insurance, but it allows you to pay the doc what he would get from an HMO which is considerably less than the going rate. Same for hospitals. This is an MLM, but the company is petty well rated. It's better than nothing.

    Love, Mikie
  4. catgal

    catgal New Member

    RE: Insurance Coverage