Does anyone have experience getting healthcare coverage..

[RadicalMom]

for people with handicaps and diabetes and who are generally "uninsurable?" Our coverage under COBRA runs out in May, and I'm petrified, having had a number of hospitalizations over the past five years. We are currently "self employed," if that option helps. Any suggestions are greatly appreciated. Remember, though, America doesn't need "health insurance for all Americans," now do we.

[SoCalDem]

1. Oh my ...You are in a real pickle

We had a similar experience years back after our son had been injured playing football..

Even though he was a healthy 18 yr old, it had been a brachial plexus injury (and a bad one at that, but he was back to 95% okay).. We were turned down flatly by several we tried, and finally had to pay $300 a month JUST FOR HIM, and another $500 for my husband and myself.. That was not including the co-pays..

We did that for almost 2 years until my husband's job started offering insurance..

If you do not make a lot of money, I would seriously look into the public health department. They may have a low-income plan that you might qualify for.. Self employed people often do not make as much as some would think..(after expenses)

[RadicalMom]

3. Thanks for the input, don't know how public health programs

would work out for us. Our home value is high, being in California, but we really have been mostly out of work for over a year and a half, due to outsourcing and other problems, plus the fact that my husband has had to take care of me, since my amputation. We have a number of ways to pursue, but it won't be easy. Might be able to insure me under some special program, and my husband and daughter under something else, till he can get back to a full time job again. I was hoping for some "miracle" solution, short of moving to Canada. Dubya! Maybe I'll call Dubya!

[SoCalDem]

4. Is there a family member who could "buy" your house

and then "rent" it back to you?? If you had someone you trusted, you might be able to free yourself from the pricey house, and then might qualify..

It might be worth the cost of a lawyer to see what could be done to help..

This issue is the scariest to me too (I'm 55)..When and IF my husband can retire in a few years, he will be medicare age, but I won't for 10 years.. We could never afford private insurance on SS and what little savings we have..

[RadicalMom]

6. Wouldn't work for us. Nobody who could do that, and I think it would be

awfully traumatic for us. I've just started this search, and I have to pursue possibilities through the union, and the motion picture community(hubby has been in the Motion Picture Screen Cartoonists Union - now called The Animation Guild - 19 years). We're both professional artists, have been for 30 years. Maybe I can find a patron or a legitimate grant. Or get employed somehow by some Foundation who'll let me work from home.

[blondeatlast]

25. You can definitely be considered "medically needy," which can

raise the income level for Medicaid or similar programs.

I've been there myself.

[Princess Turandot]

11. Did your experience pre-date HIPAA?..

That's done away with 'pre-existing' coverage issues as long as you maintain continous coverage from someplace. It is a relatively new law.

[SoCalDem]

17. It was a long time ago, so it probably did..

:(

[tavalon]

2. You can check with N.A.S.E.

National Association for the Self Employed but given your preexisting conditions I don't know. Do you live in a state that has a pool insurance for the uninsurable? It's usually catastrophic coverage but it might be better than nothing.

The last thing is that if you do get hospitalized without insurance, there are usually charity programs to help and as long as you are paying something every month ($10) their hands are pretty tied.

[RadicalMom]

5. I'll try that. Wonder if people can band together under the banner of

a special group they can form, say under DU or the Democratic Party's National Health Plan, for instance? I know one doesn't exist, but why shouldn't fifty million or so people, or a whole lot fewer, not be able to do something like that? If we can't make it work under the feds, then maybe a new approach would work. Kerry's idea of making decent coverage available under the plan Congress has would help so many people, and could be a self-supporting non-profit organization. OMG! A non-profit insurance company? Why isn't there something like that now? I know about insurance lobbies, but that could be overcome with enough grass roots support. Why, even the fundies could join in that effort.

[flygal]

7. There is for military

USAA is our auto and rent insurance company and every year we get a rebate if they make a profit. The rates are reasonable and the service is excellent. I don't think they do health care - they didn't use to. We had to use a private insurer during a one-month period when our private insurance hadn't kicked in.

[Disturbed]

8. Oregon...

has a new type of coverge. Anyone heard about that?

Maybe that could be started in CA.

It is obscene that this country refuses to provide Health Care for it's citizens.

[Princess Turandot]

13. One good reason you likely could not do this..

is that insurance companies need to maintain $$ reserves to cover expected future claim payments, or buy policies from other insurers to cover some of them. Takes quite a bit of up-front moola.

There are not-for-profit HMOS, and not-for-profit hospitals have formed insurance companies to self-insure themselves. It takes a lot of money to start these up because they not only look at existing health claims from members, but also need to anticipate the future needs and fund them to some degree.

[MarieP]

9. I've done a little research on getting insurance after COBRA ends.

After Mr. P retires, I'll be on COBRA for a while & will be looking for individual insurance. I went to an insurance broker who was quite helpful in explaining the process.

HIPPA (Health Insurance Portability and Accountibility Act) requires companies to insure people who lose their health insurance because of job loss, end of COBRA, and other cases. The trick is to make sure there's no lapse of coverage (such as when COBRA ends)before the new insurance begins.

Now, there may be a waiting period for pre-existing conditions...the link below will have more information on that. If you can talk with a good insurance broker, he/she may be able to guide you through the maize and give you some cost estimates. Good luck!

http://www.cms.hhs.gov/hipaa/hipaa1/content/cons.asp

[RadicalMom]

12. I've been doing some research, and saw the HIPPA thing..

Going to find out about that. Under that, though the premiums may be much higher. Better than no coverage, but don't know if we can manage it. Our COBRA premium for the new year for the 3 of us just went up $142 a month, to $1,142.00 a month. Plus deductibles. I watched "It's a Wonderful Life" a couple of days ago, so I guess suicide isn't an option, and I can't get life insurance either, so I wouldn't be "worth more dead than alive." Maybe we'll luck out and my husband will get another union gig.

[Must_B_Free]

15. HIPAA, not HIPPA

You have cobra, therefore you didn't let your policy lapse; thus you cannot be denied insurance for a pre-existing condition.

That's how it's supposed to work.

[RadicalMom]

16. Forgive my typo. That's encouraging. n/t

[u4ic]

28. WHAT??!?

$1100 a month!! :wow:

Holy moly. I'm disabled as well, and can complain about our health care up here, but oh my. You have my sympathies.

[Princess Turandot]

10. Self-employed helpsI I believe that as long

as you have continuous coverage, post COBRA that pre-existing conditions must be covered under the 'portability' portion of HiPAA. There may be a 6o day window between when COBRA ends and a new policy begins, which still allows for continuing coverage, but I would check the website on the post above mine.

However, if you are 'self-employed' and follow all the required tax filings which prove that you are self-employed, you can usually join a quasi 'group' which covers unaffiliated self-employed workers. That usually provides you with lower cost and better coverage.The best place to get info about that is to speak to a health insurance broker in your state. You can also check with your state's Department of Insurance, which may be able to provide you with information about existing group plans in your state.They can also usually provide you with complaint info and resolution on various health insurance companies doing business in your state. If an insurer is a large one, they often will have a lot of complaints, but the complaints will also be mostly resolved.

I would start doing your leg-work now.

[RadicalMom]

14. All good ideas, thanks. It's my New Years fun project!

[SOS]

19. My wife

just went through this.
As long as coverage doesn't lapse you should be OK.
Pay careful attention near the end of COBRA not to miss any deadlines or payments.
In NY State we have Healthy NY. It's a program for people of modest means.
I think the income limit is $26K/year.
By going though the state, her monthly premium went from $700/month to $200/month.
If your state has a similar program, it's a good thing to check into it.
Best in 2005.

[RadicalMom]

20. Again, thanks to all. I did a lot of research, and things look up...

Found that CA passed a law sometime in the past year or so, the program is CalCOBRA, and extends COBRA for an additional 18 mos. I have to verify this with my provider to make sure the lawis still the same. Then you put yourself on a waiting list while you are still under the extension for a different program, which is supposed to be with one of four providers, which includes Blue Cross PPO, which is part of what we have now. So as long as we keep finding the money we are okay for a while, and hopefully we can keep things seamless on into a good job with benefits. I believe that will happen again. There are, indeed some low income programs and some less than perfect plans for handicapped people. Right now I'm very glad I've found these things out now. It's been worrying us for a long time.

[roenyc]

21. Are you on disability?

if you are not are you planning to file? its something to think about and it doesn't matter if your husband can support you of if you own a home or whatever.

if you are taking cobra benefits i have to assume its because you can work and that would mean that you applied to ssi. (i hope) if not apply right away and use your date that you were first disabled.

you will probably be rejected first time. they like to do that. but its worth the paper work. you may be rejected the second time. then you get a lawyer. he takes 4000 out of your settlement. you almost always win at this point.

at the 2 year mark of when you first became disabled you become eligible for Medicare. yay! not so great but better then nothing. and its only around 75 bucks a month. your drugs are another problem. the drug cards are a joke.

[RadicalMom]

24. My hubby qualified for the COBRA. I stopped working enough

and made enough for nice write offs, but not enough to have to pay social security/self-employment tax, since about 1991, when my daughter was born. I'll look into it again. Thanks.

[livinginphotographs]

18. Most states offer some sort of basic health insurance for those

whom are uninsurable. In Virginia, the major carrier Anthem offers something called a standard plan. I'm not too familiar with how that works in other states, but there should be something.

Keep in mind, it's going to be a crappy plan, to say the least.

[elehhhhna]

29. Yep. Even asshat Texas has a pretty good state plan for "uninsureables"

[knitter4democracy]

22. A thought

When I was looking into offering my mom insurance through my yarn shop, I found out that one of our local hospitals offers a fairly cheap insurance for people in that situation and so creates its own risk pool. You might have something like that going on in your area. They don't advertise it, but a health insurance agent (ask your insurance agent for the name of one) would know about it. It was fairly affordable, actually--about $350/mo. for full health, vision, and dental.

[RadicalMom]

23. I'll check on that. It's hard to imagine our particular local hospital

being that socially oriented, but that would be great. Corporate owned, you know.

[knitter4democracy]

27. Oh crap.

Is there a non-profit nearby? I forget that not every state has the same rules on that Michigan does. My aunt is without insurance in California (now in Big Bear but was near San Diego), and the doctors there were charging her insane (and unethical) prices for their services. I wish you could get on a plane and come see my husband--his office charges reasonable prices, and David sometimes works something else out if he can. Nothing makes him more angry than people without access to good care.

The hospital in town offering that is a Catholic hospital with the Ascension network. I wonder if they offer it throughout the network.

[blondeatlast]

26. Strongly suggest that you make an appointment with a hospital

social worker; they have access to some very well-hidden sources.

Good luck--these are the situations that are just shameful. We WILL have a national health care plan someday. Your situation has become far, far, too common.

[proudbluestater]

30. Have you tried Blue Cross? It was my understanding they don't

turn people down, or at least I heard that was the policy.

[RadicalMom]

31. I'll try calling them directly. It would be nice to not have togo through

all the different COBRA extensions and other legal wranglings. We have Blue Cross PPO through Motion Picture, under COBRA.