I posted a question about my “sneaky little boy” and I was so excited about all the coments! I am new to this site and wanted to thank all of you for you help and throw another on at you! We live in Texas and are having a hell of a time tring to get insurance! We took our kids off my husbands insurance to get them on one that had coverage but they would be with out it for two months and low amd behold diabetes hit us in that time period! We make to much mony for the state insurance program and we have been denied social security. I had a company tell me there is a program called mini medical coverage but it dosent really cover much like $100 of our $800 endo dr visits will be covered! I dont know what to do!
Try Insure Kids Now! (www.insurekidsnow.gov), offered by the U.S. Department of Health & Human Services (or call 877-KIDS-NOW). I would explain to them the specific circumstances and see what advice they can give you. Also call your state’s health insurance commissioner and find out anything and everything you can about state laws regarding insurance coverage. DO NOT trust your insurance company to give you accurate info. Mine never would have told me that it’s illegal for them (in Maine) to refuse to insure my son if he’d been continually covered for 12 months prior to the diagnosis – I learned that from someone else – and it’s entirely possible that your state has a law that they can’t deny your son coverage if he was covered within 90 days of the diagnosis, which he was. A number of states have that law, so double check with your insurance commissioner. If the insurance company is denying coverage when they legally cannot, the insurance commissioner will be able to force them to give you coverage. But act now!!! Don’t wait!
Are your endo visits really $800 a pop? That seems WAY expensive to me. Maybe you should talk to your clinic about the fact that your children are uninsured and see if they have any suggestions about how to find insurance or if they might be willing to offer a discount. Either that, or shop around for another endocrinologist.
Are you located near any big teaching hospitals in the UT system? It might also be worthwhile to sign your child up for a clinical study, if you can find one, because the study would provide regular diabetes care for nothing. Look at http://www.diabetestrialnet.org/index.htm to see if there’s anything in your area that your child is eligible for, or ask your endocrinology clinic if they know of anything.
Another option to investigate is your state Children’s Health Insurance Program (www.cms.hhs.gov/home/chip.asp) - I don’t know if this is what you already investigated, but if it isn’t, look there. Also, the National Institute of Diabetes and Digestive and Kidney Diseases (www.niddk.nih.gov) has a publication entitled “Financial Help for Diabetes Care.” You can view it on the web at http://diabetes.niddk.nih.gov/dm/pubs/financialhelp/
Other than that, my advice is to save all your receipts, no matter how small, because if you can’t find any insurance for your son, about the only thing you can do is put in itemized deductions for your son’s healthcare costs on your taxes, and then put the refund into a healthcare savings account.
We are actuall going to the UT clinic after changing to TX childrens. We were told the visit would e $200 and then a month later got a bill for almost $500 for the visit! I have looked into chips and medicade several times and we make too much money! I will look at all the resorses you listed! Thanks!!!
Argue with them on that one, it’s not OK for health care providers to misrepresent the costs of their services. And ask specifically about clinical trials and research studies. But also, look into the Texas Health Insurance Pool http://www.txhealthpool.org, and also this: http://www.texashealthoptions.com/ - not living in Texas, I can’t say for sure what other resources you might have, so you might want to see if there’s a tudiabetes page for people living in Texas and ask your fellow Texans for info? I got my info about Maine’s laws from another Mainer that way.
Regardless of your income level, you should be eligible for Texas’s (High Risk) Health Insurance Pool. (I live in Texas, too.) They are legally obligated to cover you if you have a qualifying condition (diabetes definitely included) and are considered “uninsurable.” If SCHIP or other Medicaid style programs aren’t an option for your kids, you should check on high risk insurance. http://www.txhealthpool.org/
I looked into it when I grew too old to continue COBRA on my parents’ insurance. The premiums can be pricey, but the coverage is good. I know someone on the plan with HIV and they have few complaints about their coverage.
One thing that many don’t know is that all hospitals and/or clinics that accept federal funds must provide charity care. Ask for the financial assistance office. The charity care is based on a sliding scale fee based on your income and while you may not qualify for other programs the allowance income for charity care is much higher so you most likely will qualify for this. Wishing you the best.
Melissa I applied today!! Thanks!