I know that these are all opinions, but I was wondering if anyone has run into this problem…my daughter is currently under her father’s insurance, and has been since birth (aka - before DX). But he just told me that he is in serious danger of losing his job…how hard is it going to be to get Gabby insured with a pre-existing condition??? (We live in PA)
As long as there’s no gap (I think officially it’s 62 or 63 days), she should be OK and insurance companies waive any pre-existing clause they might have. As long as you have all the documentation from past insurers, showing when her coverage began and ended and that there was no gap at any point, then you should be covered. Insurers must provide certificates of credible/continuous coverage when asked - even if they’re former insurance carriers and you’re calling about past coverage. Your husband’s current employer should offer COBRA if he’s terminated, and doesn’t voluntarily leave. While it’s costly, having that insurance while he looks and hopefully finds another job can be a lifesaver and help ensure no gap comes from it. Good luck to your husband, and course your family!
Michael’s right. I had a similar “pre-existing” problem with my son’s insurance. His coverage ended with our family plan because he “aged off”. He was able to get health insurance through the college that he attends but I wish I’d kept the cobra coverage for him (even though it’s expensive) because the college plan’s deductibles and copays are much higher AND when I called to ask if Aetna (the college insurer) if they would give him an individual plan (my son was thinking of taking a semester off and the college plan wouldn’t cover him if he wasn’t taking classes) Aetna said “NO”, because of his type one diabetes!!! --even though there would be no break in coverage, etc. Apparently it’s OK for insurance companies to discriminate this way! It also depends on which state you live in. Only a few states will insure type one diabetics with individual plans. Another option is to get insurance through your workplace, but that can be costly too–especially if you work part time. Now I worry about the time between my son’s graduation and when he has a job that will offer him insurance. I’m hoping that healthcare reform will take care of this problem for all diabetics so that coverage won’t be such a complicated issue any longer. Wishing you a very happy new year, and continued coverage! Donna
Donna, I went on my parents’ COBRA coverage until age 28. Our plan carried me through (luckily) to age 25. Then I was able to do COBRA for 18 months according to my father’s employer/insurer’s rules, then an additional 18 months according to the state of Texas’s rules. During that time (graduation - age 22 - through age 28), I was denied coverage from every individual plan to which I applied. I wouldn’t hold out hope that your son can find an individual plan. Even if he can pay the premiums, he is unlikely to be accepted with type 1. My husband and I had to get married five months before our wedding so that I could join his insurance at age 28 before my COBRA finally dropped me. Yes, it was pricey to do COBRA - $700+ a month just for my coverage, but I agree with Michael that it’s so worth it.
I’ve never had a gap in coverage and have always been careful to get certificated of credible coverage to prove it.
Maria, I strongly recommend you look into the following information:
- COBRA for your husband’s plan - should buy you anywhere from 3-18 months for your daughter at a costly rate. Be ready to apply as soon as possible after hearing he’s been let go. Get the info now.
- SCHIP. SCHIP is the federal children’s health coverage that covers children until age 30 if they live at home, from my understanding. It is state run, so details may vary depending on location.
- See if your state has a high risk pool insurance option. More than 30 of the states in the US do. Again, like COBRA, it is costly, but they are required to take you if you have diabetes - though, depending on the state, you may have poor coverage for specific diabetes needs. I’ve looked into twice and nearly applied, but in the end found less costly alternatives.
Pennsylvania is one of the FEW states that have a program that will pick up all expenses for Type 1 children, even if you DO have insurance. No matter your income. PA will pick up the balance your insurance does not cover. I believe PA will cover everything. But I do not remember the name of the state program. Easy enough to find out. Regarding COBRA, Obama has a program that will pick up two-thirds of the cost. Instead of paying close to a thousand, you may pay $350, around there.
Thanks so much, Melissa. It’s really helpful to hear from someone who has experience with this! Our family has had coverage with my husband’s insurance for so many years, I never expected to have to think twice about insurance coverage for my son. It just shows you again, how the general public doesn’t have a clue about what people with diabetes have to go through…I wish there were more opportunities to help everyone see what it’s like to think “outside the box” (outside their own safety zone) about what others have to contend with. It’s easy to take things for granted, and hard to really understand, until you experience it for yourself.
you are lucky where you live. i am self employed an 2 years ago my health ins. was increased way above my mortgage. i had to drop it as i was self employed. i at that time was paying 2500.00 to 3000.00 in medical supplies to keep my son alive. i now am in debt up to my head but my son still alive an doing somewhat better. i gave all up to keep my son alive an would do it all over again. i am now on medicaid took a lifetime to get the help i needed but the state finally came through. my child is native american an thats the only reason. i feel thats not fair what color or race they are they all need and deserve the help.
My olest son “aged out” of our insurance a few months afer dx. Right before that, he went and picked up as many supplies as the insurance company would allow. He was able to get insurance through his current employer but it’s not the greatest. I believe insurance compamies can not deny you because of a pre existing condition anymore…but I could be wrong.