Health insurance is an issue that is central in the
lives of many people with chronic illnesses. Since medical insurance is
most often provided through the workplace, when a person's condition changes
their work status (either by making it impossible to work at all or by
necessitating that work be only part-time) that insurance may be jeopardized.
It can be difficult or impossible to convert to private insurance because
of the "pre-existing condition" exemption that many policies
have. The pre-existing condition exclusion may also come into play if
there is a new employer and a change in insurance plan. Insurance laws
are constantly in flux, so it is important to follow the news in this
area, as well as government websites that provide consumer information
(e.g., http://www.hcqualitycommission.gov).
Ways to make yourself more insurable include:
Visit your doctor regularly. Health insurers are
more favorable toward people with chronic illnesses who make an effort
to improve or successfully maintain their condition.
Take your medication exactly as prescribed by your
doctor. Patients in remission or who are being maintained with medication
are considered to be better insurance risks.
The better educated you are about your condition,
its symptoms, the drug therapy you are on, what is normal for you,
and your prognosis, the better chance you will have of finding insurance
coverage.
Tips for maintaining your insurance once you have it
include:
Pay your premiums regularly and on time.
Understand the conversion privileges in your insurance
policy in case you leave your current employment.
Be very cautious about purchasing health insurance
through the mail, TV promotions, or the newspaper.
Talk to your insurance agent or benefits administrator
at work regarding any questions you may have about your insurance.
In evaluating health insurance plans consider the extent
of the coverage, any restrictions there may be on tests or treatments
(including medications), whether or not your doctor and hospital are part
of the plan, and the cost of the monthly premiums, deductibles and copayments.
High risk insurance pools provide coverage to
people who are unable to obtain private insurance because of the pre-existing
condition exclusion. To find out about whether your state offers such
pools contact either your State Department of Insurance or the National
Association for Insurance Commissioners (phone: 816-842-3600). All state
risk pools require state residency; provide coverage for physician's fees,
hospital services, home health care, prescription drugs, and skilled nursing;
and have deductibles that range from $150 to $2,000. Eligibility requirements
may vary from state to state. Some states restrict the number of policies
available each year.
For people unable to work, Social Security may provide
disability benefits. Information on these benefits may be found at http://www.ssa.gov/disability/,
or by calling the Social Security Administration's toll-free phone number:
800-772-1213. Information about Medicare benefits is also available at
that number and at http://www.medicare.gov.
This information
is provided as a general educational service
and is not intended to recommend any particular treatment plan
or to replace the advice of physicians. It is important that patients
seek and rely on the advice of a healthcare professional
about their individual medical conditions.
