Husband diabetic. short term affordable health insurance info.

March 17, 2009 9:55 PM

I need information on affordable health care for my type 1 diabetic husband.

He was laid off due to his company closing. He is only 45 and very healthy. It seems that I can't find anything for less than $500 per month to insure him. That's insane! I just need bare bones insurance to cover him until he finds another job so that he won't lapse and then not be eligible for at least 18 months in any new job. It's a total rock and a hard place situation as unemployment will be sucked dry if we pay those premiums for him and if we don't insure him and he get's into an accident or illness, any money we do have saved will be quickly gone by huge medical bills. All the websites that I've looked at want me to submit huge amounts of information so they can quote me a rate. So far I've got nowhere with a couple of them I've tried and just wasted lots of time for nothing.
Does anyone have any suggestions?

posted by Chele66 to health & fitness (12 comments total)

If you can tell us what state you're in, I bet someone who knows the social services ropes in said state will come by and offer some ideas.
posted by fairytale of los angeles at 10:04 PM on March 17

Thanks for the suggestion. We live in California.
posted by Chele66 at 11:01 PM on March 17

Cobra?
posted by barnone at 11:20 PM on March 17

Do you have health insurance?
posted by barnone at 11:21 PM on March 17

Did you search for HDHP plans, which are designed with huge deductibles ($5-10k) and are basically only useful for catastrophes?

If you need spare insulin pump supplies or insulin you may wish to ask around on the http://www.insulin-pumpers.org mailing list. Also, talk to your local diabetes education center at the hospital and explain your situation - they will likely be willing to guide you to an insurance carrier that meets your needs.

Best of luck, diabetes is brutal to deal with even under ideal conditions.
posted by benzenedream at 11:27 PM on March 17

Thank you for the responses so far. We have health insurance until 3/31/09. Cobra is not available as the company is no longer a company. What is HDHP? I wouldn't mind that type as long as it would qualify him for immediate benefits without a waiting period with his next employer. Meaning it is considered 'real' insurance.. That's something else that confuses me as there are so many offerings that I don't know what is acceptable or not..

We are not worried about insulin supplies- he uses so little that we think we have enough to last us quite a while. His blood sugar has been under control since he started using insulin. Our concern is only that if he is uninsured that if something does happen ( accident or illness- diabetes related or not) that the medical bills will deplete our money saved to get us through his unemployment.

Please keep the answers coming in.. Every suggestion helps. Thank you!
posted by Chele66 at 12:03 AM on March 18

If you have insurance, his job loss might be a "qualifying event" which allows you to add him to your policy. If the open window happens soon, you could just get short-term insurance for him until then.

This recent Forbes article recommends getting quotes from ehealthinsurance.

Here is the page for the American Diabetes Association in California.

They link to two options:
- Medi-Cal (California's Medicaid)
- California Major Medical Insurance Program (PDF).

What a mess -- I'm so sorry you're dealing with this.
posted by barnone at 1:02 AM on March 18

I would just call Kaiser and ask about their HDHP (High Deductible Health Plan) options - try and get something with the largest deductible possible ($10k or greater per year). This should still qualify as "real" insurance. Many insurance comparator sites see "Type 1 diabetes" checked and will require you to call a human to do an in-depth evaluation of his health anyways, so I wouldn't waste time on the web.

How does he know his blood sugar levels are ok? Test strips are usually more costly than insulin, along the lines of $0.70 x 5 tests per day for about $100 bucks in cost per month.

His blood sugar has been under control since he started using insulin.

How long has he been diabetic, and are you sure he's Type 1? Type 1s are not just "out of control" without insulin, they are dead, since they cannot make ANY insulin and insulin is required for basic metabolism (thus the alternate name IDDM -- Insulin Dependent Diabetes Mellitus). They do still make some insulin during a 6-12 month "honeymoon period" after initial onset, during which time the immune system is gradually killing off all the insulin producing cells. If you've been warned about going into diabetic ketoacidosis, a C-peptide test was done, or he's had diabetes since he was a teenager, he's probably Type 1.

Apologies for the grilling, but if he's really Type 2 (still makes insulin) that's a whole different ball of wax with a different risk profile.
posted by benzenedream at 2:43 AM on March 18 [1 favorite has favorites]

While high deductible plan is a good play, the "real" insurance requirement isn't subjective. You need to be sure that the plan qualifies as "creditable coverage" under U.S. Department of Labor regulations. You need to ask the insurance company and verify with the DOL.
posted by MattD at 5:07 AM on March 18 [1 favorite has favorites]

I would add if the best you can do is $500 a month - do it. If he goes 64 days (might be off by a couple on that number) without insurance he loses credit for "uninterrupted insurance" and could be subject to a 12-18 month waiting period when he does find a new job with insurance. And really, when you consider the potential costs associated with an ER visit if he has a low blood sugar event, $500 a month isn't that bad.
posted by COD at 5:33 AM on March 18

It sounds like the $500/month plan he was offered might have been an individual conversion plan--when someone is HIPAA eligible (which means covered by a group plan for at least 18 months, and has exhausted COBRA or COBRA is not available, like for your husband), the insurance company that was covering him under a group plan must offer him an individual plan, and cannot turn him down or charge him more because of his pre-existing condition.

He also has some other options if he's HIPAA-eligible: he can buy an individual HIPAA plan. By California law every insurance company in the state that offers individual plans must sell HIPAA-eligible people its most popular plan, even if they have a pre-existing condition. This is an important thing to know about, as it's definitely possible that many plans in the individual market would reject your husband's application outright because of the diabetes. (That doesn't mean you shouldn't try; but do realize that it's possible it will be very difficult to get any coverage for any price when you go into the individual market as a middle-aged man with diabetes.)

More information on HIPAA protections in California when you lose group health insurance can be found here. (If he's not eligible for COBRA because his company is going under, than as long as he meets the 18 months of continuous coverage requirement, he should be HIPAA-eligible.) You can look at the rates here. (You should look at the rates for "HIPAA Individual," not "Conversion.") Unfortunately, not many of them get much cheaper than what your husband was offered for his conversion plan. If you're in the service area of Care1st health plan, though, it looks like their monthly premium for an individual HIPAA plan for a 45-year-old is $413, which is cheaper.

Unfortunately, any type of health insurance you get will probably not be cheap. $500 a month for one person of your husband's age sounds about right; as I recall, the average premium nationally for a family policy runs about $1,000 a month. I encourage you to look at High-Deductible Health Plans (HDHPs) right away, and maybe apply to a few companies; be prepared for the fact that some or all might reject your husband. Also, before you sign up with one of those, make sure that it counts as "credible coverage" under HIPAA (ask the company to confirm). You want to leave yourself enough time to sign up for either the conversion plan or another individual HIPAA plan if he's not able to get a bare-bones plan that counts as credible coverage in the individual market.

I'm sorry he lost his job and his health insurance at the same time; that's a really tough spot to be in.
posted by iminurmefi at 6:57 AM on March 18

I don't have much to add to the insurance-related answers, but I am also confused by your saying your husband is a 45-year-old type 1 at the same time it sounds like he started using insulin only recently. That's not impossible, but unlikely. In any event, you may want to get that figured out (my apologies if I'm missing something), since it may affect the kind of coverage you need.
posted by chinston at 7:28 AM on March 18 [1 favorite has favorites]