Unfortunately, "Move to Canada" is also not an option.

May 18, 2009 5:09 PM

I Live in A Stupid, NonSocialized Imperialistic Country Filter: Please hope me find private health insurance.

I need to buy a private health insurance plan for one person. I have a chronic pre-existing condition.

I also live in Rhode Island.

No, I can't receive insurance based on employment at this time. That option has already been explored and due to my line of work (childcare) and the RI economy (flamingly awful) it's just not going to pan out.

No, my disease isn't bad enough to qualify for disability. Since I *can* be controlled on medication, I'm not disabled. Except when I can't get my meds. Then I am. But the government doesn't really care about that and won't pay for them on that basis.

Any suggestions as to companies that sell private plans or brokers or whatnot - anything really - is helpful. I'm really overwhelmed about where to even start with all of this. I've been through this particular merry-go-round before and lived with no insurance, but that's just not an option at this point.

posted by grapefruitmoon to health & fitness (26 comments total)

You may be able to do something if you open your own small business. Even if you only make 200$ a month. Like dog sitting or one lawn care client. And it would probably involve incorporating.

Here are some recent articles I thought were helpful (both on CNN.com):

Tips for getting insurance when you have a pre-existing condition

No health insurance? get help here
posted by cda at 5:20 PM on May 18 [3 favorites has favorites]

Consumer Reports gives these sources:

"Finding new health coverage if you don't have an employer plan is a ton of work. You might want to start by checking out policies offered on ehealthinsurance.com or by asking friends about their coverage. You can also hire a licensed health-insurance broker to find a policy for you. To locate an agent, go to the Web site of the National Association of Health Underwriters (www.nahu.org). Most members are independent agents representing several plans.

Organize your questions so that you can compare insurance plans side-by-side. Among points to consider: premium cost, deductibles, co-pays and how they differ for out-of-network providers, which medical services are covered and which are specifically excluded, and limits on annual or lifetime visits to mental-health professionals and other specialists. You can lose coverage if you lie on the application or do not pay premiums, or if the insurer decides to no longer operate in your state."

If you only need insurance to cover your medicine, have you looked at the $4 prescription list at WalMart?
posted by Houstonian at 5:26 PM on May 18 [2 favorites has favorites]

I feel your pain; I'm also in RI and uninsured (and unemployed - it's a mess here!). From what I understand, Blue Cross Blue Shield does offer private plans, but I do not know about the pre-existing conditions bit, unfortunately.

http://www.bcbs.com/
posted by anthropoid at 5:35 PM on May 18

I'm self-employed and found my options so limited that I was spared the need to make a choice. Anthem Blue Cross Blue Shield turned out to be the only provider of private insurance in my region.

The quickest way to locate a provider might be through one of the many insurance quote sites. Make sure that the plan being described is real insurance and not just a limited discount plan.

I looked into the plans offered by professional associations but found that they either had nothing for my state or had something that wasn't really insurance but was (sort of) a discount that (sort of) applied to (a few) types of medical needs.

Darn, it looks like Rhode Island doesn't have a state plan for high-risk people, but you might be able to form a group of one as described in cda's link.

My business is 100% online, which means I could establish residency in another country, something I'm considering.
posted by PatoPata at 5:37 PM on May 18

All the major health care providers have individualized plans, including Blue Cross, Aetna, and Humana. The trick is getting accepted with a preexisting or chronic condition, getting that condition covered if you've had a break in coverage (like if you're not covered now, they can exclude chronic or pe for 12 months) and not paying through the nose. (Give up on not paying through the nose).

Sometimes professional, collegiate/alumni and fraternal organizations offer plans as well. Check with your alumni association (esp. if you belonged to a national sorority), national professional organizations or Rotary/Chamber of Commerce type things. You'll still have some of the problems mentioned above, but these types of places can sometimes offer better rates and/or guaranteed coverage if you're a member.

I feel your pain. What the HOLY fuck is wrong with lawmakers in this country not to mention idiot voters that buy into the "govt healthcare is communism" crap. If that's communism, please. Where do I sign up.
posted by nax at 5:46 PM on May 18 [2 favorites has favorites]

If you only need insurance to cover your medicine, have you looked at the $4 prescription list at WalMart?...

Sadly, no. Going to the neurologist is my hobby. And my neurologist's hobby is giving me EEGs.
posted by grapefruitmoon at 5:46 PM on May 18 [1 favorite has favorites]

Blue Cross/Blue Shield is the high-risk pool insurance for Rhode Island.
posted by Houstonian at 5:47 PM on May 18

Well, unfortunately you don't have a whole lot of options for private insurance if you're living in Rhode Island. Blue Cross & Blue Shield of RI is the only carrier that sells products directly to people who can't get insurance through their employer. The place to start would be here.

You definitely might face a problem with medications relating to your chronic condition not being covered. I'm not sure how to get around that, if you're not disabled enough to qualify for a state insurance program and you don't qualify for Medicaid through pregnancy or having children. Have you looked into whether you can get reduced-price or free prescription drugs through RX for RI? That might be a way to get the drugs you need, even if you can't get them covered by insurance.

If all else fails, I suppose there's always moving to Massachusetts and commuting into Rhode Island for your job--you'd have so many more options in MA, and waaaaay more protection in terms of buying insurance directly. Not a very appealing route, however.
posted by iminurmefi at 5:48 PM on May 18

This page is aimed at artists in Rhode Island, but it looks like it might be relevant for you.
posted by craichead at 5:49 PM on May 18

covered if you've had a break in coverage (like if you're not covered now, they can exclude chronic or pe for 12 months) and not paying through the nose. (Give up on not paying through the nose).

I am covered, have been for the past year, going to lose coverage when I permanently move out of MA on July 1. As for paying through the nose, that's been discussed and the price isn't an object at this point. I already pay fully half of my salary for health costs and imagine that it will be about the same. Still, price isn't the issue. I can pay through my nose AND my ears if I have to.
posted by grapefruitmoon at 5:49 PM on May 18

I was just coming in to suggest that CNN article that was linked to upthread, specifically to point you toward the "become a group of one (or two)" suggestion via opening a small business. A friend of mine in CA may be looking into doing the same thing; I'll let you know if he finds out anything useful that I can forward on to you.
posted by scody at 5:51 PM on May 18

According to this, if you're covered now and have been for the past year, then Rhode Island law says that you can't be denied individual coverage for having a pre-existing condition. So then it's pretty straightforward. Your only option is Blue Cross/ Blue Shield, and they can't turn you down. So go to BCBS and see what they have for you.
posted by craichead at 5:52 PM on May 18 [1 favorite has favorites]

I suppose there's always moving to Massachusetts and commuting into Rhode Island for your job-

Nope, not an option. Currently living in MA and moving to RI. Believe me, I've lobbied for staying in MA, but it's not a do-able option at this point. I'm moving to be with my partner and we're planning on starting a family (and hey! Getting knocked up is paid for by the state!) soon, so having a long-distance relationship is counter-productive. He can't stay in MA due to his own "job" - he's getting his PhD at Brown.
posted by grapefruitmoon at 5:55 PM on May 18

Is he possibly covered by Brown for medical insurance? You might want to check and see if they offer coverage for domestic partners. I got married recently, in part because it meant we'd be saving thousands in health insurance... so there's always that option if that's your cup of tea.
posted by smalls at 6:07 PM on May 18

I got married recently, in part because it meant we'd be saving thousands in health insurance... so there's always that option if that's your cup of tea.

Yup, that's something we're looking into, unfortunately his coverage at Brown starts in September or January and I need to be covered continuously through the summer - but in the long term, that is an option. (I mean, we're planning on getting married "soon" anyway - not just for the health insurance.)
posted by grapefruitmoon at 6:10 PM on May 18

Foundation for Health Coverage Education.

They also have a number you can call (it's on their site), that can help you find coverage options and can connect you with insurance companies directly. You might be able to look into some kind of risk pool.
posted by ishotjr at 6:56 PM on May 18

Can't you pay a bazillion dollars for COBRA between now and September/January? I thought that if you lost coverage due to a job change you had to be able to get COBRA for 18 months. But, I guess you'd have thought of that if it were possible. If COBRA is an option though, you won't have the gap in coverage that makes pre-existing conditions an issue.
posted by artychoke at 8:03 PM on May 18 [1 favorite has favorites]

This is a shot in the dark (like everything else, I guess) but: I know that you're hoping for insurance mostly for your epilepsy meds, right? I usually pay about $400 a month for my dexadrine/zoloft cocktail. I know how you feel—I just got denied coverage on my latest insurance application for having a pre-existing condition because I have ADD. What the hell?

Anyhow, when I went to refill my prescription, as I usually do, at Walgreen's, the clerk started mentioned their “prescription savings club” thingie; at first, I thought, “ah, not another thing I have to pay for,” but it's actually kind of an amazing value, at least for me: I'm now paying about half as much, $200 a month, which suits me fine, and it only costs $20 per year. Of course they trumpet the list of generics that they can give you for $12 per month; I'm pretty sure most of them are actually pretty low doses, and the higher doses cost more (my Sertraline is a hell of a lot more than 25mg per day, and I don't take that much) but it's proportional. And they discount most things even if they're not on that list.

I know it seems kind of 'ghetto,' but I imagine you're like me and you…don't really care. It seems like it's at least worth giving them a call; I know there are a number of Walgreens' in RI.
posted by koeselitz at 12:04 AM on May 19

Oh, and by the way:

cda: You may be able to do something if you open your own small business. Even if you only make 200$ a month. Like dog sitting or one lawn care client. And it would probably involve incorporating.

As someone who, within the last six months, went through the process of incorporating (as an LLC, which is much easier in CO than it is in RI) and signed up for business health insurance (that I don't have any more, long story), I can tell you: it's in every way harder to get business health insurance than private, at least as I saw it, and they qualified me just as hard. So, unfortunately, I don't think this would work.
posted by koeselitz at 12:08 AM on May 19

I thought that if you lost coverage due to a job change you had to be able to get COBRA for 18 months. But, I guess you'd have thought of that if it were possible.

I have insurance through MassHealth, not a private employer. As long as I'm a resident of MA, I'm fine, but as I'm moving...

Yeah, you can't COBRA that.

And prescription savings are great to know about, but I need *insurance* not just saving on my meds. As mentioned, having epilepsy also means that I might as well be having an affair with my neurologist with the amount of time spent in her office.
posted by grapefruitmoon at 4:25 AM on May 19

It's possible that paying for the meds directly would be about as much as health insurance. You could use the emergency room for other health care. Definitely investigate any offerings from pharmacies and pharmaceutical companies. I'm so sorry for your trouble. It's criminally, viciously stupid that you have to go through this. [shakes fist]
posted by theora55 at 8:20 AM on May 19

Do you already have a lease in RI? Consider living in Seekonk or Attleboro, MA or one of the other neighboring communities. They are 15 minutes of so from Brown.
posted by mcgsa at 11:10 AM on May 19

I am uninsurable through private health insurance; however, I am able to obtain fairly reasonable coverage through the "small business with 2+ employees" provision that others have referenced above. I'm not in RI so don't know your laws; however, in my state, it was absolutely no trouble at all. We formed an LLP (one-page application plus a small filing fee) then applied for health insurance--that's it. It's still expensive, but way better than nothing.
posted by HotToddy at 11:50 AM on May 19

Do you already have a lease in RI? Consider living in Seekonk or Attleboro, MA or one of the other neighboring communities. They are 15 minutes of so from Brown.

I already mentioned that living in MA is not an option. I know the geography well, that's not the issue.
posted by grapefruitmoon at 2:58 PM on May 19

It's possible that paying for the meds directly would be about as much as health insurance.

I happen to know that paying for my meds directly is EXACTLY as much as I pay for my monthly premium at the moment. I'd really rather pay the insurance company and also be covered when I go to the neurologist and/or get hit by a bus!
posted by grapefruitmoon at 2:59 PM on May 19

Update: I have insurance through the Blue Cross high risk thingum. It's an individual plan, blah blah blah. I have to pay through the nose for it due to aforementioned pre-existing condition, but I AM covered.

I've even got an ID card and used it for prescriptions! Score!
posted by grapefruitmoon at 5:47 PM on August 10 [1 favorite has favorites]