How to deal with losing health insurance?

January 26, 2006 9:02 AM

I'm about to lose my health insurance. What can I do?

I'm a self-employed U.S. citizen. I've been on state low-income health insurance for some time now, but for various reasons, I think I'm going to be kicked off of it at the end of February. In the past, I have been turned down for private health insurance because of the "pre-existing condition" that I've been seriously ill three times in my life (apparently, twice is the cut-off limit).

Is there health insurance I can get in spite of that? How cheaply is it possible to get health insurance if so? What about just catastrophic care? How would I go about finding out about these things? If I don't get health insurance, how can I continue to get prescriptions to a medication I use (a nasal spray), and the medication itself? And what should I do in the even of an emergency?

posted by kyrademon to health & fitness (10 comments total)

I used AmeriPlan for awhile. I don't know about pre-existing conditions with it though. It wasn't cheap, but it got me through.
posted by k8t at 9:05 AM on January 26, 2006

With regard to pre-existing conditions, an important factor is showing that you've been covered by insurance for a longish period of time without a gap. When you end with an insurance company, they are supposed to send you a statement that documents how long you were covered by them. Make sure you hold onto that. I didn't realize how important it was and pitched one of mine, and that was a mistake.
posted by lisaj32 at 9:07 AM on January 26, 2006

If you've been denied insurance because you're high risk, you might be elegible for your state's high risk insurance pool.
posted by Laen at 9:36 AM on January 26, 2006

There are a billion threads here on purchasing insurance on your own, look through them. However, depending on how critical this is to you (I maintain it's critical for everyone but you all thus far have managed to avoid living under the rule of my iron fist) you could always do what my mom has done now that my dad is retired: go get a job at Starbucks. The same thing that is an advantage for them (as people in the higher-cost category of being in their early 60s) would help you: the majority of their pool is very young, making average costs very low. You don't have to be a full-time employee to qualify.
posted by phearlez at 10:09 AM on January 26, 2006

Much of this will depend on where you live. I assume you are in the USA, but what state do you live in?
posted by alms at 10:22 AM on January 26, 2006

If I don't get health insurance, how can I continue to get prescriptions to a medication I use (a nasal spray), and the medication itself?

In general: Doctors take cash payments (or credit cards) as well as insurance payments; some even prefer not dealing with the insurance paperwork. You can even negotiate fees and payment plans (if the dollar amount is significant). And you don't need insurance to pick up a medication; you just need the prescription and money. (As for the money, those lacking insurance have a few options to reduce the price of the medicine. Some pharmacy companies have programs for low-income folks; there are discount cards; you can buy at drugstore.com rather than at a physical store; etc.)

And what should I do in the event of an emergency?

Go to an emergency room at the nearest hospital. While they prefer people with insurance, they're required by law to treat someone in an emergency health situation even if he/she lacks insurance. You may be forced to wait longer, however. (Also be aware that many cities and counties have a municipal/county hospital that for-profit hospitals often transfer patients to, once a patient's condition is stable. It may be worth finding out what hospital that is; if you have an emergency and it's not too inconvient to go to the municipal/county hospital, you'll avoid a possible transfer and being treated in two places.)
posted by WestCoaster at 10:26 AM on January 26, 2006

I didn't realize how important it was and pitched one of mine, and that was a mistake.

lisaj32, if you contacted your previous insurer, they would be required by law to issue you another Certificate of Creditable Coverage.
posted by deadfather at 10:29 AM on January 26, 2006

Go to an emergency room at the nearest hospital. While they prefer people with insurance, they're required by law to treat someone in an emergency health situation even if he/she lacks insurance. You may be forced to wait longer, however.

You will also almost certainly be charged far, far more for any treatment than an insurance company would be charged. This is because the insurers work out discounted rates with hospitals. So say you broke your arm and went to the emergency room. An insurance company may have worked out their discounts with the hospital so that all the associated costs (painkiller, setting the arm, etc.) would work out to be, say, $3000, of which you might or might not have to make a copayment (depending on your coverage). But without that insurer discount, the hospital will charge you the full cost of all associated treatments, which might work out to be, say, $8000.

Yes, this means precisely that the people who are least likely to be able to afford it -- i.e., the uninsured -- are the ones who are charged most for emergency care. Great system we've got here, eh?
posted by scody at 12:25 PM on January 26, 2006

I checked this book, The New Health Insurance Solution, out of the library 2 days ago and just started reading it -- I haven't got very far, so I can't tell you much, but you might want to check it out.
One thing he does mention is that there are a lot of state high-risk pool options for people who have been denied coverage in the past, but it varies from state-to-state.
Also, there is something called an HSA (Health Savings Account) that is available to self-employed and people with high deductible insurance. You can put pre-tax dollars into an account and use it for health-related expenses.
Additionally, since you are self-employed, you could possibly set your business up to pay for your insurance. Apparently, health insurance-related expenses are 100% deductible for businesses.
He talks about all those things in the book, but I haven't got that far yet :)
That website also has "average" premiums on a per state basis, to give you some idea. It seems a lot of assumptions are made about your age/gender/health status, though, so I wouldn't place too much stock in them.
posted by j at 1:25 PM on January 26, 2006

My city (Baltimore) has a program where any resident can get a card that will reduce the cost of medicines up to 50 percent Maybe yours has something similar.

ScriptSave, the City-sponsored prescription drug discount program, is available to all City residents, employees and retirees, regardless of income level, insurance coverage, age, or medical condition. The program has no enrollment or annual membership fees. ScriptSave will cover all FDA-approved brand name and generic medications. Additionally, the ScriptSave card provides discounts on ancillary services, including, vision, hearing, diabetic supplies and daily living products will also be available to cardholders.
posted by Airhen at 5:52 PM on January 26, 2006