Health Insurance in IL
October 12, 2004 8:33 PM   Subscribe

I'm having trouble getting health insurance in Illinois. I'm 25 years old, 6', 175 pounds, don't smoke, and in pretty good health, but I'm being categorically denied coverage because I've been taking Paxil CR for several months now. It's really changed my life, but now I seem to have been blacklisted. Has anyone else had any experience with this?
posted by anonymous to Work & Money (9 answers total)
Unfortunately this is not uncommon.
posted by gramcracker at 9:58 PM on October 12, 2004

That sucks. I think your best bet if you want coverage for your prescription is to get a job that provides it.

I had some luck about six months ago getting coverage through They're basically an online broker for major insurance companies. But none of the plans I could afford would cover any pre-existing conditions.
posted by croutonsupafreak at 9:59 PM on October 12, 2004

I'm supposed to be getting my insurance book and card back sometime this week. I answered questions that I'd have previous stomach/kidney diagnoses but never had treatment prescribed. Now I'm worried that I'll be denied any coverage at all!

I've never dealt with insurance at all before, how reasonable are my fears??
posted by mabelcolby at 10:18 PM on October 12, 2004

See, and somewhere I heard that the American healthcare system is the best in the world.

This sucks. You might want to see if you're eligible to join the Freelancer's Union.
posted by bshort at 6:47 AM on October 13, 2004

Many states have a high-risk pool for self-insured people with pre-existing conditions. In Connecticut, we have the Health Reinsurance Association, of which I will be a member once my COBRA runs out. I will be paying about what I am under my COBRA plan, but the rates are double for women and rise sharply after age 30. A quick googling shows that Illinois has "CHIP", which may be similar.
posted by PrinceValium at 7:04 AM on October 13, 2004

We only take people who are healthy. It's kinda like car insurance places only taking people who ride bikes.
posted by Civil_Disobedient at 7:08 AM on October 13, 2004

I had a fairly similar experience after my COBRA ran out -- my eventual solution was to pay for high-end coverage from Blue Cross. The idea was to make myself a very desirable customer, so I was paying $1200/month.

After about six months of paying through the nose, I stepped down to a $700/month plan. Since I'd been a valuable customer, they took me. I'm presently planning to "step down" again sometime in March, to a plan that's around $300 or so.

It sucks, it costs a fortune, but it's worked for me. BTW: do NOT go to a doctor more than once a year while using my scheme even if you're sick (unless you think you're gonna die or suffer permanent damage) -- it will count against you if you do, and the insurer is more likely to just drop you when you try to step down to more affordable coverage. I only did one annual checkup/physical exam, and they still hassled me about it.

...and if you were still wondering, the answer is yes your prescription is what's dooming you. I used to work for an insurance company, and anything that smacks of "mental problems" is a serious black mark against you. My old company even preferred people that had been nailed for insurance fraud. That was about seven years ago, but I doubt they've changed.
posted by aramaic at 7:49 AM on October 13, 2004

are you denied all coverage, or just coverage that includes mental health? when i was self-insured in illinois, i got several quotes (blue cross, unicare, usaa and something else), all of which excluded continued coverage for my migraine medicine/treatment (some for 6 months, some categorically), but none of which denied me coverage altogether (oddly enough, none denied coverage for follow-up care for a minor surgery i had had recently) and none were prohibitively expensive (like COBRA). i stocked up on the 'scrip and rode out the six months.

i realize that accepting coverage that doesn't include mental health doesn't solve the problem of needing the MH coverage, but it does cover you for medical in case of a car accident or pregnancy or other random needing to see a physician. health care really is an enormous mess around here.
posted by crush-onastick at 8:17 AM on October 13, 2004

i can't tell if you're looking for prescription and/or mental health coverage here, but if you just need basic medical coverage i'd second crouton's suggestion. my SO has been taking Paxil for a few years, and she recently found fairly affordable coverage through ehealth, though it doesn't include mental health, pre-existing conditions or prescriptions.
posted by willpie at 9:33 AM on October 13, 2004

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