What to do when COBRA health insurance runs out.
January 10, 2005 3:21 AM   Subscribe

My COBRA runs out tomorrow. I've applied to a private carrier and was declined already. I was under the impression that if there wasn't a 63 day gap in coverage, they had to insure me. [mi]

I've applied with another carrier already. If they decline me too, can I appeal the first one? Can I appeal the second one? Has anyone ever done that and what was the best way? I'm just looking for a high deductible plan with either mental health coverage included or a rider I can add to it. I don't want to discuss my medical history, albeit it's nothing salacious; I just want to know what resources I have to get insurance, now that I what I thought was the correct procedure is wrong

I am employed, but I'm a contractor. So no benefits for me.
posted by pieoverdone to Health & Fitness (6 answers total)
You should be under protection of HIPA, the Health Insurance Portability Act. Call and ask - when I went into contracting, I did the same thing and wasn't turned down so much as "encouraged not to apply here." They had good rates, so I went with them anyway, but it took some pushing.
posted by plinth at 3:35 AM on January 10, 2005

You might check state laws to see what happens if you happen to own a small company. I'm in the same boat, and I had to start a company just to get coverage.

Starting a company is not hard, and in my case was well worth it. I'm now with an insurance company that initially denied me individual coverage.

One thing, though. I did have to fill out a ton of forms, which helped determine the rate. This included a long medical history of all parties involved.

Have you found an insurance broker? They might be able to help, and they don't take as much off the top as you might think.
posted by bh at 4:22 AM on January 10, 2005

Some states have guaranteed coverage high risk pools for those who have preexisting conditions. Your profile says you're in Missouri: I found this.
posted by Saucy Intruder at 5:10 AM on January 10, 2005

You might want to try Blue Cross. I don't know how it works in Missouri but in New York, they can't turn you down. Which is probably what Saucy Intruder is talking about, except he sounds like he actually knows what he's talking about.

Check and see who insures the municipal/county/state workers where you live. The non-profit that insures NYC workers also accepts independents. I joined without a physical at all. It's not luxe coverage by any stretch but if I get hit by a bus, it won't bankrupt my family, which is all I'm after.

Several friends here have insurance through the Designers Guild. Anything similar you might be eligible for?
posted by vetiver at 6:21 AM on January 10, 2005

As for HIPPA (Title I is the relevant portion), the 63-day gap is mentioned here, along with a lot of other information.

Given your circumstances, it appears that "you can obtain coverage in the individual market as a HIPAA eligible individual."

Also: "If you meet the requirements to be a HIPAA eligible individual, you must get a choice of individual coverage with no pre-existing condition exclusion, either through a health insurance issuer or a State's high-risk pool."

As mentioned above, health insurance requirements and options vary greatly by state. For Missouri, here's an informative page from the relevant state agency(link found via this lawyer's web page). Do consider calling the state agency if their website doesn't answer all your questions - it's their job to help, and this has to be a very routine situation for them.
posted by WestCoaster at 10:49 AM on January 10, 2005

I've been declined 3x today for previous mental health coverage.
posted by pieoverdone at 1:35 PM on January 10, 2005

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