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» LymeNet Flash » Questions and Discussion » Medical Questions » Can I get private hea;th insurance while Im activly sick with Lyme?

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Author Topic: Can I get private hea;th insurance while Im activly sick with Lyme?
mountainmoma
LymeNet Contributor
Member # 6503

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Hi all.

Im wodering if it is possible to get private health coverage that would cover me ? I mean, is Lyme consedered a preexisting condition ?

The health coverage I have is thru my exfiance, I am still listed as his certified domestic partner. But, we're not seeing each other anymore, he doesnt live here anymore and he is in love with someone else. So, I dont know how much longer this will hold out.

Also, I could emotionally use more seperation. And his taking care of my medical interfers with our discussions of childsupport, etc...

Anyway, has anyone here successfully secured private insurance while sick with Lyme ? I am on SSDI and so could sign up for and pay for medicare, but I know thats not going to cover anything I need to combat lyme or pay my LLMD, so why bother ?

Thanks for any ideas.


Posts: 222 | From Santa Cruz Mountains, CA USA | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
skrwolf
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Unfortunately, we tried to get private health insurance for our family a little bit ago and they said no way, no how, for me (I have active Lyme and am on orals). Especially if I have active symptoms and am being currently treated. I had to have 6 months, treatment free and symptom free, for them to even consider me. Even at that point, they wanted medical records.

I'm in Utah, so I don't know if every company is this way, but they are EXTREMELY picky about who they accept. They will not even accept anyone who has asthma and is on steroids.

Health insurance is such a sham in this country... We are still on Cobra and it is costing us $850/month.

Kara Tyson has posted some good links about state high risk pools. I might have to do this once our Cobra runs out.

Good luck!

Shelly


Posts: 292 | From UT | Registered: Aug 2001  |  IP: Logged | Report this post to a Moderator
klcst
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Unfortunately no insurance company will accept you for Lyme unless you are covered through employers insurance. They all turned me down even though I was better with my treatments. The creeps know there is no cure for Lyme. Your best bet is Medicare through SS. It may not cover everything with Lyme but I don't know of any health insurance plan that covers everything.
I wish you well.
Lisa

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snowboarder
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Everyone's right they will not cover you.

Since you've been covered thru your ex, they by law have to offer you cobra which is what I'll be taking in March.

My husband's loosing his job and my option was either that, or get insurance for a business group of 1 since I own my own business but have no employees.

After checking insurance plans, I came to the conclusion that sticking to cobra will be my best option because most plans have higher deductibles, co-pays, and perscription drug plans were way higher.

The cost is very very high for cobra but none of us can afford to go without insurance.

Best of luck!


Posts: 738 | From Colorado | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
believe3
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Hello, I work in the insurance industry and I have never heard of an insurance not covering a condition. (ok, ok im not talking about them denying you treatment because to them you are "better")

They have a pre-exisitng clause that can range from 6-24 months. That only comes in to play if you have not been covered by insurance previously. If that is the case then you have to wait the 6 or 24 months for them to cover that condition.

I may be wrong on the private insurance thing but that would be the same thing as if you had a heart condition and they said they would not cover you because of that. It just doesn't sound right.

I will be trying to get private insurance in the next few months. I guess I will find out for myself. I hope you guys are wrong.

------------------


Posts: 261 | From minnesota | Registered: Sep 2004  |  IP: Logged | Report this post to a Moderator
Kara Tyson
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You MIGHT be able to.

Yes, it is a preexisting condition. However, almost all states have a high risk pool for people with preexisting conditions.

Here is some information. All states are differant. I believe that CA has a 6 month waiting list.

If your main cost is meds, pharmacutical companies have programs for people who do not have insurance. I have included that link also.
http://www.statecoverage.net/matrix.htm
http://www.needymeds.com


Posts: 6022 | From Mobile, AL | Registered: Apr 2001  |  IP: Logged | Report this post to a Moderator
duramater
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hey mountain:

you said: I am on SSDI and so could sign up for and pay for medicare, but I know thats not going to cover anything I need to combat lyme or pay my LLMD, so why bother ?

Just to expand your options, as far as Medicare goes, you are right, many LLMD's have "opted out" (personally, I think that stinks, but that is a political battle I don't have the energy for...but when I do, watch out!) but NOT ALL have.

Also, IV antibiotics are covered (the LLMD I consulted with said this coverage was better than most "regular" plans). The only caveat to that is that you have to get the infusions at the hospital outpatient place, a clinic, or doc's office.

Orals are partially covered currently with the prescription cards.

In addition to Medicare, you can buy (which I do), "add on" plans (also called "Medigap"). These plans pay all the deductibles and 20%/50% left overs of Medicare and may be cheaper than "regular insurance" that you want to get outright (mine is currently $138/month and BOY do I get my money's worth!!). Also, many of these plans include full prescription coverage (these have higher monthly costs).

So, I'm not advocating that you follow through on Medicare, just letting you know what it does and can cover. In the end, it may be a very viable option for you. Best of luck with your decision making.


Posts: 689 | From western MA (we say buttER and pizzA) | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
achey
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I don't know abt other states, but in NH if you currently have ins, and are switching to another carrier, you can not be denied coverage due to a prexsisting condition...

That became law in NH some years ago,and has caused many carriers to leave the state, and yes, we have very , very high insurance costs here!

So check with yoru state insurance commision and find out how things work there.


Posts: 663 | From NH USA | Registered: Sep 2004  |  IP: Logged | Report this post to a Moderator
   

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