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Question:

From West Palm Beach, Florida, USA:

I am 21 years old, have had diabetes since I was 18 months old, and recently I started insulin pump therapy. The problem is my insurance was cancelled, and I need insulin and supplies. What insurance can help me and my family get the things I need? We are on a really tight budget. Where can I get help?

Answer:

Getting new health insurance can be tough when you have diabetes. First, let's discuss resurrecting your old coverage. If you participated in a group health plan or policy sponsored by your employer, look for your copy of your benefit booklet or Explanation of Coverage (EOC). Examine the policy to see you if might be eligible for conversion from a member of the group policy to an individual policy. There is a time limit in which you have to elect conversion, usually 30 days. To convert your policy, contact the insurer.

If you lost your coverage because you left your job, you might be eligible for COBRA coverage. Under COBRA, employees of companies with 20 or more workers have the right to continue their health insurance coverage for up to 18 months. The down side is you have to pay the total cost of the insurance plus an administrative fee of no more than 2%. You have 60 days to elect coverage under COBRA through your old employer.

You also might be eligible for coverage through HIPAA. HIPAA addresses the issue of accessibility to coverage for a person who chose to leave an employer sponsored plan and obtain coverage in the individual market. If you meet the qualifications under HIPAA, you might entitled to coverage on a guaranteed issue basis in the individual market with a complete waiver of pre-existing condition exclusions. You might be eligible under HIPAA if you:

  1. You have had at least 18 months (12 months in certain cases) of continuous coverage with no break in coverage greater than 63 days (may be longer in some states).
  2. Most recent coverage was under a group health plan (defined as an employee welfare plan), a governmental plan or a church plan.
  3. You are not eligible for coverage under a group health plan, Part A or B of Medicare, Medicaid or similar state plan.
  4. You do not have other health insurance.
  5. You have exhausted coverage under any Federal or State continuation of coverage provisions (COBRA) if eligible.
Here is a link to a website sponsored by a Florida insurance broker concerning health insurance available to individuals that appears to be accurate and informative. This same site offers a page devoted to HIPAA issues where you can learn more about HIPAA and the protections it offers:

DSH

DTQ-20030305203750
Original posting 8 Mar 2003
Posted to Insurance/Costs

  
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Last Updated: Tuesday April 06, 2010 15:09:42
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