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Need help desperately , health problem , lawyers, disability issues, etc....

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Old 01-14-2004, 05:39 PM
  #11
BK
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There are new laws that require states to offer insurance even if you do have pre existing conditions. I am currently on such a policy.

The policy itself sucks ($2500 deductible, $400/mo premium, crappy drug benefit etc) But once you surpass the $3500 out of pocket yearly expense, they start to cover almost everything else at 100%.

It's not the best, but it might keep you from having to sell the house



But if you can be declared disabled, there are other benefits to add to what Clearcut posted. I think they still give SSI for children of the disabled who are in college full time. There may be limits to that, nowadays tho.



Here is more information on the High Risk Insurance Pools:


http://info.insure.com/health/highriskpool.html

High-risk health insurance pools

A high-risk health insurance pool is one you don't want to jump into unless you have to. It's considered a last resort for people who have been denied insurance in the traditional marketplace because of health problems, such as cancer, stroke, chronic depression, or heart disease.

Health insurance risk pools are special programs created by state legislatures to provide a safety net for people with pre-existing medical conditions. Each state operates its risk pool differently, although many share common features.

The boards work with insurers to collect premiums, pay claims, and administer the programs. Although the health benefits vary, most are comparable to basic private market plans except for the cost. Typically, pools can charge you between 130 and 200 percent above the standard premium for individual health insurance on the open market in your state.

Despite the expense, there are waiting lists in some states to get into the pools. This is because the only other alternative for many people with costly medical conditions is to go uninsured.

Are you eligible?
Most high-risk health insurance pools have strict eligibility guidelines, so not everyone who has a serious illness qualifies for coverage. You can't apply for health insurance through a high-risk pool if you're eligible for assistance from any other state or federal program such as COBRA, Medicaid, or Medicare. See Know your COBRA rights, Understanding Medicaid, and Understanding Medicare.

Typically you must prove you can't obtain health coverage through private insurers. Acceptable forms of proof include copies of denial letters or involuntary termination notices.
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Old 01-14-2004, 05:44 PM
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Oh drat. Just checked the next page and found this. I'm sorry -- I thought all states were required to have High Risk pools



http://info.insure.com/health/lawtool.cfm

Does New Jersey offer a high-risk health insurance pool?
No.

High-risk pool premium cap: N/A

High-risk health insurance pools are established and maintained by a state to provide health insurance for residents who, because of the existence or history of a medical condition, are unable to buy coverage on the open market and do not have other private insurance or access to an employer-sponsored group health plan. They're called "high-risk" pools because the consumers in them are considered at high risk of incurring hefty medical expenses.

In addition, most states that offer a high-risk pool impose a cap on health insurance premiums bought through the pool. The cap is a fixed percentage above the standard premium charged for individual health coverage on the open market in the state.
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Old 01-15-2004, 09:02 AM
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Of course ......... NJ controls everyhting !

Thanks ..
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Old 01-15-2004, 09:24 AM
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I am not sure how rooted in he is in NJ but I know that a lot of NJ is high price. Is moving a option? Maybe he can move to some place that does not allow insurance companies to discriminate agains pre existing conditions. I know that Mass falls under that. I have a pre existing condition and the Insurance companies HAVE to cover me. Another option and it does not soud like he has the money for this but could he perhaps get a job under your insurance with your work? I know that my father has my brother work for him every am and one of the forms of Payment is health insurance. So maybe you can have him under your policy as a employee. That would not work for me as we have health insurance through my wife. Another option is if you can make up a bus for him get insurance through NASE (national association of the self employeed) . Their web page is www.nase.com

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Old 01-15-2004, 09:06 PM
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Interesting idea ...Thanks Jon.

Still trying ..........
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Old 01-16-2004, 03:41 PM
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Also -- Jon is partly right -- the "group" plans are required to insure all employees for pre-existing conditions. Some have a waiting period but there are rules on that too.

The bad part: Individual (family) insurance plans don't fall under this law. If you have a pre-existing condition, the Insurance Co. can just refuse to offer you coverage. That's what they did to me. They bypassed the requirement by declining me from the start. There are no laws that say they must sell you a plan.

But this is where the State level High Risk Pools come in - for those who can't get on any plan. The states contract with the exact same insurance companies to offer a "High" Risk policy. The premiums are outrageous.

And so it behooves the Insurance company to "Decline" as many patients as they can -- even if they are just slightly sick -- and force them to go into "high risk pools", where they can make 10 times the premium, and offer huge deductibles.

I was on group plans all my life with never a problem. But as soon as I went off on my own and applied for an individual policy....they DECLINED me and put me in "high risk" simply for a history of migraines and a swollen disc in my neck.



But Jon also mentioned getting on with a GROUP plan somewhere. Some insurance companies have no waiting period on pre-existing (some have a 12 month wait). It depends on the policy.

NASE does offer insurance. It may be worth a shot!?

You can request a quote by clicking here:
https://www.nase.org/secured/quote_request2.asp

Last edited by BK; 01-16-2004 at 03:53 PM.
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