How to get insurance when you have a pre-existing condition

1. Become a group of one.

In about a dozen states, you can be a group all by yourself for insurance purposes. What this means is that you become, in effect, just like any other company, and insurers can’t deny you insurance or charge you higher premiums because of your pre-existing condition, according to Lembo.

“You’d be surprised at the number of folks who open their own landscaping business” to get the group of one, he says.

To find out whether your state will allow you to become a group of one, see this list from the Kaiser Family Foundation (look at the column headed “Definition of Small Group,” and look for “1-50”).

For more information on becoming a group of one, see this advice from the American Diabetes Association.

In states where you can’t become a group of one, you can become a group of two.

“You can hire your brother-in-law to become a subcontractor for your landscaping company,” Lembo said. “It’s horrible, but what else are you going to do?”

An important note: Under these rules, an insurance company might be allowed to exclude coverage for your specific condition for a short period of time, usually about six months.

2. If you’ve been laid off, get COBRA.

COBRA can be extremely expensive, but it’s worth digging deep in your pockets for the premiums, because it may be difficult, if not impossible, to get insurance any other way, Consumer Reports’ Metcalf says. If you’ve been laid off since September 1, you’re eligible for a 65 percent discount on COBRA premiums. For more information, visit the Department of Labor’s Web site.

3. When you lose your employer-related insurance, apply for new insurance within 63 days.

In all states, a designated insurance company — charmingly called “the insurer of last resort” — has to take “all comers” in insurance lingo. You have to apply for this insurance within 63 days of losing your group insurance. For all the rules, read this explanation from Families USA (scroll down and look for the “HIPAA eligible” heading).

Here’s the bad news: Although in some states there are limits to what the “insurer of last resort” can charge you, in other states, there aren’t. In those states, “the sky’s the limit,” . “They can and will charge you a fortune. It could be, say, $1,400 a month in premiums with a $5,000 deductible. But some people pay that because it’s the only game in town.”

To find out the rules in your state, visit the Kaiser Family Foundation’s State Health Facts or contact your state insurance commissioner.

4. Find out whether your state has a high-risk pool.

State high-risk pools are specifically for people with pre-existing conditions who can’t find affordable insurance on their own. Thirty states have high-risk pools, insuring 175,000 people, according to the American Diabetes Association, which lists the states on its Web site.

5. See whether your professional organization offers group insurance.

Some professional groups, such as those representing real estate agents and freelance writers, offer health insurance. Check and see whether your profession does the same.

Here’s another piece of advice, offered somewhat tongue in cheek: Move to Maryland, Massachusetts, New Jersey, New York or Vermont.

“In those states, everyone has to sell to you,” said Cheryl Fish-Parcham, deputy director of health policy at Families USA. Not only do insurance companies have to sell you a policy in those states, there are limits on how much they can charge you, she says.

For more help in finding insurance when you have a pre-existing condition, you can contact the Cover Me Foundation at 877-678-7631 or Coverage For All at 800-234-1317.

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3 Responses to How to get insurance when you have a pre-existing condition

  1. Daniela Ivey July 27, 2009 at 5:40 pm #

    how do you get insurance if you have a pre-existing condition? I’m in danger of losing my insurance through my employer

  2. admin August 11, 2009 at 12:22 am #

    If you lose your insurance you will get cobra. It will be 65% off what you currently pay. In order to keep your insurance until the Obama plan goes into effect you must try and purchase the cobra which off which will keep you insured for at least 9 months. I will research and write more on pre-existing conditions. Everyone wants to know the answer to that. Go to obama’s twitter page and voice your concerns as well.

  3. nicholas January 30, 2011 at 12:58 pm #

    i have a girl friend who was in jail for five years and now when she got out. She has found out that she has cancer. It was hard for her to get a job that pays 40hr a week. On top of medical bills she is paying child support on two children and trying to pay all her bills. Its sad that she payed her time and is now to be given the same as a death sentence. She is the most wonderful, nost beautifulest woman i have ever known. She was young and made her mistakes now she just tring to live. When will the oboama plan go in?????

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