Jump to content

Recommended Posts


    I have been trying to get medical insurance to see a tdoc and pdoc, but I just found out yesterday that I got denied coverage from kaiser permanente because of my pre-existing condition.  This is the second insurance comp. that I tried to enroll with and got denied. 

    I feel kind of trapped.  I haven't had the courage to leave the apartment for the last few days, and it really sucks.  If I thought that the ball was even rolling, I would have a little hope I think and be more motivated, but I just feel fucked over.

Link to comment
Share on other sites

Hi sal_manella,

As Neurotica said, I'd strongly advice contacting your state insurance board. I googled "state insurance boards" and here's a list I found. Be sure to scroll past the google ads; they list the 1st six states then throw in a couple ads. The rest of the states are listed below that. Sometimes they are called Department of Insurance, Division of Insurance, etc.

I'm assuming you are trying to get individual insurance, right? (Rather than get it under group insurance through work?) I had the same problem when I tried to get individual insurance. One called me "uninsurable" (how charming). If I'd had continual prior coverage, however, it wouldn't have been so difficult. Yup, there's the rub! But you still might be able to get individual insurance, even if it has a waiting period for pre-existing conditions. Really depends on the state.

If it is group insurance (usually through work) I believe in most states they can't turn you down, can't deny you because of pre-existing conditions. Even then, they can deny coverage of treatment if you have a pre-existing condition for a period of time. How long that is depends on the state. In one state I lived in it was 6 months, in another a whole year. It really sucks, but it can be a way to eventually get coverage. And getting continual coverage is the key. Continual prior coverage usually negates this waiting period, as I remember.

Bottom Line: Call your state insurance board. For example, in my last job, they tried to deny my COBRA insurance after they'd fired me. I'd worked more than the minimum of time required to get the COBRA insurance. I contacted my state's Division of Insurance and they really helped. I got my COBRA'd insurance. (It'll run out in August, so I need to deal with this issue myself.)

And if you qualify for Medicaid, get it. At least in one state I'd live in, insurance companies considered that as "continual prior coverage". I didn't realize that at the time, so when my financial circumstances started to change, I figured I'd be more likely to be able to get private individual insurance if I didn't have the "stigma" of being on Medicaid, so I got off it first. I ended up screwing myself.

I hope this helps. I know it is a daunting task and is often disheartening. Hang in there.

PS - Here's another resource: The Kaiser Family Foundation. They are more of a public policy foundation. I don't know if they provide any direct public info, but who knows? Maybe they'd have some ideas? Here's their home page: http://www.statehealthfacts.org/  and if you go here: http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi  and click on your state, you'll get the info for your state, including the Department of Insurance and your state's Medicaid websites.

Link to comment
Share on other sites

Here's some emotional support. The rest of the posts gave great references to help you get your insurance, but I feel your pain when it comes to getting denied and not knowing where your stability is going to come from.

I've been denied by every company  out there for the same reason. It makes me wish I had lied on my applications. I'm just too damn honest. It isn't good to write "I'm bipolar and I take this shit, and I've been to the hospital 5 times...!!!). Depression will get you a denial just the same. The loony bin is expensive and our drugs are expensive, and what would they DO without all that money they make? It is all a big racket- the drug companies overcharge for their crappy meds that don't work, the insurance companies have too much power over who they will insure, the gov doesn't do enough to insure or make fair laws for private insurers, and it screws us over.

And WE'RE the people who are going to feel the most pain out of it. We're the ones who are going to hide in our houses and sob, because we get so into that black hole of doom. Been there.

The truth of the matter is that the average hospitalization costs at least $15,000. It is FAR better for them to just take our damn money and give us our damn meds than to have to pay for the hospital. If we don't have insurance, at least in Ohio, then we go to the State funded mental hospital. Then the gov has to pay and they screw themselves- they could have just paid the $200 or whatever a month for our meds and avoided the $15,000 bill. It is kind of like the show Deal or No Deal. They just have to save their $200 a month and bet that we won't end up in the ER. Or worse.

What about all of our lost productivity, our lost life  years (due to our distress or due to suicide), or lost TAX money?

Well, I intended to be comforting and emotionally there for you, and ended up ranting!

This is how I ended up getting insured---

I was uninsured and unmedicated and unemployed. I got into a bad depression, followed by a terrible mixed state (the energy to think too much about distressing things, and the energy to act on it and the anxiety to fuel it, none of the tiredness of straight depression for me). I ended up in a charity hospital and they transferred me to the State hospital. Then the State decided, after I was released, that it really was better to actually give me free medical care than pay the piper to have me in the loony bin. I've been in and out of jobs and private insurance since, and the gov picks up the tab when the private insurance through work is gone. They learned their lesson with one hospitalization.

I'm NOT SUGGESTING AT ALL that you go batshit and land in the ER. I'm saying that a lot of states will jump in if you go to the right places and tell them you're going to end up in the ER unless they help you. Usually that will scare them into it, at least it does in this state.

Link to comment
Share on other sites

Actually I meant repost to the "The Health Care System Sucks!" board here on CB, but, Revlow, I like your idea better.  ;)

I read something recently (ticks over all the recent articles I've read in my disorganized memory bank...nope, can't find it), according to a recent poll, most Americans cite the price of gas and healthcare as their two most pressing concerns.  With any luck, the high price of healthcare (insurance, meds, etc.)  will grab more headlines and politicians will have no option but to sit up and take notice.  I actually think they've already taken notice, we just have to hope they don't underestimate how disgruntled and disgusted we are with the status quo.

Link to comment
Share on other sites

That does suck. Seems like insurance companies make money by wearing out the patients and doctors and denying legit claims. But sometimes they just throw money away.

If you can afford it, it's probably a good idea to get some health insurance even if they deny MI coverage due to a preexisting condition clause. Where I live, at least, after 6 months they have to cover anyway.  You could have that clock start ticking now. If you can afford it. I've got to find a job so I can afford it myself. So far have been lucky and havn't had any gaps in coverage. Not only will you have the clock ticking, but if you develop some other health problem it will be covered.

I think the whole preexisting condition thing is silly, since we've ALL been born and that's a preexisting condition which guarantees that at some point our health won't be so good.

Link to comment
Share on other sites

Thanks everyone for your responses.  It was really cool to read them.  A lot of people mentioned contacting the state insurance board.  I did that, and ended up getting referred to something called the Oregon Medical Insurance Pool.  It turns out that OMIP offers "un-conditional" medical insurance, BUT...and this is a big BUT, there is a six month waiting period for any pre-existing condition.  So I was basically back to square one...EXCEPT at around the same time my friend dug up a couple of numbers, and I was able to contact a psychiatrist who is willing to work for half price, which is still  little expensive but not much more than I'd be paying for medical ins. in the first place.  And if he turns out to be good, it could be well worth it.  Prescriptions are another story, but I'll have to find some way to pay for those too.

Link to comment
Share on other sites

That's great about the psychiatrist.

If you do get to the point where you can afford it, it still would be a good idea to get the "un-conditional" medical insurance -- even with the six month waiting period. You'll get through that period and then you will have insurance, which is important from the "continual coverage" standpoint. That continual coverage thing seems to be key.

Of course, I'm not diminishing the cost or the inability to pay for insurance right now. Been there myself.

Thanks for the update!


Edited to add: Once you get to the prescription stage, you might want to see if you qualify for the Prescription Assistance program. You can get info here: Partnership for Prescription Assistance.

And if you don't qualify for this, do check back here. There are people who can give you advice on finding prescriptions at lower costs.

Link to comment
Share on other sites


This topic is now archived and is closed to further replies.

  • Create New...