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losing medical insurance, what to do?

Discussion in 'Parents of Children with Type 1' started by anna-bananna, Feb 10, 2012.

  1. anna-bananna

    anna-bananna Approved members

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    Hi All,

    It has been awhile since I have had a chance to post/reply on here, but I am in need of advice! My husband's boss just told him that we are losing our medical insurance at the end of the month. The boss hopes it will be temporary and as soon as they get more jobs (they are in construction/remodeling), he will make reinstating the medical the first priority.

    Since work has been slow for so long, $ is already tight, and I am not sure if we could even afford to pay for Cobra or to keep our insurance going ourselves. Of course, he will be looking for another job, but many people around here have been out of work for a long time. I am a SAHM, since we have a 3 year old who would need daycare, so most of the money I would make would go to daycare and not us, anyway.

    Any advice on what to do from here would be greatly appreciated.

    We live in Oregon and currently have Kaiser.

    Thank you for any advice!
     
  2. selketine

    selketine Approved members

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  3. Mommy To 4

    Mommy To 4 Approved members

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    Dependent upon your financial situation, (I know you said that money is tight), you may qualify for the Oregon Health Plan. It is state medicaid and while not perfect or ideal it may be a way to bridge the gap for a while. The application can be found @ http://www.oregon.gov/OHA/healthplan/app_benefits/main.shtml. Hope that helps. We are in Oregon as well.
     
  4. CAGrandma

    CAGrandma Approved members

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    Beg, borrow or steal enough to pay for at least 1 month of Cobra to give yourself enough time to get something else set up. You can be disqualified for some insurance if there is a gap in insurance and it is so darn close to the end of the month already! Then look into the children's health insurance/medicaid programs in Oregon.
     
  5. Mrs. Russman

    Mrs. Russman Approved members

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    I second the suggestion to look into Children's Health Insurance Program. Wouldn't help you and your husband, but the kids would be covered.
     
  6. bnmom

    bnmom Approved members

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    I'd check with the pharmaceutical companies direct, most of them have programs for free or reduced meds and their income requirements are much more generous than state/fed guidelines for "in need" so even though your husband is still employed, you may qualify.

    Good luck and hang in there! :cwds:
     
  7. 4kids4me

    4kids4me Member

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    ITA with this as well as the previous poster's remarks. If you let this insurance lapse, you may not be able to get coverage for your child back, in that this is a preexisting condition. Very important to do whatever it takes to keep what you've got. Good luck...dealing with health insurance, in any capacity, SUCKS!!!


     
  8. MommaKat

    MommaKat Approved members

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    Disqualification or denial of coverage can't happen for kids anymore with partial implementation of the Health Care Act, but private insurance can increase the premium substantially. However, CHIP will expedite your application for the program if you bring in a letter from you dh's employer regarding cessation of employer benefits and a letter for you endo documenting diagnosis of type 1. I was able to get my kids on CHIP effective the 1st of the month for the month they would first have had no coverage, though for the first month in our state it's run through straight state assistance and then ported to the HMO that carries the SCHIP coverage.You have 63 days from the end of this insurance to new insurance to avoid issues of pre-existing conditions being denied for you and your dh, or premium hikes for you kids as a result of lack of coverage.
     
  9. momof2marchboys

    momof2marchboys Approved members

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    I have been your position before - I would highly suggesting getting some kind of coverage in place ASAP - whether it be a high deductible plan that you can afford the premiums for now or paying for COBRA.
    The most important thing is do NOT let coverage lapse on your child as most policies will deny coverage based on preexisting conditions. The new Obama health plan has a clause in it that they can not deny coverage on children but they can inflate the cost of the coverage up to 400% for that child if the insurance company wants to inorder to cover the costs they will pay out. (we learned this when we were without coverage prior Dx of diabetes based on our son's seizures).
    Research and see if your state has a comprehensive insurance pool that you can at least get coverage for your child thru. We had to do this for our son as he was denied coverage everywhere else based on his seizures and private coverage for him was going to be outlandish - we had a 6 month waiting period where they would not cover anything seizure related but we had already had all of our tests and dr visits done prior to loosing our other coverage.
     
  10. MommaKat

    MommaKat Approved members

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    The Health Care Act does not have a clause allowing the 400% uphike in premium - insurance companies discovered a loophole in order to do this as they were unhappy about being forced to cover children with pre-existing conditions. In answer to this unfortunate practice, the administration and congress worked together to expand SCHIP coverage to allow for, among other things, expedited coverage of children with pre-existing conditions losing their current coverage. That's why states are specifically asking for a letter documenting loss of coverage, diagnosis, and (if available) the letter of insurance acceptance showing elevated premium due to preexisting condition - they provide the basis for qualifying for expedited coverage. (Staggered implementation has allowed for some plans to be grandfathered under the old system, and are still able to get away with denial of coverage for pre-existing, which stinks.)

    I mention all this because forcing yourself to come up with the exorbitant premium for cobra or private insurance might be something you can avoid. There are also laws about how your dh's employer must go about canceling employer provided coverage, length of notice, etc. You might want to make sure he's meeting his obligations, and providing you with appropriate documentation as that will affect you regardless of what direction you choose to go.

    Because of directives in the Health Care Act, many state CHIP programs, including Oregon's, cover children from 'middle income' families. The website and application are here

    Best of luck!
     
  11. anna-bananna

    anna-bananna Approved members

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    Hi All,

    Thank you so much for the replies. I will follow up on all of these suggestions ASAP!

    We also found out today that our insurance has already lapsed, due to payments being already 1 month behind. :eek: :mad: (The boss' daughter went to fill all of her prescriptions today to make sure that it was all taken care of before the insurance lapsed, and the pharmacy told her this.) So, I'm afraid we may already be in big trouble.

    We will see what tomorrow brings. :cwds:
     
  12. momof2marchboys

    momof2marchboys Approved members

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    I would be checking into federal regulation about the lapse in coverage - they have to provide you with adequate notice of change in coverage. but there are some requirements that are based on how many employees there are. Like if there are less than 20 full time employees they do not have to offer you COBRA coverage.
     

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