Both my 13 year old son and my 22 year old nephew have type 1 diabetes, and as they get older, I am worried about future health care coverage. For example, my nephew will graduate from college this year and will no longer be eligible for his parents’ insurance. We may consider moving at some point if it will help our son and nephew’s situations.

Other than COBRA coverage, what health insurance options are available for people with diabetes that do not cost a fortune? Which states offer people with diabetes the most protection under the law? Which states offer state-sponsored insurance plans?

Your concerns about the availability for health insurance for your family are very appropriate. It is especially important for people with a chronic disease, like diabetes, to plan ahead to avoid having a gap between when coverage under one policy ends and new coverage begins. To use your nephew as an example, once his coverage terminates as a dependent under his parent’s policy due to his leaving school, he has several choices, but he must act quickly to protect his choices.

First, depending on the state in which your nephew’s parent’s policy was issued, he has the right to conversion; that is to convert his coverage under the family policy into individual coverage. Usually, he has 30 to 45 days to exercise this right, the new policy and does not have a waiting or pre-existing exclusion clause, but it can be expensive.

Another option he may have is to request coverage under HIPAA, or depending on the state in which your nephew resides, to participate in a state sponsored health insurance coverage pool. What is great about coverage under HIPAA is that if you are eligible, you are guaranteed to be accepted, and there are no waiting periods or preexisting exclusion periods. The down-side is that this coverage can be expensive, up to double the cost of health insurance on the open market. In order to be eligible for HIPAA coverage, one must have had at least 18 months of prior health insurance coverage, and there can be no more than a 63 day break in coverage between during the period.

The third option is for your nephew is to find a job that offers health insurance. I often advise graduating students to accept any job they can find that offers health insurance and to do so to avoid a greater than 63 day gap in coverage between their old insurance coverage and the new benefit plan that comes with the job.

As for your mention of COBRA coverage for your nephew, that is unlikely as this is a protection for people who had health insurance as a and terminated from employment. As for your question about which states offer the best health insurance climate for people with diabetes, I suggest that you consult the guide to health insurance information by state sponsored by Georgetown University. There you can also learn about HIPAA coverage offerings in each state.

DSH