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June 30, 2004


Question from Virginia, USA:

My child was diagnosed with type 1 about seven months ago. My employer does not offer health insurance, and my husband is self employed. Therefore, we have always purchased our own health insurance. We had always been healthy, and so, chose a high deductible policy to try to keep the premium down. Now we are swamped with bills, which average about $100 per month for prescriptions (after a $500 deductible was met), and if we switch to a pump, which we all want, we will have to pay about $200 per month continuously for durable medical equipment (DME) supplies (after paying $2500 deductible for the pump itself). I know there are organizations that help those with no insurance, but are there any organizations that help those with this situation? Sometimes I feel like we would be better off with no insurance. Do you have any suggestions for us?


There are not any organizations that I know of that will assist with cash assistance families where both parents are working and the income is above the poverty level. Depending on your income, your child might qualify for Child Health Plus, a state subsidized health insurance program for children. You can get information on this at the Commonwealth of Virginia web site. In my opinion, the problem you are facing is not that you have insurance, but that your current health insurance policy no longer meets your family’s needs. I would strongly encourage your family to consider alternatives to the high deductible plan that you have. Under Virginia law, you should get credit for your existing coverage against any waiting period for pre-existing conditions. I recommend that you review A Consumer’s Guide to Getting and Keeping Health Insurance in Virginia produced by the Georgetown University, School of Heath Policy.

Full disclosure: I am employed by a HMO that serves portions of Virginia.