I am a 24 year old, diagnosed with type 1 diabetes over six years ago, and I am thinking about attending graduate school in the next couple of years. I am writing because I am interested in getting more information on special considerations for a person with diabetes pursuing a master’s or other advanced degree. I have looked at several schools, and the insurance coverage offered by some is not nearly as good as what I had in undergraduate college under my parents’ plan, and what I have now through my employer. I would like to go back full-time if possible, but I want to account for the potential health and financial challenges related to diabetes.

What do I need to consider in this situation? Based on your experiences with others who have diabetes, do you have any specific recommendations or sources of information that might be of use?

Your concerns about the availability of comprehensive health insurance are very appropriate. It is especially important for people with a chronic disease, like type 1 diabetes, to plan ahead to avoid having a gap between when coverage under one policy ends and new coverage begins. Once your coverage terminates as an enrollee (employee) in your employer’s health plan, the clock starts ticking on retaining your right to new coverage without any exclusions for pre-exisiting conditions (diabetes). But, you do have several choices.

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

A second option is to continue your participation in your employer’s plan through COBRA. In most situations, employees are allowed to continue their coverage for 18 months, but the employee becomes responsible for the entire cost of the coverage plus up to a 2% administrative fee. Premiums are paid directly to the employer. Check with your HR/Benefits staff for more information.

Another option you may have is to request coverage under HIPAA, or depending on the state in which you reside, to participate in a state sponsored health insurance coverage pool. What is great about coverage under HIPAA is that it is guaranteed issue [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 last option for you is to find a part-time job that offers health insurance. I often advise students to take 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 a further resource, I suggest that you consult the Guide to Health Insurance Information by Georgetown University. There you can also learn about HIPAA coverage offerings in each state.

DSH