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February 10, 2003

Insurance/Costs

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Question from Fort Mill, South Carolina, USA:

I am 28 years old, and I have type 1 diabetes treated with a pump. I have been very responsible about going to the doctor, and I am staying on top of my diabetes. Now, I want to go to work for a company that does not provide medical insurance for a pump. Are there any health insurance companies out there that will provide individual coverage?

Answer:

From: DTeam Staff

The answer to your question is “Maybe”. Some states require health insurance plans to allow employees to convert from group coverage to individual with a guaranteed issuance of coverage without any type of waiting period. Contact your current insurer to learn if this is available to you. If you currently have health insurance through a group plan (e.g., your employer’s health plan) and have had this coverage for 18 months (12 months in some states), you are eligible for guaranteed issued health coverage without evaluation of your health status or waiting periods for preexisting conditions so long as there is no more than a 62 day interruption in your insurance coverage. However, this coverage is not cheap.

Title I of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects health insurance coverage for workers and their families when they change or lose their jobs. Also, you are probably eligible to continue your current health insurance after you leave your present employer through COBRA. You will be responsible for paying the entire cost of the coverage that your employer pays as well as a 2% administrative fee with the premiums paid directly to your employer.

DSH