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June 6, 2003

Insurance/Costs

Question from Duluth, Georgia, USA:

My husband is self employed, and we were out of the country for a while because of business. Having just returned, we tried to buy health insurance for our family, but my son has been denied because of his diabetes! Is this a common problem? What can we do about it?

Answer:

You are faced with a difficult problem. Georgia offers few protections for individuals and the self-employed who need health insurance. Issuers are allowed to medically underwrite membership in their policies. Many states permit self-employed individuals to have the same market reform protections offered to small groups, but even here, you would likely find your son would face a year long pre-existing exclusion or waiting period before the insurance would cover costs of diabetes treatment.

A couple of ideas: first would be the State’s child health insurance program. This program has income limitations, probably about 200% of the poverty line. Another alternative would be to seek out employment with an employer who offers health insurance.

DSH