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February 20, 2002


Question from Houston, Texas, USA:

My son has Medicaid right now, and I am trying to purchase health insurance for him, but a lot of insurance brokers do not want to help when they find out he has diabetes. Is there any health insurance that you know that will insure someone with diabetes? Why is so hard to get health insurance for a person with diabetes?


From: DTeam Staff

Many states have special health insurance programs for children called SCHIP. Usually, this is a separate program from the state Medicaid program, although some states will establish a benefit for children.

In some states this involves enrolling with a large carrier or HMO selected by the state and the premium is subsidized based on the family income. If this is not an option for you, then I would seek coverage through your local blue cross/blue shield carrier. Many states require that these plans provide coverage to all who apply because these companies are permitted to operate as non-profit organizations with significant tax breaks (although this is changing). In many states other insurers are permitted to be selective on who they insure. When applying to your BC/BS carrier be prepared for a high premium and a 12 month pre-existing exclusion or waiting period for coverage for diabetes care.


[Editor’s comment: See APHA SCHIP Resources and Texas Title XXI Fact Sheet — Children’s Health Insurance Program.