[WestCoastMom]

Has anyone had trouble getting new health insurance since their tbi and pcs?

I realize that a new law is going into effect that will prevent insurance companies from denying you coverage due to a pre-existing condition.

But, it does not prevent them from charging very high rates to cover you.

Any comments?

[Jeffrey]

My problem is I haven't had insurance in a decade.

I don't know how I can afford it. Maybe someone else has tips?

[stevesworldnyc]

Originally Posted by WestCoastMom

Has anyone had trouble getting new health insurance since their tbi and pcs?

I realize that a new law is going into effect that will prevent insurance companies from denying you coverage due to a pre-existing condition.

But, it does not prevent them from charging very high rates to cover you.

Any comments?

Usually, health insurance companies would find it hard pressed to deny coverage to someone whom has remained covered. You may be best off trying to get medical coverage with medicaid or medicare, then once you have coverage you can seek work and will likely have a better chance since you will be sliding from one insurer (medicaid/medicare) to another (private insurance). Unfortunately, private insurance companies are in the habit of making money. While it is a dying breed, you could search for an insurer in your area that is a not-for-profit, as they may not deny you due to a pre-existing condition. If you can find one, you would be best off getting in while you can, as many are moving to for-profit status, which allows them to make more money, spend more on administrative costs and follow different rules and regulations than a non profit does. Good luck to you. (I worked for a non profit health insurance plan for many years, so I've got an inside track as to how they run).

[Mark in Idaho]

I could not get insurance when I moved to Idaho from California 11 years ago. I kept my northern California based Kaiser plan.

From what I understand, the insurance cos want you to have not been treated or prescribed medication for the health condition for the previous 6 or 12 months, depending on the company. I was on meds that I could not stop taking so i stayed with Kaiser until my SSDI with MediCare was approved. I had to travel to California for my routine care. Not a big problem since I have family in Sacramento.

Since PCS is not a condition that requires doctors' treatment, it is possible to get past the time limit to qualify for health insurance.

I have lived with PCS for 45 years. Not a lot of need for doctors once you understand the symptoms. Once your symptoms stabilize, it should not be a problem.

If you currently have or had health insurance, you can get a Certificate of Health Insurability or something like that to provide the new company.

Jeffrey, I have paid for my own and my families health insurance since 1976 when I dropped off my father's plan at 21 years old. It has been a matter of financial priorities. Rent and health insurance were always the first bills paid.

Hope this helps.

My best to you.

[Jeffrey]

Mark, that's great you've been able to do that for your family.

My income has been sporadic since the effects of 9/11, but I've managed to stay out of debt (until just now...) The small company I'm with may finally have the breakthrough I've been hoping for the past six years or so- very soon (Lord willing).

In the meantime, hope insurance goes well for the TC (topic creator).

[patwlakewood]

Originally Posted by WestCoastMom

Has anyone had trouble getting new health insurance since their tbi and pcs?

I realize that a new law is going into effect that will prevent insurance companies from denying you coverage due to a pre-existing condition.

But, it does not prevent them from charging very high rates to cover you.

Any comments?

Hi Im new. I can't find any insurance company for my husband after his tbi.

[Mark in Idaho]

The common standard insurance companies use if based on how long it has been since last treatment. They use 6 months and 12 months as standards, depending on the situation.

The toughest part of this is they consider ongoing prescription medication to be continuing treatment. I would have had to stop taking my meds for 6 months or 12 months before I could qualify as No Pre-existing Conditions.

Some policies will restrict coverage for the pre-existing condition for a specified period of time (6 or 12 months), especially if it is just a chronic issue that does not require expensive treatment. Thus, they cover the other medical issues without limits beyond the normal health plan restrictions.

The state you live in may have rules that govern these issues.

How is your husband doing?
What kind of a TBI did he suffer?
Is he able to work productively?