by Matthew McManus
For those of us with physical disabilities who need health insurance to cover our pre-existing conditions but are not working, what do you suggest?
Jen from Florida
Thanks for your email. I completely understand your concerns regarding obtaining medical insurance if you have disability. It’s a tough hurdle to overcome but hopefully this information will point you in the right direction.
Basically there are three different options for you to pursue. The first is to simply enroll in the group health/medical plan with your employer. Most large organizations offer health/medical insurance to their full time employees, regardless of a pre-existing condition and it is usually a very manageable expense. If married, your spouse should simply enroll in a family plan and add you to his plan; once again usually in this circumstance a pre-existing condition won’t exclude you from coverage. Fortunately, some organizations also recognize same sex partnerships and allow partners to be enrolled just as a spouse would be permitted. Call your human resources department and see what enrollment opportunities are available. Definitely pursue this option first as it should prove to be the most cost effective and comprehensive.
If you’re single, can’t work full time or your employer simply doesn’t offer health/medical insurance, Medicare or Medicaid may also be viable options. Keep in mind that Medicare and Medicaid are two completely different programs but in some instances it is possible to qualify for both. Medicare is a Federal program while Medicaid is a State run and funded so obviously the rules for each state are slightly different. Both programs have strict qualification guidelines and particular attention is given to an applicant’s financial resources, including income and savings. To see if you qualify for either one of these programs visit www.socialsecurity.gov or call 1-800-772-1213.
If you’re not working and have too many financial resources to qualify for Medicare or Medicaid you can apply for insurance through the Pre-Existing Condition Insurance Plan run by the U.S. Department of Health and Human Services .The Pre-Existing Condition Insurance Plan makes health insurance available to people who have had a problem getting insurance due to a pre-existing condition.
The Pre-Existing Condition Insurance Plan:
•Covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.
•Does not charge you a higher premium just because of your medical condition.
• Does not base eligibility on income like Medicare and Medicaid.
To be eligible for the Pre-Existing Condition Insurance Plan:
•You must be a citizen or national of the United States or reside in the U.S. legally.
•You must have been without health coverage for at least the last six months. Please note that if you currently have insurance coverage that doesn’t cover your medical condition or are enrolled in a state high risk pool, you are not eligible for the Pre-Existing Condition Insurance Plan.
•You must have a pre-existing condition or have been denied coverage because of your health condition.
To learn more about the Pre-Existing Condition Insurance Plan please visit www.PCIP.gov. You can apply online and monthly premiums are very reasonable. For a 38 year old male, monthly costs are about $210.
I hope this information is helpful! Please email your financial questions to firstname.lastname@example.org.