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Worries about losing health coverage can make you reluctant to leave a job, start a business, move to another city, get divorced or retire early. And that's especially true if you have a medical condition.
But you don't have to let health insurance rule your life. Although it won't necessarily be easy, chances are you can find good coverage on your own -- often for less than you might expect -- even if you're not in the best of health. All four of the following strategies have been used successfully by the families profiled below.
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Shop the market
Each insurance company has its own rules about who it will cover. Depending on your medical condition, one insurer may reject you, another may add a 50% surcharge to your premium, and a third may cover you at standard rates. "Some companies reject as few as 5% of their applicants, and others may reject 15% or 20%," says Russ Childers, a health-insurance broker in Americus, Ga. For high-risk clients, Childers has the best luck finding coverage through Blue Cross and Blue Shield of Georgia, which serves more than 60% of the market in his area and can spread its risk over more patients.
Although most insurers reject individuals with diabetes, for instance, a few have begun offering coverage to people who control the ailment through diet or oral medicine, rather than insulin injections. Some insurers reject anyone who has been diagnosed with cancer, while others offer coverage five or seven years after a patient's last treatment. Each insurer has specific cutoffs for height, weight, cholesterol and blood pressure, and a few reject applicants with minor problems, such as seasonal allergies. What's more, states have different laws regarding coverage.
As a result, the range of policies and premiums is wide, as Mike Golm and his wife, Mary Lukanitsch, discovered. The Lake Forest, Ill., couple paid about $780 per month for COBRA coverage through Golm's former employer after he retired three years ago at age 57. Golm's COBRA would have expired after 18 months, and when the couple began shopping on the Web for new policies, they found a price range of $597 to $860 for similar coverage.
But the couple suffer from medical conditions "fairly typical for people in our age group," says Golm -- high blood pressure, elevated cholesterol and osteopenia (low bone density) -- and they were turned down by AARP, Blue Cross and Unicare. They could have qualified for coverage through the Illinois Comprehensive Health Insurance Plan (the state's high-risk pool), but those premiums were $1,500 per month, and the plan usually has a waiting list. So they continued to shop.
Humana finally offered them a policy for $1,100 per month, with a $1,000 deductible and some exclusions -- more than they were paying under COBRA but less than the high-risk pool would cost. This year they avoided a 15% premium hike by increasing their deductibles to $1,750, and they're counting the years until they turn 65 and qualify for Medicare.
Golm and Lukanitsch shopped on their own, but you can save time -- and possibly money -- by working with a health-insurance broker who is familiar with your local market. Find a broker through the National Association of Health Underwriters or work with eHealthInsurance.com (if you have medical problems, it's easier to call 800-977-8860 for personal service rather than going online). Mention your medical conditions immediately, so you don't waste time with insurers who will likely reject you once they see your records. A rejection by one company could make it tougher to get coverage elsewhere.
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