Insured at What Price

Carissa Bluestone, 30, a Seattle-based freelance editor and writer with Crohn’s Disease, was denied private health insurance in Washington State. Even though she was eligible for state-funded WSHIP, a plan with a $1,000 deductible would have cost her more than $300 per month. She waited for her upcoming wedding instead, and got covered under her husband’s insurance. But that didn’t include dental and she is now facing $5,000 in dental work, in addition to paying to have her wisdom teeth removed. “I’ll probably have to borrow money from my parents,” she says. “I’d really like to stop doing that since I’m thirty and, by most people’s standards, make a comfortable living.”

Covering Your Ass and Working the System

Know your state policies. Each state has its own set of complex rules about health insurance. Contact your state’s department of insurance.

Twenty-eight states have a high-risk pool that you can join if no private insurer will take you. You usually have to prove residency of at least six to twelve months, and it might not be cheap. As an example, a thirty-year-old Oregonian will pay $149 to $250 per month in premiums.

An excellent resource for state-specific information is Georgetown University’s Healthinsuranceinfo.net. Always double-check with your state’s insurance office to be sure.

Don’t say no to COBRA without a back-up plan. COBRA is a federal law that requires companies with twenty employees or more to offer you the same insurance you had at your job when you leave for any reason. The catch? You pay the entire premium—up to nine times what was extracted from your paycheck. In my case, that was about $400 per month.

Do research before you leave your job to find out if you’re eligible for a cheaper plan with a private insurer. You have sixty days after you’re offered COBRA to decide. If you opt out of COBRA without being insured elsewhere, there is nothing preventing you from being denied or dropped by private or state-run insurers due to pre-existing conditions.

Don’t let coverage lapse. The federal Health Insurance Portability and Accountability Act (HIPPA) provides some protections for those leaving group (employer) insurance plans if they’ve been covered continuously for 18 months without a lapse of more than 63 days. You are not eligible under HIPPA if you were offered COBRA but refused it or did not use up your COBRA benefits completely.