Q. I'm 56, have three pre-existing conditions (Hodgkin's disease, type 2 diabetes, and heart disease), and a teenage son with ADHD. I've been on COBRA since my husband died last March, paying about $1,000 a month, which I can barely afford. But my coverage expires in October and an insurance agent I talked to isn't calling me back. What do you suggest? I live in North Carolina, by the way.
A. What a cruel health-care system we have, to burden you with these worries when you're struggling with personal loss.
Your job is to hang on to some kind of insurance until then. You can do this, though it won't be as affordable as you would like. Here's the scoop:
Your COBRA might last longer than you think. If your husband worked for a company with 20 or more employees, you are probably under federal COBRA, which allows you and your son, as dependents of a covered family member who died, to stay on COBRA for 36 months, not 18. If your husband worked for a smaller company, you are getting North Carolina "mini-COBRA" and it will, indeed, expire after 18 months, in October of 2011.
Look for a high-risk pool. Don't waste any more time trying to buy private health insurance. Because of your diabetes and heart condition, no company will even consider selling you a plan (that is, until 2014 when they will have to). Instead, go straight to the Inclusive Health State Option, North Carolina's state-run high-risk insurance pool. For example, you can get a plan with a $2,500 deductible for $700 a month if your household income falls between $32,491 and $43,710. All pre-existing conditions are covered, and depending on your income, you might be eligible for premium discounts. The downside is you have to wait until your COBRA runs out to be eligible. But you can apply in advance so the transition will be seamless. (By the way, shame on the agent you contacted for not telling you about this program!)
You'll need to provide for your son. If your household income is less than about $30,000 a year, your son may be eligible for North Carolina Health Choice for Children, the state's Children's Health Insurance Plan (CHIP). That state-run health plan is comprehensive and super-cheap.
If your income is too high for CHIP, look into getting him a private plan. Go to Healthcare.gov, the federal government's consumer-friendly website, to get a comprehensive listing of individual private health plans sold in your area. The health reform law says that children under 19 can no longer be turned down for insurance on account of pre-existing conditions, although insurers are free to charge higher premiums for those with health problems (again, only until 2014). It's up to each company to decide whether to charge you extra because of your son's ADHD. They may not all reach the same conclusion, so shop around. If the available private insurance costs more than the high-risk pool would charge to cover him, he can join the high-risk pool instead. His premium would be a fraction of yours because of his age.
--Nancy Metcalf, senior program editor
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