Friday, July 29, 2005

Disabililty; Trying to Get Health Insurance!!!

Don't you just love it when folks tell you that if you had only come to them BEFORE you became disabled; or BEFORE you were diagnosed with a chronic illness; or BEFORE you could no longer do your job???

This email serves 2 purposes: 1) to provide some information to those who were not lucky enough to ask the questions BEFORE; and, 2) for you to get this website information to people who are currently struggling BEFORE diagnosis; BEFORE no longer being able to do the job; BEFORE becoming totally disabled. I'D LOVE THE OPPORTUNITY to assist folks with help in getting all the help to which they might be entitled to BEFORE they need it! So, please, please pass along this website, and this blog. AND, ask questions yourself! It is free, and I love answering questions!

So, you were not able to secure additional Long Term Disability insurance before you became disabled; you were able to trigger COBRA, but it is half-way through, and you haven't started applying for SSDI; you have no health insurance, because you cannot afford COBRA, didn't know about HIPAA, and have no income. WHAT SHOULD YOU DO???

First of all, take a deep breath. Second of all, if some of the terms used in the preceding paragraph are unknown to you, check out the other blogs that define the terms. (I mean, other blogs in this blog set; I have many subject-matter blogs that can be accessed through the website:

The first thing you have to know is what question do you need answering first? What is the biggest problem that you need to address first.

  1. If it is prescription coverage, see the blog on that for further information.
  2. If it is Short or Long Term Disability insurance, see the blogs on those for further information.
  3. If you need Medicare, are on COBRA, and haven't yet filed for SSDI, read below.
  4. If you need Medicare, aren't working, can't afford health insurance, read below.
  5. If you are still working and need to know about working while disabled, stay tuned; I haven't yet written that blog yet.
  6. If you have never worked, and are not eligible for Social Security for whatever reason, you might find some assistance below also. If not, please write a comment about your situation, and we'll trigger the collective wisdom out there and see if we can get you some help.

OK, there are 2 primary sources of health insurance for folks who are fully disabled and not working: SSDI, and SSI. SSDI is "Social Security Disability Insurance"; SSI is "Supplemental Security Income". The qualifying terms for each are different. For SSDI, you must qualify by having paid into the Social Security System for at least 40 quarters (10 years); and, must have been found to meet their definition of "disabled". (See other blogs for this definition.) Eligibility for SSI is primarily financial.

Now, you might think that all 50 states would have the same "eligibility" criteria, but it does not appear to be as easy as that. For this reason, it is ALWAYS best to get state-specific information. In searching the Internet, I found the following website maintained by the Georgetown University Health Policy Institute. It is called: Consumer Guides by state for Getting and Keeping Health Insurance.

Here is the website:

When I clicked onto my state, I found state-specific links, and a 43 page "Consumer Guide"! And, it appears to cover all sorts of information about health insurance, based on your situation.

So, here's what I would recommend. First of all, click on the above link; go to your state; check out the information. Email or call the references, and see what information you get. Please remember to write down your questions ahead of time, and be specific. Also, get the name and phone number of the person you talk to, and write down what they tell you as soon as you can after the call.

If you do not get the information that you need, then I would suggest asking an insurance broker about your situation. What you would be looking for would be what is called "catestrophic" coverage. This usually comes with high deductibles, and wouldn't cover routine things like office visits.

Many states, like mine, have what is called a "state health insurance pool". To be eligible for this pool, you need to have very little income, and probably qualify for SSI.

Hope that this resource helps! If you get stuck, write a comment, and let's see if we can be of greater help.


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