Which is the best policy for my need?

Posted: Fri Apr 02, 2010 04:12 am Post Subject:

I don't know of any individual plans that will even issue his coverage much less treat his diabetic condition. Currently, there are no states, save Massachusetts, that completely ignore preexisting conditions. Commonly, they will simply decline to issue.

School contracts are what are known as "blanket policies" and are intended to cover the insured person while performing the "activity" for which the policy was purchased. In this case, the activity would be being away at school. You often see these kind of policies associated with groups that have a high turnover, such as schools/students, sports teams and clubs, etc.

In 2014, assuming Obama's health care plan is still standing (it won't be), insurers will be required to accept him in the U.S. and treat all conditions including preexisting conditions.

So, it's either a group plan provided by an employer or you or good luck on the whole thing. I am not aware of any requirements to issue a policy to an individual in Texas, but I certainly don't know everything. There's probably a state pool available for those who cannot obtain insurance through normal channels, but these plans always require that the applicant be a legal resident of that state.

Good luck with this, I really mean it.

InsTeacher 8)

Posted: Fri Apr 02, 2010 12:12 pm Post Subject:

But they do not cover pre existing condition- in his case diabetes.

Posted: Fri Apr 02, 2010 09:33 pm Post Subject:

Man, let's clear the air here.

A pre-existing conditions exclusion, commonly referred to as "pre-x," can only exclude coverage for a medical condition in which (depending on the state) either (1) was treated by a medical professional, OR (2) was treated by a medical professional or where a prudent person would have sought out medical treatment within the six-months prior to the effective date of the coverage.

His diabetic condition, although diagnosed well before any 6- month period would absolutely be considered a pre-x situation. If the policy is issued and the insurer is aware of the diabetic condition (unlikely to be issued), the carrier can only exclude for a certain period of time after the effective date of coverage, commonly 6-12 months, and then they'll have to start paying for the diabetic condition.

InsTeacher 8)

Posted: Thu Apr 15, 2010 01:10 pm Post Subject:

"the carrier can only exclude for a certain period of time after the effective date of coverage, commonly 6-12 months, and then they'll have to start paying for the diabetic condition. "
Assuming even this is ok, which carrier will take him?
Kindly advise

Posted: Thu Apr 15, 2010 11:39 pm Post Subject:

I don't know of a single carrier that would issue this policy other than a state mandated insurance pool for those that cannot obtain coverage through normal channels...

InsTeacher 8)

Posted: Fri Apr 16, 2010 03:40 am Post Subject:

Perhaps he can find employment that offers group medical insurance. Other than that, as a Type 1 diabetic, he is pretty much out of luck as far as insurance companies in the US (and probably anywhere else in the world) are concerned.

As my colleague InsTeacher's signature states: It is what it is.

Posted: Fri Apr 16, 2010 09:05 am Post Subject:

Currently, there are no states, save Massachusetts, that completely ignore preexisting conditions.