Health Insurance & Respiratory Diseases – Getting Insured

Facing a challenging medical diagnosis can be overwhelming. There are many things that can cause stress in a situation like this, not the least of which is getting or maintaining appropriate health insurance to keep your health care expenses down.

COPD, which is a progressive respiratory disorder that makes breathing difficult, can be particularly difficult when applying for health insurance. Here are some tips on getting insured, even if you have this diagnosis:

Under-65: Individual Health Insurance

Individual health insurance companies require you to answer health questions and look into your medical history when you apply for a plan. Because of this, having COPD can be a problem when applying, as this is generally a questions that is asked in order for you to qualify for a plan. Here are a couple solutions to the problem of being declined for health insurance because you have COPD:

  1. The first and easiest way to get insured is to find coverage through either your, or a spouse’s, employer. Employer group plans typically do not ask medical questions, and although they may exclude coverage of pre-existing conditions for 6 or 12 months, you can have complete coverage after that time period.
  2. The second way is to investigate high-risk pools. Over thirty states currently maintain high-risk pools. This coverage is expensive; however, if you have a good number of medical expenses with more expected, it can certainly be worth it.
  3. The last option is to move. That sounds like a lot of work to have coverage, but if your situation is dire enough, you could move to one of five states (NY, NJ, VT, MA, and ME), which require “guaranteed issue” (i.e. the insurance companies cannot turn you down).

Over-65: Medicare-Age Insurance

When you turn 65 and go on Medicare, you do not have to qualify medically, obviously. Also, you have a 6-month period following that 65 birthday, during which you can compare Medicare supplement quotes and sign up for a plan without having to qualify medically for the supplement. This ensures that you will have full coverage, with no out of pocket costs. Medicare covers 80%, and the supplement covers the other 20%.

If you do NOT sign up for a plan during this open enrollment period, you can always sign up for a Medicare Advantage plan later. These plans do not provide as comprehensive of coverage; however, they also do not ask any medical questions to qualify you.

If you want more information about finding a Medicare plan if you have COPD, you can get a Medigap quote or contact us at 877.506.3378.