WHEN HEALTH INSURANCE IS HARD TO GET

ASK KIM



by Kimberly Lankford



I left my job to start a freelance business almost a year and a half ago and stayed on my former employer's health insurance plan through COBRA. But now that my COBRA coverage is about to expire, I'm shopping around for health insurance on my own and have already been turned down by three companies because of my medical condition. What should I do?



Contact a local health insurance agent who knows from experience which companies are likely to insure people with your conditions. You can find one through the National Association of Health Underwriters Web site or eHealthInsurance.com which works with many companies.



Tell the agent all the details about your health and see if he or she knows of any companies that are likely to insure you. Some companies may reject a person, while others may offer that person a policy but increase the rate (often by 25% to 300% above the price for healthy people) or exclude certain conditions from coverage.



You also can get a lot of helpful information about which insurers sell policies in your area from your state insurance department Web site (see our insurance page for links).



If you can't find coverage through a regular company, you may be able to get insurance through your state's high-risk health insurance pool, if you live in one of the 33 states that offer that option. The rules vary significantly from state to state. In some states, you must first be turned down by one or two insurance companies, which is already the case for you. In others you can sign up for the pool's coverage only during one particular open enrollment period during the year. The price is usually capped at 125% to 150% higher than the price of a standard policy, depending on state rules.



To find out if your state has a health insurance pool, see the National Association of State Comprehensive Health Insurance Plans Web site or the Communicating for Agriculture and the Self-Employed high-risk pool site, a nonprofit group that produces a comprehensive guide to high-risk coverage.



A few states, however, don't have high-risk pools. In some, such as New York and New Jersey, insurance companies must cover everyone regardless of their health; obviously, you don't live in one of those states. In others, such as Nevada and Arizona, there is no pool. Florida technically has a pool, but it hasn't been offering policies for more than ten years. So it essentially has no open pool, which means that some people won't be able to get insurance at any price. You should consider this if you're about to retire to one of the states without a pool before you're eligible for medicare at age 65.



Some of these states, however, do offer some consumer protections. In Florida, many insurers must offer you a continuation policy after COBRA expires, as long as your previous policy made you eligible and you haven't gone without coverage for more than 63 days. The rules are complicated and vary from state to state. Contact your state insurance department for more information about any consumer protections that might help you.