Health insurance - there is hope!

[Guest guest]

It's been a few weeks, but I recall reading some posts from women

who had concerns about health insurance, COBRA, getting insurance

with a pre-existing condition (fibroids), etc. I thought it might

be helpful to share information about my own situation.

I voluntarily left my last corporate-employed job in February 2001.

I enrolled in COBRA, as I wasn't sure of what I would do after a

planned 1-year absence from working. I decided that I would pursue

my own business, and thus close to the time my COBRA was running out

(18 months), I sought personal health insurance.

I worked with an insurance agent, who was very helpful in sorting

through the plans and helping me identify the best provider for me.

(Her rates were identical to those I found on the web sites, so I

did not have to pay inflated premiums for her services.) I applied

to Blue Cross of California. My initial application for " preferred "

insurance was declined due to my fibroids. I re-applied under the

HIPAA provision, which basically ensures insurance for " high risk "

applicants, provided that certain conditions have been met. In my

case, these were met (I had previously been insured continuously in

group coverage and had exhausted my COBRA coverage.) I was approved

for the HIPAA insurance.

Now, the good news is that I received insurance. The bad news is

that I most certainly paid for it. I chose a PPO plan with a $1500

deductible. At the time of my initial application, I was 38 years

old. If I had qualified for the preferred policy, my monthly rate

would have been $142; under HIPAA it was $230. I started coverage

in August 2002, and had my myomectomy in September 2002 (more on

that in a minute). My premium increased to $279 in April 2003 as

part of BC's standard increases, then jumped to $353 in September

2003 when I hit my 40th birthday - ouch!

Since it had been over a year since my myo, I contacted my insurance

agent in November and asked her about re-applying for a preferred

rate again. She checked with the Blue Cross underwriter, and they

advised that if it had been at least 14 months since my myo, and

there was no recurrence of fibroids, I should qualify. I submitted

a new application, and it was approved rather quickly -

surprisingly, they did not request the records from my last GYN

visit in September. My new premium is $201 - a drop of over $150

per month!

I've shared a lot of details to provide information and also perhaps

a bit of hope for those who have wondered about insurance.

Understand that I have no other health issues - I'm in excellent

health. My only pre-existing condition was the fibroids. With my

HIPAA insurance and choice of plans, I had to pay my $1500

deductible plus 25% of the negotiated rates for my surgery,

hospital, related doctors' fees, etc. If anyone is doubting the

value of insurance, let me tell you - despite having to pay 25%,

this was 25% of the NEGOTIATED rates, which represented a discount

of anywhere from 15% to 75% off the original fees. (NO surprise why

some doctors elect to stop accepting insurance, but that's another

discussion.)

Anyway - hope that sharing my story can be of help to at least one

person out there. Feel free to contact me offline if you want more

details, keeping in mind that insurance varies widely from state to

state and company to company.