Health insurance for Crohn's disease

L

loginname

Expert
60
Hey guys and gals,

I'm mostly a life insurance agent, but I had a client ask me about health insurance. The client's daugher is 19 and going to college. She is currently insured through a plan provided by the university, but has already exceeded her drug maximum ($500). She has Crohn's disease which I understand requires some ongoing medications. She is paying $91/month for the coverage. I do not know what kind of deductible it has.

What options does this client have? If the Crohn's is under control, could she get better coverage elsewhere? I just don't see why an insurance company what want a Crohn's sufferer as a policy holder.

Help!

Thanks in advance
 
Most of the plans offered by the school are junk. She needs to get on a real plan ASAP.

Scott (Sti) has pointed you in the right direction. If she is in a guaranteed issue state she can qualify for major med, otherwise she has very limited options.

What is her state of residence, and is she going to school in that state or a different one?
 
I think at least 29 states have what is called a High Risk pool. These are health insurance plans that people can get if they are declined for health insurance.

In some states it's total crap and in others it might even be better than what the competition has to offer.

Here's a list of the states and what the plan is called. Hope this helps.
 
loginname said:
Hey guys and gals,

I'm mostly a life insurance agent, but I had a client ask me about health insurance. The client's daugher is 19 and going to college. She is currently insured through a plan provided by the university, but has already exceeded her drug maximum ($500). She has Crohn's disease which I understand requires some ongoing medications. She is paying $91/month for the coverage. I do not know what kind of deductible it has.

What options does this client have? If the Crohn's is under control, could she get better coverage elsewhere? I just don't see why an insurance company what want a Crohn's sufferer as a policy holder.

Help!

Thanks in advance
Click to expand...

I can tell you in Indiana it's impossible to get an individual policy with Crohn's. My wife was labeled with it 7-years ago. Has never been sick, has never had any treatments, and we are sure she doesn't really have Crohn's at all. It has been a huge problem.

Her current doctors tell her if she has Crohn's she is the healthiest person they have ever seen with it. They think they can get the diagnosis reversed for us.

But in my experience, no insurace company who underwrites at all will touch someone with Crohns.
 
Unfortunately the diagnoses reversal probably wouldn't matter. Just dealt with a client who got "mis-diagnosed" with diabetes 2 years ago - doctor put her on meds and the meds made her sick. She went back to the doctor and turns out she's not diabetic at all - something messed up with the testing.

Tried her with two companies, both pulled records, both declined. In both cases she remitted a doctor's note stating that she was never diabetic - didn't matter - declined. Had to put her with MHIP.
 
Newby -

Try GR. Don't have their underwriting manual in front of me but seem to recall something about 2 yrs treatment free (including meds) and they will consider her.

Also, might want to see a new doc for an updated test to confirm or dispute the earlier diagnosis.
 
Pulled up Aetna - in their guide it refers Crohn's to IBS

chronesje1.jpg
 
Colorado Newbie said:
I think at least 29 states have what is called a High Risk pool. These are health insurance plans that people can get if they are declined for health insurance.

In some states it's total crap and in others it might even be better than what the competition has to offer.

Here's a list of the states and what the plan is called. Hope this helps.
Click to expand...

Where did you obtain this list from?
 
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