If you live in the United States and you have thalassemia, buying medical insurance if you are not covered by your employer or your parents' insurance and do not qualify for federal or state-funded programs can be a challenge.
As long as you have symptomatic thalassemia and your medical records show that you have an intermediate form of thalassemia or more severe, it is almost guaranteed that you will NOT PASS the underwriting/pre-screening process required for purchasing individual medical insurance plans and will therefore be declined.
What does this mean?
In point blank terms, this means that you are now either disqualified completely from purchasing individual medical insurance policies, period (this is the most common outcome), or you are now disqualified from purchasing medical insurance from the company you are applying to at a reasonable rate and will be offered what is called high-risk insurance.
So what are you supposed to do if you are fully disqualified from buying individual medical insurance plans and you have no more group coverage and don't qualify for government funded programs?
Get a HIPAA plan if possible, but there's a catch.
First of all, though, what is a HIPAA plan?
A HIPAA plan is a United States federally implemented guaranteed coverage plan that all medical insurance companies that offer individual medical insurance plans are required to provide. This means that regardless of health condition, if you qualify for a HIPAA plan, you are guaranteed to be accepted if you apply.
That is, IF you qualify.
How do you qualify?
To qualify for a HIPAA plan, you must:
- have exhausted/used up your previous group plan's COBRA coverage
- can not have a break in your insurance coverage longer than 63 days
- must be ineligible for any group plans including Medicare and Medicaid
As HIPAA is a last-chance/last ditch individual health insurance plan that can only be applied for if certain conditions are met, you only have one chance to pick the HIPAA plan that is right for you, so make sure you choose carefully because once you choose it, you cannot choose another plan.
Also because it is a last resort plan, the plans more often than not fall into the high risk category in terms of cost and many of these plans are the catastrophic plans meaning they are there to help buffer catastrophes but little else.
Obviously, for the amount of money you might end up paying for a HIPAA plan and for the more-than-likely-lousy type of plan you can get, it would be best to have insurance coverage through a group plan (employer).
But life doesn't always pan out that way and for those of us who do not qualify for state and/or federally funded plans because they are caught between major (having full blown symptoms) and minor (typically having few symptoms) like me, HIPAA is the only way to go.
That is... if you even knew about HIPAA in the first place!
Insurance is insurance and for people with thalassemia, even bad insurance is better than having no insurance.