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Pre-Existing Conditions, Insurance and Health Care Reform

I have 2 children that are chronically ill. If you know me or follow HWHAP even occasionally you know that my son, Nate has type1 diabetes and my daughter, Sophie has Crohn's. In September of 2010 we reached the the end of our COBRA coverage and found ourselves without health insurance.  I worked for months prior to the expiration of our policy trying to find a company that would cover Nate and Sophie but found that with their pre-existing conditions we could not get coverage through a private policy. In Texas we have the Texas Health Insurance Pool which is basically a state plan through BCBS that charges a premium to cover pre-existing conditions.  The monthly premium is determined by your zip code and which deductible you choose.  If you live in Texas and need to look up the rates you can check them out here.   Expensive!   There are now different options through the federally run programs including a Pre-Existing Condition Insurance Plan where the rates are 1/2 the price of the State High Risk Pool.  But - - - you knew there was a but --- right?  To qualify for coverage you must have been uninsured for at least the last six months before you apply.  Yes, that rule applies to children too. Still, a very good option to have because many people have gone months and even years without coverage.  If you have a pre-existing condition and have been without insurance --- I encourage you to check this out! I really don't know enough about the health care reform to preach it here on my blog.  I wish I had time to sit down and go through the plan page by page but you know - - - I haven't had a chance to get that done.  One thing I do know is that beginning in October of 2010 Health Insurance Companies can no longer deny a child with a pre-existing condition from a private policy if they are under the age of 19 and on a policy with a parent. Sounds amazing right? Just the answer we were looking for - right? Once I found out about this part of the health care reform I started researching policies and filling out applications.  We decided to go with the same company we were on with COBRA since we were familiar with them and somewhat knew what they would cover.  We received a quote and I filled out the very lengthy application for the Houston Five and held my breath.  I received a call from a nurse that worked with the due diligence team and my 1st thought was that she would be asking questions and inquiring further about both Sophie and Nate.  I was shocked when she told me all of her questions would be about me and why I had a hysterectomy.  Not a single question or concern about Nate or Sophie. A few days later I received word that we had been accepted with one small change. Sophie and Nate were indeed offered the opportunity to have private health insurance with one small catch --- their monthly premium would be 300% more expensive than originally quoted.  This put the monthly premium WAY over our budget and my head was only moments away from exploding!!  So, yes with the health care reform bill our children can get the coverage that they deserve but you have to pay a small fortune to get it. Still, at least there is an option. We have been blessed beyond belief since losing our coverage back in September.  I was able to fill all of our supplies before we lost coverage and it seems like just as we get close to running out of supplies someone from the DOC has been kind enough to send us just the things we need just when we need them.  We've received test strips, lancets, lancing devices, insulin and even pods so that Nate can keep pumping.  I have been blown away by the generosity and kindness of these people that we have never even met (in person).  These people deserve way more than my thanks.  We look forward to paying it forward when we can. Thank you so much!!! I love the DOC!!! So, for some good news . . . After all of the research, applications, let downs, endless phone calls . . . the list goes on. We finally have coverage for the children through the TX CHIP program. I will occasionally be chronicling our journey with CHIP here on HWHAP.  It's been interesting so far -- I will post more soon.  Let's just say I'm SO happy to have the supplies from our friends in the DOC because we haven't been approved for test strips, pods or pretty much anything except for insulin and even that was quite a little battle. Thanks to Penny over at A Sweet Grace  for the suggestion to request a case manager.  We were assigned a case manager today and things are already looking SO MUCH BETTER!! More soon - I promise.

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