Diabetes Forecast

Insurance: How To Get Coverage

Don’t have insurance? The cost of caring for diabetes without insurance can be staggering. Here are some options for getting coverage:

An individual policy. Most health insurers can decide to deny you coverage based on your medical history, age, and other factors. Diabetes is considered a preexisting condition and reason for coverage to be denied. However, in a few states, such a denial is illegal, and insurance must be sold on a “guaranteed issue” basis to anyone who wants it. In some other states, one company is designated the “insurer of last resort” and must sell insurance to anyone, or there is a high-risk pool that sells coverage to people deemed uninsurable. Check with your state insurance commissioner’s office.

A group plan. If you can get group coverage through your employer, you’ll want to take it. It’s illegal for group plans to exclude you (though they may impose a waiting period if you have a preexisting condition, such as diabetes). Some membership organizations, including unions, professional groups, and alumni associations, offer group plans. 

COBRA. While COBRA coverage (see glossary) is expensive, it may be your best option if you can’t find private health insurance. Under COBRA, you can’t be denied coverage for a preexisting condition.

Medicaid and assistance programs. If your income is low enough, you may be eligible for Medicaid or other state assistance programs. Children may be eligible for coverage under the State Children’s Health Insurance Program (SCHIP). Veterans assistance and other programs may be available to you; you can request an information packet from the American Diabetes Association National Call Center by calling 1-800-DIABETES (1-800-342-2383).

Once you're part of a plan, learn what is covered. It will help you save money and get the care you deserve.



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