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Health Insurance - SSDI Issues Message Board


Health Insurance - SSDI Issues Board Index


Hello all,

I'm 34 years old and I can't currently find employment and I need coverage. Now, the bad news. I have been diagnosed as Biploar type II and I have a testosterone deficiency and I have been battling an addiction to pain killers, via subutex for 5 years. I have had 10 orthopedic surgeries, but none of those give me any trouble and haven't for years. One final note, I ruptured 3 disks in my cervical spine, but I have not been treated for it nor do I believe I need treatment for it as this time, but it is how I ended up hooked on pain pills. I see an addiction specialist and I see my endocrinologist once a year. Here is where the issue begins. I am out of pocket 525 a month for prescriptions for the addiction and for my testosterone deficiency. I can't even pretend to be able to consider treating the bipolar let alone get therapy.

I want to apply for personal coverage, but I'm afraid that 1. I will end up with coverage for 250 a month that doesn't cover any of the above medications. That would take my monthly health care costs up to close to 800 a month which I simply do not have. I'm also concerned that should I apply and disclose all of the above information as I'm required to do, that when I get employed again, I will somehow be excluded by a group policy because of the disclosures I make to a private insurer. I was told that there is a medical clearing house information system that all insurers use to determine coverage. I wrote them and requested my record, but because I have never applied for private health insurance, they have nothing on me, but the minute I apply for private insurance, I know that my information is out there and forever accessible.

The funny thing is, I am a very physically fit person that leads a healthy lifestyle as far as diet and exercise so I'm rarely sick and even then it's simply the common cold.

What does someone in my situation do? I currently am waiting tables and making about 350 a week, but I make good money in my professional field once I can get back in. In a discussion without giving any personal information to an insurance broker, I disclosed the information and he flat told me I was very unlikely to get coverage and If I got coverage the medications I take will be under a "rider" and they wouldn't be covered. What's a guy to do? I feel like I'm almost better off just not applying so the information stays private and because while I can barely put together 500 a month for insurance if I can get it, I can't do that and continue to essentially self-insure for the conditions I am currently dealing with.

I'm sure the short answer is that I'm screwed, but I before throwing my hands up and giving up, I thought I would pose this scenario to those out there that might be able to share some suggestions. I see my addiction specialist every 30 days, and I have always paid that $150 out of pocket as they don't take insurance and I didn't want that on any paper except at that office. So, the insurance wouldn't have to pay for those visits, and I since I only see my endocrinologist once or twice a year, that would cost them about 400 a year plus blood work which I found at a very reasonable price(35 dollars) for all that I needed for my bi-annual checkup. I know that lab work is far too overpaid for by insurance companies because I have seen the bills on lab work before and the same tests were roughly 700 bucks.

Any help or suggestions will be valued and greatly appreciated.





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