Will our difficult children be able...

Discussion in 'General Parenting' started by pepperidge, May 11, 2008.

  1. pepperidge

    pepperidge New Member

    to get health insurance when they reach adulthood?

    Sorry, not the most interesting topic, but last night I watched the movie SICKO about the state of health care in the US (very interesting movie if you haven't seen it). I noticed that bipolar disorder and some other mental illnesses were considered pre-existing conditions. Made me realize that my difficult children might not be able to get health insurance when they get older, unless of course they get a great job with a great company that actually provides health insurance, and even then their mental illnesses might not be covered. Of course, not too much hope of that with a modified high school diploma, if we are lucky.

    Any one have any insights? I try not to worry too much about the future, but when I do I get really worried about what lies ahead for my children.
  2. Andy

    Andy Active Member

    Check with your state's health care program. You may be able to find coverage on line under "(your state) Department of Human Services" then look for Medical Assistance or General Assistance Medical Care. When we had a patient admitted to our State psychiatric hospital who does not have financial coverage, I used to help them apply for fiancial assistance which will cover medical needs. (our State psychiatric hospital has split locations so I no longer help out the behavioral health division)There are many levels of state medical assistance including some where the client can have a job but still get assistance because their job doesn't offer it.
  3. klmno

    klmno Active Member

    I don't know- but you raise a very good question and one that I should be planning for now.

    Thank you!!
  4. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I don't know. Right now my difficult child qualifies for Medicaid through Katie Beckett but that is for children. I think my difficult child will probably continue to qualify for Medicaid through something else but I'm really not sure.
  5. Matty's Mummy

    Matty's Mummy Member

    I watched this move and was really surprised that when it comes to mental illness that it isn’t consider discrimination
    I hope you can find some answers, it was a very disturbing movie ,my partner and I kept reliving parts of it for a few days :dissapointed:
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Medical assistance takes everyone. We have great state healthcare and I'm covered completely, even with a laundry list of diagnosis., including bipolar. medications are covered 100%.
  7. Sara PA

    Sara PA New Member

    Not chosing to sell insurance to people with brain disorders is no different than chosing not to sell insurance to people with other medical conditions. I know a woman with diabetes who can purchase insurance. She's self employed and has no option to join an employer's plan.
  8. Andy

    Andy Active Member

    Minnesota started co-pays on medical assistance so there is $1.00 or $3.00 or more for each medication. I believe it is 50% on most dental. Not sure what the co-pay is for doctor visits. I know there is also co-pay for ER and hospital sevices. I don't get it - people on medical assistance are on for a purpose - I think it is just downright wrong to ask them to pay co-pay for medical anything.

    In Minnesota, you apply through the county of residence at the county social service office.
  9. Christy

    Christy New Member

    It is my understanding that if our difficult children are not able to work due to their disability then they can apply for disability and medical assistance. Also, if you can doccument special needs, it is possible sometimes to keep a child (turned adult) on your own health insurance longer that usual.

    Did you post this in the Insurance and SSI Help section of the forum? The moderators my be able to provide you with a better answer.

    Good question!

  10. dreamer

    dreamer New Member

    a few years ago, when I first could no longer work, but could not yet get Medicare becuz you must be on soc sec disability 2 years before you get your Medicare, me and my kids did not have insurance. At that time our soc security benefits took us just barely over the income cut off for even just our kids to get Medicaide. It was a horrible time for us, my medications were rather expensive, so were my daughters, - they cost far more than our income even was in a month. We did get prescription patient assistance at that time, and we depended on clinics and charity funding etc, but also accrued some ugly medical bills. I found out at that time, that my RA and Lupus made me "uninsurable" here, and my daughters bipolar made her uninsureable and my sons diagnosis'es also made him uninsureable. We could NOT purchase insurance thru standard public insurance companies here. If I had been able to work, I would have been able to get coverage thru work for us, if my job offered it, but, I could NOT purchase it on my own at any price.
    I did find that at least in IL there was a program called IIRC CHIP for people with a verifiable diagnosis that made them uninsureable, thru the state. BUT the coverage for mental illness and neurological illness was not equal to coverage for other illnesses. And you bought it per individual. In order to get it, you had to have confirmation of an uninsureable illness, IIRC. The cost, in my opinion was rather prohibitive, and it had typical deductions and co pays etc. For my difficult child, the cost, IIRC was going to be in neighborhood of $600 a month, for my son, approx $500 per month, for me, $600 a month and my easy child would not have been able to get this particular coverage at all- so SHE would need to get insurance via standard purchased insurance. well, need I say, with both me and husband on soc sec disability, husband already for several years, and me coming from a min wage job, there was no way we could afford that.
    Eventually our state upped the income cut off for the KIDS to get coverage thru the state, but what we then found was that in our geographical area, at least, Medicaide turned out to be nearly worthless. Docs would not accept it becuz it took too long for them to be paid by the state, and even our ER handled Medicaide patients far differently - now, I KNOW this is not right or fair or legal, but- when you show up in ER via ambulance and are released with no XRays done at all, no broken bones set, or whatever, and hospital simply continues to say they see no need, it is NOT a good situation.
    When difficult child turned 18, she was unable thus far to function enough to hold a job, still does not have a HS diploma, can barely leave house, so she did get soc sec disability, disabled before age 18, and then she was able to apply for Medicaide, and she did get that. Altho, again, we have been searching for a doctor to take her into care for 18 months with no luck so far. When we have tried going into the city, we have been told we are living out of their service area. Locally our docs simply refuse to accept it.
    I have my Medicare, now.
    For us, we were lucky becuz my husband military bens FINALLY kicked in after fighting for them for 10 years- he is permanant total service connected disability, and after x years of that classification, his family is awarded coverage thru ChampVA medical. Altho they are still in appeal over disabled before age 18 daughter, my easy child and son get that coverage, now. (until age 18) We pay no premiums, if we have no other coverage we can go onto military base for care for no cost, or it can be used as typical insurance with co pays and deductibles similar to any other insurance (80/20) and it works as a primary coverage with my Medicare being secondary for me, altho I cannot go to military base for care. It comes with a mail in medication program, where medications are at no cost to us at all if we use the medication by mail, altho it takes up to 5 weeks to get our medications, and they cannot be faxed or phoned in, they must be snail mailed in and are snail mailed out. This has been a great help, becuz my medications alone cost approx $4,000 a month, now. LOL, that is more than we bring in in a month for the whole family.
    SO, in IL there are many diagnosis'es that can prevent someone from being able to buy standard insurance on their own. Most auto immune disorders, many neuro disorders, many psychiatric disorders, cancers, etc can prevent someone from getting standard individual insurance coverage, they are "uninsureable" and many illnesses do not have insurance parity, meaning they are not covered to the same degree as other illnesses. even in standard insurance here, the limits and coverage for mental illness and neuro illness is less than for say, a broken arm.
    SOme states have programs that have waivers for certain issues, so certain circumstances can be covered thru a state medical coverage, coverage for AIDs is one that jumps into mind first. I believe coverage for something like TB also can be covered thru the state without a lot of rigamoroll.....and Ie read of other thngs that can get waivers so as the patient can get coverage. SO far, I do not hear a lot of problems if a job offers group coverage, it seems that still so far if there is group coverage offered, even the otherwise "uninsureable" can get coverage THAT way.
    More and more states are trying harder to find ways to get coverage to larger groups of people who for a wide variety of reasons do not have coverage, but, I am sure this is going to be a long term problem. Some of our difficult children are going to be able to hold jobs, some of their jobs will come with option to get medical insurance thru a group plan at their job. Some of our difficult children will qualify for disability......and should be able to apply for Medicaide if they are awarded soc sec disability. BUT there are also going to be many of our kids who are denied soc sec disability, who have great difficulty getting or holding a job, and many who will land in jobs that do not offer medical insurance. Even if they have documentation of an uninsureable illness, they might have grave difficulty affording it, unless that program CHIPS is revamped. It is a huge problem. Medical coverage is a hot topic and huge problem. Definetly for our difficult children, but also even for PCs........and for all kinds of people.
  11. dreamer

    dreamer New Member


    I tried to google uninsureability, I got this blog but.....not sure how relevant it is, altho, LOL, I did find it intersting.

    ALso, LOL, from this blog- um- well, uh, yes, some fire departments do bill for haveing to come out on a fire call. I have also heard of some police departments billing for some things....
    I have heard of and know of one person personally, who commited a small crime to intentionally land themself in jail, hoping to get medical care, well I know our county jail here has begun to now bill inmates. - not just for medical services, but also for "room and board"
  12. jal

    jal Member

    I know I had worried and continue to worry about that. I lost my job in Oct 07 of 9.5 yrs due to difficult child. I received a package that paid me weekly through Dec and also covered my insurance. I landed a new job in January. Due to incompetence at my last place my insurance actually continued on through April and my new insurance kicked in in May. I know in my state (CT) in order not to have trouble with getting insurance for a pre-existing condition you cannot have a lapse of coverage over 63 days. Luckily, I only lapsed 30. When I filled out all of my insurance paperwork, I was honest about difficult child's pre-existing because they asked if you or anyone to be covered had over $5000 worth of expenses for the last year and we did. We had neuropsychologist testing, labs etc. They covered us with no problem. Good thing considering difficult child had to have levels drawn and an EEG this past Friday and I just picked up another medication this am.
  13. KTMom91

    KTMom91 Well-Known Member

    I wonder about this as well. Hubby and I tried to purchase our own health insurance since neither of us had it through work, and couldn't find a company that would accept us. Hubby and I are both too fat and we're on medications, and Miss KT's medications were the reasons they gave for not accepting us. Hubby and I were told to lose about 100 pounds each (I'm not THAT heavy), and keep it off for 6 months, and Miss KT had to be medication free for TWO YEARS. Yeah, right.
  14. Nancy

    Nancy Well-Known Member Staff Member

    I don't know, I am very worried about this. Heck I'm worried that we won't be able to maintain our family health coverage much longer. It's a very serious problem and one of the most important ones I hope is addressed very soon. We are in a healthcare crisis int his country.

  15. Nomad

    Nomad Guest

    Been meaning to pick up that movie.
    I'm also a bit worried about this, although at the moment difficult child (knock on wood) is covered well.
    Many of our difficult children will need to go on disability and their coverage will have some limitations because of that.
    When I first realized all of this, it was a very painful thought.
    On the positive side, we can be grateful that at least this is available to them.
    This is one of those realizations that hits a mom in the gut.
  16. amazeofgrace

    amazeofgrace New Member

    and LIFE INSURANCE? a whole nother >?
  17. pepperidge

    pepperidge New Member

    Wow, I hadn't even thought about life insurance.

    On the perhaps positive side, someone told me that if a kid used ADHD drugs (not to mention beyond that) they wouldn't be eligible for the Army. that has some benefits, I suppose, (lol) but it makes me wonder what else they would be prevented from doing.
  18. dreamer

    dreamer New Member

    The thing about the army? not true. adhd medications do not prohibit enlisting in army. JUst this past week, I read a newspaper article about military and diagnosis'es such as ADHD, bipolar etc.
    For the record, my nephew spent time inpatient psychiatric hospital, was diagnosis;ed several ugly psychiatric diagnosis, including bipolar, and he joined Marines and served 3 tours in Iraq.

    And yes, you are right to worry about Life INsurance, - might be able to GET life ins, but probable certain causes of death will be excluded.