20 answers

Health Insurance for Adults

Thankfully I have Florida KidCare for my children, but my husband and I are not covered by health insurance. It's offered for us through his work but we just can't afford it. I'm just waiting out the time hoping he'll get another job with insurance covered or at least affordable with a new income. Thankfully we're both healthy. But we haven't been covered by insurance for about 5 years. I take care of my special needs child and have often thought I need to take care of myself just as much as him because he needs me to be healthy for him! I think I've developed RLS (restless leg syndrome) and rather than self diagnose it would be a wise idea to get it diagnosed officially. I'm wondering how insurance would handle covering something if I already know about it....like the pre-existing condition clause. I've heard of walk-in clinics I could probably utilize (although not exactly sure where to go in Sarasota County) and just pay out of pocket, but don't want to get anything 'diagnosed' in case insurance won't cover for it later. Am I right in having this concern? or am I misinformed about the pre-existant condition clause?

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Featured Answers

Hi M.,

I realize this is a late response, I read you questions about health care. I also have restless leg syndromw I am a work from home mom 45 yrs old. I take calcium for my restless legs and it works! My husband like to study alternatives he read the restless leg is lack of calcium, I did go the my physician and he did some blood work and guess what I was low in calcium! So I now take a supplement and have no problems.
Also I work from home with Ameriplan, Ameriplan offers discount health plans, very affordable from 19.95 monthly to 59.95 monthly and that covers everyone in you house!!
Go to my website www.mybenefitsplus.com/40561882, then if you are interested or have questions call me.

L. H.
____@____.com
866-400-1538

More Answers

pre-existing conditions, I am pretty sure means that a Doctor diagnosed you previously with a condition.

I don't know much else about insurance.

If you listen to the radio or the tv commercials there are alot of advertisements for insurance companies. You can also do a search on line.

I wish I could be of more help. I will pray for your daughter that you have been having issues with... But I would recommend if you have Healthy Kids, I would take her to a neurologist and start there. They can look at brain activities and stuff and then make recommondations on what the next step is... I have a 15 year old who has been diagnosed ADHD since age 5. He also has Oppositional Defient Disorder (ODD) (Sorry about the spelling... they really should put a spell checker on here.)

Well, Blessings to you and your family.
K. J.

Hi, I can't tell you about insurance. My work is to keep people healthy so it is not such a concern . You could try extra iron for your legs. You probably need to take a multi vitamin/
mineral as "insurance" against ill health in general . That would include some iron and might be enough if you are not taking it. Iron supplements can cause constipation, but start with low dosages. Lots of foods contain iron also . S.

I'm not sure if this is something you are interested in but I thought I would just let you know just in case you are. I recently started a home based business that allows me to help people that are uninsured or under insured with health care services. It's NOT insurance but it is an affordable alternative. I don't know alot about pre-existing conditions, but they are accepted with Ameriplan, No waiting period, no limit on visits or services...I could go on & on but you can contact me for more info & you can also visit my website for more info as well as check for providers in your area. Go to: www.AmeriHealthPlus.com

Good Luck & God Bless :)

D.

I am not 100% on this, but I think pre-existing means that you have been diagnosed with it already. When you get the insurance, just go for a physical, and tell your physician all of your concerns, you should be fine. Good luck!

Dear M., I know what you are going thru, since my husband is a self-employed General Contractor! We have a 12 year old on FloridaKidCare, too and we have no insurance,either.

We use the Manatee Rural Health Clinics for our health care. Especially the one in Parrish. Dr. Bowden is the best!

We had insurance for 2 years while my husband was employed by a large company. We used Lakewood Ranch doctors because we were covered. Everything was "high dollar" cost, but the care wasn't as good as the care we get from Dr. Bowden.

The cost of your visits, lab tests, etc. are based on your income.

I'm not sure what Sarasota offers, but if you don't mind driving and want a really caring, professional doctor who listens to you and has your finances as much of a concern as your health, go see Dr. Bowden. She is a real blessing to me and my husband. She always checks to see what WalMart has for $4 before she prescibes medicine, too.

As far as the RLS....if you listen to the commercials for the medicine that they prescribe for it....leg problems don't seem that bad! You should go to the health food store and tell them. They'll probably recommend a Calcium and magnesium combo. I drink Sleepy Time Tea or Camamile tea before I go to bed or I take an Aleve if it's real bad. Also, prayer for relief works miracles!

Prayers for good health for you and your family!

Yes, M. you are correct, if you do get diagnosed it will not be covered if you do get insurance. There is a clinic in sarasota county that will go by your income. It is owned by manatee county rural health services inc. I use to work for them and there is a pa-c that works there his name is art ball and he is really good. Unless they have changed the name of the clinic it is called north county. You can call the hr department and they can give you the phone number and address. ###-###-####. If this number is not correct then just look up in the sarasota phone book.. Good luck with your family. Remember if you are not healthy then no one else can be healthy. You have to be well rested and if you are not well rested you can care for your family. With rls you don't rest properly at night. Good luck again and i hope you find a good doctor and are able to get the medical help you need.
D. w-34yoa, stay at home mom......

In Florida, GROUP coverage does not have exclusions for pre-existing conditions. If you purchase personal insurance, or a Health Savings Account (HSA) compatile plan, you could have that exclusion affect you.

You can contact the FL Dept of Insurance with specific questinos or search for similar services from other states if you aren't in Florida.
Insurance Consumer Advocate
200 East Gaines Street
Tallahassee, FL 32399-0308
###-###-####

Your best bet is to contact a local health insurance agent and ask them about it. They are the in the field and can usually help if not point you in the right direction. I'm not sure where you are located but I work for AAA and our life and health insurance agent here is the top agent for AAA. Nancy Francis ###-###-####. She works between the Trinity, Port Richey and Spring Hill AAA offices. Hope that helps!!

a friend of mine just got an individual plan through Aetna that is affordable with great coverage.

If you sign up for insurance during open enrollment you don't have to worry about pre existing conditions. Most employers offer open enrollment.

Hi M.,

I realize this is a late response, I read you questions about health care. I also have restless leg syndromw I am a work from home mom 45 yrs old. I take calcium for my restless legs and it works! My husband like to study alternatives he read the restless leg is lack of calcium, I did go the my physician and he did some blood work and guess what I was low in calcium! So I now take a supplement and have no problems.
Also I work from home with Ameriplan, Ameriplan offers discount health plans, very affordable from 19.95 monthly to 59.95 monthly and that covers everyone in you house!!
Go to my website www.mybenefitsplus.com/40561882, then if you are interested or have questions call me.

L. H.
____@____.com
866-400-1538

My last job before motherhood was with a insurance company. If you end up getting health insurance on a individual basis they will underwrite you. If you have been seen for this condition and it is documented, then it is considered pre-existing.

Like many americans, it is a toss up between health insurance and paying bills. I can personally tell you that when you think you are healthy and nothing can go wrong, it does. I am 35 and ended up having emergency surgery last summer due to a cystic rupturing and i had no idea. $60K in medical bills later, i am very lucky to be here to talk about it. Only 6 weeks later my husband (also 35) went into the hosptial for viral menengitis. His bills were around $20k. Without some kind of health insurance, we would have had lost most everything to pay the debt off. As the hospital wanted $500 up front before they rushed me in for emergency surgery. More concerned about their money than if i would even survive the surgery. This was hard as a mother of 3 small children.

You can google individual plans in florida and have a local agent see what is out there for you.It may not be as bad in monthly premiums as you think.

Good luck

You might want to check into Golden Rule Insurance. It used to be pretty affordable when I was self employed. Also a pre-existing condition is like cancer, ms, etc. The company my husband works for has switched insurance companies several times and we have had no problems at all. They don't even question it. If the pre existing conditions were a big deal then over half of America wouldn't be covered on insurance. Also I was told at one time I had restless leg syndrome. But I found out later that it wasn't. I just had to start exercising more and cut out drinking a lot of caffeine...Some doctors also will tell you things are wrong when they really aren't just to keep you coming back so be careful where you go.
Hope this helps.

Don't get the actual diagnosis until you are settled wit insurance. They will definitely hit you up for more because of a preexisting condition, or even worse, decline you altogether.

When my husband's ten year old daughter came to live with us full time, after having suffered intense emotional trauma at her previous residence we thought it would be a good idea to get her counseling until she came to terms with everything. We called the insurance company. to see if there were any psychologists that would be in network only to find out that they didn't cover behavioral health in our plan, and when we mentioned switching to a different plan, they told us it would cost a lot more since she has a pre-existing condition. Keep in mind she had never seen a councilor before, but now it's on her file, and for the next eight years, any health insurance provider will see this and raise both the premium and the deductible for any mental health costs.

It's crazy. So my advise to you is that you don't even mention it to the insurance company that you are applying for until it is certain that they are covering you. RLS isn't something that they are going to check for if they require a physical as part of the application process. Wait until you have the insurance provider that you want before you go to the doctor about it.

In the mean time, you can take a couple of capsules of valerian root (whole foods) if it keeps you up at night, and a smaller dose of it during the day. It's a holistic sleep aid that doesn't make you fall asleep but once you actually get to sleep, it's much more restful. A smaller dose of it acts as an anti-anxiety, and sometimes that can be helpful for RLS. Also make sure that you get a lot of iron in your diet, as well as some extra exercise.

-L.

I don't know if this will help or not, but perhaps it will help someone else. My husband & I are self-employed and had to cancel our health insurance because of the cost. Our natural health care doctor told us about Samaritan Ministries. They are a Christian organization that believes that Christians should help Christians. They gave me references and I called the people and they could not say enough good about the Organization. It is not health insurance, as we know it. If we would happen to have a bill over $300.00, then we would submit it to them and they have other members assigned to send you money. Each month we get a letter showing how much to send to a particular person, along with a note of encouragement. There's more to it than this, but it has taken a load off of us. If anyone wants more info about the organization, send me an email.
This is an old wives' tale, but it has worked for me, I used to get camps in my legs & feet at night & would jump out of bed rubbing them. I put a couple bars of soap under the sheet by my legs, and the cramps are gone. Dove does not work. Sounds silly, but it has worked for me. Don't know if that would help you or not either. Hope so!

M.,

My family has Golden Rule. Rates are based on the deductible you have. We pay approx $450/month for a family of 3. I do have some things not covered due to pre-existing problems. As for the RLS if it is not diagnosed you can't say you have a problem. If you need info on a good insur. agent email me privately & I can give you his # & or email address. Not sure what you can actually afford, but the higher deductibles have lower rates.

There is no doubt that the best way to go is insurance through an employer. Usually it does not cost that much more, insurance is just insanely expensive for women. Getting an individual insurance leaves you open to them dropping you at any time and not covering more things than they would through an employer. Pre-exitsting does mean you have been diagnosed, but you also have to be careful to fill out their forms completely honestly! If you don't, they can drop you saying that you were aware that something might be going on. Going through an employer, you are completely safe and covered with the insurance with very little arguing. Just look around and crunch numbers and decide from there. Good luck!

No you are not wrong about the insurance clause. I live in Polk County and county insurance through work I don't think can deny you coverage but they will not pay out a claim on pre existing conditions for x amount of time. I am retired now so I don't recall wether it was 3 months or 1 year before they would pay for treatment. I would go on line and research this syndrom if you haven't already and see what causes it, what are the symptoms and maybe you can get an herbal suppliment that will control it temporarily. I know that leg cramping often is caused by a deficiency in either calcium or potassium, can't remember which one. Though I know of restless leg syndrom, I don't know anything about it.

You are right about the pre-existent condition clause. Things which are diagnosed while you're not covered are not covered in future cases. Some insurance companies do provide coverage for pre-existing conditions, I believe, after you've been on their plans for a certain amount of time without coverage of those conditions. You have to sign up, wait a year or so, and then you can get coverage for some of those conditions. But it's not something I would bank on.

Good companies for self-paid insurance are Humana and United Healthcare. They have inexpensive plans, and they give free quotes. You can look at samples at their online sites, and United Healthcare even has a directory where you can find an agent in your zip code. UHC's Golden Rule program provides a lot of people with insurance who would have trouble affording it otherwise. You just go to their web address, fill out a few details (you don't even have to have a physical!), and someone will call you to set up a quote. If you want something more immediate, look up one of their agents in your area and ask them to work with you in setting up the plan that's best for your health and your money.

I am not sure about the pre- existing condition clause..although I think it would greatly affect your insurance rate.. however I did want to mention I had a very hard time finding insurance because I had been denied insurance after I had my first son and had an abnormal pap. Needless to say I went without insurance for 5 years and when my second son was born I found out about ehealthinsurance.com. I now have insurance for 3 of us including dental for $250 a month. I know it would be much less for you as an individual. I had Florida Kid Care for my son however when they started requesting pay stubs, etc to show income I had to cancel because I am self employed..selling on ebay..and could not provide them. It seems to me like your question was more in regars to the pre existing condition but I just wanted to mention the website in case you are looking. It was simple, fast and affordable!!

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