Do I qualify for Medicare or Medicaid?

Question

I am 34 years old single self employed and make about $65,000 a year. I used to have insurance under my ex-employer cobra plan, but last year I got sick with a rear cardiovascular illness (Aortic Dissection) and was in the hospital and out of work to long to make payments so they canceled me. At this point no individual insurance plan will accept me because of my pre-existing condition. It looks like I make too much to qualify for any government assistance, but there is no way I can afford to pay for the CT scans, treatments and medicines, they far exceed my salary. My hospital bill alone was $203,000 thank god I still had insurance then. Any ideas what I can do?

Answer 1

If you COBRA expired less than 63 days ago you are HIPPA qualified and can get just about any plan, outside that 63 days your options are limited.

Your states Blue Cross should have a guaranteed issue health plan, in Virginia it is called VA standard.

Do you have any employees? If you have at least two employees, yourself being one of them you could get a small group plan.

There are some carriers that will waiver out coverage for certain medical conditions at least that way you are covered for other events.

If you go without medical insurance and have more bills you can use a medical claim review and settlement organization. If you visit guaranteed.com they will try and negotiate a lower price for you. If they succeed you will pay them 30% of what they saved you, if they are not able to get you a better price you are not charged anything.

In any event I suggest you use yellowpages.com to search for health insurance brokers in your area. A Broker represents multiple carriers and can help you sort through all the different insurance companies and plan options in your state. Don't call your auto and home agent they specialize in property and causality insurance. You need someone that specializes in health insurance. These areas of insurance even require separate licenses.

Answer 2

The only way you would qualify for medicare or medicaid is if you are considered permanently 100% disabled. (Which is probably not the case.)

Perhaps look into a High Risk Pool for your state.

Aside from that, you may have to get your care at a county facility where they have sliding scales based on income. It's also possible that your physician and other providers,will offer you a discounted cash rate.

Answer 3

I had about 10K worth of medical bills.  I called each provider and told them  how much I owed and that I didnt have insurance.  I asked each one what kind of discount I could get and each place lowered my bill by 50%.  But you have to talk to the doctors themselves, not the book keepers, nurses or receptionists.  This will get you nowhere!

Answer 4

OK, most states have a high risk health pool.  You need to do a yahoo search, for "Texas High Risk Health Pool" or whatever your state is.  It's a state subsidized short term (usually 5 years or so) health insurance program for people who can't get health insurance any other place.  

Some states, it's not currently open to new participants; others will have a waiting list.

Then you'll have to give up the self employed bit, and get a job with an employer, so you can get onto the group health plan.

No, you won't qualify for medicare or medicaid, unless you're disabled - which it doesn't sound like you are.