Can a diabetic get health insurance? This is always the first question, which is always followed by, how much will it cost? The first question cannot be answered with a simple yes or no. The second question can also not be easily answered, since the insurance companies determine the pricing in their own way. Diabetics can get health insurance, but sometimes there are certain terms and conditions placed on them, at least for some period of time. It’s critical to be able to find health insurance help for diabetics. Should you be unfortunate enough to be a diabetic in the position of having to find health insurance coverage, even if it is for the basic medical care needed, you will learn that it can be frustrating and expensive. There are so many complications of diabetes that require specialized care and even regular health issues sometimes require specialized treatment. There are many countries in which diabetics are fortunate enough to get their regular care covered by national health care. In the U.S., the question of can a diabetic get health insurance becomes tricky. If you are a diabetic trying to get health insurance as an individual, as opposed to through a group plan, you will find the insurance companies will refuse you coverage of any kind for your diabetic condition for at least one year. This is because diabetes is considered a pre-existing condition, since it was an established condition prior to you purchasing the insurance. On the other hand, if you get health insurance through your employers group plan, you can get immediate coverage even if you are a diabetic, since any delay in coverage for pre-existing condition is not allowed by law. Clearly, obtaining health insurance coverage through an employer is a diabetic’s best option.
The challenge for Diabetics trying to get health insurance is two fold. First, they have a high “out of pocket” medical cost and at the same time they are being denied eligibility to many low cost plans. Although it is true that diabetics can get health insurance through their employer with no pre-existing condition provision, the problem is that complications of diabetes makes it less likely that a person would be employed on a full time basis and eligible for group insurance benefits. This, of course, depends on each individual’s diabetic condition. As a result, diabetics face the additional challenge of having a lower income with a condition that results in more out of pocket cost than a person without diabetes. So can a diabetic get health insurance? Fortunately, all diabetics can get health insurance one way or another, but it is not easy. Sometimes two or more policies must be combined to achieve the necessary coverage. The problem here is cost. In many cases, although a diabetic can get health insurance, the cost is so excessive that it severely impairs their lifestyle and for that reason many choose to do without. In some cases, insurance for diabetics is so expensive that they conclude that insurance is just not available.
The average medical costs for a diabetic is approximately $22,000 per year. This is about 13 times greater than the medical cost of a person without a chronic health condition. It is obvious that the huge medical costs of treating diabetes could not possibly be directly reflected in the individual insurance rates. If insurance actuaries were to apply the standard medical risk underwriting guidelines to the pricing of health insurance for diabetics, the premium would exceed the total net income of the majority of diabetics. So, medical costs for treating diabetes are absorbed in the following two ways:
Many people make the observation that our current health system appears to be designed to bankrupt diabetics. There is some coverage available through Medicaid plans for diabetes but this is only after the patient has already spent almost all of their own savings, going broke in the process, on their own health care. It becomes clear that the question can diabetics get health insurance is not a question with an easy answer. In the end, a diabetic’s best hope falls back on the state in which they live. There are some states that have a new type of limited benefit policy that provides a balance between cost and coverage. There is also the possibility of providing coverage for the pre-existing medical condition after six or twelve months. These state sponsored plans work differently from state to state. Eligibility requirements vary. It is in your best interest to check with your state as soon as possible, since waiting lists for entrance into the plans are sometimes in place. In addition, there are also a growing number of commercial insurance policies that are available to provide supplemental coverage.
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