Health Insurance Articles
Managing Diabetes With Health Insurance Coverage
2011-10-19
Diabetes is a chronic disease affecting millions of individuals and their families. As a leading cause of heart disease, kidney disease and stroke, diabetes is a condition that cannot safely be ignored by people diagnosed with it. Although there is no known cure for diabetes, it is a health condition that can be managed and controlled by the diabetic working with his or her medical team. Managing diabetes takes a combination of diet, exercise, constant medical testing, prescription medicines and self-monitoring equipment. It is only through managing and controlling the disease that the risks of possible serious complications from diabetes can be reduced. For this reason, health insurance coverage is vital to someone with diabetes. Not having any coverage or having inadequate coverage means not being able to manage the disease and that means very serious health problems sooner or later.
However, as great as the need is for a diabetic to have insurance coverage, it can be very hard to come by unless the diabetic is already insured when diagnosed. Under current law, employer-sponsored group health plans cannot refuse or cancel coverage because of health status. Unfortunately, individual health insurance policies are not required to follow the same rules. It is possible that a newly-diagnosed diabetic already on an individual plan or wanting to buy one could either be refused coverage or has his existing coverage canceled.
The Affordable Care Act (ACA) of 2010 is in the process of addressing issues surrounding being denied coverage for preexisting conditions; however, the rules prohibiting discriminating based on preexisting conditions do not fully take effect until 2014. It's important to note that one of the ACA provisions that has already kicked in does prohibit insurance coverage from being denied to children under the age of 19 who have diabetes and young adults (whether they have diabetes or not) can be carried on their parents' plans until age 26.
For now, the old rules remain in effect for other diabetics. There are some options available for those diabetics. One is the Pre-Existing Condition Insurance Plan (PCIP) which was set up by the ACA to serve individuals who were not insurable under the old rules. PCIP plans will be available until the ACA is fully implemented in 2014. These plans can vary depending upon state of residence. Another option is to apply to a high-risk pool. Over 30 states have these programs which offer insurance coverage to residents considered uninsurable due to their health status. Insurance coverage available through a high-risk pool is expensive and offers limited benefits.
Managing diabetes is difficult. Having adequate health insurance that covers medicines, doctor visits, lab tests and the equipment needed to self-test blood glucose is essential.
