Which of my 4 medical conditions cause me to have high premiums?

Question

I do not have health insurance available at my place of employment and have to pay $470 per month for a high deductible, bare-bones policy.
I am a 48-year-old female living with depression, Sjogren's Syndrome, fibromyalgia, and restless leg syndrome - all of which are under control with meds. I am active and otherwise quite healthy, and feel 1,000% better than I did when diagnosed a few years ago. (btw, I have tried to get off the depression med, but always crash)
If I knew which of these are responsible for my insurance woes, perhaps my doc could tell the insurance company that I'm "cured" or something......

I do not have health insurance available at my place of employment and have to pay $470 per month for a high deductible, bare-bones policy.
I am a 48-year-old female living with depression, Sjogren's Syndrome, fibromyalgia, and restless leg syndrome - all of which are under control with meds. I am active and otherwise quite healthy, and feel 1,000% better than I did when diagnosed a few years ago. (btw, I have tried to get off the depression med, but always crash)
If I knew which of these are responsible for my insurance woes, perhaps I could ask my doctor if we could try a non-pharmaceutical treatment for the condition and if it doesn't worsen, would the insurance company take a new look at my situation.
For my own health's sake, I should probably do that anyway....
Thanks for your response.

Answer 1

Since your employer does not have a group program in place you are obviously covered by an individual policy.

1. Depression and anxiety are not usually a factor since individual policies typically exclude coverage for mental or nervous disorders. If diagnosed as extreme maladies such as manic depression or bi-polar disorder you are considered
"uninsureable".

2. Restless leg may or may not be rated depending on the companies underwriting guidelines.

3. Fibromyalgia is always rated and if severe will disqualify you from coverage

4. Sjogren's is always rated and may disqualify you with some carriers.

Your doc will not provide the underwriters with bogus feedback.
However, if your Fibro is treatment free for 2 years certain carriers will drop the rating. Sjogrens has no recovery period and will always be rated whether controlled or not since insurers will not rely on you to faithfully take your meds.

Your premiums seem high for a "Bare Bones" plan with a high deductible, but a number of factors such as location and optional benefits vary from state to state as well as carrier to carrier.

Answer 2

Unfortunately all of your medical conditions are going to cause a higher rate for you in terms of insurance premiums. People diagnosed with fibromyalgia (which in some states is no longer considered a viable diagnosis for worker's compensation claims) typically require a high amount of treatment, same as Sjogren's Syndrome and RLS. It is possible that you could seek further confirmation of your diagnosis with a specialist and if not confirmed, it may be removed but as far as the insurance company is concerned, you're going to remain high risk for at least five years. Good luck!

Answer 3

Honestly, it probably has more to do with your age than your conditions. Once you hit 40, premiums skyrocket. You are going to find this is only going to get worse as you pass 50 no matter how healthy you are. Insurers play the statistics game.

I would strongly suggest looking for a job with group coverage or discussing it with your current employer (maybe suggest a 50/50 premium arrangement) if it's a good situation.

If neither of the above are options, you might consider Kaiser (if you have it where you live). They have a horrible reputation, but have been trying to improve in the last few years.

Answer 4

Your doctor will not lie for you. He could be fined and lose his license if you file a claim for something that he didn't divulge. Any of those that "could" cause a claim in the future, which is possibly all of them, at least the first three, are going to be of concern. But, are you sure your premiums are based on your history, or just the fact that you have to get a policy without the benefit of an employer paying a part of it or having a group of people in the same plan as you?

Answer 5

I am not sure which of your conditions make your insurance so high but i would suspect its just that the company you are insured with is expensive no matter what medical conditions.. I believe the only insurance that can charge sur charges for medical conditions is a life insurance policy... I live in NYS and we have insurance from the state (not Medicaid) that is geared in premiums by your income when your employment does not furnish medical insurance with small or no co pays... and I believe most states have this same program being it comes on the back of my insurance statements .. which is a federal form.. I would contact your local social service dept due to the fact they set up the apt. for you to apply for state insurance and please understand this is not medicaid it is a insurance program so all people can have insurance

Answer 6

Was you paying that amount, before you got sick? Was that the rate you always paid? Did it go up, after you got sick? For the most part, our insurance, is so high, because to many people are scamming the system. If someone, without insurance, gets sick, and has to go to the hospital, guess who is paying? Thats why most insurance is so high. For us honest people, who pay our own way, it seems like we are the ones stuck, because someone else could not, or would not pay. It is a law, that if someone comes into a hospital, (even with a cold) they have to be treated, even if they have no insurance. I think the middle class, is getting the brunt, of everything, in this country. If you are poor, you go to social services, and if you are rich, you don't have to worry about paying for insurance. My friend, pays about the same amount, that you do, but he has his wife on his policy, and neither one of them are sick. Anyway, I am glad you are feeling better. I don't know if I helped answer your question, sorry I went on a little rant!! God Bless!!

Answer 7

Truthfully, some companies will have a "nurse" contact you and question whether some of your ailments can be treated without medication. They give advise on diet, excercise, etc. You should not penalized at work for your ailments. I would surmise most companies have flat rates and you are part of those rates. Therefore, when the company decides to cut back on those rates, they look more to those who really use the insurance more than others. However, they can pick and chose so to speak.

Answer 8

Real happiness and peace can be ONLY found in submitting to the commands of the Creator and the Sustainer of this world. God has said in the Qur’an: (Truly, in remembering God do hearts find rest.)
(Qur’an, 13:28)

On the other hand, the one who turns away from the Qur’an will have a life of hardship in this world. God has said:
(But whoever turns away from the Qur’an, he will have a hard life, and We will raise him up blind on the Day of Judgment.) (Qur’an, 20:124)
This may explain why some people commit suicide while they enjoy the material comfort money can buy. For example, look at Cat Stevens (now Yusuf Islam), formerly a famous pop singer who used to earn sometimes more than $150,000 a night. After he converted to Islam, he found true happiness and peace, which he had not found in material success.
To read the stories of people who have converted to Islam, please visit

http://www.islam-guide.com/stories

At this web page, you can read the thoughts and feelings of these people, who are from different countries and have different backgrounds and levels of education.
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Answer 9

Depression

Answer 10

I don't know if this will help or not but...In the state of Utah they have a insurance program the is administered through the medicaid program. Your premium depends on your income. Maybe you can check this out.