United Brachial Plexus Network, Inc.

I am in the process of looking for health insurance as my husband may soon become self-employed. Two companies so far have refused to take us on due to our son's bp. Is anyone out there self-insured? Can you tell me the name of the insurance company? Thanks. We are in PA and see docs in DE too.

Hi, Im a regular poster here but this time I think I should post as guest not to offend anyone I hope but because I am having some insurance issues too. When these companies denyed you because of your sons BPI, was it because of the injury itself you think, or because it was a pre-existing condition?? Did they say? Actually, Id like to speak to you personally on this matter for info such as who are these insurance companies and where you live and things but Im not sure how to get our contact info to eachother without actually posting here. Any advice anyone?

We were turned down for coverage due to the pre-existing condition of my son's bpi and the past surgeries, potential future surgeries, current therapy, etc. Does anyone have coverage for their child soley through Medicaid? How has that been for you? Do they cover the therapy, etc?

I have been told that since our daughter has a pre-existing condition (BPI is considered this) that we would never be able to receive insurance by ourselves. That we would always have to have one of us work at a company and receive insurane through the company. I think that this is not fair but I don't know of any other way around it. Also, we were told that you can never have your insurance lapse because then you will also be dropped.

Lisa

Yes, it is difficult to get insurance because of a prexisting condition. In our state, you can get it theoretically, but it is way too expensive. Also, the laws vary by state as to what insurance companies must offer. So, possiblbe solutions in your case will depend on what state you live in. Again, depending on your state, if you work for a corporation and get insurance through them, the prexisting condition clause does not apply. So what the previous posted said was correct. I know one state we lived in did allow refusal to treat prexisting conditions for 6 months even with insurance through your employer.

One solution when you are self-employed is to incorporate -- become your own corporation, then you can take advantage of the state laws that don't allow exclusions for preexisting conditions. In our state (Maryland), you have to have a minimum of two employees (could be you and your husband), on the payroll. They count you as on the payroll if you are paying wages and unemployment to that person. Then, you can get insurance at the same price that other small companies pay regardless of prexisting conditions. Premium amounts are based on the average age of the employees

You should talk to at least two insurance brokers. The laws are so complex, you want to make sure you are getting consistent answers to your questions. You can find a broker by asking other small companies who they use, contacting your local chamber of commerce, etc.

It's a lot of work, and it's expensive. I hate dealing with insurance. I so wish we had a single payer plan. I hate that most of everyone's health care dollars go toward administering all these plans.

Good luck.
Maggie

Dear Steph
What type of business might you be going into. I am not 100% sure about this, but I am thinking......Depending on what it is....You might check if there is an organization, of this type of business owners. If so, there might be a group plan for people in this type of business. As you know larger group plans offer better insurance coverage.

Personally, when my LOBPI daughter was 2 years old. Her father quit his job as a union bricklayer, wanting his own business. In order to keep insurance, and because I had a prior business background, I did what I had to do. I became 100% owner of my Sub-Chapter S Corporation (Sub-Chapter S is better for taxes and Corporation is better for Liability) My now ex-husband, was my employee. I paid union benefits for him as well as for my other 20+ union employees. As a woman owned business it was also better to do Capital Development Board (State Projects) that required minority (Construction and women is a minority). A lot of work but I did what I had to do?

Dear StephP,

We thankfully have private insurance since I work full-time at a hospital. But, I did get my daughter, Amber, Medicaid waiver benefits through medicaid coordination. This is a benefit that is offerred to a "disabled person". The qualifications are not based on family income, but rather on the "disability". Check into it as right now it pays for aquatic therapy for Amber since our primary insurance would only pay for 2 months of service.

Tanya in NY

Wow Tanya

Back in 1985, when my LOBPI daughter was only 1, I tried that (Public Aid, for insurance). We were denied. I was told because I owned a car etc, I had too much. (Needed a car, lived 5 miles from the nearest very small town, and drove 100 miles, one way, for Doctor and Therapists). I was also told that as an infant, it was not considered a disability. I also went to DORS, department of rehab, and was told similar (as an infant not considered disabled for DORS). In the early years I was so frequently told, "the doctors report state she can not get better, so there is nothing to do". I even heard that once from a person in my church congregation, when I wanted help.

In 1996 I took Jill to Easter Seals, because my Chicago Dr thought they could help with the Electric Muscle Stimulator, placement and training for me to try again. Easter Seals would not treat Jill until I paid $200.00 up front for the evaluation. I told them I had insurance that would pay 80% of anything that was done for her. They said they didn't care...pay the money. I did, but never could understand it. I was never sucessful in getting any public funds.

TWO Questions: 1)Is BPI disability now recognized, or does it just matter what person you get at the Public Aid Office when you apply and get processed? 2)My daughter is now 20 and a full time college student. Dr Nath says she needs surgery on her shoulder, said there was nothing he could do for her hand. Should she be going to Public Aid? And if so how do you do so successfully?