Obamacare — covering pre-existing conditions

I am uninsured with a pre-existing condition called AVM. It’s a congenital condition that gets worse over the years. I just learned that I need surgery, but first need to go through the pre-op stuff such as MRI’s with contrast, EKG’s, Stress Tests, etc., and then the surgery.   Now, of course, I need health insurance. Badly. And cannot afford it, as I am self-employed.

Do I need to wait for ObamaCare to kick in?  I’m afraid – and so is my Doctor – that my body won’t make it that long. I am perfectly healthy other than this AVM condition.

California Dreaming

Dear California Dreaming,

Have you tried the Major Risk Medical Insurance Program?  You would qualify to join this if you are a California resident, are not covered by Medicare (unless you get Medicare because you have end stage renal disease), have no COBRA plan open to you, and are unable to get a plan on the individual market.  You will likely have to show them a rejection letter from a carrier.

You will have to pay fees (premiums) to be covered by the major risk program, and they may be high.  Plans available and rates vary by county.  See the Rate Brochure.

The Major Risk program has an enrollment limit, meaning that it will only accept a certain number of people.  In case you cannot get into that program, there is another you could try: the Pre-Existing Condition Insurance Plan.  The requirements are similar.

This could be a short-term solution for 2013.  In 2014, as you say, all plans will accept you and won’t be able to charge you more because of your health conditions.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.