Inclusive Health: A Big Help or a Big Hassle?

I recently became aware of the availability of health insurance for seriously ill individuals in the state of North Carolina, which is where I live. Since starting several years ago, there had always been a state option of Inclusive Health, which is what this insurance is referred to, but the passage of healthcare reform has created a federal option with much lower premium costs as well. I learned that having been diagnosed with lupus qualified me for this type of insurance, which is provided by Blue Cross Blue Shield of North Carolina, yet there are certain requirements that a person must meet in order to completely qualify. Since I was going to be losing my health insurance soon and I believed that I met all the strict requirements, I applied yet was denied. The reason I was denied is because my husband's job offered health insurance, but since it cost $600 a month through his employer and we couldn't afford this hefty price, we began looking for other options. We thought that Inclusive Health would have been that other option for me because it offers comprehensive health coverage and the quoted rate was only a third of what it would have cost at his job.

Another thing about Inclusive Health (the state option) is that if you can't provide proof of at least 18 months of continuous health insurance that ended 62 days or less previous to applying for Inclusive Health, you must wait a 12-month waiting period before any pre-existing medical conditions will be covered. If Inclusive Health is specifically for people with serious medical conditions, they're certainly going to have pre-existing medical issues, and for many who are too ill to work, prior health coverage may be next to impossible. For the federal option there is no pre-existing medical condition limitation, yet you have to have been without health insurance for a minimum of 6 months before you're eligible to apply for insurance under this option.

My husband was laid off from his job that offered health insurance coverage for $600 a month and was forced to work a job that only provided a limited benefit health insurance plan. It covers many services yet it only pays a small percentage of doctor's visits, prescriptions, surgeries, etc. This left my husband and I had to foot the rest of the bill, which at times could really add up. So when my doctor recommended an expensive surgical procedure, we knew we had to do something fast. My only other options were to either use the limited benefit plan to pay a small portion of the $35,000 surgery which would cause us to go into debt, or continue to suffer and wait to have the surgery sometime in the future when we were able to get comprehensive health insurance. This was when I decided to apply for Inclusive Health again, but before wasting my time applying, I first decided to call and make sure I'd be eligible. Much to my disappointment, I was informed that although some limited benefit plans wouldn't be considered viable health insurance, but mine probably would be considered "regular" health insurance, making me ineligible.

Inclusive Health may be a wonderful option for seriously ill North Carolinians with no other health insurance and who aren't eligible for Medicaid or Medicare. Despite this fact, I do feel that the guidelines that must be met in order to qualify for Inclusive Health are too strict and as long as a person has an illness that's listed on their list of serious illnesses and does not have any other affordable health insurance available to them, they should be able to be covered under Inclusive Health's plan. I realize that this is an insurance of last resort, but if the government is trying to prevent people from dying from treatable medical conditions due to lack of insurance, why not make it a little bit easier for these people to become insured? It's not as if traditional insurance plans will allow them to obtain coverage, because they will undoubtedly be denied due to their health.