My health care dilemma

[Philosophy]

Due to privacy concerns this will have to lack some detail, but I hope you'll get the gist.

I suffer from a rare congenital medical condition. Until just recently, I thought I was just going to have to live with it the rest of my life (and it the single most annoying thing that has really hampered, both directly and due to associated psychological problems, my life thus far to a degree that would just make you sad if you knew the icky details). Now I find out that there is a fairly simple surgery that can pretty much correct it so I can lead a normal life from then on. Problem is that the surgury, even though it is outpatient, will still cost at least $15000 and maybe up to $30000, because it has to be done by highly trained specialist and that's just how much those type of things cost. There is no way I can afford that out of my own pocket right now, and my credit sucks from being unempoyed last year so there is no way I can even get a loan.

Now the company I currently work for does offer group health insurance that would appear to cover the surgery immediately if I actually had the insurance, because mine would not be a preexisting condition because it has not yet been officially diagnosed by a physician. But because I am an idiot who doesn't read the fine print on stuff, and because I didn't know about the possibility of the surgery then, I declined the coverage back in January during our open enrollment period because I thought I could save a few bucks because I am strong like bull and I never get sick; our HR manager at the time (who has since been let go due to downsizing) assured me that if I changed my mind I could choose to get on the plan at any time. Turns out that is not the case - I am going to have to wait until next January to sign up again, unless I have a life changing event like getting married or having a child (and paradoxically those are much less likely to happen without me having the surgery first). And on top of that our company has been struggling financially lately, so there's no guarantee that I'll even be employed there by next January. I've looked into just getting health insurance on my own, but the best one I can find has a year waiting period on congenital conditions.

The saddest part is the knowing that making that single at-the-time trivial decision back in January is causing me at least another entire year of living with this when it could have been taken care of already, and that is almost driving me insane.

Feel free to offer advice, or just point and laugh - I'm used to it.

[NMDemDist2]

1. geez what can i say except good luck

does sound like you're stuck tho til next year.

[burrowowl]

2. If surgery would cure the condition

in one fell swoop, I would think it would be covered somehow. Usually after a year they will ask if you want to change your coverage and you say you want coverage. You've lived with it this long, you can go another year. Ask for some expert advice .... from whom, maybe other DUers know the anwer.

[lpbk2713]

3. When and if you get coverage

make damned sure there's no waiting period before you have in-patient surgery. Also check with other employees who have similar coverage and seek advice. When you decide to go ahead with it make sure you have all your i's dotted and all your t's crossed and that everything involved is approved. If the insurance carrier sees one little loophole they'll take it every time. And best of luck to you.

[Stephanie]

4. Get married

Just get a friend to marry you. Maybe a friend who also needs health insurance? Our health care system is barbaric. Our health shouldn't depend on the mercy of our employers.