Taking Stock

What to Look for in Health Insurance Providers

There is no "right" insurance provider for people with epilepsy or seizure disorders, but obtaining health insurance often difficult for people with epilepsy, in effect making an employer's group policy the only viable option for many. Qualifying to purchase insurance depends on the type of insurance, the person's medical history and the state in which the person is living. For any type of insurance, it is always best for the patient to obtain the broadest coverage at the best possible rates — and group rates are always the least expensive. Patients must do their homework, comparing insurance plans, and if needed, hiring an independent broker to aid their evaluation.

The three primary health insurance programs are health maintenance organizations (HMOs), preferred provider organizations (PPOs) and point-of-service plans (POSs). Again, there is no universal best plan for people with epilepsy. Patients must determine which one provides the best and most affordable coverage for their needs. Also, many insurance plans require patients to pay co-payments, coinsurance and deductibles, which have varying prices. It is important for the patient to note how much they'll be required to pay for their medication.

There are two other specialized health insurance plans, both of which are government funded and eligibility-based: Medicare and Medicaid. Medicare is a federally-funded health insurance program for people age 65 and over, and for people under age 65 who are disabled and have received or were eligible to receive Social Security Disability Insurance or Railroad Disability benefits for two consecutive years. Medicaid is a state-funded benefit program that provides free healthcare services for people with low income. It is available for many recipients of Social Security and Social Security Disability Insurance, as well as for others who may not qualify for Social Security, but whose medical expenses exceed a certain level, as established by each state.

For more details on these health insurance programs, contact the Epilepsy Foundation at (800) 332-1000.