Will Toenail Fungus Make My Insurance Rate Go Up?

One fifth of Americans under 65 have a chronic condition that makes them uninsurable on the private market. According to the Daily KosCalifornians are having trouble getting health insurance due to something as minor as toenail fungus! People who purchased health insurance on the individual market find that they are suddenly placed in a “high risk” pool when they are diagnosed with toenail fungus. Clearly, the system is broken.

health insurance premiums

Image Source: STLToday.com

A Tale of Toenail Fungus

Sandy Kleffman, writing for the Contra Timestells the story of Ralf Burgert, an otherwise healthy 43-year-old nurse practitioner who happened to come down with a common toenail fungus infection that he treated with a prescription of Lamisil. When the San Rafael resident applied for health insurance on the independent market, he was informed he’d have to pay a 50% jump in premiums for being in a “high risk” pool!

What About Obamacare?

“The things that people have been denied for raise the question if simply living is a pre-existing condition,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group.

Your insurance premiums could go through the roof if you suffer from a common condition like:

– Asthma

– Mild depression

– Migraine headaches

– Joint sprains

– Allergies

– Ear infections

– Eczema

– Acne

– High blood pressure

– Sleep apnea

– Pregnancy

All this is set to change in 2014 when new laws are set to go into effect and state exchanges are to be set up with a $761 million federal allowance. However, for now, it’s like the Wild West. Insurers’ competition is based on their ability to deny coverage or charge more than what they’re paying out in claims, according to industry insiders.

health insurance toenail fungus

Image Source: NCSL.org

Group plans are the best way for people with pre-existing conditions to achieve some level of care. At least 21 million Californians are covered through employers and enjoy the bargaining power that such a large insurance pool carries. As the size of a particular group expands, the risk is spread out more, so the cost of health care for a few really sick people is balanced out by the hundreds of people who are generally quite healthy.

Why Is Toenail Fungus Such A Concern For Insurers?

While many people enjoy employer-funded health care in this country, problems like toenail fungus are still a concern for the 2.5 million people who rely on the individual market. In the smaller individual health care market, costs are determined through estimates of the cost of treatment, medications and doctor’s visits. Sometimes minor conditions can lead to bigger problems. For instance, diabetics with toenail fungus may suffer deformity, difficulty walking, secondary infection, widespread foot fungus, athlete’s foot, ulcers, gangrene, and even amputation.

diabetes toenail fungus

Image Source: DelRayFootCare.com

According to Blue Shield of California“Antifungal pills give the best chance of curing a severe fungal nail infection, but they cost a lot and have serious side effects. You will need to see your doctor for regular testing if you take these pills.” It’s true that drugs like Lamisil are particularly hard on the liver and require patients to have regular liver function tests while undergoing treatment. An alternative would be laser treatment for fungal nails, but insurance doesn’t cover that cost at all because they deem the treatment to be “cosmetic” — even though they acknowledge that the failure to treat the chronic condition could lead to bigger problems down the road.

So, to avoid this hassle, do everything you can to avoid toenail fungus in the first place. SteriShoe is happy to be part of your fight against exposure to foot fungus.

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