Migraine headaches are characterized by an intense throbbing or pulsing in one area of the head, and is typically paired with other symptoms including nausea, vomiting, and an extreme degree of sensitivity to light and sound. These severe headaches are sometimes preceded by warnings such as light flashes, blind spots, and tingling in the arms or legs. The intense amount of pain caused by a migraine can extend for several hours or even days.
This type of headache is caused by a combination of blood vessel enlargement and the release of chemicals from the nerve fibers surrounding these blood vessels. While having a migraine, the temporal artery enlarges, resulting in a release of chemicals that lead to inflammation, pain, and further enlargement of the artery. Over 28 million people living in the U.S. experience these tremendously painful headaches, a larger majority being female.
Many different factors may induce a migraine, though some individuals who have them are still unable to identify what triggered their massive headache. Some triggers may include allergies, overwhelming lights, sounds, or odors, physical or emotional stress, smoking, fasting, alcohol, certain foods, and changes in sleep patterns. However, triggers are not always the cause of a migraine, and avoiding them does not ensure a migraine will not occur.
Migraine treatment and prevention is centered around avoiding triggers, controlling symptoms, as well as using medications. While some can effectively use over-the-counter medications such as Excedrin, others may not respond and decide to use a serotonin antagonist, or even an antidepressant (not permitted in some countries) to reduce migraine symptoms. Other remedies and prevention includes a range of solutions for avoiding triggers such as herbs and vitamins, Botox, surgery, prescriptions, and exercise.
Private Coverage for Migraines
Certain health insurance companies do not take migraines as seriously as other conditions, which means the option of private insurance may be open, depending on the carrier. Other accounts of individuals being declined for having a history of migraines has been documented, though it is all contingent upon the company and the state. Of course, there are still health insurance options for everyone, especially those who need it most. While they may be slightly more difficult to access for the next year or so, coverage is out there.
One of our national carriers’ underwriting criteria features migraines on their list of conditions with risk associated, and in turn, how an agent should rate up someone with migraines. Based on the severity and frequency of an applicant’s migraine headaches, they could not receive any rate increase whatsoever, or pay almost double a normal premium. It also depends on how the applicant is managing their migraines, and if they are taking recommended measures to control them from recurring.
Health insurance coverage on an individual and family level can help those who are self-employed, or otherwise have no source of group insurance. Treating migraines will be significantly more smooth a process and more financially possible if you are covered. Although it is not a chronic or life-threatening illness, migraines can still prevent individuals from living a normal, full life, and require that some action be taken to prevent or control attacks. Testing or consulting with a doctor may be needed for some individuals on a regular basis in order to maintain normalcy, which is where a health plan can be a positive contribution.
Public Coverage for Migraines
In the event that you do get turned away for your migraines, try another carrier, or you can fall back on PCIP. So long as you have not had any sort of insurance coverage for the past six months and have adequate documentation of your migraines’ severity, or a letter of declined coverage from a health insurance company, PCIP is available. Though administered by state and federal government, PCIP is sometimes available through private insurers (like East Coast Health Insurance), and will not increase your rates based on your health status. They will also cover any necessary treatment and medications you may require without imposing an exclusion period or elimination rider.
Low-income individuals who have migraines may be eligible for other government-issued coverage such as Medicaid or Medicare. Qualifying for these programs involves an income screening, being of a certain age, and fitting into a group of eligible individuals. Currently, children who have migraines are the most accepted, though adults in most states must have children and an extremely low income to qualify. Adults with disabilities also qualify for Medicaid, or Medicare if the disability is permanent. These programs cover the majority of services and medications needed to treat migraines, and would likely make exceptions based on your condition if they do not cover them already.
The Affordable Care Act will modify this eligibility criteria, opening the program up to non-disabled adults, who are not required to have children. This will enable millions of Americans who do not have the means to purchase a health plan to get the coverage they need, as long as they earn up to 138 percent of the Federal Poverty Level. Certain states have already implemented this provision, while others may do so if they choose to expand Medicaid in 2014. More low-income individuals will be able to purchase health insurance via federal subsidy received by those who have income over the Medicaid limits, yet cannot afford a health plan. A dramatically increased number of people with migraines and other conditions will be able to receive coverage they had not been able to previously.