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October 5th, 2009
11:18 AM ET

Too sick for comprehensive health insurance?

Randi Kaye
CNN AC360° correspondent

Forty-five-year-old Nancy Pessler is too sick to work full time. Instead, she has turned fighting her insurance company into a full-time job. Pessler, who lives in Cincinnati, Ohio, is one of so many Americans falling through the cracks in the health care debate.

She was diagnosed in 2003 with a rare disease known as "mixed connective tissue disease" which is combination of lupus, rheumatoid arthritis, and a few others all wrapped into one. Pessler wakes up every day feeling like she has the flu. "My immune system is in the tank," she told CNN. Because of this, she says, she's too fatigued to work full time. And that's why she finds herself in this predicament.

She's too sick to work full time, so she can't get full comprehensive health coverage from an employer. And she can't get an individual comprehensive health coverage either because of what insurance companies view as her "pre-existing condition." Pessler says she spends hours on the phone battling to get her bills paid, and she's going broke in the process. "First, you're on hold for about 20, 30 minutes. Then after you get off being on hold you get a representative ... they'll get back in touch with you or call another person or transfer you to another person ... it's quite an ordeal," says Pessler.

Pessler had COBRA, the government plan that allows former employees to continue to pay for their previous employer's insurance out of their own pocket, with the same benefits, for 18 months. Once it ran out, she says her insurance company, Anthem Insurance, only offered her a plan which didn't cover anything related to her "pre-existing condition." She says, "I feel the system has failed me ... I've paid into Social Security, Medicare, disability. It leaves me hopeless. I feel like there's no solution for my situation."

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Filed under: 360° Radar • Health Care • Randi Kaye
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